AC |
Doxorubicin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) Vesicant(99. How C, Brown J. Extravasation of cytotoxic chemotherapy from peripheral veins. Eur J Oncol Nurs. 1998;2(1):51-8.)
|
Cyclophosphamide CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Cyclophosphamide is a prodrug catalyzed directly by cytochrome P450, mainly through CYP2B6.(1111. Chang TK, Weber GF, Crespi CL, Waxman DJ. Differential Activation of Cyclophosphamide and ifosphamide by cytochromes p-450 2b and 3a in human liver microsomes. Cancer Res. 1993;53(23):5629-37.) Doxorubicin is a (moderate) inhibitor of the same enzyme.(1212. Bachmann KA, Lewis JD, Fuller MA, Bonfiglio MF. Interações medicamentosas: o novo padrão de interações medicamentosas e fitoterápicas. Um guia completo dos substratos, indutores e inibidores de enzimas do citocromo P450. 2a ed. Barueri (SP): Manole; 2006.) To avoid delayed plasma clearance of doxorubicin due to cyclophosphamide metabolism, it is recommended to infuse doxorubicin before cyclophosphamide.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.)
|
CAF |
Doxorubicin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) Vesicant(99. How C, Brown J. Extravasation of cytotoxic chemotherapy from peripheral veins. Eur J Oncol Nurs. 1998;2(1):51-8.)
|
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Cyclophosphamide CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Fluorouracil acts in specific cell cycle phases, while doxorubicin and cyclophosphamide are CCNS.(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) However, doxorubicin has a high tissue vesicant potential, which reinforces the importance of it being administered first.(99. How C, Brown J. Extravasation of cytotoxic chemotherapy from peripheral veins. Eur J Oncol Nurs. 1998;2(1):51-8.) Cyclophosphamide is a prodrug catalyzed directly by cytochrome P450, especially through CYP2B6.(1111. Chang TK, Weber GF, Crespi CL, Waxman DJ. Differential Activation of Cyclophosphamide and ifosphamide by cytochromes p-450 2b and 3a in human liver microsomes. Cancer Res. 1993;53(23):5629-37.) Doxorubicin is a (moderate) inhibitor of the same enzyme.(1212. Bachmann KA, Lewis JD, Fuller MA, Bonfiglio MF. Interações medicamentosas: o novo padrão de interações medicamentosas e fitoterápicas. Um guia completo dos substratos, indutores e inibidores de enzimas do citocromo P450. 2a ed. Barueri (SP): Manole; 2006.) To avoid delayed plasma clearance of doxorubicin due to cyclophosphamide metabolism, it is recommended to infuse doxorubicin before cyclophosphamide.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) Regarding fluorouracil and cyclophosphamide, it has been observed that fluorouracil sensitizes the DNA so it can be attacked by alkylating agents.(1313. Santelli G, Valeriote F, Vietti T, Coultert D. Cytotoxic effect of 5-fluorouracil plus cyclophosphamide against transplantable leukemias. Eur J Cancer. 1981; 17(6):629-34.)
|
Cisplatin + Gemcitabine |
Gemcitabine CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Cisplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Gemcitabine is a CCS drug while cisplatin is CCNS, which justifies this infusion sequence. Also, gemcitabine administration (4 or 24 hours) before cisplatin administration proved less toxic, causing less leukopenia.(1414. Kroep JR, Peters GJ, van Moorsel CJ, Catik A, Vermorken JB, Pinedo HM, et al. Gemcitabine-cisplatin: a schedule finding study. Ann Oncol. 1999; 10(12):1503-10.)
|
Cisplatin + irinotecan |
Cisplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Irinotecan CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Irinotecan is a CCS drug, while cisplatin is CCNS. However, with previous administration of cisplatin, there is an increase in the synergistic effect, with the presence of toxicity regardless of the administration sequence.(1515. de Jonge MJ, Verweij J, Planting AS, van Der Burg ME, Stoter G, de Boer-Dennert MM, et al. Drug-administration sequence does not change pharmacodynamics and kinetics of irinotecan and cisplatin. Clin Cancer Res. 1999;5(8):2012-7.,1616. Han JY, Lim HS, Lee DH, Ju SY, Lee SY, Kim HY, et al. Randomized Phase II study of two opposite administration sequences of irinotecan and cisplatin in patients with advanced nonsmall cell lung carcinoma. Cancer. 2006; 106(4):873-80.)
