Toxicities may include: Fatigue, joint swelling or discomfort, hypokalemia, edema, hot flushes, diarrhea, urinary tract infection, cough, hypertension, arrhythmia, urinary frequency, nocturia, dyspepsia, upper respiratory tract infection, increases in liver enzyme levels, adrenocortical insufficiency Albumin-bound (nab) paclitaxelUse: Metastatic breast cancer as second line treatment, locally advanced or metastatic non-small–cell lung cancer (NSCLC), metastatic adenocarcinoma of the pancreas in combination with gemcitabine. Dosage: For patients with metastatic breast cancer, 260 mg/m2 IV every 3 weeks; for those with NSCLC, 100 mg/m2 IV on days 1,8, and 15 of a 21-day cycle; for patients with pancreatic cancer, 125 mg/m2 IV on days 1,8, and 15 of a 28-day cycle Toxicities may include: Bone marrow depression, sensory and peripheral neuropathy, arthralgia/myalgia, asthenia, abnormal electrocardiogram, alopecia, fatigue, nausea AlemtuzumabUse: Chemotherapy-refractory B-cell chronic lymphocytic leukemia Dosage: Premedication with acetaminophen and diphenhydramine recommended prior to first dose and dose escalations. Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 minutes, three times per week on alternate days for up to 12 weeks Toxicities may include: Pancytopenia, infusion reaction, opportunistic infections, skin rash, nausea/vomiting, insomnia AltretamineUse: Ovarian cancer Dosage: 260 mg/m2 PO, divided in four doses for 14–21 days of a 28-day regimen Toxicities may include: Nausea and vomiting, bone marrow depression, neuropathies, neurotoxicities BelinostatUse: Peripheral T-cell lymphoma Dosage: 1,000 mg/m2 IV over 30 minutes on days 1–5 of a 21-day cycle Toxicites may include: Nausea, fatigue, fevers, anemia, and vomiting BendamustineUse: Chronic lymphocytic leukemia, B-cell non-Hodgkin lymphoma (relapsed) Dosage: 100 mg/m2 IV on day 1 and day 2 of a 28-day cycle, up to 6 cycles Toxicities may include: Bone marrow depression, fever, nausea, and vomiting BevacizumabUse: Breast cancer, colorectal cancer, non–small-cell lung cancer, renal cell carcinoma, glioblastoma (relapse), cervical cancer, epithelial ovarian, fallopian tube, primary peritoneal cancer. Dosage: 5–15 mg/kg/wk IV every 14–21 days Toxicities may include: Asthenia, headache, epistaxis, proteinuria, gastrointestinal perforations/wound-healing complications, hypertension/hypertensive crisis; hemorrhage, thromboembolic event, ovarian failure, osteonecrosis of the jaw, posterior reversible encephalopathy syndrome, infusion reactions, embryo-fetal toxicity, rhinitis, taste alterations, dry skin, lacrimation disorder, back pain, exfoliative dermatitis BlinatumomabUse: Philadelphia chromosome–negative (Ph−) relapsed or refractory B-cell acute lymphoblastic leukemia Dosage: Cycle one: 9 μg/d as a continuous infusion on days 1–7, then 28 μg/d as a continuous infusion on days 8–28. Subsequent cycles: 28 μg/d as a continuous infusion on days 1–28 Toxicities may include: cytokine release syndrome, neurologic toxicities, pyrexia, headache, peripheral edema, febrile neutropenia, nausea, hypokalemia, tremor, rash, constipation BleomycinUse: Testicular cancer, Hodgkin lymphoma; reticulum cell sarcoma (histiocytic lymphoma); lymphosarcoma; squamous cell cancer of the head and neck, skin, cervix, vulva, and penis Dosage: 10–20 U/m2 given IV, IM, or SC weekly or twice weekly; maximum total dose, 400 U; a 2-U test dose should be given because of a possible anaphylactoid reaction Toxicities may include: Pneumonitis and pulmonary fibrosis, fever and allergic reactions, anaphylaxis, hyperpigmentation, Raynaud phenomenon, alopecia BortezomibUse: Multiple myeloma Dosage: 1.3 mg/m2 on days 1, 4, 8, and 11 every 3 weeks Toxicities may include: Diarrhea, peripheral neuropathy, asthenia, fever, anorexia, Mantle cell lymphoma, nausea and vomiting, rash, headache, thrombocytopenia Brentuximab vedotinUse: Hodgkin lymphoma after failure of autologous stem cell transplant (ASCT) or after failure of at least two prior multiagent chemotherapy regimens in patients who are not candidates for ASCT; or treatment of patients with systemic anaplastic large-cell lymphoma after failure of at least one prior multi-agent chemotherapy regimen. Dosage: 1.8 mg/kg IV infusion over 30 minutes every 3 weeks (maximum of 16 cycles) Toxicities may include: Neutropenia, peripheral sensory neuropathy, abdominal pain, fatigue, nausea, anemia, upper respiratory tract infection, diarrhea, pyrexia, rash, thrombocytopenia, cough, vomiting BusulfanUse: Chronic myeloid leukemia, bone marrow transplantation for refractory leukemia, lymphomas Dosage: 2–8 mg PO daily for remission induction; adjust dosage to white blood cell (WBC) count; 1–3 mg PO daily for maintenance; withhold induction if WBC count is < 15,000/µL; resume therapy when WBC count is > 50,000/µL Toxicities may include: Bone marrow depression, pulmonary fibrosis, aplastic anemia, amenorrhea, gynecomastia, skin hyperpigmentation CabazitaxelUse: Hormone-refractory metastatic prostate cancer previously treated with docetaxel regimens Dosage: 25 mg/m2 IV every 3 weeks in combination with prednisone at 10 mg PO daily throughout cabazitaxel treatment. Premedicate 30 minutes before each dose with antihistamine, corticosteroid, and H2 antagonist. Toxicities may include: Febrile