Combination Regimens
Cisplatin + Radiation Therapy
Radiation therapy: | 1.8 to 2 Gy per fraction (total dose, 45 Gy) |
Cisplatin: | 40 mg/m2 IV weekly (maximal dose, 70 mg per week) |
Cisplatin is given 4 hours before radiation therapy on weeks 1-6 [197]. |
Paclitaxel + Cisplatin
Paclitaxel: | 135 mg/m2 IV over 24 hours on day 1 |
Cisplatin: | 75 mg/m2 IV on day 2 |
Repeat cycle every 21 days [198]. |
Cisplatin + Topotecan
Cisplatin: | 50 mg/m2 IV on day 1 |
Topotecan: | 0.75 mg/m2/day IV on days 1-3 |
Repeat cycle every 21 days [199]. |
Paclitaxel + Topotecan
Paclitaxel: | 175 mg/m2 IV on day 1 |
Topotecan: | 0.75 mg/m2 IV on days 1-3 |
Repeat cycle every 21 days [200]. |
Paclitaxel + Topotecan + Bevacizumab
Paclitaxel: | 175 mg/m2 IV on day 1 |
Topotecan: | 0.75 mg/m2/day IV on days 1-3 |
Bevacizumab: | 15 mg/kg IV on day 1 |
Repeat cycle every 21 days [200]. |
Cisplatin + Paclitaxel + Bevacizumab
Cisplatin: | 50 mg/m2 IV on day 1 |
Paclitaxel: | 135 or 175 mg/m2 IV on day 1 |
Bevacizumab: | 15 mg/kg IV on day 1 |
Repeat cycle every 21 days [201]. |
BIP
Bleomycin: | 30 U IV over 24 hours on day 1 |
Ifosfamide: | 5,000 mg/m2 IV over 24 hours on day 2 |
6,000 mg/m2 IV over 36 hours on day 2 | |
Cisplatin: | 50 mg/m2 IV on day 2 |
Repeat cycle every 21 days [202]. |
BIC
Bleomycin: | 30 U IV on day 1 |
Ifosfamide: | 2,000 mg/m2 IV on days 1-3 |
Mesna: | 400 mg/m2 IV, 15 minutes before ifosfamide dose, then 400 mg/m2 IV at 4 and 8 hours following ifosfamide |
Carboplatin: | 200 mg/m2 IV on day 1 |
Repeat cycle every 21 days [203]. |
Cisplatin + 5-Fluorouracil
Cisplatin: | 75 mg/m2 IV on day 1 |
5-Fluorouracil: | 1,000 mg/m2/day IV continuous infusion on days 2-5 |
Repeat cycle every 21 days [204]. |
Cisplatin + Vinorelbine
Cisplatin: | 80 mg/m2 IV on day 1 |
Vinorelbine: | 25 mg/m2 IV on days 1 and 8 |
Repeat cycle every 21 days [205]. |
Cisplatin + Irinotecan
Cisplatin: | 60 mg/m2 IV on day 1 |
Irinotecan: | 60 mg/m2 IV on days 1, 8, and 15 |
Repeat cycle every 28 days [206]. |
Cisplatin + Gemcitabine
Carboplatin + Docetaxel
Carboplatin: | AUC of 6, IV on day 1 |
Docetaxel: | 60 mg/m2 IV on day 1 |
Repeat cycle every 21 days [209]. |
Cisplatin + Pemetrexed
Cisplatin: | 50 mg/m2 IV on day 1 |
Pemetrexed: | 500 mg/m2 IV on day 1 |
Repeat cycle every 21 days [210]. Folic acid at 350-1,000 μg PO q day and vitamin B12 at 1,000 μg IM to start 1 week prior to first dose of pemetrexed and repeated every 3 cycles. |
Pembrolizumab + Paclitaxel + Cisplatin/Carboplatin + Bevacizumab
Pembrolizumab: | 200 mg IV on day 1 |
Paclitaxel: | 175 mg/m2 IV on day 1 |
Cisplatin: | 50 mg/m2 IV on day 1 |
or | |
Carboplatin: | AUC of 5 IV on day 1 |
Bevacizumab: | 15 mg/kg IV on day 1 |
Repeat cycle every 21 days for 6 cycles and/or for 2 cycles beyond complete response [211]. |
Single-Agent Regimens
Docetaxel
Docetaxel: | 100 mg/m2 IV on day 1 |
Repeat cycle every 21 days [212]. |
Paclitaxel
Paclitaxel: | 175 mg/m2 IV over 3 hours on day 1 |
Repeat cycle every 21 days [213]. |
Irinotecan
Irinotecan: | 125 mg/m2 IV weekly for 4 weeks |
Repeat cycle every 6 weeks [214]. |
Topotecan
Topotecan: | 1.5 mg/m2/day on days 1-5 |
Repeat cycle every 21 days [215]. |
Pemetrexed
Pemetrexed: | 500 mg/m2 IV on day 1 |
Repeat cycle every 21 days [216]. Folic acid at 350-1,000 μg PO q day and vitamin B12 at 1,000 μg IM to start 1 week prior to first dose of therapy and repeated every 3 cycles. |
Gemcitabine: | 800 mg/m2 IV on days 1, 8, and 15 |
Repeat cycle every 28 days [217]. |
Tisotumab vedotin
Tisotumab vedotin: | 2 mg/kg (up to a maximum of 200 mg) IV on day 1 |
Repeat cycle every 21 days [218]. |
Pembrolizumab
Pembrolizumab: | 200 mg IV on day 1 |
Repeat cycle every 3 weeks [219]. May also administer 400 mg IV every 6 weeks. |