ION Breast Cancer Clinical Pathways - ION Solutions

Best Supportive Care and/or Hospice:Consider supportive care options and Hospice when appropriate.Note: Switch maintenance refers to the initiation of a different agent, not includedas a part of the first-line regimen, in the absence of disease progression, after 4-6 cycles of initial therapy.Non-Small Cell Lung (NSCL): Second Line MetastaticChemotherapy:Taxotere (Docetaxel) EP=Low; FN=10%-20%Docetaxel 75mg/m 2 D1q 21 Day Cycle>> J Clin Oncol 18:2354-2362, 2000Navelbine (Vinorelbine) EP=Minimal; FN> J Clin Oncol 18:2354-2362, 2000Gemzar (Gemcitabine) EP=Low; FN> J Clin Oncol 23:8380-8388, 2005Alimta (Pemetrexed) EP=Low; FN> J Clin Oncol 22:1589-1597, 2004>> J Clin Oncol 26:3543-3551, 2008Tarceva (Erlotinib)Erlotinib 150mg PO q D>> N Engl J Med 353:123-132, 2005Taxol (Paclitaxel) EP=Low; FN=10%-20%Paclitaxel 80mg/m2 D1, D15, D21q 28 Day Cycle>> Cancer1997;79:724-729Paraplatin (Carboplatin) Taxol (Paclitaxel) +/- Avastin (Bevacizumab) EP=Moderate;FN=10%-20%Carboplatin AUC 6 D1Paclitaxel 200mg/m2 D1+/- Bevacizumab 15mg/kg D1q 21 Day Cycle x 4-6 CyclesThen continue maintenance bevacizumab until disease progression>> NEJM 355:2542-2550,2006Page 28 of 39© 2013 by ION Solutions. All rights reserved