OncoWiki - User contributions [en]

SMILE

2018-08-27T05:22:19Z

Palmdoc:

== Indication ==
Advanced-stage NK-cell lymphomas

== Regimen ==
Methotrexate with leucovorin 2 g/m2 IV over 6 h d1
Ifosfamide with mesna 1.5 g/m2 IV d2, 3 and 4
Dexamethasone 40 mg IV or oral d2, 3 and 4
Etoposide 100 mg/m2 IV d2, 3 and 4
L-asparaginase (Leunase) 6000 U/m2 IV d8, 10, 12, 14, 16, 18 and 20
G-CSF r to be started on day 6. Cycles to be repeated every 28 days.

====Supportive medications====
*[[Folinic acid (Leucovorin)]] 45 mg PO Q6H x 4 doses per day on days 2 to 4 (or until serum methotrexate level is below the toxic range), starting 24 hours after completion of [[Methotrexate (MTX)]]
**Methotrexate levels checked at 24, 48, and 72 hours after methotrexate is given, or until methotrexate levels fall below toxic range. Folinic acid should be continued until methotrexate levels are below toxic range.
*[[Mesna (Mesnex)]] 900 mg/m² IV over 6 hours once per day on days 2 to 4, given together with [[Ifosfamide (Ifex)]]
*Hydration with normal saline (no volume specified) Q8H x 1 day prior to [[Methotrexate (MTX)]]
*Patients told to drink at least 2 liters of fluid per day on days 1 to 4; target urine output of greater than or equal to 3 liters per day on days 1 to 4
*[[Filgrastim (Neupogen)]] 300 mcg SC once per day, starting on day 6, given until ANC greater than 1000/uL
*[[Trimethoprim/Sulfamethoxazole (Bactrim DS)|Cotrimoxazole]] or [[Pentamidine (Nebupent)]] for PJP prophylaxis
*[[Famotidine (Pepcid)]] and potassium slow release tablets (no dose specified) "for [[Dexamethasone (Decadron)]]" on days 2 to 4
*[[Chlorpheniramine (Chlor-Trimeton)]] 10 mg PO once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20
*[[Hydrocortisone (Cortef)]] 100 mg IV once prior to [[Asparaginase (Elspar)]] infusions on days 8, 10, 12, 14, 16, 18, 20

'''Given for up to 6 cycles'''

''Neither paper nor supplement specified the length of each cycle, but other SMILE regimens, e.g. Yamaguchi et al. 2011, describe 28-day cycles.''

== References ==
[http://onlinelibrary.wiley.com/doi/10.1111/j.1349-7006.2008.00768.x/abstract Motoko Yamaguchi Ritsuro Suzuki, Yok-Lam Kwong3 et al .Phase I study of dexamethasone, methotrexate, ifosfamide, l-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia]

Yamaguchi M et al. Phase II Study of SMILE Chemotherapy for Newly Diagnosed Stage IV, Relapsed, or Refractory Extranodal Natural Killer (NK)/T-Cell Lymphoma, Nasal Type: The NK-Cell Tumor Study Group Study. [http://jco.ascopubs.org/content/29/33/4410 JCO November 20, 2011 vol. 29 no. 33 4410-4416]

[http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=42702 M. Yamaguchi, Y. Kwong, Y. Maeda, C. Hashimoto, W. Kim et al Phase II study of SMILE chemotherapy for newly-diagnosed stage IV, relapsed or refractory extranodal NK/T-cell lymphoma, nasal type: NKTSG study]

[http://www.medscape.com/viewarticle/731901_22 Medscape. Diagnosis and Management of Natural Killer-cell Malignancies: Treatment of Advanced-stage NK-cell Lymphoma (Nasal & Non-nasal)]

Lymphoma Hodgkin's, Adult

2018-08-27T01:44:44Z

Palmdoc: /* Frontline */

== Frontline ==
[[ABVD]]

[[MOPP]]

[[MOPPABV Hybrid]]

[[ChlVPP]]

[[COPP]]

[[Standard BEACOPP]]

[[Escalated BEACOPP]]

[[SMILE]]

== Salvage ==
[[ABDIC]]

[[ASHAP]]

[[Brentuximab vedotin]]

[[BeGeV]]

[[CEP]]

[[EBVMm]]

[[EPIC]]

[[EVA]]

[[EVAP]]

[[GEM-P]]

[[GVD]]

[[IMVP-16]]

[[IVE]]

[[MIME]]

[[Dexa-BEAM ]]

[[Mini-BEAM]]

[[Stanford V]]

[[MiCMA]]

[http://www.cancer.gov/cancertopics/pdq/treatment/adulthodgkins/healthprofessional/ NCI PDQ]

BeGeV

2017-06-14T13:06:09Z

Palmdoc: Created page with "== Hodgkin disease == salvage regimen in relapsed Hodgkin's lymphoma == Regimen == phase II study * Gemcitabine 800 mg/m2 on days 1 and 4 * Vinorelbine 20 mg/m2 on day 1, *..."

== Hodgkin disease ==
salvage regimen in relapsed Hodgkin's lymphoma

== Regimen ==

phase II study

* Gemcitabine 800 mg/m2 on days 1 and 4
* Vinorelbine 20 mg/m2 on day 1,
* Bendamustine 90 mg/m2 on days 2 and 3
* Prednisolone 100 mg per day was administered on days 1 to 4

Patients received four cycles of the BeGEV regimen administered every 21 days. Growth factor support with granulocyte colony-stimulating factor (G-CSF) was administered at each cycle. Patients received Pneumocystis pneumonia prophylaxis and antiemetics in accordance with institutional guidelines.