neutropenia (primary prophylaxis with granulocyte colony-stimulating factor should be considered in high-risk patients), nausea, vomiting, diarrhea, renal failure, hypersensitivity reactions CapecitabineUse: Breast cancer (relapsed), colorectal cancer, and other gastrointestinal malignancies Dosage: 1,250 mg/m2 bid PO with food (2 weeks on drug, 1 week of rest) Toxicities may include: Diarrhea, stomatitis, nausea and vomiting, fatigue, hand-foot syndrome, bone marrow depression (minimal) CarboplatinUse: Ovarian cancer; endometrial, head and neck, lung, testicular, and breast cancers; relapsed acute leukemia, non-Hodgkin lymphoma Dosage: Single agent: 360 mg/m2 IV every 4 weeks; combination: 300 mg/m2 IV every 4 weeks; Calvert formula: Total dose (mg) = Target area under the curve × [glomerular filtration rate (GFR) + 25] Toxicities may include: Bone marrow depression, nausea and vomiting, peripheral neuropathy, ototoxicity Total carboplatin dose calculation based on serum creatinine levels measured by isotope dilution mass spectrometry using the Calvert formula may result in overestimation of the GFR in some patients with normal renal function, and therefore increased drug-related toxicity. When actual GFR measurements are made to assess renal function, carboplatin can be safely dosed as outlined in the package insert. CarmustineUse: Brain tumor, multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, melanoma, bone marrow transplant for patients with refractory solid tumors and lymphomas Dosage: 150–200 mg/m2 IV every 6–8 weeks Toxicities may include: Delayed bone marrow depression, nausea and vomiting, reversible hepatotoxicity, local phlebitis, pulmonary and renal damage (with high-dose therapy) CeritinibUse: Patients with ALK-positive metastatic non–small-cell lung cancer who progress on, crizotinib or cannot tolerate it Dosage: 750 mg PO once a day Toxicites may include: Interstitial lung disease, QT interval prolongation, hyperglycemia, bradycardia, embryo-fetal toxicity, diarrhea, nausea, transaminitis, vomiting, abdominal pain, fatigue, decreased appetite, constipation CetuximabUse: KRAS wild-type colorectal cancer, head and neck cancer Dosage: Loading dose of 400 mg/m2 IV over 120 min, and 250 mg/m2 IV over 60 min every 7 days, as maintenance Toxicities may include: Skin rash, infusion reaction, asthenia, diarrhea, nausea, hypomagnesemia ChlorambucilUse: Chronic lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, ovarian cancer, choriocarcinoma, lymphosarcoma Dosage: 0.1–0.2 mg/kg PO daily for 3–6 weeks as required (usually 4–10 mg/d) or intermittent 0.4 mg/kg every 3–4 weeks; increase by 0.1 mg/kg until control of disease or toxicity Toxicities may include: Bone marrow depression, gonadal dysfunction, leukemia, hyperuricemia, pulmonary fibrosis CisplatinUse: Testicular, ovarian, bladder, uterine, cervical, and lung cancers, squamous cell cancer of the head and neck, sarcoma, non-Hodgkin lymphoma Dosage: 50 mg/m2 IV or more every 3 weeks; or 20 mg/m2 IV daily for 4–5 days every 3–4 weeks; hydrate patient vigorously before and after chemotherapy Toxicities may include: Renal damage, nausea and vomiting, electrolyte disturbance, peripheral neuropathy, bone marrow depression, ototoxicity, radiosensitizer CladribineUse: Hairy-cell leukemia, non-Hodgkin lymphoma, mycosis fungoides, acute myeloid leukemia, chronic myeloid leukemia, chronic lymphocytic leukemia Dosage: 0.09 mg/kg/d (4 mg/m2/d) by continuous IV infusion for 7 consecutive days Toxicities may include: Bone marrow depression, febrile episodes, rash, infections, septicemia CrizotinibUse: Anaplastic lymphoma kinase (ALK)-mutation–positive non–small-cell lung cancer Dosage: 250 mg orally twice daily Toxicities may include: Vision disorder, nausea, diarrhea, vomiting, edema, constipation, increased levels of alanine aminotransferase, neutropenia, pneumonitis CyclophosphamideUse: Acute myeloid leukemia, acute lymphoblastic leukemia, chronic lymphocytic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma, multiple myeloma; mycosis fungoides; neuroblastoma; ovarian and breast cancers; retinoblastoma; lung, testicular, and bladder cancers; sarcoma Dosage: 40–50 mg/kg IV in divided doses over 2–5 days to start, followed by 10–15 mg/kg IV every 7–10 days; or 3–5 mg/kg IV twice weekly; or 1–5 mg/kg/d PO Toxicities may include: Bone marrow depression, hemorrhagic cystitis, immunosuppression, alopecia, stomatitis, syndrome of inappropriate antidiuretic hormone secretion (SIADH) Cytarabine (Ara-C)Use: Acute myeloid leukemia (AML), acute lymphoblastic leukemia, chronic myeloid leukemia, non-Hodgkin lymphoma, central nervous system leukemia (intrathecal) Dosage: Induction therapy for AML: 100 mg/m2/d by continuous IV infusion on days 1–7; or 100 mg/m2 IV every 12 hours on days 1–7; Relapsed ALL: 3 g/m2 IV over 1–3 hours every 12 hours for four doses Toxicities may include: Bone marrow depression, nausea and vomiting, diarrhea, arachnoiditis (intrathecal), stomatitis, hepatic dysfunction, fever, conjunctivitis, confusion, somnolence, cerebellar toxicity DabrafenibUse: As monotherapy for patients with unresectable or metastatic melanoma with BRAF V600E mutations or in combination with trametinib Dosage: 150 mg PO twice a day Toxicites may include: New primary malignancies, tumor