Gastrointestinal Chemotherapy Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option.  In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to the HSE.ie terms of use.

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie.

Gastrointestinal Chemotherapy Regimens

Regimen Name Indication

Aflibercept -14 days

Regimen

00238a

In combination with FOLFIRI for the treatment of adults with mCRC that is resistant to or has progressed after an oxaliplatin-containing regimen.

Bevacizumab 5mg/kg – 14 days

Regimen

00211a

In combination with fluoropyrimidine-based chemotherapy for treatment of adult patients with metastatic carcinoma of the colon or rectum.

Bevacizumab 10 mg/kg –14 days

Regimen

00212a

In combination with fluoropyrimidine-based chemotherapy for treatment of adult patients with metastatic carcinoma of the colon or rectum.

Bevacizumab 7.5 mg/kg –21 days

Regimen

00214a

In combination with fluoropyrimidine-based chemotherapy for treatment of adult patients with metastatic carcinoma of the colon or rectum.

Bevacizumab 15 mg/kg –21 days

Regimen

00215d

In combination with fluoropyrimidine-based chemotherapy is indicated for treatment of adult patients with metastatic carcinoma of the colon or rectum.

Capecitabine Monotherapy

Regimen

00216b

Treatment of metastatic colorectal cancer.

00216c

Adjuvant treatment of patients following surgery of stage III colon cancer.

00216d*

Adjuvant treatment of patients following surgery of stage II colon cancer.

00216e*

Adjuvant treatment of patients with metastatic colorectal cancer following complete resection.

Capecitabine/Oxaliplatin (XELOX) Therapy

Regimen

00321a

Adjuvant treatment of stage III (Dukes C) colon cancer after complete resection of the primary tumour.

00321b

Treatment of advanced or metastatic colorectal cancer.

Carboplatin (AUC 2) Weekly and Paclitaxel (50mg/m2) Weekly with Radiotherapy (RT) -5 weeks

Regimen

00422a

Preoperative chemoradiation treatment of oesophageal and gastro-oesophageal junction carcinomas.

Cetuximab Monotherapy -7 days

Regimen

00207a

Treatment of patients with EGFR-expressing RAS wild-type mCRC.

00207b

Treatment of patients with squamous cell cancer of the head and neck: In combination with radiation therapy for locally advanced disease.

Cetuximab (7days) and Irinotecan (14 days ) Therapy

Regimen

00330a

Second line therapy for metastatic colorectal cancer with non-mutated (wild type) RAS after failure of or contraindication to oxaliplatin based therapy.

Cetuximab (14 days) and Irinotecan (14 days) Therapy*

Regimen

00331a

Second line therapy for metastatic colorectal cancer with non-mutated (wild type) RAS after failure of or contraindication to oxaliplatin based therapy.

Cisplatin and Teysuno®-28 day cycle

Regimen

00235a

Treatment of advanced gastric cancer when given in combination with cisplatin.

DOXOrubicin 60mg/m2 Therapy

Regimen

00386a

Treatment of unresectable or metastatic hepatocellular carcinoma not suitable for treatment with regional therapies.

Epirubicin, Cisplatin and 5-FU (ECF) Therapy

Regimen

00240a

Metastatic or locally advanced (unresectable) gastric adenocarcinoma.

00240b

Metastatic or locally advanced (unresectable) esophagogastric junction adenocarcinoma.

00240c

Metastatic or locally advanced (unresectable) oesophageal  adenocarcinoma.

00240d

Perioperative treatment of resectable gastric adenocarcinoma.

00240e

Perioperative treatment of resectable gastroesophageal junction adenocarcinoma.

00240f

Perioperative treatment of resectable lower oesophagus adenocarcinoma.

Epirubicin, Cisplatin and Capecitabine (ECX) Therapy

Regimen

00380a

Perioperative treatment of resectable gastric adenocarcinoma.

00380b

Perioperative treatment of resectable gastrioesophageal junction adenocarcainoma.

00380c

Perioperative treatment of resectable lower oesophagus adenocarcinoma.

00380d

Palliative therapy for metastatic or locally advanced gastric adenocarcinoma.

00380e

Palliative therapy for metastatic or locally advanced oesphagogastric adenoccarcinoma.

Epirubicin, Oxaliplatin and Capecitabine (EOX)Therapy

Regimen

00239a

Locally advanced or metastatic gastric carcinoma.

00239b

Locally advanced or metastatic oesophageal carcinoma.

00239c

Locally advanced or metastatic gastroesophageal carcinoma.