== References ==
[http://ascopubs.org/doi/full/10.1200/JCO.2016.66.4466 BBendamustine in Combination With Gemcitabine and Vinorelbine Is an Effective Regimen As Induction Chemotherapy Before Autologous Stem-Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma: Final Results of a Multicenter Phase II Study Santoro et al . J Clin Oncol 2016]

Lymphoma Hodgkin's, Adult

2017-06-14T12:57:55Z

Palmdoc: /* Salvage */

== Frontline ==
[[ABVD]]

[[MOPP]]

[[MOPPABV Hybrid]]

[[ChlVPP]]

[[COPP]]

[[Standard BEACOPP]]

[[Escalated BEACOPP]]

== Salvage ==
[[ABDIC]]

[[ASHAP]]

[[Brentuximab vedotin]]

[[BeGeV]]

[[CEP]]

[[EBVMm]]

[[EPIC]]

[[EVA]]

[[EVAP]]

[[GEM-P]]

[[GVD]]

[[IMVP-16]]

[[IVE]]

[[MIME]]

[[Dexa-BEAM ]]

[[Mini-BEAM]]

[[Stanford V]]

[[MiCMA]]

[http://www.cancer.gov/cancertopics/pdq/treatment/adulthodgkins/healthprofessional/ NCI PDQ]

Flu Bu ATG - Slavin

2016-09-21T02:03:25Z

Palmdoc:

*[[Fludarabine (Fludara)]] 30 mg/m² IV once per day on days -10 to -5 (6 consecutive days)
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -5 (2 consecutive days) or IV Busulfex 3.2 mg/kg days -6 to -5
*[[Antithymocyte globulin (ATG)|ATG-Fresenius]] 10 mg/kg/day on days -4 to -1 (4 consecutive days)

==References==
# Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, Varadi G, Kirschbaum M, Ackerstein A, Samuel S, Amar A, Brautbar C, Ben-Tal O, Eldor A, Or R. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998 Feb 1;91(3):756-63. [http://www.bloodjournal.org/content/91/3/756.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9446633 PubMed]

Flu Bu ATG - Slavin

2016-09-21T02:02:46Z

Palmdoc: Created page with "*Fludarabine (Fludara) 30 mg/m² IV once per day on days -10 to -5 (6 consecutive days) *Busulfan (Myleran) 4 mg/kg/day PO on days -6 to -5 (2 consecutive da..."

Stem Cell Transplantation

2016-09-21T01:55:47Z

Palmdoc: /* Non-myeloablative conditioning regimens */

== Mobilization Protocols ==
[[Plerixafor and G-CSF]]

== Myeloablative conditioning regimens ==

== Non-myeloablative conditioning regimens ==
[[Flu Bu ATG - Slavin]]

[[Flu Bu ATG for Haplo]]

== Autograft regimens ==

[[BEAC]]

[[BEAM]]

Stem Cell Transplantation

2016-09-21T01:54:26Z

Palmdoc: /* Non-myeloablative conditioning regimens */

== Mobilization Protocols ==
[[Plerixafor and G-CSF]]

== Myeloablative conditioning regimens ==

== Non-myeloablative conditioning regimens ==
[[Flu Bu ATG - Slavin]]
[[Flu Bu ATG for Haplo]]

== Autograft regimens ==

[[BEAC]]

[[BEAM]]

Flu Bu ATG for Haplo

2016-07-06T20:21:59Z

Palmdoc: Created page with "== Regimen == *Busulfan (Busulfex, Otsuka Pharmaceuticals) 3.2 mg/kg per day intravenously on days −7 and −6 *Fludarabine 30 mg/m2 per day intravenously on days −7 to..."

== Regimen ==
*Busulfan (Busulfex, Otsuka Pharmaceuticals) 3.2 mg/kg per day intravenously on days −7 and −6
*Fludarabine 30 mg/m2 per day intravenously on days −7 to −2
*Rabbit ATG (thymoglobulin, Genzyme Transplant) 3 mg/kg per day on days −4 to −1

== Stem cell collection ==
Starting on day −3, each hematopoietic cell donor was given granulocyte colony-stimulating factor (G-CSF) 10 μg/kg per day subcutaneously for 4 to 5 days. Starting on the fourth day (day 0 of HCT) of G-CSF administration, donor mononuclear cells were harvested by large-volume leukapheresis, with the goal of collecting at least 5 × 106 CD34+ cells per kilogram of recipient body weight. The collected cells were administered on the same day to the designated patient through a central venous catheter. Sixty-eight donors (82%) required cell collections on 2 days (days 0 and 1), 13 (16%) required 3 collections, and 1 each required 4 and 5 collections.

== GVHD prophylaxis and supportive care ==
For GVHD prophylaxis, patients were given cyclosporine 1.5 mg/kg intravenously every 12 hours starting on day −1, and subsequently switched to a 1.5- to 2-fold greater oral dose of cyclosporine. The blood concentrations of cyclosporine were monitored at least once weekly and were referenced to 100 to 300 ng/mL. In addition, patients received methotrexate 15 mg/m2 intravenously 1 day and 10 mg/m2 3, 6, and 11 days after the last donor cell infusion. The dose of cyclosporine was halved if serum creatinine concentration increased to twice the baseline level and was discontinued if the concentration rose to 3 times the baseline level. The dose of methotrexate was halved if serum creatinine concentration increased to twice the baseline level or if a patient developed a grade 2 hepatic toxicity or stomatitis, and was withheld if serum creatinine increased to 3 times the baseline level or if a patient developed grade 3 hepatic toxicity or stomatitis. Starting 30 to 60 days after HCT, the cyclosporine dose was decreased by 10% every 2 to 4 weeks in patients with no evidence of GVHD. In 7 patients who were transplanted after September 2009, the last dose of methotrexate was omitted.