promotion in BRAF wild-type melanoma, hemorrhage, thromboembolism, cardiomyopathy, occular toxicities, fevers, skin rashes and infections, hyperglycemia, embryo-fetal toxicity, hyperkeratosis, headache, arthralgia, alopecia, palmar-plantar erythrodysesthia, night sweats, chills, nausea, vomiting, peripheral edema, decreased appetite, constipation, myalgias DacarbazineUse: Malignant melanoma, Hodgkin lymphoma (HL), soft-tissue sarcomas, neuroblastoma Dosage: Melanoma: 2–4.5 mg/kg/d IV for 10 days every 4 weeks; or 250 mg/m2/d IV for 5 days every 3 weeks HL: 375 mg/m2 IV on day 1, repeated every 15 days (single agent); 150 mg/m2/d IV for 5 days every 4 weeks (combination therapy) Toxicities may include: Bone marrow depression, nausea and vomiting, flu-like syndrome, transient hepatotoxicity, local irritation, facial flushing, alopecia DactinomycinUse: Testicular cancer, gestational trophoblastic tumors, Wilms tumor, rhabdomyosarcoma, Ewing sarcoma Dosage: 0.010–0.015 mg/kg IV daily for 5 days every 3 weeks (usual adult dose, 0.5 mg) or 2 mg/m2 IV as a single dose every 3–4 weeks Toxicities may include: Stomatitis, bone marrow depression, anorexia, nausea and vomiting, diarrhea, alopecia, skin changes, anaphylactoid reaction DasatinibUse: Chronic myeloid leukemia (CML), Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia Dosage: 140 mg/d (divided doses; 70 mg bid) or 100 mg/d PO (chronic phase CML) Non-hematologic toxicities may include: Fluid-retention events (eg, pleural effusion); gastrointestinal events (diarrhea, nausea, abdominal pain, and vomiting; and bleeding events). Hematologic toxicities may include: neutropenia, thrombocytopenia, anemia DaunorubicinUse: Acute myeloid leukemia, acute lymphoblastic leukemia Dosage: Remission induction: 30–45 mg/m2/d IV for 3 days in combination therapy; total cumulative dose, 550 mg/m² Toxicities may include: Bone marrow depression, cardiotoxicity, alopecia, nausea and vomiting, diarrhea, stomatitis, fever, dermatitis at previously irradiated sites, red urine, anaphylactoid reaction DaunoXome (liposomal daunorubicin)Use: Kaposi sarcoma, acute lymphoblastic leukemia, acute myeloid leukemia Dosage: Liposomal preparation: 40 mg/m2 IV every 2 weeks DepoCyt (liposomal cytarabine)Use: Central nervous system leukemia/lymphoma Dosage: Intrathecal: DepoCyt, 50 mg over 1–5 minutes every 14 days, with dexamethasone, 4 mg PO bid × 5 days DocetaxelUse: Breast, non–small-cell lung, prostate, ovarian, pancreatic, head and neck, esophagus, stomach, cervical, uterine, and bladder cancers; Kaposi sarcoma Dosage: 60–100 mg/m2 IV over 1 hour every 21 days or up to 42 mg/m2 IV every week Toxicities may include: Bone marrow depression, fluid retention, hypersensitivity reaction, paresthesias, rash, alopecia, myalgias Doxil (liposomal doxorubicin)Use: Ovarian cancer (refractory to paclitaxel- and platinum-based regimens), Kaposi sarcoma, breast cancer, multiple myeloma Dosage: 50 mg/m2 IV every 4 weeks, 20 mg/m2 IV every 3 weeks Toxicities may include: Bone marrow depression, hand-foot syndrome, infusional reactions DoxorubicinUse: Acute lymphoblastic leukemia, acute myeloid leukemia; breast, ovarian, and bladder cancers; Hodgkin lymphoma and non-Hodgkin lymphoma, small-cell lung cancer, gastric cancer, sarcoma, Wilms tumor, neuroblastoma, and thyroid cancer; soft-tissue and bone sarcomas Dosage: 60–90 mg/m2 single IV injection every 21 days, 20–30 mg/m2/d IV for 3 days every 3–4 weeks, or 20 mg/m2 IV weekly. Total cumulative dose should be 550 mg/m2; reduce dose for liver dysfunction Toxicities may include: Bone marrow depression, cardiotoxicity, stomatitis (continuous infusion), alopecia, nausea and vomiting, diarrhea, fever, dermatitis at previously irradiated sites, red urine, anaphylactoid reaction E–NEpirubicinUse: Breast cancer Dosage: 100 mg/m2 IV on day 1 or 60 mg/m2 IV on days 1 and 8 in combination therapy Toxicities may include: Bone marrow depression, cardiotoxicity, stomatitis, alopecia Eribulin mesylateUse: Breast cancer (relapse) Dosage: 1.4 mg/m2 on days 1 and 8 every 21 days Toxicities may include: Neutropenia, anemia, asthenia/fatigue, alopecia, peripheral neuropathy, nausea, constipation ErlotinibUse: Non–small-cell lung cancer, pancreatic cancer Dosage: 150 mg/d PO; 100 mg/d PO (pancreatic cancer) Toxicities may include: Acneiform skin rash, diarrhea, anorexia, fatigue, dyspnea EstramustineUse: Prostate, renal cell carcinomas Dosage: 14 mg/kg/d PO in 3–4 equally divided doses; 300 mg/d IV for 3–4 weeks, followed by 300–450 mg/weeks IV over 3–8 weeks Toxicities may include: Bone marrow depression, ischemic heart disease, thromboembolism, thrombophlebitis, gynecomastia, nausea and vomiting, hepatotoxicity EtoposideUse: Testicular cancer (refractory), small-cell lung cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, gestational trophoblastic tumors. (For both indications, etoposide is given with combination therapy and repeated every 3–4 weeks.) Dosage: Testicular cancer: 50–100 mg/m2/d IV for 5 days or 100 mg/m2/d IV on days 1, 3, and 5; lung cancer: 35–50 mg/m2/d IV for 5 days or 100 mg/m2/d PO for 5 days Toxicities may include: Bone marrow depression, nausea and vomiting, diarrhea, fever, hypotension (in case of rapid infusion), alopecia, rash, acute myeloid leukemia (late effect) EverolimusUse: