E–N
Epirubicin
Use: Breast cancer
Dosage: 100 mg/m2 IV on D 1 or 60 mg/m2 IV on D 1 and 8 in combination therapy
Toxicities: Bone marrow depression, cardiotoxicity, stomatitis, alopecia
Eribulin mesylate
Use: Breast cancer (relapse)
Dosage: 1.4 mg/m2 on D 1 and 8 every 21 days
Toxicities: Neutropenia, anemia, asthenia/fatigue, alopecia, peripheral neuropathy, nausea, constipation
Erlotinib
Use: NSCLC, pancreas
Dosage: 150 mg/d PO; 100 mg/d PO (pancreatic cancer)
Toxicities: Acneiform skin rash, diarrhea, anorexia, fatigue, dyspnea
Estramustine
Use: Prostate, renal cell carcinomas
Dosage: 14 mg/kg/d PO in 3–4 equally divided doses; 300 mg/d IV for 3–4 wk, followed by 300–450 mg/wk IV over 3–8 wk
Toxicities: Bone marrow depression, ischemic heart disease, thromboembolism, thrombophlebitis, gynecomastia, nausea and vomiting, hepatotoxicity
Etoposide
Use: Testicular cancer (refractory) SCLC, HL, NHL, AML, gestational trophoblastic tumors (For both indications, given with combination therapy and repeated every 3–4 wk)
Dosage: Testicular: 50–100 mg/m2/d IV for 5 d or 100 mg/m2/d IV on Days 1, 3, and 5
Lung: 35–50 mg/m2/d IV for 5 d or 100 mg/m2/d PO for 5 d
Toxicities: Bone marrow depression, nausea and vomiting, diarrhea, fever, hypotension with rapid infusion, alopecia, rash, AML (late effect)
Everolimus
Use: Renal cell carcinoma (progression to TKI), pancreatic neuroendocrine tumors (PNET), subependymal giant cell astrocytoma (SEGA)
Dosage: 10 mg/d PO
SEGA: initial dose based on body surface area with subsequent titration to attain trough concentrations of 5–10 ng/mL
Toxicities: Stomatitis, infections, asthenia, diarrhea, pneumonitis, dyslipidemia, hyperglycemia, elevated serum creatinine
Floxuridine
Use: GI adenocarcinomas metastatic to liver, including oral, pancreatic, biliary, colon, and hepatic cancers, and metastatic breast cancer
Dosage: 0.1–0.6 mg/kg/d over several days via continuous arterial infusion supplying well-defined tumor; treatments given over 1–6 wk
Toxicities: Stomatitis and GI ulcers, bone marrow depression, abdominal pain, nausea and vomiting, diarrhea, liver dysfunction (transient)
Fludarabine
Use: CLL, AML, NHL (low-grade)
Dosage: 25 mg/m2/d IV over 30 min for 5 d; repeat every 28 d
Toxicities: Bone marrow depression, nausea and vomiting, fever, malaise, pulmonary infiltrates, tumor lysis syndrome, CNS effects (high dose)
Fluorouracil
Use: Colon, rectal, stomach, pancreatic, breast, head and neck, renal cell, prostate, and ovarian cancers, squamous cell carcinomas of esophagus, basal and squamous cell carcinoma of skin (topical), hepatic cancer (intra-arterial)
Dosage: Loading dose: 300–500 mg/m2; or 12 mg/kg IV daily for 3–5 d, followed by weekly maintenance
Maintenance: 10–15 mg/kg IV weekly, as toxicity permits Infusion: 20–25 mg/kg by continuous IV over 24 h for 4–5 d, every 4 wk
Toxicities: Stomatitis and GI ulcers (infusion), bone marrow depression (bolus), diarrhea, nausea and vomiting, esophagitis, angina, cerebellar ataxia, radiosensitizer
Gefitinib
Use: NSCLC
Dosage: 250 mg/d PO
Toxicities: Acneiform skin rash, diarrhea, transaminitis, asthenia, nausea/vomiting, interstitial lung disease
Gemcitabine
Use: Pancreatic, lung, breast, ovarian, and bladder cancers
