GASTROINTESTINAL :    LIVER (HEPATOCELLULAR) CANCER

Regimen/Number

Of Patients

Drug Dose and Route

Leukopenia/

Neutropenia

Toxicity

Anemia

Toxicity

Other

Grade III-IV Toxicities

Emetogenic

Potential

Consequences of

Adverse Event(s)

Cisplatin

5-Fluorouracil

interferon alfa-2b

Doxorubicin

(Leung TWT, et al.

Clin Cancer Res.

1999;5:1676–81)

N = 50

Cisplatin 20 mg/m²/d IV

Over 1 hour days 1–4

5-Fluorouracil 400 mg/m²/d IV days 1–4

interferon alfa-2b 5 MU/ mg/m²/d SQ days 1–4

Doxorubicin 40 mg/m² IV day 1

Repeat cycle every 21 days

Appropriate premedications listed in section 2.

Commonly Used Premedication Regimens

WHO Toxicity =≥ 3 Leukopenia

WHO Toxicity ≥3:

Hemoglobin 12%

WHO Toxicity ≥3:

Thrombocytopenia 22%

Renal 2%

Nausea/vomiting 12%

Drug-Related Fever 2%

Diarrhea 8%

Alopecia 18%

Mucositis 4%

Days 1–4—

level 5

Gemcitabine

(Yang TS,et al. Cancer.

2000;89:750-56

N = 28

Gemcitabine 1250 mg/m² IV

over 30 minutes days 1, 8, 15

Repeat cycle every 28 days

Leukopenia

Grade III

10.7%

Grade III 14.3%

Infection (Grade III ) 3.6%

Thrombocytopenia 10.7%

Hepatotoxicity

(Grade III) 14.3%

Skin Rash (Grade  III) 3.6%

Days 1, 8, 15

―level 2

Hospitalization for

febrile neutropenia

in 3.6% of patients

Dose reduction or

omission occurred

in 50% of patients

No drug-related

discontinuations

or toxic deaths

Most patients had to

omit a dose due to

hematologic toxicity

on day 15