Renal cell carcinoma (with treatment progression to tyrosine kinase inhibitors), pancreatic neuroendocrine tumors, subependymal giant cell astrocytoma (SEGA) Dosage: 10 mg/d PO; SEGA: initial dose based on body surface area with subsequent titration to attain trough concentrations of 5–10 ng/mL Toxicities may include: Stomatitis, infections, asthenia, diarrhea, pneumonitis, dyslipidemia, hyperglycemia, elevated serum creatinine levels FloxuridineUse: Gastrointestinal (GI) adenocarcinomas metastatic to liver, including oral, pancreatic, biliary, colon, and hepatic cancers; and metastatic breast cancer Dosage: 0.1–0.6 mg/kg/d over several days via continuous arterial infusion supplying well-defined tumor; treatments given over 1–6 weeks Toxicities may include: Stomatitis and GI ulcers, bone marrow depression, abdominal pain, nausea and vomiting, diarrhea, liver dysfunction (transient) FludarabineUse: Chronic lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin lymphoma (low-grade) Dosage: 25 mg/m2/d IV over 30 min for 5 days; repeat every 28 days Toxicities may include: Bone marrow depression, nausea and vomiting, fever, malaise, pulmonary infiltrates, tumor lysis syndrome, central nervous system effects (high dose) FluorouracilUse: Colon, rectal, stomach, pancreatic, breast, head and neck, renal cell, prostate, and ovarian cancers; squamous cell carcinomas of the esophagus; basal and squamous cell carcinoma of skin (topical); and hepatic cancer (intra-arterial) Dosage: Loading dose: 300–500 mg/m2; or 12 mg/kg IV daily for 3–5 days, followed by weekly maintenance; maintenance: 10–15 mg/kg IV weekly, as toxicity permits; infusion: 20–25 mg/kg by continuous IV over 24 hours for 4–5 days, every 4 weeks Toxicities may include: Stomatitis and gastrointestinal ulcers (infusion), bone marrow depression (bolus), diarrhea, nausea and vomiting, esophagitis, angina, cerebellar ataxia, radiosensitizer GefitinibUse: Non–small-cell lung cancer Dosage: 250 mg/d PO Toxicities may include: Acneiform skin rash, diarrhea, transaminitis, asthenia, nausea/vomiting, interstitial lung disease GemcitabineUse: Pancreatic, lung, breast, ovarian, and bladder cancers Dosage: 1,000 mg/m2 IV over 30 minutes, once weekly for up to 7 weeks (or until toxicity necessitates reducing or withholding a dose), followed by 1 week of rest; subsequent cycles: infusions once weekly for 3 consecutive weeks out of every 4 weeks Toxicities may include: Bone marrow depression, transient fever, flu-like syndrome, skin rash, mild nausea and vomiting Gliadel wafersUse: Glioblastoma multiforme Dosage: Up to 8 in brain cavity created by tumor removal Toxicities may include: Fever, pain, and abnormal healing HydroxyureaUse: Chronic myeloid leukemia, acute leukemia (emergent treatment), head and neck cancer, ovarian cancer, melanoma, essential thrombocytosis, polycythemia vera Dosage: Intermittent: 80 mg/kg PO every third day; continuous: 20–30 mg/kg PO daily Toxicities may include: Bone marrow depression, mild nausea and vomiting, skin rashes, radiosensitivity IbritumomabUse: CD20+ low grade follicular B-cell non-Hodgkin lymphoma (relapse) Dosage: Dosimetric step: rituximab at 250 mg/m2 IV, followed by 5 mCi In-111 ibritumomab on day 1; therapeutic step: day 7, 8, or 9 rituximab at 250 mg/m2 IV, followed by 0.4–0.3 mCi/kg Y-90 ibritumomab Toxicities may include: Myelosuppression, infection, gastrointestinal symptoms, myelodysplastic syndromes/, acute myeloid leukemia IbrutinibUse: Mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), Waldenström macroglobulinemia (WM) Dosage: MCL 560 mg PO once a day; CLL, WM: 420 mg PO once a day Toxicities may include: Hemorrhage, infections, myelosuppression, atrial fibrillation, second primary malignancies, tumor lysis syndrome, embryo-fetal toxicites, diarrhea, fatigue, musculoskeletal pain, bruising, nausea, upper respiratory tract infections, rash IdarubicinUse: Acute myeloid leukemia, chronic myeloid leukemia (blast phase), acute lymphoblastic leukemia Dosage: 12 mg/m2/d IV for 3 days every 3 weeks in combination therapy Toxicities may include: Bone marrow depression, nausea and vomiting, stomatitis, alopecia, cardiotoxicity IdelalisibUse: Chronic lymphocytic leukemia in combination with rituximab, follicular lymphoma, small lymphocytic lymphoma Dosage: 150 mg orally twice a day Toxicities may include: Severe cutaneous reactions, anaphylaxis, neutropenia, embryo-fetal toxicity, diarrhea, pyrexia, fatigue, nausea, cough, pneumonia abdominal pain, chills, and rash IfosfamideUse: Germ-cell testicular cancer, sarcoma, non-Hodgkin lymphoma, lung cancer Dosage: 1.2 g/m2/d via slow IV infusion for 5 consecutive days; repeat every 3 weeks; give with mesna Toxicities may include: Bone marrow depression, hemorrhagic cystitis, confusion, somnolence ImatinibUse: Chronic myeloid leukemia (CML), gastrointestinal stromal tumor (GIST), Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia, dermatofibrosarcoma protuberans, mastocytosis, myelodysplastic syndromes/myeloproliferative disorders Dosage: 400 mg/d PO in chronic-phase CML and GIST and 600 mg/d PO for CML in accelerated phase or blast crisis/800 mg/d PO (dermatofibrosarcoma protuberans) Toxicities may include: Nausea and vomiting, edema and fluid retention, myalgias, diarrhea, myelosuppression, transaminitis