Systemic Anti-Cancer Therapy Regimen Library
HN SQCC NON-Metastatic - CETUximab chemoradiation
Treatment Overview
Commence cycle 1 (Loading dose) one week prior to radiotherapy and cycle 2 concurrently with radiotherapy or as per institutional policy.
Cycle 1 - 7 days - Loading dose
Cycles 2 to 8 - 7 days - Maintenance dose
Cycle details
Cycle 1 - 7 days - Loading dose
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| doxycycline * | 100 mg Once daily | oral administration | 0 | |
| hydrocortisone * | 1 % Once daily | topical administration | 0 | |
| avobenzone + homosalate + octisalate + octocrilene + oxybenzone | 50 g | topical administration | 0 | |
| cetostearyl alcohol + paraffin liquid + paraffin soft white | 50 g Once daily | topical administration | 0 | |
| dexamethasone * | 8 mg | oral administration | 1 | |
| loratadine * | 10 mg | oral administration | 1 | |
| CETUximab | 400 mg/m² | intravenous | 1 | 120 minutes |
| loperamide | 2 mg | oral administration | 1 |
Cycles 2 to 8 - 7 days - Maintenance dose
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration | 1 | |
| loratadine * | 10 mg | oral administration | 1 | |
| CETUximab | 250 mg/m² | intravenous | 1 | 60 minutes |
| loperamide | 2 mg | oral administration | 1 |
Full details
Cycle 1 - 7 days - Loading dose
Day: 0
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| doxycycline * | 100 mg Once daily | oral administration |
Instructions:
To prevent rash. Commence taking the day before CETUximab infusion and continue for 6 weeks or as per institutional policy. If no rash develops after 6 weeks, consider stopping. Take each dose with food and a large glass of water. Swallow whole, do not crush or chew. Remain sitting upright or standing for at least 30 minutes afterwards. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine. Protect yourself from too much natural or artificial sunlight while being treated with this medicine. |
|
| hydrocortisone * | 1 % Once daily | topical administration |
Instructions:
Apply to the face, hands, feet, neck, back and chest at bedtime or as directed by your oncologist to prevent rash. If no rash develops after 6 weeks, consider stopping. |
|
| avobenzone + homosalate + octisalate + octocrilene + oxybenzone | 50 g | topical administration |
Instructions:
SPF 50+ Sunscreen—apply to skin 30 minutes before going outdoors as directed by your oncologist. Certified condition for subsidy. Quantity is approximate only, prescriber discretion required. Whilst this is the subsidised preparation, alternative SPF 50+ sunscreen preparations may also be suitable. |
|
| cetostearyl alcohol + paraffin liquid + paraffin soft white | 50 g Once daily | topical administration |
Instructions:
Apply as a moisturiser to the face, hands, feet, neck, back and chest each morning or as directed by your oncologist. Quantity is approximate only, prescriber discretion required. Whilst this is a subsidised preparation, other moisturisers may also be suitable. |
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to CETUximab with food. |
|
| loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to CETUximab. |
|
| CETUximab | 400 mg/m² | intravenous | 120 minutes |
Instructions:
Maximum rate of 5 mg/min for initial loading dose. Doses above 600 mg will have a longer infusion duration than 120 minutes. Most centres have a mandatory observation period of 60 minutes after first two exposures. |
| loperamide | 2 mg | oral administration |
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist. |
Cycles 2 to 8 - 7 days - Maintenance dose
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to CETUximab with food. |
|
| loratadine * | 10 mg | oral administration |
Instructions:
ONE hour prior to CETUximab. |
|
| CETUximab | 250 mg/m² | intravenous | 60 minutes |
Instructions:
Maximum rate of 10 mg/min for maintenance dose. Most centres have a mandatory observation period of 60 minutes after first two exposures. |
| loperamide | 2 mg | oral administration |
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
| Emetogenicity: | Minimal |
| Growth factor support: | Growth factor prophylaxis not recommended |
| Hypersensitivity / Infusion related reaction risk: | High - routine premedication recommended |
References
Healthcare Logistics Ltd. Erbitux New Zealand Data Sheet 4 September 2018. https://www.medsafe.govt.nz/profs/Datasheet/e/Erbituxinf.pdf (Accessed 22 June 2021)
* 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.