O–Z
Ofatumumab
Use: CLL refractory to fludarabine and alemtuzumab(Drug information on alemtuzumab)
Dosage: 12 doses administered as follows: 300 mg initial dose, followed 1 wk later by 2,000 mg weekly for 7 doses, followed 4 wk later by 2,000 mg every 4 wk for 4 doses. Premedicate with acetaminophen PO, antihistamine PO or IV, and corticosteroids IV.
Toxicities: Neutropenia, infection, infusion reaction, fatigue, rash
Oxaliplatin
Use: Colorectal, ovarian cancers
Dosage: 85 mg/m2 oxaliplatin and 200 mg/m2 leucovorin (lv) IV infusion over 120 min on D 1 followed by 400 mg/m2 fluorouracil(Drug information on fluorouracil) (5-FU) IV bolus, then 600 mg/m2 5-FU by IV infusion over 22 h. On D 2, 200 mg/m2 IV over 120 min IV, followed by 400 mg/m2 5-FU IV bolus, 600 mg/m2 5-FU IV infusion over 22 h. Repeat every 2 wk
Toxicities: Bone marrow depression, diarrhea, nausea and vomiting, neuropathies exacerbated by cold exposure, pharyngolaryngeal dysesthesia, pulmonary toxicity
Paclitaxel
Use: Ovarian cancer (relapsed), NSCLC (in combination with cisplatin(Drug information on cisplatin)), Kaposi sarcoma, breast cancer, head and neck, gastric, colon, esophagus, uterine, prostate, bladder cancers, and melanomas
Dosage: 135–175 mg/m2 by IV infusion (ranging from 3–96 h) every 3 wk or 80 mg/m2 IV every wk
Toxicities: Bone marrow depression, peripheral neuropathy, alopecia, mucositis, anaphylaxis, dyspnea, myalgias
Panitumumab
Use: KRAS wild type colorectal cancer
Dosage: 6 mg/kg IV over 60 min every 14 d
Toxicities: Skin rash, hypomagnesemia, paronychia, fatigue, infusion reactions, nausea/vomiting, diarrhea
Pazopanib
Use: Renal cell cancer
Dosage: 800 mg PO once daily, without food
Toxicities: Diarrhea, hypertension, hair color change, nausea/vomiting, fatigue, anorexia
Peginterferon alfa-2b
Use: Melanoma
Dosage: 6 mcg/kg/wk SC for 8 doses followed by 3 mcg/kg/wk SC for up to 5 years
Toxicities: Fatigue, depression, anorexia, increased ALT/AST, myalgia, chills, nausea, headache, pyrexia, injection site reaction
Pemetrexed
Use: Mesothelioma, NSCLC
Dosage: 500 mg/m2 IV over 10 min every 21 d. Premedication needed with corticosteroid and vitamin supplementation
Toxicities: Bone marrow depression, stomatitis/pharyngitis, rash/skin desquamation, diarrhea
Pentostatin
Use: Hairy-cell leukemia, ALL, CLL, lymphoblastic lymphoma, mycosis fungoides
Dosage: 4 mg/m2 IV over 30 min every other wk or for 3 consecutive wk; give vigorous hydration before and after chemotherapy
Toxicities: Nephrotoxicity, CNS depression, bone marrow depression, nausea and vomiting, conjunctivitis
Pralatrexate
Use: Relapsed and refractory T-cell lymphoma
Dosage: 30 mg/m2 administered as an IV push over 3 to 5 min once weekly in 7-wk cycles. Supplement with Vitamin B-12, 1 mg IM every 8–10 wk and folic acid(Drug information on folic acid) 1–1.25 mg PO daily
Toxicities: Mucositis, thrombocytopenia, nausea, fatigue, febrile neutropenia
Procarbazine
Use: HL, NHL, brain tumors, lung cancer
Dosage: Single agent: 4–6 mg/kg/d PO until maximum response
HL (mechlorethamine, Oncovin, procarbazine(Drug information on procarbazine), and prednisone(Drug information on prednisone) [MOPP]): 100 mg/m2/d PO for 14 d
Toxicities: Bone marrow depression, nausea and vomiting, lethargy, depression, paresthesias, headache, flu-like symptoms
