Systemic Anti-Cancer Therapy Regimen Library
IE [IFOSFamide and etoposide] (SAR Ewing sarcoma - VAC, VC and IE [Q3W])
Treatment Overview
Administered 3 weeks after VAC/VDC or VC, as per patient's individual treatment plan.
This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.
Cycles 1 to 7 - 21 days
Cycle details
Cycles 1 to 7 - 21 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration | 1 to 7 | |
| ondansetron | 8 mg | oral administration | 1 to 5 | |
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 1 to 5 | 60 minutes |
| sodium chloride | 0.9 % | intravenous | 1 to 5 | 120 minutes |
| mesna * | 360 mg/m² | intravenous | 1 to 5 | 15 minutes |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 1 to 5 | 120 minutes |
| sodium chloride | 0.9 % | intravenous | 1 to 5 | 120 minutes |
| mesna * | 360 mg/m² | intravenous | 1 to 5 | 15 minutes |
| mesna * | 360 mg/m² | intravenous | 1 to 5 | 15 minutes |
| ondansetron | 8 mg | oral administration | 1 to 5 | |
| pegFILGRASTIM | 6 mg | subcutaneous injection | 6 | |
| domperidone | 10 mg Three times daily | oral administration | 1 | |
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration | 1 |
Full details
Cycles 1 to 7 - 21 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy with food. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 60 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
Immediately prior to IFOSFamide infusion over 15 minutes, or as per institutional practice. |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 120 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 4 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 8 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| 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. |
|
| docusate sodium + sennoside B | 2 Tablet(s) | oral administration |
Instructions:
At night when required for constipation. Each tablet contains docusate sodium 50 mg + sennoside B 8 mg. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 60 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
Immediately prior to IFOSFamide infusion over 15 minutes, or as per institutional practice. |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 120 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 4 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 8 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| ondansetron | 8 mg | oral administration |
Instructions:
EIGHT hours after chemotherapy OR before bed. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 60 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
Immediately prior to IFOSFamide infusion over 15 minutes, or as per institutional practice. |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 120 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 4 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 8 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| ondansetron | 8 mg | oral administration |
Instructions:
EIGHT hours after chemotherapy OR before bed. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 60 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
Immediately prior to IFOSFamide infusion over 15 minutes, or as per institutional practice. |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 120 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 4 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 8 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| ondansetron | 8 mg | oral administration |
Instructions:
EIGHT hours after chemotherapy OR before bed. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| ondansetron | 8 mg | oral administration |
Instructions:
ONE hour prior to chemotherapy. |
|
| etoposide (as phosphate) * | 100 mg/m² Once daily | intravenous | 60 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
Immediately prior to IFOSFamide infusion over 15 minutes, or as per institutional practice. |
| IFOSFamide * | 1800 mg/m² Once daily | intravenous | 120 minutes | |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After IFOSFamide infusion. Recommended daily hydration is 3000 ml per day as oral or IV fluid on day(s) of IFOSFamide and for 24 hours after, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 4 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| mesna * | 360 mg/m² | intravenous | 15 minutes |
Instructions:
At 8 hours from the start of IFOSFamide infusion, or as per institutional practice. |
| ondansetron | 8 mg | oral administration |
Instructions:
EIGHT hours after chemotherapy OR before bed. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
|
| pegFILGRASTIM | 6 mg | subcutaneous injection |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg | oral administration |
Instructions:
ONCE daily in the morning with food. Dose and duration may be individualised at clinician’s discretion. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Constipation risk: | laxatives are usually prescribed |
| Emetogenicity: | Medium |
| Growth factor support: | Recommended for primary prophylaxis |
| Hydration: | Routine hydration recommended |
| Mesna uroprotection: | Routine mesna uroprotection recommended |
References
No references
* 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.