|
Cisplatin + paclitaxel |
Paclitaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Cisplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Paclitaxel is a CCS drug, whereas cisplatin is CCNS, which justifies this infusion sequence.(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) When cisplatin is administered first, paclitaxel clearance is reduced, and myelosuppression is more severe. It has been suggested that this decrease in paclitaxel clearance, after cisplatin, may be due to cytochrome P450 inhibition, which is responsible for paclitaxel metabolism.(1717. Kennedy MJ, Zahurak ML, Donehower RC, Noe DA, Sartorius S, Chen TL, et al. Phase I and pharmacologic study of sequences of paclitaxel and cyclophosphamide supported by granulocyte colony-stimulating factor in women with previously treated metastatic breast cancer. J Clin Oncol. 1996;14(3):783-91.)
|
Docetaxel + pamidronate |
Docetaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Pamidronate |
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) No studies were found on administration order. The recommendation is to administer docetaxel first, considering pamidronate may cause nephrotoxicity, which manifests as nephritic syndrome, kidney function deterioration and renal failure, which could alter docetaxel excretion.(1818. Micromedex 2.0Soluntions. Pamidronate Disodium, Medication Safety, Precautions [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch#
http://www-micromedexsolutions-com.ez22....
)
|
FOLFIRI |
Irinotecan CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) + Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) (bolus) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) (continuous infusion – 46 hours) |
- |
Incompatible in Y (irinotecan – fluorouracil)(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Folinic acid stabilizes thymidylate synthase when administered before fluorouracil, increasing the efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of folinic acid, a minimum 60-minute period is required for drug distribution and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) We observed a synergistic effect when there was previous exposure to irinotecan, intensifying fluorouracil-induced DNA damage.(2121. Grivicich I. A Importância da sequência de administração do irinotecan e 5-fluorouracil na inibição da proliferção do carcinoma de cólon humano in vitro [tese]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 1999.) According to a study by Falcone et al., toxicity was affected by the administration sequence of irinotecan and fluorouracil, with acceptable toxicity when irinotecan was followed by fluorouracil.(2222. Falcone A, Di Paolo A, Masi G, Allegrini G, Danesi R, Lencioni M, et al. Sequence effect of irinotecan and fluorouracil treatment on pharmacokinetics and toxicity in chemotherapy-naive metastatic colorectal cancer patients. J Clin Oncol. 2001;19(15):3456-62.) To provide faster patient care, the concomitant initial infusion of irinotecan and folinic acid was proposed, followed by fluorouracil in bolus and fluorouracil in continuous infusion.(88. Rodrigues R. Ordem de Infusão de Medicamentos Antineoplásicos - Sistematização de informações para auxiliar a discussão e criação de protocolos assistenciais. São Paulo: Atheneu; 2015.) It is worth mentioning the importance of cleaning the Y system between the infusions of irinotecan and fluorouracil, due to incompatibility. |
FOLFOXIRI |
Irinotecan CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Oxaliplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) + Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) (continuous infusion–46 hours) |
- |
