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Systemic Anti-Cancer Therapy Regimen Library

Home > SAR Ewing sarcoma - VAC, VC and IE [Q2W] > SAR - IE [IFOSfamide and etoposide][Q2W]
This regimen is a component of SAR Ewing sarcoma - VAC, VC and IE [Q2W]

IE [IFOSFamide and etoposide] (SAR Ewing sarcoma - VAC, VC and IE [Q2W])

Treatment Overview

Administered 2 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 - 14 days

Cycle length:
14

filgrastim: Give filgrastim 5 microgram/kg subcutaneously ONCE daily from Day 6 until neutrophil recovery past the nadir.

Cycle details

Cycles 1 to 7 - 14 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
filgrastim 5 microgram/kg Once daily subcutaneous injection 6
domperidone 10 mg Three times daily oral administration 1
docusate sodium + sennoside B 2 Tablet(s) oral administration 1

filgrastim: Give filgrastim 5 microgram/kg subcutaneously ONCE daily from Day 6 until neutrophil recovery past the nadir.

Full details

Cycles 1 to 7 - 14 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.
filgrastim 5 microgram/kg Once daily subcutaneous injection
Instructions:

Give ONCE daily from Day 6 until neutrophil recovery past the nadir.

Round dose to nearest prefilled syringe dose of 300 micrograms or 480 micrograms.

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.