Genitourinary 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.

 

Bladder Cancer Chemotherapy Regimens

Regimen Name Indication

CISplatin 40mg/m2 Weekly with Radiotherapy (RT)

Protocol

00385b

Chemoradiation treatment for locally advanced bladder cancer.

Cisplatin, Methotrexate and Vinblastine (CMV) Therapy

Protocol

00337a

Neoadjuvant treatment of muscle invasive transitional cell carcinoma (TCC) of the urothelium.

5-Fluorouracil (5 day) and mitoMYcin Chemoradiation Therapy

Protocol 

00450a

Treatment of muscle invasive bladder cancer in patients.

Gemcitabine (1000mg/m2) and CARBOplatin (AUC5) Therapy-21 day

Protocol

00310a

Treatment of patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium where cisplatin is contraindicated*

00310b

Treatment of patients with locally advanced, recurrent or metastatic non small cell lung cancer (NSCLC)*

Gemcitabine (1000mg/m2) and CISplatin (70mg/m2) Therapy-28 day

Protocol

00282a

Treatment of patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium

Methotrexate, VinBLAStine, DOXOrubicin, CISplatin (MVAC) Therapy-14 days

Protocol

00333a

Locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium.

Methotrexate, vinBLAStine, DOXOrubicin, CISplatin (MVAC) Therapy-28 days

Protocol

00338a

Neoadjuvant treatment of muscle invasive transitional cell carcinoma (TCC) of the urothelium.

00338b

Adjuvant treatment of muscle invasive TCC of the urothelium.

00338c

Locally advanced or metastatic TCC of the urothelium.

PACLitaxel Monotherapy 80mg/m2-7day cycle

Protocol

00226e

Second line chemotherapy for metastatic bladder cancerii

Germ Cell Chemotherapy Regimens

Regimen Name Indication

Bleomycin, Etoposide and CISplatin (BEP) Therapy

Protocol

00300a

Adjuvant treatment of high risk (vascular invasion carcinoma) stage 1 nonseminoma germ cell tumour.

00300b

Metastatic germ cell tumours of the testis.

00300c

Advanced stage or metastatic germ cell tumours (dysgermimoma) of the ovaries.

00300d

Extra-gonadal germ cell tumours.

CARBOplatin (AUC7) and Etoposide- Autologous Conditioning Germ Cell Tumour Regimen

Protocol

00453a

Treatment of metastatic relapsed/refractory germ cell tumours.

Etoposide and CISplatin 20mg/m2 (EP) Therapy

Protocol

00301a

Treatment of good prognosis (IGCCCG criteria) metastatic germ cell tumours (both non-seminoma and seminoma).

TICE - Autologous Conditioning Germ Cell Tumour Regimen

Protocol

00437a

Treatment of metastatic relapsed/refractory germ cell tumours.

Prostate Chemotherapy Regimens

Regimen Name Indication

Abiraterone and Prednisolone Therapy

Protocol

00103a

Treatment of mCRPC which has  progressed on or after a docetaxel-based chemotherapy regimen

00103b

Treatment of metastatic castration resistant prostate cancer in adult men who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated

Bicalutamide Therapy

Protocol

00482

Treatment of advanced prostate cancer in combination with luteinizing-hormone releasing hormone (LHRH) analogue therapy or surgical castration

Cabazitaxel and Prednisolone

Protocol

00101a

Cabazitaxel is indicated in combination with prednisone or prednisolone for the treatment of patients with hormone refractory metastatic prostate cancer previously treated with a docetaxel-containing regimen

Degarelix Therapy

Protocol

00481a 

Treatment of adult male patients with advanced hormone-dependent prostate cancer

Goserelin 3.6mg Therapy -28 day

Protocol

00478a

Treatment of locally advanced or metastatic hormone sensitive prostate cancer

Goserelin 10.8mg Therapy -12week

Protocol

00477a 

Treatment of locally advanced or metastatic hormone sensitive prostate cancer

Leuprorelin 3.75mg Therapy-28 day

Protocol

00494a 

Management of prostatic carcinoma for which a suppression of testosterone is indicated