Incompatible in Y (irinotecan – fluorouracil)(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Not tested in Y (fluorouracil – oxaliplatin)(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Irinotecan in a prodrug and thus requires hepatic microsomal activation. Therefore, whenever possible, this type of drug should be prioritized in multiple infusions.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) Also, some studies demonstrated there may be an increase in cholinergic side effects of irinotecan when administered after oxaliplatin.(2323. Valencak J, Raderer M, Kornek GV, Henja MH, Scheithauer W. Irinotecan-related cholinergic syndrome induced by coadministration of oxaliplatin. J Natl Cancer Inst. 1998;90(2):160.) Dodds et al., observed the cholinergic effects of irinotecan are manifested by inhibiting acetylcholinesterase.(2424. Dodds HM, Bishop JF, Rivory LP. More about: irinotecan-related cholinergic syndrome induced by coadministration of oxaliplatin. J Natl Cancer Inst. 1999;91(1):91-2.) Similarly to other alkylating agents, oxaliplatin can also inhibit this enzyme, which can potentiate the cholinergic effects of irinotecan. Regarding the combination between oxaliplatin and fluorouracil, Qin et al. observed in vitro synergistic effect, i.e., apoptosis was more prominent when cells were treated with oxaliplatin first and then with fluorouracil.(2525. Qin B, Tanaka R, Shibata Y, Arita S, Ariyama H, Kusaba H, et al. In-vitro schedule-dependent interaction between oxaliplatin and 5-fluorouracil in human gastric cancer cell lines. Anticancer Drugs. 2006;17(4):445-53.) Furthermore, some studies demonstrated oxaliplatin can inhibit the main enzyme of fluorouracil metabolism (dihydropyrimidine dehydrogenase).(2626. Fischel JL, Formento P, Ciccolini J, Rostagno P, Etienne MC, Catalin J, et al. Impact of the oxaliplatin-5 fluorouracil-folinic acid combination on respective intracellular determinants of drug activity. Br J Cancer. 2002;86(7):1162-8.) A synergistic effect was observed when there was previous exposure to irinotecan, intensifying DNA damage induced by fluorouracil.(2121. Grivicich I. A Importância da sequência de administração do irinotecan e 5-fluorouracil na inibição da proliferção do carcinoma de cólon humano in vitro [tese]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 1999.) According to a study by Falcone et al., toxicity was affected by the administering sequence of irinotecan and fluorouracil, with acceptable toxicity when irinotecan was followed by fluorouracil.(2222. Falcone A, Di Paolo A, Masi G, Allegrini G, Danesi R, Lencioni M, et al. Sequence effect of irinotecan and fluorouracil treatment on pharmacokinetics and toxicity in chemotherapy-naive metastatic colorectal cancer patients. J Clin Oncol. 2001;19(15):3456-62.) Folinic acid stabilizes thymidylate synthase when administered before fluorouracil, increasing efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of folinic acid, a minimum 60-minute period is required for the distribution of the drug and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) It is worth mentioning the importance of cleaning the Y system between the infusions of irinotecan and fluorouracil, due to incompatibility. |
FLOX/B-FOL |
Oxaliplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
Not tested in Y (fluorouracil – oxaliplatin).(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Folinic acid stabilizes thymidylate synthase when administered before fluorouracil, increasing efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of folinic acid, a minimum 60-minute period is required for distribution of the drug and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) Regarding the combination between oxaliplatin and fluorouracil, Qin et al. observed in vitro synergistic effect, i.e., apoptosis was more prominent when cells were treated with oxaliplatin first and then with fluorouracil.(2525. Qin B, Tanaka R, Shibata Y, Arita S, Ariyama H, Kusaba H, et al. In-vitro schedule-dependent interaction between oxaliplatin and 5-fluorouracil in human gastric cancer cell lines. Anticancer Drugs. 2006;17(4):445-53.) Furthermore, some studies demonstrated that oxaliplatin can inhibit the main enzyme of fluorouracil metabolism (dihydropyrimidine dehydrogenase).(2626. Fischel JL, Formento P, Ciccolini J, Rostagno P, Etienne MC, Catalin J, et al. Impact of the oxaliplatin-5 fluorouracil-folinic acid combination on respective intracellular determinants of drug activity. Br J Cancer. 2002;86(7):1162-8.)
