Systemic Anti-Cancer Therapy Regimen Library
LUNG NSCLC Metastatic - daBRAFEnib and tRAMEtinib
Treatment Overview
Cycle 1 (and all further cycles) - 28 days
Cycle length:
28
Emetogenicity: MEDIUM to HIGH—Routine antiemetic premedication may not be required for continuous dosing of oral anti-cancer medicines with MEDIUM to HIGH emetic risk; an individualised approach is appropriate.
Cycle details
Cycle 1 (and all further cycles) - 28 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration | 1 to 28 | |
| tRAMEtinib | 2 mg Once daily | oral administration | 1 to 28 | |
| domperidone | 10 mg Three times daily | oral administration | 1 | |
| loperamide | 2 mg | oral administration | 1 |
Emetogenicity: MEDIUM to HIGH—Routine antiemetic premedication may not be required for continuous dosing of oral anti-cancer medicines with MEDIUM to HIGH emetic risk; an individualised approach is appropriate.
Full details
Cycle 1 (and all further cycles) - 28 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
|
| 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. |
|
| loperamide | 2 mg | oral administration |
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 10
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 11
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 12
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 13
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 14
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 16
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 17
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 18
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 19
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 20
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 21
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 22
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 23
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 24
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 25
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 26
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 27
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Day: 28
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| daBRAFEnib | 150 mg Twice daily | oral administration |
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. ONE of the daily doses should be taken concurrently with tRAMEtinib. Take with a glass of water and swallow whole, do not crush or chew. |
|
| tRAMEtinib | 2 mg Once daily | oral administration |
Instructions:
ONCE daily at the same time each day, concurrently with a daBRAFEnib dose. Take on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
| Emetogenicity: | Medium to high |
References
Novartis New Zealand Ltd. Tafinlar capsules data sheet 22 October 2019. https://www.medsafe.govt.nz/profs/Datasheet/t/tafinlarcap.pdf (accessed 29 September 2020).
Novartis New Zealand Ltd. Mekinist tablets data sheet 01 October 2019. https://www.medsafe.govt.nz/profs/Datasheet/m/mekinisttab.pdf (accessed 29 September 2020).
* 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.