Systemic Anti-Cancer Therapy Regimen Library
LYM - GDP [gemcitabine, dexamethasone and cISplatin]
Treatment Overview
Number of cycles: 2 to 3; responding patients may be considered for high dose chemotherapy and autologous stem cell transplant otherwise, continue up to a total of 6 cycles, unless disease progression or unacceptable toxicity.
Cycles 1 to 6 - 21 days
If for stem cell harvest, mobilise as per institutional practice.
Cycle details
Cycles 1 to 6 - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing Once daily | oral administration | 1 to 4 | |
| gemcitabine * | 1000 mg/m² | intravenous | 1, 8 | 30 minutes |
| magnesium sulfate heptahydrate | 10 mmol | intravenous | 1 | 60 minutes |
| cISplatin * | 75 mg/m² | intravenous | 1 | 60 minutes |
| sodium chloride | 0.9 % | intravenous | 1 | 60 minutes |
If for stem cell harvest, mobilise as per institutional practice.
Full details
Cycles 1 to 6 - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
|
| gemcitabine * | 1000 mg/m² | intravenous | 30 minutes | |
| magnesium sulfate heptahydrate | 10 mmol | intravenous | 60 minutes |
Instructions:
In 1000 mL of sodium chloride 0.9%, prior to cISplatin infusion. |
| cISplatin * | 75 mg/m² | intravenous | 60 minutes |
Instructions:
In 500 - 1000 mL of sodium chloride 0.9%, depending on stability. Ensure patient has passed urine as per institutional policy. Hypersensitivity risk increases with number of cycles of cISplatin. |
| sodium chloride | 0.9 % | intravenous | 60 minutes |
Quantity:1000 mL
Instructions:
After cISplatin infusion. If cISplatin is infused in 1000 mL, centres may choose to omit this bag of fluid. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing Once daily | oral administration |
Instructions:
Take in the morning with food. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| gemcitabine * | 1000 mg/m² | intravenous | 30 minutes |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis may be considered |
| Emetogenicity: | Variable |
| Gastroprotection: | Gastroprotection may be considered |
| Hydration: | Routine hydration recommended |
| Irradiated blood components: | Variable |
| 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.
Emetogenicity: HIGH day 1; LOW day 8.
Irradiated blood components: Required for Hodgkin lymphoma patients at all stages of disease and therapy. Continue indefinitely.
Tumour lysis syndrome prophylaxis: Recommended for cycle 1 and consider for subsequent cycles.
References
Connors JM, Sehn LH, Villa D, et al. Gemcitabine, dexamethasone, and cisplatin (GDP) as secondary chemotherapy in relapsed/refractory peripheral T-cell lymphoma [abstract]. Blood 2013;122:Abstract 4345.
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).
New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 16 June 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.