== Reference ==
[http://www.bloodjournal.org/content/118/9/2609 Kyoo-Hyung Lee et al Blood 2011 118:2609-2617]

Stem Cell Transplantation

2016-07-06T20:07:16Z

Palmdoc: /* Non-myeloablative conditioning regimens */

== Mobilization Protocols ==
[[Plerixafor and G-CSF]]

== Myeloablative conditioning regimens ==

== Non-myeloablative conditioning regimens ==

[[Flu Bu ATG for Haplo]]

== Autograft regimens ==

[[BEAC]]

[[BEAM]]

Stem Cell Transplantation

2016-07-06T20:06:53Z

Palmdoc: /* Non-myeloablative conditioning regimens */

== Mobilization Protocols ==
[[Plerixafor and G-CSF]]

== Myeloablative conditioning regimens ==

== Non-myeloablative conditioning regimens ==

[[Flu Bu ATG for Haplo]

== Autograft regimens ==

[[BEAC]]

[[BEAM]]

R-MPV

2016-05-16T21:52:46Z

Palmdoc: Created page with "== Regimen == IV Rituximab 500 mg/m2 day 1 IV Methotrexate 3.5 mg/m2 (over 2hours) day 2 IV Vincristine 1.4 mg/m2 (capped at 2.8mg)day 2 Procarbazine 100 mg/m2 /day was gi..."

== Regimen ==
IV Rituximab 500 mg/m2 day 1
IV Methotrexate 3.5 mg/m2 (over 2hours) day 2
IV Vincristine 1.4 mg/m2 (capped at 2.8mg)day 2
Procarbazine 100 mg/m2 /day was given on days 2-8 during odd cycles.

1 cycle = 14 days

Standard hydration and leucovorin rescue were given per institutional guidelines.
To prevent febrile neutropenia and toxic deaths
previously observed with R-MPV, prophylactic filgrastim was given to all patients.

An MRI of the brain was performed after 5 cycles. Patients with progressive disease (PD) were taken off-study. Patients with complete response (CR) proceeded directly to HDC-ASCT. Patients in partial response (PR) or stable disease (SD) received two additional cycles, and proceeded with HDC-ASCT if PR/CR was observed on a repeat MRI, or taken off-study if SD or PD. After transplant, patients were followed radiographically, with no WBRT or further treatments offered until progression.
Responses were assessed utilizing previously described criteria;18 in addition to CR, PR, SD and PD, those criteria also characterize unconfirmed CR (CRu), defined by absence of contrast-enhancing disease in the setting of corticosteroids use, or minimal enhancing abnormalities of uncertain significance, typically corresponding to postoperativechanges following biopsy.

=== Reference ===
R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma Blood. 2015 Feb 26;125(9):1403-10. doi: 10.1182/blood-2014-10-604561. Epub 2015 Jan 7. [http://www.bloodjournal.org/content/bloodjournal/early/2015/01/07/blood-2014-10-604561.full.pdf?sso-checked=true Full Text]

Lymphoma Non-Hodgkin's, Adult

2016-05-16T21:45:01Z

Palmdoc: /* Primary CNS Lymphoma */

== Regimens ==

=== Indolent NHL ===
*[[Bendamustine]]
*[[Chlorambucil#Indolent_NHL|Chlorambucil]]
*[[Cyclophosphamide#Indolent_NHL|Cyclophosphamide]]
*[[Fludarabine#Indolent_NHL|Fludarabine]]
*[[Rituximab]]
*[[Rituximab, Bendamustine, Bortezomib]]
*[[CVP]]
*[[R-CVP]]
*[[FC]]
*[[FCM]]
*[[R-FCM]]
*[[FN]]
*[[FND]]
*[[MCP]]
*[[R-MCP]]
*[[RC]]

=== Aggressive NHL ===
==== B Cell ====
[[CHOP]]

[[R-CHOP]]

[[CHOP-14]]

[[CHOEP-14]]

[[CEOP]]

[[CNOP]]

[[COPP]]

[[DHAP]]

[[DHAX]]

[[EPIC]]

[[EPOCH]]

[[EPOCH-DA]]

[[R-EPOCH]]

[[ESHAP]]

[[GEM-P]]

[[GEM-Vinorelbine-Pred]]

[[HyperCVAD]]

[[ICE]]

[[RICE]]

[[IMVP-16 ]]

[[MACOP-B]]

[[VNCOP-B]]

[[MIME]]

[[MINE/ESHAP]]

[[m-BACOD]]

[[MiCMA]]

==== T Cell ====
[[SMILE]]

== Mantle Cell Lymphoma ==
[[Bendamustine]]

[[R-CHOP]]

[[R-FCM]]

[[R-FCM + maintenance R]]

[[Bortezomib#Mantle_Cell_Lymphoma|Bortezomib]]

[[R-GemOx]]

[[HyperCVAD]]

