Systemic Anti-Cancer Therapy Regimen Library
PCN MM - CyBorDex High [CYCLOPHOSPHamide, bortezomib and dexamethasone]
Treatment Overview
Usually 4 cycles. More cycles may be required depending on transplant eligibility and response.
Cycle 1 (and all further cycles) - 28 days
Bortezomib is ONLY to be administered subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.
Cycle details
Cycle 1 (and all further cycles) - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing | oral administration | 1, 8, 15, 22 |
|
| CYCLOPHOSPHamide | 300 mg/m² | oral administration | 1, 8, 15, 22 |
|
| bortezomib * | 1.5 mg/m² | subcutaneous injection | 1, 8, 15, 22 |
Bortezomib is ONLY to be administered subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.
Full details
Cycle 1 (and all further cycles) - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing | oral administration |
Instructions:
Take in the morning with food. |
|
| CYCLOPHOSPHamide | 300 mg/m² | oral administration |
Instructions:
Take each dose with food and a large glass of water, preferably in the morning. Round each dose to closest multiple of 50 mg tablets. |
|
| bortezomib * | 1.5 mg/m² | subcutaneous injection |
Instructions:
ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing | oral administration |
Instructions:
Take in the morning with food. |
|
| CYCLOPHOSPHamide | 300 mg/m² | oral administration |
Instructions:
Take each dose with food and a large glass of water, preferably in the morning. Round each dose to closest multiple of 50 mg tablets. |
|
| bortezomib * | 1.5 mg/m² | subcutaneous injection |
Instructions:
ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing | oral administration |
Instructions:
Take in the morning with food. |
|
| CYCLOPHOSPHamide | 300 mg/m² | oral administration |
Instructions:
Take each dose with food and a large glass of water, preferably in the morning. Round each dose to closest multiple of 50 mg tablets. |
|
| bortezomib * | 1.5 mg/m² | subcutaneous injection |
Instructions:
ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal. |
Day: 22
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 40 mg flat dosing | oral administration |
Instructions:
Take in the morning with food. |
|
| CYCLOPHOSPHamide | 300 mg/m² | oral administration |
Instructions:
Take each dose with food and a large glass of water, preferably in the morning. Round each dose to closest multiple of 50 mg tablets. |
|
| bortezomib * | 1.5 mg/m² | subcutaneous injection |
Instructions:
ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Emetogenicity: | Medium to high |
| Gastroprotection: | Gastroprotection may be considered |
| Pneumocystis jirovecii pneumonia (PJP) prophylaxis: | Routine antibiotic prophylaxis 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.
References
Simpson, D., R. McCulloch, J. Liang, et al. 2013. "Weekly Subcutaneous Bortezomib Is Well Tolerated and Effective As Initial Therapy Of Symptomatic Myeloma." 53rd ASH Annual Meeting, Abstract: 3229.
Juno Pharmaceuticals NZ Ltd. Bortezomib JUNO New Zealand medicine datasheet 6 April 2020 https://www.medsafe.govt.nz/profs/datasheet/b/bortezomibjunoinj.pdf (Accessed 31 March 2022).
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.