Systemic Anti-Cancer Therapy Regimen Library
LYM NHL T-cell - CHOEP14 [CYCLOPHOSPHamide, DOXOrubicin, etoposide, vinCRISTine and prEDNISone] [IV/oral etoposide]
Treatment Overview
Use CHOEP14 with caution in patients over 60 years of age.
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 - 14 days
If for stem cell harvest, mobilise as per institutional practice.
Cycle details
Cycles 1 to 6 - 14 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration | 1 to 5 | |
| DOXOrubicin * | 50 mg/m² | intravenous | 1 | 15 minutes |
| vinCRISTine | 1.4 mg/m² Cap dose per administration at: 2 mg | intravenous | 1 | 10 minutes |
| etoposide (as phosphate) * | 100 mg/m² | intravenous | 1 | 60 minutes |
| etoposide * | 200 mg/m² Once daily | oral administration | 2, 3 | |
| CYCLOPHOSPHamide | 750 mg/m² | intravenous | 1 | 60 minutes |
| pegFILGRASTIM | 6 mg | subcutaneous injection | 4 |
If for stem cell harvest, mobilise as per institutional practice.
Full details
Cycles 1 to 6 - 14 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
|
| DOXOrubicin * | 50 mg/m² | intravenous | 15 minutes |
Instructions:
Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration. |
| vinCRISTine | 1.4 mg/m² Cap dose per administration at: 2 mg | intravenous | 10 minutes |
Instructions:
|
| etoposide (as phosphate) * | 100 mg/m² | intravenous | 60 minutes | |
| CYCLOPHOSPHamide | 750 mg/m² | intravenous | 60 minutes |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
|
| etoposide * | 200 mg/m² Once daily | oral administration |
Instructions:
Take each dose on an empty stomach - one hour before OR two hours after food. Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist. Round dose to closest multiple of 50 mg and/or 100 mg capsules. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
|
| etoposide * | 200 mg/m² Once daily | oral administration |
Instructions:
Take each dose on an empty stomach - one hour before OR two hours after food. Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist. Round dose to closest multiple of 50 mg and/or 100 mg capsules. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
|
| pegFILGRASTIM | 6 mg | subcutaneous injection |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| prEDNISone | 100 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis may be considered |
| Constipation risk: | laxatives are usually prescribed |
| Emetogenicity: | Medium |
| Gastroprotection: | Gastroprotection may be considered |
| Growth factor support: | Recommended for primary prophylaxis |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis recommended |
| Tumour lysis syndrome prophylaxis: | Tumour lysis syndrome prophylaxis is recommended |
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.
Tumour lysis syndrome prophylaxis: Recommended for cycle 1 and consider for subsequent cycles.
References
Link Pharmaceuticals VEPESID® datasheet 18 November 2021 https://www.medsafe.govt.nz/profs/datasheet/v/Vepesidcapinj.pdf (accessed 24 January 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.