IpilimumabUse: Melanoma Dosage: 3 mg/kg IV over 90 minutes every 3 weeks for a total of 4 doses Toxicities may include: Fatigue, immune-mediated adverse reactions (diarrhea/colitis, pruritus, rash, hepatitis/elevated liver function tests, hypopituitarism, hypo-/hyperthyroidism, uveitis, pneumonitis, nephritis, pancreatitis, aseptic meningitis, neuromuscular disorders) IrinotecanUse: Colorectal cancer, lung, ovarian, and cervical cancers Dosage: 125 mg/m2 IV over 90 min once weekly for 4 weeks; then 2-week rest or 350 mg/m2 every 21 days or 180 mg/m2 every 2 weeks Toxicities may include: Bone marrow depression, diarrhea, nausea and vomiting, anorexia, weight loss IxabepiloneUse: Breast cancer (relapse) Dosage: 40 mg/m2 IV over 3 hours every 3 weeks Toxicities may include: Myelosuppression, peripheral sensory neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, vomiting, stomatitis/mucositis, diarrhea, musculoskeletal pain, abdominal pain, palmar-plantar erythrodysesthesia syndrome, hypersensitivity reaction LanreotideUse: Gastroenteropancreatic neuroendocrine tumors Dosage: 120 mg every 4 weeks Toxicities may include: Abdominal pain, cholelithasis, headache, hyperglycemia, hypertension, injection site reactions, musculoskeletal pain, vomiting Warnings/Precautions include: Bradycardia, blood glucose alterations, gallstones LapatinibUse: HER2-positive metastatic breast cancer, or in combination with letrozole for postmenopausal women with hormone receptor–positive breast cancer for whom hormonal therapy is indicated Dosage: 1,250 mg PO daily × 21 days in combination with capecitabine at 2,000 mg/m2/d PO (divided doses) on days 1–14 of a repeating 21-day cycle Toxicities may include: Diarrhea, hand-foot syndrome, nausea, rash, vomiting, fatigue, left ventricular ejection fraction decrease, pneumonitis, QT prolongation LenalidomideUse: Multiple myeloma (relapse) Dosage: 10 mg/d PO Toxicities may include: Birth defects, neutropenia and thrombocytopenia, thrombosis LenvatinibUse: Locally recurrent, metastatic, progressive, radioactive iodine–refractory differentiated thyroid cancer Dosage: 24 mg PO once a day Toxicites may include: Hypertension, cardiac dysfunction, arterial thrombotic events, hepatotoxicity, proteinuria, renal failure, renal impairment, gastrointestinal perforation, QT prolongation, hypocalcemia, reversible posterior leukoencephalopathy syndrome, hemorrhage, changes in thyroid stimulating hormone, embryo-fetal toxicity, fatigue, diarrhea, arthralgia, appetite suppression, weight loss, nausea/vomiting, stomatitis, headache, palmar-plantar erythrodysesthesia LomustineUse: Brain tumors, Hodgkin lymphoma, gastrointestinal carcinomas, non–small-cell lung cancer Dosage: 130 mg/m2 PO every 6 weeks; adjust dose in combination chemotherapy Toxicities may include: Delayed bone marrow depression, nausea and vomiting, reversible hepatotoxicity, pulmonary and renal damage, neurologic reactions, leukemia MechlorethamineUse: Hodgkin lymphoma, non-Hodgkin lymphoma, chronic myeloid leukemia, chronic lymphocytic leukemia, mycosis fungoides, bronchogenic carcinoma, lymphosarcoma, polycythemia vera, malignant effusions (intracavitary) Dosage: 0.4 mg/kg ideal body weight given as single dose or in divided doses of 0.1–0.2 mg/kg/d Toxicities may include: Bone marrow depression, nausea and vomiting, local phlebitis, severe skin necrosis if extravasated, gonadal dysfunction MelphalanUse: Multiple myeloma, breast and ovarian cancers, sarcoma, testicular cancer, and lung cancer Dosage: Continuous therapy: 6 mg PO daily for 2–3 weeks, no therapy for 2–4 weeks, then maintenance with 2–4 mg PO daily. For pulse therapy: 10 mg/m2 PO daily for 4 days every 4–6 weeks Toxicities may include: Bone marrow depression, anorexia, nausea and vomiting, gonadal testicular dysfunction, leukemia MercaptopurineUse: Acute lymphoblastic leukemia, chronic myeloid leukemia, acute myeloid leukemia Dosage: 1.5–2.5 mg/kg/d PO (100–200 mg in average adult) until patient responds to treatment or toxic effects are seen; may increase dose to 5 mg/kg/d; adjust for maintenance dose; reduce dose by 50%-75% if given with allopurinol or if renal or hepatic insufficiency ensues Toxicities may include: Bone marrow depression, nausea and vomiting, anorexia, diarrhea, cholestasis MethotrexateUse: Breast, head and neck, gastrointestinal, and lung cancers, acute lymphoblastic leukemia, central nervous system leukemia (intrathecal), gestational trophoblastic tumors, non-Hodgkin lymphoma (advanced stage), Burkitt lymphoma, osteosarcoma, mycosis fungoides Dosage: Numerous dosing schedules with combination therapy. Low dose: 2.5–5.0 mg PO daily; or 5–25 mg/m2 PO, IM, IV twice weekly; or 50 mg/m2 IV every 2–3 weeks; high dose: 1–12 g/m2 IV with leucovorin rescue every 1–3 weeks; intrathecal: 5–10 mg/m2 (up to 15 mg) every 3–7 days Toxicities may include: Mucositis, gastrointestinal ulceration (may produce hemorrhage or perforation), bone marrow depression, pulmonary fibrosis (previously irradiated area), nerve root irritation and convulsion (intrathecal), liver cirrhosis and osteoporosis (chronic therapy), renal damage (high dose), diarrhea, skin erythema MitomycinUse: Gastric, colorectal, anal cancer, pancreatic adenocarcinomas, non–small-cell lung cancer, breast, uterine, cervical, and