== Pre-B or T lymphoblastic lymphoma ==
[[HyperCVAD]]

[[CALGB 9111]]

== Burkitt's Lymphoma ==
*[[BFM B-Cell]] (German protocol)
*[[CODOX-M/IVAC]]
*[[Modified CODOX-M]]
*[[CALGB 9251]]

== Primary CNS Lymphoma ==
[[High dose Methotrexate]]

[[Bonn protocol]]

[[RTOG study 93-10]] (deAngelis regime)

[[R-MPV]]

[[Temozolomide]]

== External Links ==
[http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/healthprofessional Cancernet PDQ]

Lymphoma Non-Hodgkin's, Adult

2016-05-16T21:44:38Z

Palmdoc: /* Primary CNS Lymphoma */

== Regimens ==

=== Indolent NHL ===
*[[Bendamustine]]
*[[Chlorambucil#Indolent_NHL|Chlorambucil]]
*[[Cyclophosphamide#Indolent_NHL|Cyclophosphamide]]
*[[Fludarabine#Indolent_NHL|Fludarabine]]
*[[Rituximab]]
*[[Rituximab, Bendamustine, Bortezomib]]
*[[CVP]]
*[[R-CVP]]
*[[FC]]
*[[FCM]]
*[[R-FCM]]
*[[FN]]
*[[FND]]
*[[MCP]]
*[[R-MCP]]
*[[RC]]

=== Aggressive NHL ===
==== B Cell ====
[[CHOP]]

[[R-CHOP]]

[[CHOP-14]]

[[CHOEP-14]]

[[CEOP]]

[[CNOP]]

[[COPP]]

[[DHAP]]

[[DHAX]]

[[EPIC]]

[[EPOCH]]

[[EPOCH-DA]]

[[R-EPOCH]]

[[ESHAP]]

[[GEM-P]]

[[GEM-Vinorelbine-Pred]]

[[HyperCVAD]]

[[ICE]]

[[RICE]]

[[IMVP-16 ]]

[[MACOP-B]]

[[VNCOP-B]]

[[MIME]]

[[MINE/ESHAP]]

[[m-BACOD]]

[[MiCMA]]

==== T Cell ====
[[SMILE]]

== Mantle Cell Lymphoma ==
[[Bendamustine]]

[[R-CHOP]]

[[R-FCM]]

[[R-FCM + maintenance R]]

[[Bortezomib#Mantle_Cell_Lymphoma|Bortezomib]]

[[R-GemOx]]

[[HyperCVAD]]

== Pre-B or T lymphoblastic lymphoma ==
[[HyperCVAD]]

[[CALGB 9111]]

== Burkitt's Lymphoma ==
*[[BFM B-Cell]] (German protocol)
*[[CODOX-M/IVAC]]
*[[Modified CODOX-M]]
*[[CALGB 9251]]

== Primary CNS Lymphoma ==
[[High dose Methotrexate]]

[[Bonn protocol]]

[[RTOG study 93-10]] (deAngelis regime)

[[R-MPV]]
[[Temozolomide]]

== External Links ==
[http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/healthprofessional Cancernet PDQ]

VDT-PACE

2016-04-18T02:18:29Z

Palmdoc: VDTPACE

== Multiple Myeloma ==
Cisplatin (10 mg/sqm/d) d1-4 continuous infusion
Doxorubicin (10 mg/sqm/d) d1-4 continuous infusion
Cyclophosphamide (400 mg/sqm/d) d1-4 continuous infusion
Etoposide (40 mg/sqm/d) d1-4 continuous infusion
Bortezomib IV 1.0 mg/sqm (d 1,4,8,11)
Thalidomide 100 mf daily PO

A total of 4 cycles of VDT-PACE were administered every 4-6 weeks

=== Reference ===
Gabriele Buda et al VDTPACE As Salvage Therapy For Heavily Pretreated MM Patients [http://www.bloodjournal.org/content/122/21/5377 November 15, 2013; Blood: 122 (21)]

Overall response rate was 63% (very-good partial response 7%, partial response 56%) with stable disease in an additional 12% of patients. Median progression-free survival (PFS) was 7 months (95% confdence interval [CI]:4.0 - 9.9). VDTPACE is an intensive regimen which was given in our cohort on an inpatient basis because myelotoxicity is common. The rates of grade 3-4 neutropenia (56%) and febrile neutropenia (56%) were high although GCSF support was used routinely as prophylaxis. The most common non-haematological toxicities were grade 1-2 metabolic abnormalities that were easily corrected. VDTPACE is an effective salvage therapy for heavily pretreated MM patients. In the era of new targeted, biologically active agents against MM, there are now many more options for refractory and relapsed disease. Unfortunately, many of these newer agents are costly and awaiting approval in a number of countries. Consequently, alternative therapies are needed. Although the overall response rate of 63% in this poor prognosis cohort is more than promising, the PFS is short, suggesting the best role for VDTPACE is in bridging to defnitive therapy, such as allo-transplantation.