Rituximab
Use: CD20-positive B-cell NHL, CLL
Dosage: 375 mg/m2 IV infusion (50–100 mg/h) once weekly in combination with fludarabine and cyclophosphamide(Drug information on cyclophosphamide). Rituxamab 375 mg/m2 (first cycle) and 500 mg/m2 in cycles 2–6
Toxicities: Infusion reactions, asthenia, headache, skin rash/pruritus, leukopenia/infection, nausea, tumor lysis syndrome, hepatitis B reactivation, PML
Romidepsin
Use: Cutaneous T-cell lymphoma refractory to 1 prior systemic therapy
Dosage: 14 mg/m2 IV over 4 h on D 1, 8, 15 of a 28-d cycle
Toxicities: Myelosuppression, QT prolongation (make sure magnesium and potassium are normal prior to administration), nausea, fatigue
Ruxolitinib
Use: Myelofibrosis
Dosage: Starting dose 15–20 mg orally twice daily
Toxicities: Thrombocytopenia, anemia, bruising, dizziness, headache
Sipuleucel-T
Use: Asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone-refractory) prostate cancer
Dosage: Administer 3 doses at approximately 2-wk intervals. Premedicate patients with acetaminophen and antihistamine. Infuse sipuleucel-T IV over a period of 60 min. Each dose contains a minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF (prostatic acid phosphatase granulocyte-macrophage colony stimulating factor) suspended in 250 mL of lactated Ringer’s injection.
Toxicities: Chills, fever, back pain, nausea, joint ache, headache
Sorafenib
Use: Renal cell cancer, hepatocellular carcinoma
Dosage: 400 mg bid PO
Toxicities: Diarrhea, nausea, stomatitis, asthenia, cardiac ischemia, hand-foot syndrome, hypertension, bleeding, anorexia
Streptozocin
Use: Pancreatic islet-cell, carcinoid, colon, hepatoma, NSCLC, HL
Dosage: Daily: 500 mg/m2 IV for 5 d every 6 wk until maximum benefit or toxicity
Weekly: 1,000 mg/m2 IV weekly for first 2 wk, then escalate dose to response or toxicity, not to exceed a single dose of 1,500 mg/m²
Toxicities: Renal damage, nausea and vomiting, diarrhea, altered glucose metabolism, liver dysfunction
Sunitinib
Use: Renal cell cancer, GIST, PNET
Dosage: 50 mg/d PO for 4 wk, then 2-wk rest period
PNET: 37.5 mg PO qd continuously
Toxicities: Diarrhea, nausea, stomatitis, asthenia, skin discoloration, hand-foot syndrome, hypertension, bleeding, anorexia, hepatotoxicity, cardiac toxicity, thyroid dysfunction
Temozolomide
Use: Glioblastoma, anaplastic astrocytoma (relapsed), renal cell cancer, melanoma
Dosage: 150–200 mg/m2/d PO for 5 d every 28 d; 75 mg/m2 PO/d concomitant with radiotherapy
Toxicities: Bone marrow depression, nausea and vomiting
Temsirolimus
Use: Renal cell cancer
Dosage: 25 mg IV weekly over 30–60 min
Toxicities: Rash, asthenia, mucositis, edema, dyslipidemia, hyperglycemia, elevated serum creatinine. Rarely, interstitial lung disease
Teniposide
Use: Relapsed ALL in children, SCLC
Dosage: ALL: 100 mg/m2 once or twice wk or 20–60 mg/m2/d for 5 d in combination with Ara-C
Lung: 80–90 mg/m2/d for 5 d as a single agent
Toxicities: Bone marrow depression, nausea and vomiting, alopecia, hypotension with rapid infusion, increased liver enzymes, AML (late effect)
Thalidomide
Use: Multiple myeloma
Dosage: 200 mg/d PO
Toxicities: Birth defects, thrombotic events, somnolence, peripheral neuropathy, neutropenia
Thioguanine
Use: AML, ALL, CML, advanced colorectal cancer, multiple myeloma