|
FOLFOX |
Oxaliplatin CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) + Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) (bolus) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.) (continuous infusion – 46 hours) |
|
Not tested in Y (fluorouracil – oxaliplatin).(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Folinic acid stabilizes thymidylate synthase when administered before 5-FU, increasing the efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of the folinic acid, a minimum 60-minute period is required for distribution of the drug and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) Regarding the combination between oxaliplatin and 5-FU, Qin et al., observed in vitro synergistic effect; apoptosis was more prominent when cells were treated with oxaliplatin first and then with 5-FU.(2525. Qin B, Tanaka R, Shibata Y, Arita S, Ariyama H, Kusaba H, et al. In-vitro schedule-dependent interaction between oxaliplatin and 5-fluorouracil in human gastric cancer cell lines. Anticancer Drugs. 2006;17(4):445-53.) Furthermore, some studies demonstrated oxaliplatin can inhibit the main enzyme of 5-FU metabolism (dihydropyrimidine dehydrogenase).(2626. Fischel JL, Formento P, Ciccolini J, Rostagno P, Etienne MC, Catalin J, et al. Impact of the oxaliplatin-5 fluorouracil-folinic acid combination on respective intracellular determinants of drug activity. Br J Cancer. 2002;86(7):1162-8.) To provide more efficient patient care, concomitant initial infusion of oxaliplatin and folinic acid was proposed, followed by fluorouracil in bolus and fluorouracil in continuous infusion.(2727. Buzaid AC, Hoff PM, Malui FC. Mini-MOC - poket do manual de oncologia clínica do Hospital Sírio-Libanês. São Paulo: Dendrix; 2009.)
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IFL |
Irinotecan CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
Incompatible in Y (irinotecan – fluorouracil).(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Folinic acid stabilizes thymidylate synthase when administered before fluorouracil, increasing the efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of the folinic acid, a minimum 60-minute period is required for distribution of the drug and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.) A synergistic effect was observed when there was previous exposure to irinotecan, intensifying DNA damage induced by fluorouracil.(2424. Dodds HM, Bishop JF, Rivory LP. More about: irinotecan-related cholinergic syndrome induced by coadministration of oxaliplatin. J Natl Cancer Inst. 1999;91(1):91-2.) According to a study by Falcone et al., toxicity was affected by the administering sequence of irinotecan and fluorouracil, with acceptable toxicity when irinotecan was followed by fluorouracil.(2222. Falcone A, Di Paolo A, Masi G, Allegrini G, Danesi R, Lencioni M, et al. Sequence effect of irinotecan and fluorouracil treatment on pharmacokinetics and toxicity in chemotherapy-naive metastatic colorectal cancer patients. J Clin Oncol. 2001;19(15):3456-62.) It is worth mentioning the importance of cleaning the Y system between the infusions of irinotecan and fluorouracil, due to incompatibility. |
MAYO/ McDonald/ fluorouracil + folinic acid |
Folinic acid (60 minutes prior) |
Fluorouracil CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
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- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Folinic acid stabilizes thymidylate synthase when administered before fluorouracil, increasing the efficacy and cytotoxicity of the latter.(1919. Jolivet J. Role of leucovorin dosing and administration schedule. Eur J Cancer. 1995;31A(7-8):1311-5. Review.,2020. Rustum YM, Cao S, Zhang Z. Rationale for treatment design: biochemical modulation of 5-fluorouracil by leucovorin. Cancer J Sci Am. 1998;4(1):12-8. Review.) Moreover, for better action of the folinic acid, a minimum 60-minute period is required for distribution of the drug and intracellular metabolism.(55. Bonassa EM, Gato MI. Terapêutica Oncológica para Enfermeiros e Farmacêuticos. 4a ed. São Paulo: Atheneu; 2012.)
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Paclitaxel + zoledronic acid |
Paclitaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
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Zoledronic acid |
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Increase of synergistic effects due to increased apoptosis.(2828. Neville-Webbe HL, Evans CA, Coleman RE, Holen I. Mechanisms of the synergistic interaction between the bisphosphonate zoledronic acid and the chemotherapy agent paclitaxel in breast cancer cells in vitro. Tumor Biol. 2006;27(2):92-103.)
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Paclitaxel + pamidronate |
Paclitaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
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Pamidronate |
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) No studies were found describing an administration sequence. The recommendation is to administer paclitaxel first, considering pamidronate can cause nephrotoxicity, which manifests as nephritic syndrome, kidney function deterioration and renal failure, which could alter paclitaxel excretion.(1818. Micromedex 2.0Soluntions. Pamidronate Disodium, Medication Safety, Precautions [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/PFDefaultActionId/evidencexpert.DoIntegratedSearch#
http://www-micromedexsolutions-com.ez22....