Multiple Myeloma And Plasma Cell Dyscrasias

2016-04-18T01:50:41Z

Palmdoc: /* Combinations */

== Combinations ==
*[[DT-PACE]] (Dexamethasone Thalidomide CISplatin DOXOrubicin CYCLOPHOSphamide ETOPOside)
*[[VDT-PACE]]
*[[DVD]]
*[[MP]] (Melphalan & Prednisolone)
*[[MPT]] ((Melphalan, Prednisolone, Thalidomide)
*[[Dexamethasone]] alone
*[[PCAB]]
*[[VAD]]

== Thalidomide/Lenalinomide containing regimens ==
* [[Thal/Dex]]
* [[Rev/Dex]]
* [[dtZ]]
* [[BiRD]]

== Bortezomib regimens ==
[[Bortezomib#Multiple_Myeloma|Bortezomib]] (Velcade)

[[VRD]]

CVD or CyBorD [[Cyclophosphamide Bortezomib Dexamethasone]]

[[VMP]]

[[VMPT]]

[[PAD]]

== Total Therapy variants (Arkansas) ==
[[Total Therapy 1]]

[[Total Therapy 2]]

[[Total Therapy 3]]

[[Total Therapy 4]]

Multiple Myeloma And Plasma Cell Dyscrasias

2016-04-18T01:50:17Z

Palmdoc:

== Combinations ==
*[[DT-PACE]] (Dexamethasone Thalidomide CISplatin DOXOrubicin CYCLOPHOSphamide ETOPOside)
*[[VDT-PACE]
*[[DVD]]
*[[MP]] (Melphalan & Prednisolone)
*[[MPT]] ((Melphalan, Prednisolone, Thalidomide)
*[[Dexamethasone]] alone
*[[PCAB]]
*[[VAD]]

== Thalidomide/Lenalinomide containing regimens ==
* [[Thal/Dex]]
* [[Rev/Dex]]
* [[dtZ]]
* [[BiRD]]

== Bortezomib regimens ==
[[Bortezomib#Multiple_Myeloma|Bortezomib]] (Velcade)

[[VRD]]

CVD or CyBorD [[Cyclophosphamide Bortezomib Dexamethasone]]

[[VMP]]

[[VMPT]]

[[PAD]]

== Total Therapy variants (Arkansas) ==
[[Total Therapy 1]]

[[Total Therapy 2]]

[[Total Therapy 3]]

[[Total Therapy 4]]

Lymphoma Non-Hodgkin's, Adult

2014-05-01T22:01:37Z

Palmdoc: /* Aggressive NHL */

== Regimens ==

=== Indolent NHL ===
*[[Bendamustine]]
*[[Chlorambucil#Indolent_NHL|Chlorambucil]]
*[[Cyclophosphamide#Indolent_NHL|Cyclophosphamide]]
*[[Fludarabine#Indolent_NHL|Fludarabine]]
*[[Rituximab]]
*[[Rituximab, Bendamustine, Bortezomib]]
*[[CVP]]
*[[R-CVP]]
*[[FC]]
*[[FCM]]
*[[R-FCM]]
*[[FN]]
*[[FND]]
*[[MCP]]
*[[R-MCP]]
*[[RC]]

=== Aggressive NHL ===
==== B Cell ====
[[CHOP]]

[[R-CHOP]]

[[CHOP-14]]

[[CHOEP-14]]

[[CEOP]]

[[CNOP]]

[[COPP]]

[[DHAP]]

[[DHAX]]

[[EPIC]]

[[EPOCH]]

[[EPOCH-DA]]

[[R-EPOCH]]

[[ESHAP]]

[[GEM-P]]

[[GEM-Vinorelbine-Pred]]

[[HyperCVAD]]

[[ICE]]

[[RICE]]

[[IMVP-16 ]]

[[MACOP-B]]

[[VNCOP-B]]

[[MIME]]

[[MINE/ESHAP]]

[[m-BACOD]]

[[MiCMA]]

==== T Cell ====
[[SMILE]]

== Mantle Cell Lymphoma ==
[[Bendamustine]]

[[R-CHOP]]

[[R-FCM]]

[[R-FCM + maintenance R]]

[[Bortezomib#Mantle_Cell_Lymphoma|Bortezomib]]

[[R-GemOx]]

[[HyperCVAD]]

== Pre-B or T lymphoblastic lymphoma ==
[[HyperCVAD]]

[[CALGB 9111]]

== Burkitt's Lymphoma ==
*[[BFM B-Cell]] (German protocol)
*[[CODOX-M/IVAC]]
*[[Modified CODOX-M]]
*[[CALGB 9251]]

== Primary CNS Lymphoma ==
[[High dose Methotrexate]]

[[Bonn protocol]]

[[RTOG study 93-10]] (deAngelis regime)

[[Temozolomide]]

== External Links ==
[http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/healthprofessional Cancernet PDQ]

Brentuximab vedotin

2014-05-01T21:54:53Z

Palmdoc: /* Brentuximab vedotin (Adcetris) */

==Brentuximab vedotin (Adcetris)==

===Regimen===

*Brentuximab vedotin (Adcetris) 1.8 mg/kg IV over 30 minutes on day 1

'''21-day cycles, given until progression (Rothe et al. 2012) or up to 16 infusions (Younes et al. 2012)'''

===References===
# Younes A, Gopal AK, Smith SE, Ansell SM, Rosenblatt JD, Savage KJ, Ramchandren R, Bartlett NL, Cheson BD, de Vos S, Forero-Torres A, Moskowitz CH, Connors JM, Engert A, Larsen EK, Kennedy DA, Sievers EL, Chen R. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin's lymphoma. J Clin Oncol. 2012 Jun 20;30(18):2183-9. Epub 2012 Mar 26. [http://jco.ascopubs.org/content/30/18/2183.long Link]