Epirubicin Oxaliplatin and 5-FU (EOF) -21 day

Regimen

00429a

Locally advanced or metastatic gastric carcinoma

00429b

Locally advanced or metastatic oesophageal carcinoma

00429c

Locally advanced or metastatic gastroesophageal carcinoma

Everolimus Monotherapy

Regimen

00320b

Treatment of unresectable or metastatic, well- or moderately-differentiated neuroendocrine tumours of pancreatic origin in adults with progressive disease.

FLOT Therapy-14 day

Regimen

00344a

Treatment of locally advanced (≥T2) and/or nodal positive (N+) resectable gastric adenocarcinoma

00344b

Treatment of locally advanced ((≥T2) and/or nodal positive (N+) resectable adenocarcinoma of the oesophagogastreal junction

FOLFIRI Therapy-14 day

Regimen

00227a

Treatment of patients with advanced colorectal cancer.

FOLFIRI + Cetuximab Therapy

Regimen

00328a

Treatment of patients with RAS wild type metastatic colorectal cancer.

FOLFOX- 4 Therapy-14 day

Regimen

00210a

Adjuvant treatment of stage II and stage III colon cancer after complete resection of primary tumour.

00210b

Metastatic colorectal carcinoma

Modified FOLFOX- 6 Therapy-14 day

Regimen

00209a

Adjuvant treatment of stage II or III colon cancer after complete resection of primary tumour

00209b

Metastatic colorectal carcinoma

FOLFIRINOX

Regimen

00329a

Metastatic pancreatic cancer.

5-FU 225mg/m2/day and Radiotherapy (RT)-Continuous infusion (7day)

Regimen

00421a

Treatment of locally advanced rectal cancer.

Gemcitabine + Capecitabine Therapy

Regimen

00384a

Locally advanced or metastatic pancreatic carcinoma.

00384b

Locally advanced bilary tree carcinoma.

Gemcitabine + CISplatin Therapy

Regimen

00383a

Locally advanced or metastatic pancreatic carcinoma.

00383b

Locally advanced or metastatic bilary tree carcinoma.

Gemcitabine Monotherapy-Locally Advanced or Metastatic

Regimen

00283a

Treatment of patients with locally advanced or metastatic adenocarcinoma of the pancreas.

Gemcitabine Monotherapy-Adjuvant Treatment

Regimen

00284a

Adjuvant chemotherapy for pancreatic adenocarcinoma.

Irinotecan Monotherapy -21days

Regimen

00213a

Treatment of patients with advanced colorectal cancer as a single agent in patients who have failed an established 5-fluorouracil containing treatment regimen.

Nab-Paclitaxel (Abraxane®) and Gemcitabine -28 Days

Regimen

00256a

First-line treatment of adult patients with metastatic adenocarcinoma of the pancreas.

Paclitaxel Monotherapy 80mg/m2-7day cycle

Regimen 

00226c*

Second line chemotherapy for advanced or recurrent gastric cancer.

Panitumumab 6mg/kg Therapy

Regimen

 

00225a

Treatment of adult patients with wild-type RAS metastatic colorectal cancer (mCRC) in first line in combination with FOLFOX or FOLFIRI.

00225b

Treatment of adult patients with wild-type RAS metastatic colorectal cancer (mCRC) in second line in combination with FOLFIRI for patients who have received first-line fluorpyridine–based chemotherapy (excluding irinotecan).

00225c

Treatment of adult patients with wild-type RAS metastatic colorectal cancer (mCRC) as monotherapy after failure of fluorpyridine, oxaliplatin, and irinotecan containing chemotherapy regimens.

QUASAR (Modified) Flu Fluorouracil (370mg/m2) and
Folinic Acid (50mg) weekly

Regimen

00428a

Treatment of metastatic colorectal cancer.

00428b

Adjuvant treatment of colorectal cancer.

Regorafenib Monotherapy

Regimen

00244a

Treatment of adult patients with metastatic colorectal cancer (mCRC) who have been previously treated with, or are not considered candidates for, available therapies. These include fluoropyrimidine-based chemotherapy, an anti-VEGF therapy and an anti-EGFR therapy.

Modified Roswell Park (Flu Fluorouracil 500mg/m2 and Folinic Acid 50mg weekly x 6) Regimen

Regimen

00427a

Treatment of metastatic colorectal cancer.

00427b

Adjuvant treatment of colorectal cancer.

Sorafenib Therapy

Regimen

00294a

Treatment of hepatocellular carcinoma (HCC).

Trifluridine and Tipracil (Lonsurf®)Therapy

Regimen

00382a

Treatment of adult patients with metastatic colorectal cancer (CRC) who have been previously treated with, or are not considered candidates for, available therapies including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies, anti-VEGF agents, and anti-EGFR agents.

* Unlicensed indication. See regimen for more details