Dosage: 1,000 mg/m2 IV over 30 min, once weekly for up to 7 wk (or until toxicity necessitates reducing or withholding a dose), followed by 1 wk of rest Subsequent cycles: Infusions once weekly for 3 consecutive wk out of every 4 wk
Toxicities: Bone marrow depression, transient fever, flu-like syndrome, skin rash, mild nausea and vomiting
Gliadel wafers
Use: Glioblastoma multiforme
Dosage: Up to 8 in brain cavity created by tumor removal
Toxicities: Fever, pain, and abnormal healing
Hydroxyurea
Use: CML, acute leukemia (emergent treatment), head and neck cancer, ovarian cancer, melanoma, essential thrombocytosis, polycythemia vera
Dosage: Intermittent: 80 mg/kg PO every third day Continuous: 20–30 mg/kg PO daily
Toxicities: Bone marrow depression, mild nausea and vomiting, skin rashes, radiosensitizer
Ibritumomab
Use: CD20+ low grade follicular B-cell NHL (relapse)
Dosage: Dosimetric step: Rituximab(Drug information on rituximab) 250 mg/m2 IV; 5 mCi In-111 Ibritumomab on D 1 Therapeutic step: D 7, 8, or 9 rituximab 250 mg/m2 IV; 0.4–0.3 mCi/kg Y-90 ibritumomab
Toxicities: Myelosuppression, infection, GI symptoms, myelodysplastic syndromes (MDS)/AML
Idarubicin
Use: AML, CML (blast phase), ALL
Dosage: 12 mg/m2/d IV for 3 d every 3 wk in combination therapy
Toxicities: Bone marrow depression, nausea and vomiting, stomatitis, alopecia, cardiotoxicity
Ifosfamide
Use: Germ-cell testicular cancer, sarcoma, NHL, lung cancer
Dosage: 1.2 g/m2/d via slow IV infusion for 5 consecutive days; repeat every 3 wk; give with mesna(Drug information on mesna)
Toxicities: Bone marrow depression, hemorrhagic cystitis, confusion, somnolence
Imatinib
Use: CML, gastrointestinal stromal tumor (GIST), Ph+ ALL, dermatofibrosarcoma protuberans, mastocytosis, MDS/MPD
Dosage: 400 mg/d PO in chronic-phase CML and GIST and 600 mg/d PO for CML in accelerated phase or blast crisis/800 mg/d PO (DFSP)
Toxicities: Nausea and vomiting, edema and fluid retention, myalgias, diarrhea, myelosuppression, transaminitis
Ipilimumab
Use: Melanoma
Dosage: 3 mg/kg IV over 90 minutes every 3 weeks for a total of 4 doses
Toxicities: Fatigue, immune-mediated adverse reactions (diarrhea/colitis, pruritus, rash, hepatitis/elevated liver function tests, hypopituitarism, hypo-/hyperthyroidism, uveitis, pneumonitis, nephritis, pancreatitis, aseptic meningitis, neuromuscular disorders)
Irinotecan
Use: Colorectal cancer, lung, ovarian, and cervical cancers
Dosage: 125 mg/m2 IV over 90 min once weekly for 4 wk; then 2 wk rest or 350 mg/m2 every 21 d or 180 mg/m2 every 2 wk
Toxicities: Bone marrow depression, diarrhea, nausea and vomiting, anorexia, weight loss
Ixabepilone
Use: Breast cancer (relapse)
Dosage: 40 mg/m2 IV over 3 hours every 3 weeks
Toxicities: Myelosuppression, peripheral sensory neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, vomiting, stomatitis/mucositis, diarrhea, musculoskeletal pain, abdominal pain, palmar-plantar erythrodysesthesia syndrome, hypersensitivity reaction
Lapatinib
Use: HER2-positive metastatic breast cancer, or in combination with letrozole(Drug information on letrozole) for postmenopausal women with hormone receptor-positive breast cancer for whom hormonal therapy is indicated
Dosage: 1,250 mg PO qd × 21 d in combination with capecitabine(Drug information on capecitabine) 2,000 mg/m2/d PO (divided doses) on D 1–14 of a repeating 21-d cycle
Toxicities: Diarrhea, hand-foot syndrome, nausea, rash, vomiting, fatigue, LVEF decrease, pneumonitis, QT prolongation
