Systemic Anti-Cancer Therapy Regimen Library
Neuroendocrine carcinoma Advanced - cARBOplatin and oral etoposide
Treatment Overview
Usually maximum of 6 cycles.
Cycles 1 to 6 - 21 days
Cycle details
Cycles 1 to 6 - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| aprepitant | 125 mg | oral administration | 1 | |
| aprepitant | 80 mg | oral administration | 2, 3 | |
| dexamethasone * | 8 mg | oral administration | 1, 2, 3 | |
| ondansetron | 8 mg | oral administration | 1 | |
| cARBOplatin * | 5 AUC (area under the curve) | intravenous | 1 | 60 minutes |
| etoposide (as phosphate) * | 100 mg/m² | intravenous | 1 | 60 minutes |
| ondansetron | 8 mg | oral administration | 1 | |
| etoposide * | 200 mg/m² Once daily | oral administration | 2, 3 | |
| domperidone | 10 mg Three times daily | oral administration | 1 |
Full details
Cycles 1 to 6 - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| aprepitant | 125 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy with food. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| cARBOplatin * | 5 AUC (area under the curve) | intravenous | 60 minutes |
Instructions:
Hypersensitivity risk increases with number of cycles of cARBOplatin. |
| etoposide (as phosphate) * | 100 mg/m² | intravenous | 60 minutes | |
| ondansetron | 8 mg | oral administration |
Instructions:
EIGHT hours after chemotherapy OR before bed. |
|
| domperidone | 10 mg Three times daily | oral administration |
Instructions:
When required for nausea and/or vomiting. The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| aprepitant | 80 mg | oral administration |
Instructions:
ONCE daily in the morning. |
|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| 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. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| aprepitant | 80 mg | oral administration |
Instructions:
ONCE daily in the morning. |
|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| 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. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Emetogenicity: | High |
References
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).
Link Pharmaceuticals Limited. Vepesid New Zealand Data Sheet 18 November 2021. https://www.medsafe.govt.nz/profs/Datasheet/v/Vepesidcapinj.pdf (Accessed 19 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.