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Systemic Anti-Cancer Therapy Regimen Library

Home > PCN MM Relapsed - carfilzomib, thalidomide and dexamethasone

PCN MM Relapsed - carfilzomib, thalidomide and dexamethasone

Treatment Overview

Cycle 1 - 28 days - carfilzomib starting dose

Cycle length:
28

dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.

Cycles 2 to 12 - 28 days

Cycle length:
28

dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.


carfilzomib: For cycle 2 and further cycles, consider increasing carfilzomib dose to 70 mg/m2 (cap dose at: 154 mg) IV days 1, 8 and 15, according to response and if tolerated.

Cycles 13 to 18 - 28 days - carfilzomib Q2W

Cycle length:
28

thalidomide: Consider discontinuing thalidomide after 12 cycles.


dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.


carfilzomib: For cycle 2 and further cycles, consider increasing carfilzomib dose to 70 mg/m2 (cap dose at: 154 mg) IV days 1 and 15, according to response and if tolerated.

Cycle details

Cycle 1 - 28 days - carfilzomib starting dose

Medication Dose Route Days Max Duration
thalidomide * 100 mg Once daily oral administration 1 to 28
dexamethasone * 40 mg flat dosing oral administration 1, 8, 15,
22
sodium chloride 0.9 % intravenous 1, 8, 15 30 minutes
carfilzomib * 20 mg/m² Cap dose per administration at: 44 mg intravenous 1 30 minutes
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 8, 15 30 minutes

dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.

Cycles 2 to 12 - 28 days

Medication Dose Route Days Max Duration
thalidomide * 100 mg Once daily oral administration 1 to 28
dexamethasone * 40 mg flat dosing oral administration 1, 8, 15,
22
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 1, 8, 15 30 minutes

dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.


carfilzomib: For cycle 2 and further cycles, consider increasing carfilzomib dose to 70 mg/m2 (cap dose at: 154 mg) IV days 1, 8 and 15, according to response and if tolerated.

Cycles 13 to 18 - 28 days - carfilzomib Q2W

Medication Dose Route Days Max Duration
thalidomide * 100 mg Once daily oral administration 1 to 28
dexamethasone * 40 mg flat dosing oral administration 1, 15
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 1, 15 30 minutes

thalidomide: Consider discontinuing thalidomide after 12 cycles.


dexamethasone: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients.


carfilzomib: For cycle 2 and further cycles, consider increasing carfilzomib dose to 70 mg/m2 (cap dose at: 154 mg) IV days 1 and 15, according to response and if tolerated.

Full details

Cycle 1 - 28 days - carfilzomib starting dose

Day: 1

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
sodium chloride 0.9 % intravenous 30 minutes
Quantity:250 mL
Instructions:

Prior to carfilzomib infusion.

  • Centres may choose to increase to 500 ml or omit this bag of fluid if not required or for clinical reasons.
carfilzomib * 20 mg/m² Cap dose per administration at: 44 mg intravenous 30 minutes

Day: 2

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 3

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 4

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 5

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 6

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 7

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 8

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
sodium chloride 0.9 % intravenous 30 minutes
Quantity:250 mL
Instructions:

Prior to carfilzomib infusion.

  • Centres may choose to increase to 500 ml or omit this bag of fluid if not required or for clinical reasons.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes

Day: 9

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 10

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 11

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 12

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 13

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 14

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 15

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
sodium chloride 0.9 % intravenous 30 minutes
Quantity:250 mL
Instructions:

Prior to carfilzomib infusion.

  • Centres may choose to increase to 500 ml or omit this bag of fluid if not required or for clinical reasons.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes

Day: 16

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 17

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 18

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 19

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 20

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 21

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 22

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

  • Consider dose reduction to 20 mg ONCE a week in older or frail patients.

Day: 23

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 24

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 25

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 26

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 27

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 28

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Cycles 2 to 12 - 28 days

Day: 1

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes
Instructions:

Consider increasing dose to 70 mg/m2 (cap dose at: 154 mg) according to response and if tolerated.

Day: 2

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 3

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 4

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 5

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 6

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 7

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 8

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes
Instructions:

Consider increasing dose to 70 mg/m2 (cap dose at: 154 mg) according to response and if tolerated.

Day: 9

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 10

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 11

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 12

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 13

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 14

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 15

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes
Instructions:

Consider increasing dose to 70 mg/m2 (cap dose at: 154 mg) according to response and if tolerated.

Day: 16

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 17

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 18

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 19

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 20

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 21

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 22

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

  • Consider dose reduction to 20 mg ONCE a week in older or frail patients.

Day: 23

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 24

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 25

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 26

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 27

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 28

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Cycles 13 to 18 - 28 days - carfilzomib Q2W

Day: 1

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes
Instructions:

Consider increasing dose to 70 mg/m2 (cap dose at: 154 mg) according to response and if tolerated.

Day: 2

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 3

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 4

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 5

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 6

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 7

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 8

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 9

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 10

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 11

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 12

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 13

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 14

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 15

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:
dexamethasone * 40 mg flat dosing oral administration
Instructions:

30 minutes to 4 hours prior to carfilzomib with food.

  • Consider dose reduction to 20 mg in older or frail patients.
carfilzomib * 56 mg/m² Cap dose per administration at: 123 mg intravenous 30 minutes
Instructions:

Consider increasing dose to 70 mg/m2 (cap dose at: 154 mg) according to response and if tolerated.

Day: 16

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 17

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 18

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 19

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 20

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 21

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 22

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 23

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 24

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 25

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 26

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 27

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 28

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
  • Take at night at least an hour after food.
  • This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Additional details

Section 1: Teratogenic effects

All patients must fulfil the requirements of the pregnancy prevention risk management programme to ensure pregnant women are not exposed to thalidomide.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Constipation risk: laxatives are usually prescribed
Emetogenicity: Variable
Gastroprotection: Gastroprotection may be considered
Hydration: Variable
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended
Thromboprophylaxis: Thromboprophylaxis is recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

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: LOW - carfilzomib; MINIMAL to LOW - thalidomide alone.

References

Ninkovic S, Harrison SJ, Lee JJ, et al., Carfilzomib, thalidomide, and dexamethasone are safe and effective in relapsed and/or refractory multiple myeloma: final report of the single-arm, multicenter, phase II ALLG MM018/AMN002 study. Haematologica. 2024 Jul 1;109(7):2229-2238. doi: 10.3324/haematol.2023.284238., PMID: 38235519

Moreau P, Mateos MV, Berenson JR et al., Once weekly versus twice weekly carfilzomib dosing in patients with relapsed and refractory multiple myeloma (A.R.R.O.W.): interim analysis results of a randomised, phase 3 study. Lancet Oncol. 2018 Jul;19(7):953-964. doi: 10.1016/S1470-2045(18)30354-1. Epub 2018 Jun 1. Erratum in: Lancet Oncol. 2018 Aug;19(8):e382. doi: 10.1016/S1470-2045(18)30492-3., PMID: 29866475

Celgene Limited Thalidomid New Zealand Datasheet 10 October 2023. https://www.medsafe.govt.nz/profs/datasheet/t/thalomidcap.pdf (Accessed 23 July 2024).

Amgen (New Zealand) Limited Kyprolis New Zealand Datasheet 4 December 2020 https://www.medsafe.govt.nz/profs/datasheet/k/kyprolisinf.pdf (Accessed 23 July 2024).

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* 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.