ION Breast Cancer Clinical Pathways - ION Solutions

Ixempra (Ixabepilone) Xeloda (Capecitabine) EP=Low; FN=10%-20%Ixabepilone 40mg/m 2 D1Capecitabine 2000mg/m 2 PO BID D1-14q 21 Day Cycle>> J Clin Oncol 25:5210-5217, 2007Paraplatin (Carboplatin) EP=Moderate; FN> No reference needed as will only be used as a doublet.Cytoxan (Cyclophosphamide) EP=Moderate; FN˃20%Cyclophosphamide 600mg/m2 D1q 21 Day CycleNote: To be used in combination with docetaxel.>> JClinOncol2006Dec1;24(34):5381-7Clinical Trial:Screen patient for clinical trial. Check www.clinicaltrials.gov for available trials.Best Supportive Care and/or Hospice:Consider supportive care options and Hospice when appropriate.Note: For patients with visceral crisis, chemotherapy with a combination of activeagents is appropriate.Note: Treatment for PS≥4 will be considered off pathway.Metastatic Breast: HER2/neu PositiveHormone Therapy:Nolvadex (Tamoxifen)Tamoxifen 20mg PO q D>> J Natl Cancer Inst 91:1829-1846, 1999Aromatase Inhibitor (plus ovarian ablation for premenopausal women)Anastrozole 1mg PO q DExemestane 25mg PO q DLetrozole 2.5mg PO q D>> J Clin Oncol 26:1059-1065, 2008Page 11 of 39© 2013 by ION Solutions. All rights reserved