#Rothe A, Sasse S, Goergen H, Eichenauer DA, Lohri A, Jäger U, Bangard C, Böll B, von Bergwelt Baildon M, Theurich S, Borchmann P, Engert A. Brentuximab vedotin for relapsed or refractory CD30+ hematologic malignancies: the German Hodgkin Study Group experience. Blood. 2012 Aug 16;120(7):1470-2. Epub 2012 Jul 11.[http://bloodjournal.hematologylibrary.org/content/120/7/1470.long Link]

# Zinzani PL, Viviani S, Anastasia A, Vitolo U, Luminari S, Zaja F, Corradini P, Spina M, Brusamolino E, Gianni AM, Santoro A, Botto B, Derenzini E, Pellegrini C, Argnani L. Brentuximab vedotin in relapsed/refractory Hodgkin's lymphoma: Italian experience and results of the use in the daily clinic outside clinical trials. Haematologica. 2013 May 3 [http://www.haematologica.org/content/98/8/1232.full Link]

Brentuximab vedotin

2014-05-01T21:53:45Z

Palmdoc: /* Regimen */

==Brentuximab vedotin (Adcetris)==

===Regimen===

*Brentuximab vedotin (Adcetris) 1.8 mg/kg IV over 30 minutes on day 1

'''21-day cycles, given until progression (Rothe et al. 2012) or up to 16 infusions (Younes et al. 2012)'''

===References===
# Younes A, Gopal AK, Smith SE, Ansell SM, Rosenblatt JD, Savage KJ, Ramchandren R, Bartlett NL, Cheson BD, de Vos S, Forero-Torres A, Moskowitz CH, Connors JM, Engert A, Larsen EK, Kennedy DA, Sievers EL, Chen R. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin's lymphoma. J Clin Oncol. 2012 Jun 20;30(18):2183-9. Epub 2012 Mar 26. [http://jco.ascopubs.org/content/30/18/2183.long Link]

#Rothe A, Sasse S, Goergen H, Eichenauer DA, Lohri A, Jäger U, Bangard C, Böll B, von Bergwelt Baildon M, Theurich S, Borchmann P, Engert A. Brentuximab vedotin for relapsed or refractory CD30+ hematologic malignancies: the German Hodgkin Study Group experience. Blood. 2012 Aug 16;120(7):1470-2. Epub 2012 Jul 11.

# Zinzani PL, Viviani S, Anastasia A, Vitolo U, Luminari S, Zaja F, Corradini P, Spina M, Brusamolino E, Gianni AM, Santoro A, Botto B, Derenzini E, Pellegrini C, Argnani L. Brentuximab vedotin in relapsed/refractory Hodgkin's lymphoma: Italian experience and results of the use in the daily clinic outside clinical trials. Haematologica. 2013 May 3

===References===

Brentuximab vedotin

2014-05-01T21:50:56Z

Palmdoc: Created page with "==Brentuximab vedotin (Adcetris)== ===Regimen=== *Brentuximab vedotin (Adcetris) 1.8 mg/kg IV over 30 minutes on day 1 Supportive medications: *Rothe et al. 2012: "no p..."

==Brentuximab vedotin (Adcetris)==

===Regimen===

*[[Brentuximab vedotin (Adcetris)]] 1.8 mg/kg IV over 30 minutes on day 1

Supportive medications:
*Rothe et al. 2012: "no premedications were administered"

'''21-day cycles, given until progression (Rothe et al. 2012) or up to 16 infusions (Younes et al. 2012)'''

===References===

Lymphoma Hodgkin's, Adult

2014-05-01T21:49:23Z

Palmdoc: /* Salvage */

== Frontline ==
[[ABVD]]

[[MOPP]]

[[MOPPABV Hybrid]]

[[ChlVPP]]

[[COPP]]

[[Standard BEACOPP]]

[[Escalated BEACOPP]]

== Salvage ==
[[ABDIC]]

[[ASHAP]]

[[Brentuximab vedotin]]

[[CEP]]

[[EBVMm]]

[[EPIC]]

[[EVA]]

[[EVAP]]

[[GEM-P]]

[[GVD]]

[[IMVP-16]]

[[IVE]]

[[MIME]]

[[Dexa-BEAM ]]

[[Mini-BEAM]]

[[Stanford V]]

[[MiCMA]]

[http://www.cancer.gov/cancertopics/pdq/treatment/adulthodgkins/healthprofessional/ NCI PDQ]

Adrenocortical Carcinoma

2013-10-30T03:36:13Z

Palmdoc:

=Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy=

==Mitotane (Lysodren)==
'''There is limited and controversial clinical trial information about adjuvant mitotane use. See the references for additional case series and expert recommendation articles.'''