Leuprorelin 11.25mg Therapy-12 week

Protocol

00492a 

Management of prostatic carcinoma for which a suppression of testosterone is indicated

Leuprorelin 22.5mg Therapy-12 week

Protocol

00479a

Treatment of hormone dependent advanced prostate cancer

00479b 

Treatment of high-risk localized and locally advanced hormone dependent prostate cancer in combination with radiotherapy

Leuprorelin 30mg-24 week

Protocol

00493a

Treatment of locally advanced or metastatic hormone dependent advanced prostate cancer

Leuprorelin 45mg Therapy-24 week

Protocol

00491a 

Treatment of hormone dependent advanced prostate cancer 

00491b

Treatment of high-risk localized and locally advanced hormone dependent prostate cancer in combination with radiotherapy

Triptorelin 3mg Therapy-28 day

Protocol

00489a 

Treatment of locally advanced or metastatic hormone dependent advanced prostate cancer

Triptorelin 11.25mg Therapy-12 week

Protocol

00480a

Treatment of locally advanced or metastatic hormone dependent advanced prostate cancer

Triptorelin 22.6mg Therapy-24 week

Protocol

00488a

Treatment of locally advanced or metastatic hormone dependent advanced prostate cancer

Leuprorelin 7.5mg Therapy-28 day

Protocol

00490a 

Treatment of hormone dependent advanced prostate cancer 

00490b 

Treatment of high-risk localized and locally advanced hormone dependent prostate cancer in combination with radiotherapy

Docetaxel Monotherapy 50mg/m2 – 14 day cycle

Protocol

00313a

In combination with prednisone or prednisolone is indicated for the treatment of patients with hormone refractory metastatic prostate cancer.

DOCEtaxel Monotherapy 75mg/m2 - 21 day cycle

Protocol

00203b

Treatment of patients with mHRPC in combination with prednisone or prednisolone.

Enzalutamide Monotherapy

Protocol

00233a

Treatment of adult men with metastatic castration-resistant prostate cancer whose disease has progressed on or after docetaxel therapy.

00233b
Treatment of adult men with metastatic castration-resistant prostate cancer who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated.

Radium 223 Therapy

Protocol

00257a

As monotherapy or in combination with LHRH analogues for the treatment of adults with progressive castration-resistant metastatic prostate cancer  (mCRPC, symptomatic bone metastases and no extensive visceral metastases after at least two prior lines of systemic therapy for mCRPC (other than LHRH analogues), or ineligible for any available licensed systemic mCRPC treatment

 

Renal Chemotherapy Regimens

Regimen Name Indication

Renal Cell Metastatic Axitinib

Protocol

00104a

Treatment of adult patients with advanced RCC after failure, on a previous line of therapy, i.e. treatment with SUNItinib, or a cytokine.

Bevacizumab 10 mg/kg –14 days

Protocol

00212d

In combination with interferon alfa-2a is indicated for first line treatment of adult patients with advanced and/or metastatic renal cell cancer.

Everolimus Therapy

Protocol

00320a

Treatment of patients with advanced renal cell carcinoma, whose disease has progressed on or after treatment with VEGF-targeted therapy.

Nivolumab 240mg Monotherapy

Protocol

00483b

As monotherapy for the treatment of advanced renal cell carcinoma (RCC) after prior therapy in adults.

Nivolumab 480mg Monotherapy

Protocol

00484b 

As monotherapy for the treatment of advanced renal cell carcinoma (RCC) after prior therapy in adults.

SORAfenib Therapy

Protocol

00294b

Treatment of patients with advanced renal cell carcinoma (RCC) who have failed prior interferon-alpha or interleukin-2 based therapy or are considered unsuitable for such therapy.

SUNitnib 50mg Therapy

Protocol

00325b

Treatment of advanced/metastatic renal cell carcinoma (MRCC) in adults

PAZOPanib Therapy

Protocol

00445a

First line treatment of advanced Renal Cell Carcinoma (RCC) in adults and for patients who have received prior cytokine therapy for advanced disease.

Temsirolimus Monotherapy

Protocol

00326a

First-line treatment of adult patients with advanced renal cell carcinoma (RCC) who have at least three of six prognostic risk factors.