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Information

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

Mesna:

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

Cisplatin:

50 mg/m2 IV on day 1

Gemcitabine:

1,000 mg/m2 IV on days 1 and 8

Repeat cycle every 21 days for up to 6 cycles [207].

or

Cisplatin:

30 mg/m2 IV on day 1

Gemcitabine:

800 mg/m2 IV on days 1 and 8

Repeat cycle every 28 days [208].

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

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.