head and neck cancers Dosage: 20 mg/m2 IV every 6–8 weeks as a single agent or 5–10 mg/m2 IV every 6 weeks in combination therapy Toxicities may include: Bone marrow depression (cumulative), nausea and vomiting, anorexia, alopecia, stomatitis, fever, pulmonary fibrosis MitoxantroneUse: Acute myeloid leukemia, prostate, acute lymphoblastic leukemia, chronic myeloid leukemia, breast and ovarian cancers Dosage: Remission induction: 12 mg/m2/d IV for 3 days, in combination with Ara-C Toxicities may include: Bone marrow depression, cardiotoxicity, alopecia, stomatitis, nausea and vomiting, blue urine and sclera NilotinibUse: Chronic myeloid leukemia (CML) Dosage: Newly diagnosed CML (chronic phase): 300 mg PO twice daily; resistant or intolerant CML(chronic phase or accelerated phase): 400 mg PO twice daily Toxicities may include: Myelosuppression, hyperbilirubinemia, rash, pruritus, nausea, headache, fatigue, constipation, elevated lipase, QTc prolongation NivolumabUse: Unresectable or metastatic melanoma after ipilimumab or BRAF inhibitor, if BRAF V600–positive. Non–small-cell lung cancer with progression on or after a platinum-based chemotherapy Dosage: 3 mg/kg every 2 weeks Toxicities may include: Immune-mediated complications including: pneumonitis, colitis, hepatitis, nephritis, renal dysfunction, hyperthyroidism, hypothyroidism, embryo-fetal toxicity. Other toxicities may include: rash, fatigue, dyspnea, musculoskeletal pain, decreased appetite, cough, nausea, and constipation O–ZOfatumumabUse: Chronic lymphocytic leukemia (CLL) refractory to fludarabine and alemtuzumab; and in combination with chlorambucil for CLL patients who would not tolerate fludarabine. Dosage: Premedicate with acetaminophen PO, antihistamine PO or IV, and corticosteroids IV. For CLL refractory to fludarabine and alemtuzumab: 300 mg initial dose, followed 1 week later by 2,000 mg weekly for 7 doses, followed 4 weeks later by 2,000 mg every 4 weeks for 4 doses. For CLL in combination with chlorambucil: 300 mg on day 1, followed by 1,000 mg on day 8, then 1,000 mg on day 1 of a 28-day cycle for a minimum of 3 cycles, up to a maximum of 12 cycles. Toxicities may include: Cytopenias, including neutropenia, infection, infusion reactions, fatigue, rash, tumor lysis syndrome, pneumonia, pyrexia, cough, diarrhea, dyspnea, nausea, bronchitis, upper respiratory tract infections OlaparibUse: Ovarian cancer Dosage: 400 mg by mouth twice a day Toxicities may include: Anemia, arthralgia/musculoskeletal pain/discomfort, cough, decreased appetite, diarrhea, dyspepsia, dysgeusia, fatigue/asthenia, headache, nausea, nasopharyngitis/pharyngitis/upper respiratory infection, and vomiting Warnings/Precautions include: Embryo-fetal toxicity, pneumonitis, myelodysplastic syndrome/acute myeloid leukemia OxaliplatinUse: Colorectal, ovarian cancers Dosage: 85 mg/m2 oxaliplatin and 200 mg/m2 leucovorin IV infusion over 120 min on day 1 followed by a 400 mg/m2 fluorouracil (5-FU) IV bolus, then 600 mg/m2 5-FU by IV infusion over 22 hours. On day 2, dose at 200 mg/m2 IV over 120 minutes IV, followed by 400 mg/m2 5-FU IV bolus, 600 mg/m2 5-FU IV infusion over 22 hours. Repeat every 2 weeks. Toxicities may include: Bone marrow depression, diarrhea, nausea and vomiting, neuropathies exacerbated by cold exposure, pharyngolaryngeal dysesthesia, pulmonary toxicity PaclitaxelUse: Ovarian cancer (relapsed); non–small-cell lung cancer (in combination with cisplatin); Kaposi sarcoma; breast, head and neck, gastric, colon, esophagus, uterine, prostate, and bladder cancers; and melanomas Dosage: 135–175 mg/m2 by IV infusion (ranging from 3–96 hours) every 3 weeks or 80 mg/m2 IV every week Toxicities may include: Bone marrow depression, peripheral neuropathy, alopecia, mucositis, anaphylaxis, dyspnea, myalgias PalbociclibUse: Estrogen receptor–positive, HER2-negative breast cancer, in combination with letrozole Dosage: 125 mg PO daily with food on days 1–21 of a 28-day cycle Toxicities may include: Neutropenia, infections, embryo-fetal toxicities, fatigue, anemia, upper respiratory tract infections, nausea, stomatitis, alopecia, diarrhea, thrombocytopenia, decreased appetite, vomiting, asthenia, peripheral neuropathy, epistaxis PanitumumabUse:KRAS wild-type colorectal cancer Dosage: 6 mg/kg IV over 60 minutes every 14 days Toxicities may include: Skin rash, hypomagnesemia, paronychia, fatigue, infusion reactions, nausea/vomiting, diarrhea PazopanibUse: Renal cell carcinoma Dosage: 800 mg PO once daily, without food Toxicities may include: Diarrhea, hypertension, hair color change, nausea/vomiting, fatigue, anorexia PanobinostatUse: Multiple myeloma in combination with bortezomib and dexamethasone Dosage: 20 mg PO on days 1, 3, 5, 8, 10, and 12 of a 21-day cycle Toxicities may include: Hemorrhage, hepatotoxicity, embryo-fetal toxicity, diarrhea, fatigue, nausea, peripheral edema, decreased appetite, pyrexia, and vomiting. Other laboratory and hematologic toxicities may occur. PEG-asparaginaseUse: Acute lymphoblastic leukemia, chronic myeloid leukemia, acute myeloid leukemia Dosage: 6,000 IU/m2 IM 3 times weekly for 9 doses or 100 IU/kg/d IV for 10 continuous days, starting on day 22 of treatment; usually given with vincristine and prednisone Toxicities may include: Allergic reactions (fever, chills, skin