Systemic Anti-Cancer Therapy Regimen Library
GYN OV Recurrent - PACLitaxel [Q1W] and beVACizumab
Treatment Overview
This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.
Cycles 1 to 6 - 21 days
If the initial infusion of PACLItaxel is well tolerated, the clinician may decide at their discretion to taper off and eventually omit dexamethasone premedication. If dexamethasone is omitted, the clinician may consider ondansetron 8 mg ONE hour prior to PACLItaxel infusion for antiemetic cover.
Cycle specific Supportive Care Factors:
Emetogenicity: LOW.
Hypersensitivity / infusion related reaction risk: HIGH - routine premedication recommended.
Cycle 7 (and all further cycles) - 21 days
Cycle specific Supportive Care Factors:
Emetogenicity: MINIMAL.
Cycle details
Cycles 1 to 6 - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration | 1, 8, 15 | |
| loratadine * | 10 mg | oral administration | 1, 8, 15 | |
| famotidine * | 20 mg | oral administration | 1, 8, 15 | |
| beVACizumab * | 15 mg/kg | intravenous | 1 | 90 minutes |
| PACLItaxel * | 80 mg/m² | intravenous | 1, 8, 15 | 60 minutes |
| domperidone | 10 mg Three times daily | oral administration | 1 |
If the initial infusion of PACLItaxel is well tolerated, the clinician may decide at their discretion to taper off and eventually omit dexamethasone premedication. If dexamethasone is omitted, the clinician may consider ondansetron 8 mg ONE hour prior to PACLItaxel infusion for antiemetic cover.
Cycle specific Supportive Care Factors:
Emetogenicity: LOW.
Hypersensitivity / infusion related reaction risk: HIGH - routine premedication recommended.
Cycle 7 (and all further cycles) - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| beVACizumab * | 15 mg/kg | intravenous | 1 | 90 minutes |
Cycle specific Supportive Care Factors:
Emetogenicity: MINIMAL.
Full details
Cycles 1 to 6 - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion with food. |
|
| loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. |
|
| famotidine * | 20 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine. |
|
| beVACizumab * | 15 mg/kg | intravenous | 90 minutes |
Instructions:
Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion. If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes. |
| PACLItaxel * | 80 mg/m² | intravenous | 60 minutes |
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy. |
| domperidone | 10 mg Three times daily | oral administration |
Instructions:
When required for nausea and/or vomiting. The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion with food. |
|
| loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. |
|
| famotidine * | 20 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine. |
|
| PACLItaxel * | 80 mg/m² | intravenous | 60 minutes |
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion with food. |
|
| loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. |
|
| famotidine * | 20 mg | oral administration |
Instructions:
ONE hour prior to PACLItaxel infusion. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine. |
|
| PACLItaxel * | 80 mg/m² | intravenous | 60 minutes |
Instructions:
Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size. Please carry out graded challenge as per institutional policy. |
Cycle 7 (and all further cycles) - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| beVACizumab * | 15 mg/kg | intravenous | 90 minutes |
Instructions:
Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion. If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Emetogenicity: | Variable |
| Hypersensitivity / Infusion related reaction risk: | Variable |
References
Roche Products (New Zealand) Limited. Avastin New Zealand Data Sheet. 15 January 2021 https://www.medsafe.govt.nz/profs/datasheet/a/Avastininf.pdf (Accessed 14 October 2021).
Novartis New Zealand Ltd. Paclitaxel Ebewe New Zealand Data Sheet 16 April 2020. https://www.medsafe.govt.nz/profs/Datasheet/p/PaclitaxelEbeweinj.pdf (Accessed 26 November 2020)
Castells, M.C., Matulonis, U.A., and Horton, TM. Infusion reactions to systemic chemotherapy. Savarese DMF and Feldweg AM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com/contents/infusion-reactions-to-systemic-chemotherapy (Accessed 26 March 2021).
Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.