ION Breast Cancer Clinical Pathways - ION Solutions

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Camptosar (Irinotecan) Avastin (Bevacizumab) EP=Moderate; FN> TherAdvMedOncol2010Sep;2(5):309-17Camptosar (Irinotecan) Vectibix (Panitumumab) EP=Moderate; FN> NEnglJMed2004;351:337-345FOLFIRI Vectibix (Panitumumab) EP=Moderate; FN=10%-20%Irinotecan 180mg/m2 D1, D15Leucovorin 400mg/m2 D1, D155-Fluorouracil 400mg/m2 IVP D1, D155-Fluorouracil 2400mg/m2 CI over 46 hours D1, D15Panitumumab 6mg/kg D1, D15q 28 Day Cycle>> BrJCancer2008Aug5;99(3):455-8Erbitux (Cetuximab) EP=Minimal; FN> NEnglJMed2004;351:337-345Xeloda (Capecitabine) +/- Erbitux (Cetuximab) EP=Low; FN> JClinOncol2005Feb1;23(4):792-9>> J Clin Oncol 19:4097-4106, 2001>> J Clin Oncol 26:2013-2019, 2008Vectibix (Panitumumab) EP=Minimal; FN> J Clin Oncol 25:1658-1664, 2007Stivarga (Regorafenib)Regorafenib 160mg PO D1-21q 28 Day Cycle>> J Clin Oncol 30 (suppl 4):LBA385, 2012Clinical 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.Page 22 of 39© 2013 by ION Solutions. All rights reserved
Note: Wild Type KRAS documentation is required for all newly metastatic casesbefore cetuximab or panitumumab is used.Note: 1 st line EGFR directed treatment must be cetuximab. Panitumumab maybe used 2 nd line or later with reaction or intolerance to cetuximab. A second lineof VEGF directed treatment (bevacizumab) is considered compliant if there is nodocumented failure.Page 23 of 39© 2013 by ION Solutions. All rights reserved
Page 1 and 2: ION SolutionsNational Physician Net
Page 3: Best Supportive Care and/or Hospice
Page 6 and 7: Chemotherapy:Taxotere (Docetaxel) A
Page 8 and 9: Taxotere (Docetaxel) Paraplatin (Ca
Page 10 and 11: Taxotere (Docetaxel) EP=Low; FN=10%
Page 12 and 13: Herceptin (Trastuzumab) Followed by
Page 14 and 15: Herceptin (Trastuzumab) Taxotere (D
Page 16 and 17: Colon: First Line MetastaticChemoth
Page 18 and 19: 5-FU (5-Fluorouracil) Leucovorin +/
Page 20 and 21: Note: Wild Type KRAS documentation
Page 24 and 25: Adjuvant Non-Small Cell Lung (NSCL)
Page 26 and 27: Paraplatin (Carboplatin) Taxotere (
Page 28 and 29: Best Supportive Care and/or Hospice
Page 30 and 31: Clinical Trial:Screen patient for c
Page 32 and 33: Small Cell Lung: Extensive Disease
Page 34 and 35: Paraplatin (Carboplatin) VP-16 (Eto
Page 36 and 37: Anti-EmeticsEmetogenic Risk:High Em
Page 38 and 39: Lung CancerPage 38 of 39© 2013 by

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