rash, anaphylaxis), nausea and vomiting, anorexia, liver dysfunction, central nervous system depression, coagulopathy, hyperglycemia Peginterferon alfa-2bUse: Melanoma Dosage: 6 μg/kg/week SC for 8 doses followed by 3 μg/kg/week SC for up to 5 years Toxicities may include: Fatigue, depression, anorexia, increased ALT/AST, myalgia, chills, nausea, headache, pyrexia, injection site reaction PembrolizumabUse: Metastatic melanoma Dosage: 2 mg/kg intravenously over 30 minutes every 3 weeks Toxicities may include: Immune-mediated reactions, including pneumonitis, colitis, hepatitis, hypophysitis, nephritis, and thyroid dysfunction. Other adverse effects include embryo-fetal toxicity, fatigue, cough nausea, pruritus, rash, decreased appetite, constipation, arthralgia, diarrhea. PemetrexedUse: Mesothelioma, non–small-cell lung cancer Dosage: 500 mg/m2 IV over 10 minutes every 21 days. Premedication needed with corticosteroid and vitamin supplementation Toxicities may include: Bone marrow depression, stomatitis/pharyngitis, rash/skin desquamation, diarrhea PentostatinUse: Hairy-cell leukemia, acute lymphoblastic leukemia, chronic lymphocytic leukemia, lymphoblastic lymphoma, mycosis fungoides Dosage: 4 mg/m2 IV over 30 minutes every other week or for 3 consecutive weeks; give vigorous hydration before and after chemotherapy Toxicities may include: Nephrotoxicity, central nervous system depression, bone marrow depression, nausea and vomiting, conjunctivitis PralatrexateUse: Relapsed and refractory T-cell lymphoma Dosage: 30 mg/m2 administered as an IV push over 3 to 5 minutes once weekly in 7-week cycles. Supplement with vitamin B-12, 1 mg IM every 8–10 weeks, and folic acid at 1–1.25 mg PO daily Toxicities may include: Mucositis, thrombocytopenia, nausea, fatigue, febrile neutropenia ProcarbazineUse: Hodgkin lymphoma (HL), non-Hodgkin lymphoma, brain tumors, lung cancer Dosage: Single agent: 4–6 mg/kg/d PO until maximum response; HL (mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone [MOPP]): 100 mg/m2/d PO for 14 days Toxicities may include: Bone marrow depression, nausea and vomiting, lethargy, depression, paresthesias, headache, flu-like symptoms RamucirumabUse: Gastric cancer, non–small-cell lung cancer (NSCLC), colorectal cancer Dosage: Gastric cancer: 8 mg/kg IV every 2 weeks, alone or in combination with paclitaxel; NSCLC: 10 mg/kg IV on day 1 of a 21-day cycle, prior to docetaxel; colorectal cancer: 8 mg/kg IV every 2 weeks, prior to FOLFIRI Toxicities may include: asthenia, diarrhea, epistaxis, fatigue, hypertension, neutropenia, stomatitis/mucositis, gastric perforations, hemorrhage, hypertension, impaired wound healing, proteinuria, thyroid dysfunction RituximabUse: CD20-positive B-cell non-Hodgkin lymphoma, chronic lymphocytic leukemia Dosage: 375 mg/m2 IV infusion (50–100 mg/h) once weekly in combination with fludarabine and cyclophosphamide; rituximab 375 mg/m2 (first cycle) and 500 mg/m2 in cycles 2–6 Toxicities may include: Infusion reactions, asthenia, headache, skin rash/pruritus, leukopenia/infection, nausea, tumor lysis syndrome, hepatitis B reactivation, progressive multifocal leukoencephalopathy RomidepsinUse: Cutaneous T-cell lymphoma refractory to 1 prior systemic therapy Dosage: 14 mg/m2 IV over 4 hours on days 1, 8, and 15 of a 28-day cycle Toxicities may include: Myelosuppression, QT prolongation (make sure magnesium and potassium are normal prior to administration), nausea, fatigue RuxolitinibUse: Myelofibrosis, polycythemia vera in patients who failed to respond to, or were intolerant of, treatment with hydroxyurea Dosage: Starting dose for patients with myelofibrosis: 5–20 mg PO twice daily; polycythemia vera: 10 mg PO twice daily Toxicities may include: Thrombocytopenia, anemia, bruising, dizziness, headache, infections, nonmelanoma skin cancers Sipuleucel-TUse: Asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone-refractory) prostate cancer Dosage: Administer 3 doses at approximately 2-week intervals. Premedicate patients with acetaminophen and antihistamine. Infuse sipuleucel-T IV over a period of 60 minutes. Each dose contains a minimum of 50 million autologous CD54+ cells activated with prostatic acid phosphatase granulocyte-macrophage colony stimulating factor suspended in 250 mL of lactated Ringer’s injection. Toxicities may include: Chills, fever, back pain, nausea, joint ache, headache SorafenibUse: Renal cell cancer, hepatocellular carcinoma Dosage: 400 mg PO twice a day Toxicities may include: Diarrhea, nausea, stomatitis, asthenia, cardiac ischemia, hand-foot syndrome, hypertension, bleeding, anorexia StreptozocinUse: Pancreatic islet-cell, carcinoid, colon, hepatoma, non–small-cell lung cancer, Hodgkin lymphoma Dosage: daily: 500 mg/m2 IV for 5 days every 6 weeks until maximum benefit or toxicity; weekly: 1,000 mg/m2 IV weekly for first 2 weeks, then escalate dose to response or toxicity, not to exceed a single dose of 1,500 mg/m² Toxicities may include: Renal damage, nausea and vomiting, diarrhea, altered glucose metabolism, liver dysfunction SunitinibUse: Renal cell cancer, gastrointestinal stromal tumor, pancreatic neuroendocrine tumors (PNETs) Dosage: 50 mg/d PO for 4 weeks, then 2-week rest period; PNETs: 37.5 mg PO daily continuously Toxicities may include: Diarrhea, nausea, stomatitis, asthenia, skin