Systemic Anti-Cancer Therapy Regimen Library
LEU AML FLT3-ITD mutated Relapsed - azacitidine and soRAFENib
Treatment Overview
Cycle 1 (and all further cycles) - 28 days
azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.
soRAFenib:
- Cardiovascular risk factor assessment is recommended—consult prescribing information for details.
- May prolong QTc interval and close monitoring is recommended. Avoid or reduce risk factors for QTc prolongation. Consult prescribing information.
Cycle details
Cycle 1 (and all further cycles) - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection | 1 to 7 | |
| soRAFENib * | 400 mg Twice daily | oral administration | 1 to 28 |
azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.
soRAFenib:
- Cardiovascular risk factor assessment is recommended—consult prescribing information for details.
- May prolong QTc interval and close monitoring is recommended. Avoid or reduce risk factors for QTc prolongation. Consult prescribing information.
Full details
Cycle 1 (and all further cycles) - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| azacitidine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site. |
|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 10
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 11
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 12
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 13
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 14
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 16
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 17
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 18
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 19
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 20
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 21
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 22
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 23
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 24
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 25
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 26
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 27
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Day: 28
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| soRAFENib * | 400 mg Twice daily | oral administration |
Instructions:
Swallow whole with a large glass of water. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antifungal prophylaxis: | Routine antifungal prophylaxis may be considered |
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis may be considered |
| Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
| Emetogenicity: | Variable |
| Tumour lysis syndrome prophylaxis: | Variable |
Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.
Emetogenicity: MEDIUM days 1 to 7; MINIMAL to LOW days 8 to 28.
Tumour lysis syndrome prophylaxis: Recommended for first cycle of treatment and only for further cycles if not in complete remission.
References
Bayer New Zealand Limited Nexavar data sheet 15 October 2020 https://medsafe.govt.nz/profs/Datasheet/n/Nexavartab.pdf (accessed 14 July 2022).
* 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.