===Regimen #1, Wängberg et al. 2010===
''Patients started on adjuvant mitotane within 4 weeks of their surgical resection.''
*[[Mitotane (Lysodren)]] 2000 mg PO per day (frequency not specified, such as whether the total daily dose was divided into a few doses throughout the day); within the first 2 to 3 months, [[Mitotane (Lysodren)]] dose was adjusted to achieve a target therapeutic drug level of 14 to 20 mg/L

'''2 to 3-year course'''

===Regimen #2, Haak et al. 1994===

''Haak et al. 1994 concluded that "mitotane treatment in adrenocortical carcinoma is effective only when high
serum levels [trough of at least 14 mg/L] can be achieved."''
*[[Mitotane (Lysodren)]] 1000 to 2000 mg PO QID (total dose per day: 4000 to 8000 mg), with target mitotane trough of above 14 mg/L

'''2-year course "if resection was judged to be complete or for 1 year after apparent disappearance of the tumour"'''

Supportive medications:
*Hydrocortisone (Cortef) 30 to 120 mg per day or Fludrocortisone (Florinef) 0.1 to 0.4 mg per day
*Metoclopramide (Reglan) and Loperamide (Imodium) prn "gastrointestinal side-effects"

===References===
Vassilopoulou-Sellin R, Guinee VF, Klein MJ, Taylor SH, Hess KR, Schultz PN, Samaan NA. Impact of adjuvant mitotane on the clinical course of patients with adrenocortical cancer. Cancer. 1993 May 15;71(10):3119-23. [http://onlinelibrary.wiley.com/doi/10.1002/1097-0142%2819930515%2971:10%3C3119::AID-CNCR2820711037%3E3.0.CO;2-8/abstract link to original article]

Haak HR, Hermans J, van de Velde CJ, Lentjes EG, Goslings BM, Fleuren GJ, Krans HM. Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients. Br J Cancer. 1994 May;69(5):947-51. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968906/ link to original article]

Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, Rossetto R, Buci L, Sperone P, Grossrubatscher E, Reimondo G, Bollito E, Papotti M, Saeger W, Hahner S, Koschker AC, Arvat E, Ambrosi B, Loli P, Lombardi G, Mannelli M, Bruzzi P, Mantero F, Allolio B, Dogliotti L, Berruti A. Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med. 2007 Jun 7;356(23):2372-80. [http://www.nejm.org/doi/full/10.1056/NEJMoa063360 link to original article]

Veytsman I, Nieman L, Fojo T. Management of endocrine manifestations and the use of mitotane as a chemotherapeutic agent for adrenocortical carcinoma. J Clin Oncol. 2009 Sep 20;27(27):4619-29. doi: 10.1200/JCO.2008.17.2775. Epub 2009 Aug 10. link to original article

Wängberg B, Khorram-Manesh A, Jansson S, Nilsson B, Nilsson O, Jakobsson CE, Lindstedt S, Odén A, Ahlman H. The long-term survival in adrenocortical carcinoma with active surgical management and use of monitored mitotane. Endocr Relat Cancer. 2010 Feb 18;17(1):265-72. doi: 10.1677/ERC-09-0190. Print 2010 Mar. link to original article

Adrenocortical Carcinoma

2013-10-30T03:35:05Z

Palmdoc:

Adapted from Hemonc.org

=Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy=

==Mitotane (Lysodren)==
'''There is limited and controversial clinical trial information about adjuvant mitotane use. See the references for additional case series and expert recommendation articles.'''

===Regimen #1, Wängberg et al. 2010===
''Patients started on adjuvant mitotane within 4 weeks of their surgical resection.''
*[[Mitotane (Lysodren)]] 2000 mg PO per day (frequency not specified, such as whether the total daily dose was divided into a few doses throughout the day); within the first 2 to 3 months, [[Mitotane (Lysodren)]] dose was adjusted to achieve a target therapeutic drug level of 14 to 20 mg/L

'''2 to 3-year course'''

===Regimen #2, Haak et al. 1994===

''Haak et al. 1994 concluded that "mitotane treatment in adrenocortical carcinoma is effective only when high
serum levels [trough of at least 14 mg/L] can be achieved."''
*[[Mitotane (Lysodren)]] 1000 to 2000 mg PO QID (total dose per day: 4000 to 8000 mg), with target mitotane trough of above 14 mg/L

'''2-year course "if resection was judged to be complete or for 1 year after apparent disappearance of the tumour"'''

Supportive medications:
*Hydrocortisone (Cortef) 30 to 120 mg per day or Fludrocortisone (Florinef) 0.1 to 0.4 mg per day
*Metoclopramide (Reglan) and Loperamide (Imodium) prn "gastrointestinal side-effects"

===References===
Vassilopoulou-Sellin R, Guinee VF, Klein MJ, Taylor SH, Hess KR, Schultz PN, Samaan NA. Impact of adjuvant mitotane on the clinical course of patients with adrenocortical cancer. Cancer. 1993 May 15;71(10):3119-23. [http://onlinelibrary.wiley.com/doi/10.1002/1097-0142%2819930515%2971:10%3C3119::AID-CNCR2820711037%3E3.0.CO;2-8/abstract link to original article]

Haak HR, Hermans J, van de Velde CJ, Lentjes EG, Goslings BM, Fleuren GJ, Krans HM. Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients. Br J Cancer. 1994 May;69(5):947-51. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968906/ link to original article]

Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, Rossetto R, Buci L, Sperone P, Grossrubatscher E, Reimondo G, Bollito E, Papotti M, Saeger W, Hahner S, Koschker AC, Arvat E, Ambrosi B, Loli P, Lombardi G, Mannelli M, Bruzzi P, Mantero F, Allolio B, Dogliotti L, Berruti A. Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med. 2007 Jun 7;356(23):2372-80. [http://www.nejm.org/doi/full/10.1056/NEJMoa063360 link to original article]

Veytsman I, Nieman L, Fojo T. Management of endocrine manifestations and the use of mitotane as a chemotherapeutic agent for adrenocortical carcinoma. J Clin Oncol. 2009 Sep 20;27(27):4619-29. doi: 10.1200/JCO.2008.17.2775. Epub 2009 Aug 10. link to original article