Dosage: 2 mg/kg/d PO until response or toxic effects are seen; may cautiously increase to 3 mg/kg/d
Toxicities: Bone marrow depression, liver damage, stomatitis
Thiotepa
Use: Ovarian, breast, and superficial bladder cancers, HL, CML, CLL, bronchogenic carcinoma, malignant effusions (intracavitary), BMT for refractory leukemia, lymphomas
Dosage: IV: 0.3–0.4 mg/kg by rapid IV infusion
Intravesical: 60 mg/60 mL sterile water instilled and retained in bladder for 2 h; repeat weekly for 4 wk
Intracavitary: 0.6–0.8 mg/kg
Toxicities: Bone marrow depression, nausea and vomiting, mucositis, skin rashes
Topotecan
Use: Cervical cancer, ovarian cancer (relapsed), SCLC (relapsed), MDS, chronic myelomacrocytic leukemia
Dosage: 1.5 mg/m2 IV over 30 min for 5 consecutive days at 21-d intervals or 2.3 mg/m2/d PO for 5 consecutive days every 21 d
Toxicities: Bone marrow depression, fever, flu-like symptoms, nausea and vomiting
Tositumomab
Use: CD20+ low-grade follicular or transformed NHL (relapse)
Dosage: Dosimetric step: D 1: tositumomab 450 mg IV over 60 min; I-131 tositumomab (5 mCi and 35 mg tositumomab) IV over 20 min
Therapeutic step: D 7–14: tositumomab; 450 mg IV over 60 min; I-131 tositumomab calculated
Toxicities: Myelosuppression, hypothyroidism, second malignancies
Trastuzumab
Use: HER2-overexpressing breast cancer, HER2-overexpressing gastric cancer
Dosage: 4 mg/kg IV over 90 min, loading dose, and 2 mg/kg IV over 30 min every 7 d, as maintenance or 8 mg/kg loading dose and 6 mg/kg every 21 d as maintenance
Toxicities: Cardiac failure, infusion reaction, diarrhea
Valrubicin
Use: Bladder
Dosage: 800 mg intravesically once a wk for 6 wk
Toxicities: Local bladder symptoms
Vandetanib
Use: Medullary thyroid cancer
Dosage: 300 mg PO qd
Toxicities: Prolonged QT interval, torsades de pointes, sudden death, diarrhea, rash, acne, nausea, hypertension, headache, fatigue, decreased appetite and abdominal pain, decreased calcium, increased ALT, decreased glucose
Vemurafenib
Use: Melanoma with a BRAF V600E mutation
Dosage: 960 mg, orally twice daily, administered approximately 12 h apart, with or without a meal
Toxicities: Arthralgia, rash, alopecia, fatigue, photosensitivity reaction, and nausea, squamous cell carcinomas of the skin and keratoacanthomas, hypersensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, uveitis, QT prolongation, liver enzyme laboratory abnormalities
Vinblastine
Use: HL, NHL, gestational trophoblastic tumors, testicular and breast cancers, mycosis fungoides, Kaposi sarcoma, histiocytosis X, bladder and renal cancers, NSCLC, CML (blast crisis)
Dosage: 4–12 mg/m2 IV as a single agent every 1–2 wk; titrate dose to myelosuppression; adjust for hepatic insufficiency
Toxicities: Bone marrow depression, nausea and vomiting, ileus, alopecia, stomatitis, myalgias, vesication
Vincristine
Use: ALL, HL, NHL, rhabdomyosarcoma, neuroblastoma, Wilms’ tumor, multiple myeloma, sarcomas, breast cancer
Dosage: 0.4–1.4 mg/m2 IV weekly; maximum total dose, 2 mg/wk; reduce dose for hepatic insufficiency
Toxicities: Peripheral neuropathy, ileus, abdominal pain, SIADH, bone marrow depression (mild)
Vinorelbine
Use: NSCLC, breast, ovarian, head and neck cancers, HL
Dosage: 30 mg/m2 IV over 10 min; repeat weekly
Toxicities: Peripheral neuropathy, bone marrow depression, nausea, vomiting, hepatic dysfunction
