Systemic Anti-Cancer Therapy Regimen Library
SAR Ewing sarcoma - VAC, VC and IE [Q2W]
Treatment Overview
VAC [vinCRISTine, daCTINomycin and CYCLOPHOSPHamide] may be used as an alternative to VDC [vinCRISTine, DOXOrubicin and CYCLOPHOSPHamide] in the case of cardiotoxicity with DOXOrubicin. DO NOT substitute DOXOrubicin with daCTINomycin if the maximum cumulative dose of 375 mg/m2 DOXOrubicin has been reached.
VDC is the preferred regimen except when DOXOrubicin is contraindicated, see SAR Ewing sarcoma - VDC, VC, IE [Q2W].
This regimen is given as 2-weekly cycles of VAC [vinCRISTine, daCTINomycin and CYCLOPHOSPHamide] or VC [vinCRISTine and CYCLOPHOSPHamide] alternating with IE [IFOSFamide and etoposide] as per patient's individual treatment plan.
Exact scheduling of cycles is dependent on type of local therapy (e.g. surgery and/or radiation therapy) and when it is given.
The General Treatment schema is below, refer to the patient's individual treatment plan for details.
General Treatment schema overview
Alternating with IE at 2-weekly intervals as per patient's individual treatment plan.
Alternating with VAC or VC at 2-weekly intervals as per patient's individual treatment plan.
Alternating with IE at 2-weekly intervals as per patient's individual treatment plan.
Supportive Care Factors
| Factor | Value |
|---|---|
| Constipation risk: | laxatives are usually prescribed |
| Emetogenicity: | Variable |
| Growth factor support: | Recommended for primary prophylaxis |
| Hydration: | Variable |
| Mesna uroprotection: | Routine mesna uroprotection recommended |
References
Children’s Oncology Group AEWS0031 Trial of Chemotherapy Intensification Through Interval Compression in Ewing Sarcoma and Related Tumors A Phase III Intergroup study Version Date: 12/2/03 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494838/bin/supp_30_33_4148__index.html
* 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.