Wängberg B, Khorram-Manesh A, Jansson S, Nilsson B, Nilsson O, Jakobsson CE, Lindstedt S, Odén A, Ahlman H. The long-term survival in adrenocortical carcinoma with active surgical management and use of monitored mitotane. Endocr Relat Cancer. 2010 Feb 18;17(1):265-72. doi: 10.1677/ERC-09-0190. Print 2010 Mar. link to original article

2013-10-30T03:07:10Z

Palmdoc:

Adrenocortical Carcinoma

2013-10-30T03:01:12Z

Palmdoc:

Adrenocortical Carcinoma

2013-10-30T02:44:54Z

Palmdoc: /* Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy */

Adrenocortical Carcinoma

2013-10-30T02:43:55Z

Palmdoc: /* Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy */

Adrenocortical Carcinoma

2013-10-30T02:41:06Z

Palmdoc: Created page with "=Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy="

=Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy=

OncoWiki:General disclaimer

2013-10-30T02:34:40Z

Palmdoc: Created page with "Information on this website is meant only for Healthcare Practitioners. Use of any information obtained from this website is entirely at the user's discretion. You are advised..."

Information on this website is meant only for Healthcare Practitioners. Use of any information obtained from this website is entirely at the user's discretion. You are advised to check the accuracy of any information yourself before using it in any way or in any clinical situation. The authors of OncoWiki do not warrant, represent or guarantee that the information contained herein is free from errors or omission. The authors of any section in Onco Wiki are not responsible for any consequences as a result of use of information from this website. Onco Wiki is not a substitute for up-to-date personal knowledge and good clinical judgment.

OncoWiki:About

2013-10-30T02:34:06Z

Palmdoc: Created page with "This site will serve as a free repository for oncology information, chemotherapy protocols and cancer treatment regimens and is meant for Healthcare providers working in the f..."

This site will serve as a free repository for oncology information, chemotherapy protocols and cancer treatment regimens and is meant for Healthcare providers working in the field of Oncology.

Main Page

2013-10-26T09:46:33Z

Palmdoc:

== Welcome to Onco Wiki ==

This site will serve as a free repository for oncology information, chemotherapy protocols and cancer treatment regimens and is meant for Healthcare providers working in the field of Oncology.

== Sections ==

[[Cytotoxic Regimens|Treatment Regimens]]

[[Cancer treatment information]]

== Guidelines ==
[[Guidelines on using this site]]

[[Guidelines for contributors]]

== Editors ==

Site editors are volunteers who help supervise the content of Oncowiki.
If you wish to be a volunteer, or wish to see a protocol included in the wiki please [mailto:[email protected] email me].

Current editors:

Alan Teh MBBS FRCP

== Disclaimer & Terms of Use ==

Information on this website is meant only for Healthcare Practitioners.
Use of any information obtained from this website is entirely at the user's discretion. You are advised to check the accuracy of any information yourself before using it in any way or in any clinical situation. The authors of OncoWiki do not warrant, represent or guarantee that the information contained herein is free from errors or omission. The authors of any section in Onco Wiki are not responsible for any consequences as a result of use of information from this website. Onco Wiki is not a substitute for up-to-date personal knowledge and good clinical judgment.

EPOCH-DA

2013-08-29T07:28:33Z

Palmdoc: /* References */

== Regimen ==
R-EPOCH-DA: Dose Adjusted EPOCH
Regimen, Dunleavy, et al. 2013
Rituximab 375 mg/m2 IV over 3 hours once on day 1
Etoposide 50 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 200 mg/m2)
Prednisolone 60 mg/m2 PO BID on days 1 to 5
Vincristine 0.4 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 1.6 mg/m2)
Doxorubicin 10 mg/m2/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 40 mg/m2)
Cyclophosphamide 750 mg/m2 IV over 2 hours once on day 5

21-day cycles x 6 to 8 cycles

=== Supportive medications ===

Filgrastim (Neupogen) 300 mcg sc once per day, starting on day 6 and continuing until ANC > 5,000/uL past nadir

Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg (or equivalent if allergic) PO once per day on 3 days per week

=== Dose adjustments===
Start cycle 1 as described above.

Obtain CBCs twice per week for nadir measurements.

If nadir ANC >500, increase etoposide, doxorubicin, and cyclophosphamide by one level (20%) compared to previous cycle.

If nadir ANC <500, use same doses as last cycle.

If nadir platelet count <25,000, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to the previous cycle.

== References ==
Wilson WH, Dunleavy K, Pittaluga S, Hegde U, Grant N, Steinberg SM, Raffeld M, Gutierrez M, Chabner BA, Staudt L, Jaffe ES, Janik JE. Phase II study of dose-adjusted EPOCH and rituximab in untreated diffuse large B-cell lymphoma with analysis of germinal center and post-germinal center biomarkers. J Clin Oncol. 2008 Jun 1;26(16):2717-24. [http://jco.ascopubs.org/content/26/16/2717.long link]

Dunleavy K, Pittaluga S, Maeda LS, Advani R, Chen CC, Hessler J, Steinberg SM, Grant C, Wright G, Varma G, Staudt LM, Jaffe ES, Wilson WH. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013 Apr 11;368(15):1408-16. doi: 10.1056/NEJMoa1214561. [http://www.nejm.org/doi/full/10.1056/NEJMoa1214561 link]

EPOCH-DA

2013-08-29T07:21:21Z

2013-08-29T07:04:22Z

Palmdoc: /* Regimen */