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Systemic Anti-Cancer Therapy Regimen Library

Home > SKIN MCC Metastatic - cARBOplatin and oral etoposide

SKIN MCC Metastatic - cARBOplatin and oral etoposide

Treatment Overview

Cycles 1 to 4 - 21 days

Cycle length:
21

Cycle details

Cycles 1 to 4 - 21 days

Medication Dose Route Days Max Duration
aprepitant 125 mg oral administration 1
aprepitant 80 mg oral administration 2, 3
dexamethasone * 8 mg oral administration 1, 2, 3
ondansetron 8 mg oral administration 1
cARBOplatin * 5 AUC (area under the curve) intravenous 1 60 minutes
etoposide (as phosphate) * 100 mg/m² intravenous 1 60 minutes
etoposide * 200 mg/m² Once daily oral administration 2, 3
ondansetron 8 mg oral administration 1
domperidone 10 mg Three times daily oral administration 1

Full details

Cycles 1 to 4 - 21 days

Day: 1

Medication Dose Route Max duration Details
aprepitant 125 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
cARBOplatin * 5 AUC (area under the curve) intravenous 60 minutes
Instructions:
Hypersensitivity risk increases with number of cycles of cARBOplatin.
etoposide (as phosphate) * 100 mg/m² intravenous 60 minutes
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.

Day: 2

Medication Dose Route Max duration Details
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

Dose and duration may be individualised at clinician’s discretion.
etoposide * 200 mg/m² Once daily oral administration
Instructions:
  • Take each dose on an empty stomach - one hour before OR two hours after food.
  • Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.
  • Round dose to closest multiple of 50 mg and/or 100 mg capsules.

Day: 3

Medication Dose Route Max duration Details
aprepitant 80 mg oral administration
Instructions:
ONCE daily in the morning.
dexamethasone * 8 mg oral administration
Instructions:

ONCE daily in the morning with food.

Dose and duration may be individualised at clinician’s discretion.
etoposide * 200 mg/m² Once daily oral administration
Instructions:
  • Take each dose on an empty stomach - one hour before OR two hours after food.
  • Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.
  • Round dose to closest multiple of 50 mg and/or 100 mg capsules.

Supportive Care Factors

Factor Value
Emetogenicity: High

References

Satpute S R, Ammakkanavar NR, Einhorn LH et al. Role of platinum-based chemotherapy for Merkel cell tumor in adjuvant and metastatic settings. JCO. 2014 May 20; 32:9049-9049. DOI:10.1200/jco.2014.32.15_suppl.9049

Rossi, A., M. Di Maio, P. Chiodini, et al. Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: the COCIS meta-analysis of individual patient data. J Clin Oncol 2012; 30(14):1692-1698., PMID: 22473169

Johnson, D. H., J. C. Ruckdeschel, J. H. Keller, et al. A randomized trial to compare intravenous and oral etoposide in combination with cisplatin for the treatment of small cell lung cancer." Cancer. 1991; 67(1 Suppl):245-249., PMID: 1845847

Boulanger J, Boursiquot JN, Cournoyer G, et al. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. Curr Oncol. 2014;21(4):e630-e641., PMID: 25089112

Castells, M.C., Matulonis, U.A., and Horton, TM. Infusion reactions to systemic chemotherapy. Savarese DMF and Feldweg AM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed 26 March 2021).

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* 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.