Lenalidomide
Use: Multiple myeloma (relapse)
Dosage: 10 mg/d PO
Toxicities: Birth defects, neutropenia and thrombocytopenia, thrombosis
Lomustine
Use: Brain tumors, HL, GI carcinomas, NSCLC
Dosage: 130 mg/m2 PO every 6 wk; adjust dose in combination chemotherapy
Toxicities: Delayed bone marrow depression, nausea and vomiting, reversible hepatotoxicity, pulmonary and renal damage, neurologic reactions, leukemia
Mechlorethamine
Use: HL, NHL, CML, CLL, mycosis fungoides, bronchogenic carcinoma, lymphosarcoma, polycythemia vera, malignant effusions (intracavitary)
Dosage: 0.4 mg/kg ideal body weight given as single dose or in divided doses of 0.1–0.2 mg/kg/d
Toxicities: Bone marrow depression, nausea and vomiting, local phlebitis, severe skin necrosis if extravasated, gonadal dysfunction
Melphalan
Use: Multiple myeloma, breast and ovarian cancers, sarcoma, testicular and lung cancers
Dosage: Continuous therapy: 6 mg PO daily for 2–3 wk, no therapy for 2–4 wk, then maintenance with 2–4 mg PO daily Pulse: 10 mg/m2 PO daily for 4 d every 4–6 wk
Toxicities: Bone marrow depression, anorexia, nausea and vomiting, gonadal testicular dysfunction, leukemia
Mercaptopurine
Use: ALL, CML, AML
Dosage: 1.5–2.5 mg/kg/d PO (100– 200 mg in average adult) until response or toxic effects are seen; may increase dose to 5 mg/kg/d; adjust for maintenance dose; reduce dose by 50%–75% if given with allopurinol(Drug information on allopurinol) or if renal or hepatic insufficiency ensues
Toxicities: Bone marrow depression, nausea and vomiting, anorexia, diarrhea, cholestasis
Methotrexate
Use: Breast, head and neck, GI, and lung cancers, ALL, CNS leukemia (intrathecal), gestational trophoblastic tumors, NHL (advanced stage), Burkitt lymphoma, osteosarcoma, mycosis fungoides
Dosage: Numerous dosing schedules with combination therapy.
Low dose: 2.5–5.0 mg PO daily; or 5–25 mg/m2 PO, IM, IV twice weekly; or 50 mg/m2 IV every 2–3 wk
High dose: 1–12 g/m2 IV with leucovorin rescue every 1–3 wk Intrathecal: 5–10 mg/m2 (up to 15 mg) every 3–7 d
Toxicities: Mucositis, GI ulceration (may produce hemorrhage or perforation), bone marrow depression, pulmonary fibrosis (previously irradiated area), nerve root irritation and convulsion (intrathecal), liver cirrhosis and osteoporosis (chronic therapy), renal damage (high dose), diarrhea, skin erythema
Mitomycin
Use: Gastric, colorectal, anal cancer, pancreatic adenocarcinomas, NSCLC, breast, uterine, cervical, and head and neck cancers
Dosage: 20 mg/m2 IV every 6–8 wk as a single agent or 5–10 mg/m2 IV every 6 wk in combination therapy
Toxicities: Bone marrow depression (cumulative), nausea and vomiting, anorexia, alopecia, stomatitis, fever, pulmonary fibrosis
Mitoxantrone
Use: AML, prostate, ALL, CML, breast and ovarian cancers
Dosage: Remission induction: 12 mg/m2/d IV for 3 d, in combination with Ara-C
Toxicities: Bone marrow depression, cardiotoxicity, alopecia, stomatitis, nausea and vomiting, blue urine and sclera
Nilotinib
Use: CML
Dosage: Newly diagnosed CML-chronic phase: 300 mg PO twice daily. Resistant or intolerant CML-chronic phase or accelerated phase: 400 mg PO twice daily
Toxicities: Myelosuppression, hyperbilirubinemia, rash, pruritus, nausea, headache, fatigue, constipation, elevated lipase, QTc prolongation
