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Systemic Anti-Cancer Therapy Regimen Library

Home > SAR Rhabdomyosarcoma - vinCRISTine, irinotecan, IFOSFamide, etoposide, DOXOrubicin, CYCLOPHOSPHamide and daCTINomycin [ARST0431] [high risk] > SAR - vinCRISTine days 1 and 8 and irinotecan ARST0431 [high risk]
This regimen is a component of SAR Rhabdomyosarcoma - vinCRISTine, irinotecan, IFOSFamide, etoposide, DOXOrubicin, CYCLOPHOSPHamide and daCTINomycin [ARST0431] [high risk]

ARST0431 [high risk] - V, Irin + V [vinCRISTine days 1 and 8 and irinotecan] (SAR Rhabdomyosarcoma - vinCRISTine, irinotecan, IFOSFamide, etoposide, DOXOrubicin, CYCLOPHOSPHamide and daCTINomycin [ARST0431] [high risk])

Treatment Overview

As cycles 2, 10, 19 and 20 (refer Treatment Schema), or as per patient's individual treatment plan.

Commence regimen in relation to radiation therapy as per institutional policy.

Cycles 1 to 4 - 21 days

Cycle length:
21

vinCRISTine, day 1: Administer prior to irinotecan.

Cycle details

Cycles 1 to 4 - 21 days

Medication Dose Route Days Max Duration
dexamethasone * 8 mg oral administration 1 to 7
ondansetron 8 mg oral administration 1 to 5
vinCRISTine * 1.5 mg/m² Cap dose per administration at: 2 mg intravenous 1, 8 10 minutes
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 1 to 5 60 minutes
atropine sulfate * 600 microgram intravenous 1 to 5 2 minutes
ondansetron 8 mg oral administration 1 to 5
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

vinCRISTine, day 1: Administer prior to irinotecan.

Full details

Cycles 1 to 4 - 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.
vinCRISTine * 1.5 mg/m² Cap dose per administration at: 2 mg intravenous 10 minutes
Instructions:
  • Administer prior to irinotecan.
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 60 minutes
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
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.
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
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 60 minutes
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
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.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 60 minutes
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
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.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 60 minutes
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
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.
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.
irinotecan * 50 mg/m² Once daily Cap dose per administration at: 100 mg intravenous 60 minutes
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:

Only if required for acute diarrhoea or cholinergic symptoms.

  • Alternatively, dose may be administered subcutaneously.
  • 600 microgram = 0.6 mg.
  • Some centres may wish to give a reduced dose of 300 microgram (= 0.3 mg) in line with institutional policy.
  • Dose may be repeated up to a maximum dose of 1200 microgram (= 1.2 mg).
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.

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.

Day: 8

Medication Dose Route Max duration Details
vinCRISTine * 1.5 mg/m² Cap dose per administration at: 2 mg intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Variable

Emetogenicity: MEDIUM days 1 to 5; MINIMAL day 8.

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.