)
|
TC |
Docetaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
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Cyclophosphamide CCNS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
|
- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Docetaxel is a CCS drug, while cyclophosphamide is a CCNS drug, which justifies this infusion sequence. Cyclophosphamide is a prodrug, catalyzed directly through cytochrome P450.(1111. Chang TK, Weber GF, Crespi CL, Waxman DJ. Differential Activation of Cyclophosphamide and ifosphamide by cytochromes p-450 2b and 3a in human liver microsomes. Cancer Res. 1993;53(23):5629-37.) Docetaxel is also oxidated by cytochrome P450 enzymes, especially by CYP3A4 in the liver.(2929. Miyoshi Y, Ando A, Takamura Y, Taguchi T, Tamaki Y, Noguchi S. Prediction of response to docetaxel by CYP3A4 mRNA expression in breast cancer tissues. Int J Cancer. 2002;97(1):129-32.) We found a few controversial studies that relate ifosfamide and docetaxel because ifosfamide and cyclophosphamide are similar.(3030. Bramwell VH, Mouridsen HT, Santoro A, Blackledge G, Somers R, Verwey J, et al. Cyclophosphamide versus ifosfamide: final report of a randomized phase II trial in adult soft tissue sarcomas. Eur J Cancer Clin Oncol. 1987;23(3):311-21.) Schijvers et al. observed the AUC of ifosfomide and its metabolites were smaller when docetaxel was administered first.(3131. Schrijvers D, Pronk L, Highley M, Bruno R, Locci-Tonelli D, De Bruijn E, et al. Pharmacokinetics of ifosfamide are changed by combination with docetaxel: results of a phase I pharmacologic study. Am J Clin Oncol. 2000;23(4):358-63.) A study by Ando et al., suggests that docetaxel can competitively inhibit the biotransformation of the prodrug ifosfamide through the isoenzyme CYP3A4 of cytochrome P450.(3232. Ando Y. Possible metabolic interaction between docetaxel and ifosfamide. Br J Cancer. 2000;82(2):497.) However, the studies we found present no clear evidence for an administration sequence of these drugs. |
Trastuzumab + paclitaxel |
Trastuzumab |
Paclitaxel CCS(77. Almeida VL, Leitão A, Reina LC, Montanari CA, Donnici CL, Lopes MT. [Cancer and cell cicle-specific and cell cicle nonspecific anticancer DNA-interactive agents: an introduction]. Quim Nova. 2005;28(1):118-29. Portuguese.)
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- |
- |
Compatible in Y(1010. Micromedex 2.0 Solutions. Intravenous (IV) Compatibility Search [Internet]. Ann Arbor (MI): Truven Health Analytics Inc. 2013 [cited 2017 Jan 20]. Available from: http://www-micromedexsolutions-com.ez22.periodicos.capes.gov.br/micromedex2/librarian/CS/359299/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/282BE0/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.FindIVCompatibility?navitem=topIV&isToolPage=true
http://www-micromedexsolutions-com.ez22....
) Lee et al., observed pre-treatment with trastuzumab resulted in better sensitization of breast cancer cells, i.e., trastuzumab followed by paclitaxel increased the activation and induction of programmed cell death or cell apoptosis.(3333. Lee S, Yang W, Lan KH, Sellappan S, Klos K, Hortobagyi G, et al. Enhanced sensitization to taxol-induced apoptosis by herceptin pretreatment in ErbB2-overexpressing breast cancer cells. Cancer Res. 2002;62(20):5703-10.) Moreover, due to the possible infusion reaction of the monoclonal antibody, it is recommended that trastuzumab be infused first.(3434. Chung CH. Managing premedications and the risk for reactions to infusional monoclonal antibody therapy. Oncologist. 2008;13(6):725-32. Review.,3535. Hannawa IS, Bestul DJ. Rituximab tolerability when given before or after CHOP. J Oncol Pharm Pract. 2011;17(4):381-6.)
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