discoloration, hand-foot syndrome, hypertension, bleeding, anorexia, hepatotoxicity, cardiac toxicity, thyroid dysfunction TemozolomideUse: Glioblastoma, anaplastic astrocytoma (relapsed), renal cell carcinoma, melanoma Dosage: 150–200 mg/m2/d PO for 5 days every 28 days; 75 mg/m2 PO/d concomitant with radiotherapy Toxicities may include: Bone marrow depression, nausea and vomiting TemsirolimusUse: Renal cell carcinoma Dosage: 25 mg IV weekly over 30–60 minutes Toxicities may include: Rash, asthenia, mucositis, edema, dyslipidemia, hyperglycemia, elevated serum creatinine. Rarely, interstitial lung disease TeniposideUse: Relapsed acute lymphoblastic leukemia (ALL) in children, small-cell lung cancer Dosage: ALL: 100 mg/m2 once or twice weekly or 20–60 mg/m2/d for 5 days in combination with Ara-C; lung: 80–90 mg/m2/d for 5 days as a single agent Toxicities may include: Bone marrow depression, nausea and vomiting, alopecia, hypotension with rapid infusion, increased levels of liver enzymes, acute myeloid leukemia (late effect) ThalidomideUse: Multiple myeloma Dosage: 200 mg/d PO Toxicities may include: Birth defects, thrombotic events, somnolence, peripheral neuropathy, neutropenia ThioguanineUse: acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, advanced colorectal cancer, multiple myeloma Dosage: 2 mg/kg/d PO until patient responds to treatment or toxic effects are seen; may cautiously increase to 3 mg/kg/d Toxicities may include: Bone marrow depression, liver damage, stomatitis ThiotepaUse: Ovarian, breast, and superficial bladder cancers, Hodgkin lymphoma, chronic myeloid leukemia, chronic lymphocytic leukemia, bronchogenic carcinoma, malignant effusions (intracavitary), bone marrow transplant for refractory leukemia, lymphomas Dosage: IV: 0.3–0.4 mg/kg by rapid IV infusion; intravesical: 60 mg/60 mL sterile water instilled and retained in bladder for 2 hours, repeated weekly for 4 weeks; intracavitary: 0.6–0.8 mg/kg Toxicities may include: Bone marrow depression, nausea and vomiting, mucositis, skin rashes TopotecanUse: Cervical cancer, ovarian cancer (relapsed), small-cell lung cancer (relapsed), myelodysplastic syndrome, chronic myelomonocytic leukemia Dosage: 1.5 mg/m2 IV over 30 min for 5 consecutive days at 21-day intervals or 2.3 mg/m2/d PO for 5 consecutive days every 21 days Toxicities may include: Bone marrow depression, fever, flu-like symptoms, nausea and vomiting TositumomabUse: CD20+ low-grade follicular or transformed non-Hodgkin lymphoma (relapse) Dosage: dosimetric step, on day 1: tositumomab 450 mg IV over 60 min, I-131 tositumomab (5 mCi and 35 mg tositumomab) IV over 20 minutes; therapeutic step on days 7–14: tositumomab 450 mg IV over 60 min; I-131 tositumomab calculated Toxicities may include: Myelosuppression, hypothyroidism, second malignancies TrametinibUse: Patients with unresectable or metastatic melanoma with BRAF V600E mutations or BRAF V600K mutations who have not received prior BRAF-inhibitor therapy Dosage: 2 mg PO once a day on an empty stomach Toxicities may include: Retinal pigment epithelial detachment, retinal vein occlusion, interstitial lung disease, skin infections or rash, embryo-fetal toxicity, diarrhea, lymphedema TrastuzumabUse: HER2-overexpressing breast cancer, HER2-overexpressing gastric cancer Dosage: 4 mg/kg IV over 90 min, loading dose, and 2 mg/kg IV over 30 minutes every 7 days, as maintenance; or 8 mg/kg loading dose and 6 mg/kg every 21 days as maintenance Toxicities may include: Cardiac failure, infusion reaction, diarrhea ValrubicinUse: Bladder Dosage: 800 mg intravesically once a week for 6 weeks Toxicities may include: Local bladder symptoms VandetanibUse: Medullary thyroid cancer Dosage: 300 mg PO daily Toxicities may include: Prolonged QT interval, torsades de pointes, sudden death, diarrhea, rash, acne, nausea, hypertension, headache, fatigue, decreased appetite and abdominal pain, decreased calcium, increased ALT levels, decreased glucose levels VemurafenibUse: Melanoma with a BRAF V600E mutation Dosage: 960 mg PO twice daily, administered approximately 12 hours apart, with or without a meal Toxicities may include: Arthralgia, rash, alopecia, fatigue, photosensitivity reaction, nausea, squamous cell carcinomas of the skin and keratoacanthomas, hypersensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, uveitis, QT prolongation, liver enzyme laboratory abnormalities VinblastineUse: Hodgkin lymphoma, non-Hodgkin lymphoma, gestational trophoblastic tumors, testicular and breast cancers, mycosis fungoides, Kaposi sarcoma, histiocytosis X, bladder and renal cancers, non–small-cell lung cancer, chronic myeloid leukemia (blast crisis) Dosage: 4–12 mg/m2 IV as a single agent every 1–2 weeks; titrate dose to myelosuppression; adjust for hepatic insufficiency Toxicities may include: Bone marrow depression, nausea and vomiting, ileus, alopecia, stomatitis, myalgias, vesication VincristineUse: Acute lymphoblastic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, rhabdomyosarcoma, neuroblastoma, Wilms tumor, multiple myeloma, sarcomas, breast cancer Dosage: 0.4–1.4 mg/m2 IV weekly; maximum total dose, 2 mg/week; reduce dose for hepatic insufficiency Toxicities may include: Peripheral neuropathy, bone marrow depression, nausea, vomiting, hepatic dysfunction |