Systemic Anti-Cancer Therapy Regimen Library
UKALL14 with daSATinib - Phase 2 Induction (LEU ALL precursor B-cell BCR-ABL1+ - UKALL14 with daSATinib)
Treatment Overview
Starts after count recovery from Phase 1 Induction, with neutrophils greater than 0.75 x 109/L and platelets greater than 75 x 109/L.
Cycle 1 - 28 days
daSATinib: Take continuously during treatment, an increase or reduction of dose is recommended based on individual patient response and tolerability.
mercaptOPURine: Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
Intrathecal metHOTREXATe:
- Day of administration can be moved +/- 3 days.
- For Ommaya reservoir reduce dose to 6 mg intraventricularly.
cytarabine: Administer by subcutaneous injection (as above) or alternatively administer intravenously as per institutional practice.
Cycle details
Cycle 1 - 28 days
Medication | Dose | Route | Days | Max Duration |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration | 1 to 28 | |
CYCLOPHOSPHamide | 1000 mg/m² | intravenous | 1, 15 | 60 minutes |
mercaptOPURine | 60 mg/m² Once daily | oral administration | 1 to 28 | |
metHOTREXATe | 12 mg flat dosing | intrathecal injection | 1, 8, 15, 22 |
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection | 2 to 5, 9 to 12, 16 to 19, 23 to 26 |
daSATinib: Take continuously during treatment, an increase or reduction of dose is recommended based on individual patient response and tolerability.
mercaptOPURine: Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
Intrathecal metHOTREXATe:
- Day of administration can be moved +/- 3 days.
- For Ommaya reservoir reduce dose to 6 mg intraventricularly.
cytarabine: Administer by subcutaneous injection (as above) or alternatively administer intravenously as per institutional practice.
Full details
Cycle 1 - 28 days
Day: 1
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
CYCLOPHOSPHamide | 1000 mg/m² | intravenous | 60 minutes |
Instructions:
Consider hydration with at least 2000 to 3000 ml over 24 hours as oral or IV fluid on day(s) of CYCLOPHOSPHamide and for 24 hours after or as per institutional practice. |
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
metHOTREXATe | 12 mg flat dosing | intrathecal injection |
Instructions:
|
Day: 2
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 3
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 4
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 5
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 6
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 7
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 8
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
metHOTREXATe | 12 mg flat dosing | intrathecal injection |
Instructions:
|
Day: 9
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 10
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 11
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 12
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 13
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 14
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 15
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
CYCLOPHOSPHamide | 1000 mg/m² | intravenous | 60 minutes |
Instructions:
Consider hydration with at least 2000 to 3000 ml over 24 hours as oral or IV fluid on day(s) of CYCLOPHOSPHamide and for 24 hours after or as per institutional practice. |
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
metHOTREXATe | 12 mg flat dosing | intrathecal injection |
Instructions:
|
Day: 16
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 17
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 18
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 19
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 20
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 21
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 22
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
metHOTREXATe | 12 mg flat dosing | intrathecal injection |
Instructions:
|
Day: 23
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 24
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 25
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 26
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
|
cytarabine | 75 mg/m² Once daily | subcutaneous injection |
Instructions:
Or administer intravenously as per institutional practice. |
Day: 27
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Day: 28
Medication | Dose | Route | Max duration | Details |
---|---|---|---|---|
daSATinib | 140 mg Once daily | oral administration |
Instructions:
|
|
mercaptOPURine | 60 mg/m² Once daily | oral administration |
Instructions:
|
Supportive Care Factors
Factor | Value |
---|---|
Antifungal prophylaxis: | Routine antifungal prophylaxis recommended |
Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
Diarrhoea risk: | Consider prescribing antidiarrhoeals with this treatment |
Emetogenicity: | Variable |
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis recommended |
Antifungal prophylaxis: Inhibition of CYP3A4 by azole antifungals may lead to reduced daSATinib clearance and increased toxicities. Consider using a non-azole antifungal for prophylaxis. If an azole is used the daSATinib dose must be reduced – consult prescribing information.
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 and 15; MINIMAL to LOW days 2 to 28, excluding day 15.
References
No references
* 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.