Alkylating Agents—Nitrogen Mustards |
Bendamustine (Treanda) | 100–120 mg/m2 intravenously every 3–4 weeks | Acute: hypersensitivity, nausea, vomiting Delayed: myelosuppression, rash, pyrexia, fatigue |
Cyclophosphamide (Cytoxan) | 500–1000 mg/m2 intravenously every 3 weeks; 100 mg/m2/day orally for 14 days every 4 weeks; various doses | Acute: nausea and vomiting Delayed: myelosuppression, alopecia, hemorrhagic cystitis, cardiotoxicity (high dose) |
Ifosfamide (Ifex) | 1200 mg/m2 intravenously daily for 5 days every 3 weeks; various doses | Acute: nausea and vomiting Delayed: alopecia, myelosuppression, hemorrhagic cystitis, neurotoxicity |
Mechlorethamine (Mustargen) | 0.4 mg/kg intravenously every 3–6 weeks | Acute: nausea and vomiting Delayed: myelosuppression |
Melphalan (Alkeran) | 0.25 mg/kg/day or 8–10 mg/m2/day orally for 4 days every 4–6 weeks; 16 mg/m2 intravenously every 2–4 weeks; various doses | Acute: nausea, vomiting, diarrhea, hypersensitivity (intravenously) Delayed: mucositis (intravenously), myelosuppression, increased risk of secondary malignancies |
Alkylating Agents—Platinum Analogs |
Carboplatin (Paraplatin) | Area under the curve (AUC)-based dosing use Calvert equation [Dose (mg) = AUC × (GFR + 25)] AUC = 2–7 mg/mL/min every 2–4 weeks | Acute: nausea and vomiting Delayed: myelosuppression, electrolyte disturbances, peripheral neuropathy, nephrotoxicity, hypersensitivity |
Cisplatin (Platinol) | 50–100 mg/m2 intravenously every 3–4 weeks; 20 mg/m2/day intravenously for 5 days every 3 weeks; various doses | Acute: nausea and vomiting Delayed: nephrotoxicity, ototoxicity, neurotoxicity, myelosuppression, electrolyte disturbances |
Oxaliplatin (Eloxatin) | 85–130 mg/m2 intravenously every 2–3 weeks | Acute: peripheral neuropathy exacerbated by cold, nausea, vomiting, diarrhea Delayed: myelosuppression, elevated transaminases |
Alkylating Agents—Triazenes |
Dacarbazine (DTIC-Dome) | 375 mg/m2 intravenously on day 1 and 15 every 4 weeks; 900–1000 mg/m2 intravenously over 3 to 4 days; various doses | Acute: nausea, vomiting, photosensitivity Delayed: myelosuppression, anorexia, hypotension, flu-like syndrome |
Procarbazine (Matulane) | 60–100 mg/m2 orally for 14 days every 4 weeks; various doses | Acute: nausea and vomiting Delayed: myelosuppression, disulfiram-like reaction, MAO inhibition, rash |
Temozolomide (Temodar) | 75 mg/m2 orally daily during radiation for 42 days; 150–200 mg/m2 orally for 5 days every 4 weeks | Acute: nausea, vomiting, constipation Delayed: myelosuppression, fatigue |
Alkylating Agent—Miscellaneous |
Busulfan (Myleran) | 1–8 mg orally daily; 0.8 mg/kg intravenously every 6 hours for 4 days | Acute: nausea and vomiting Delayed: myelosuppression, mucositis, rash, edema, electrolyte disturbances, hepatic veno-occlusive disease (high dose) |
Chlorambucil (Leukeran) | 0.1–0.2 mg/kg/day orally for 3–6 weeks; 0.4 mg/kg pulse every 4 weeks | Acute: nausea Delayed: myelosuppression, rash |
Lomustine (CCNU) | 100–130 mg/m2 orally every 6 weeks | Acute: nausea and vomiting Delayed: myelosuppression |
Antimetabolites—Folate Antagonists |
Methotrexate (MTX; Trexall) | Intrathecal: 12 mg High dose: 1000–12,000 mg/m2 intravenously every 2–3 weeks | Acute: nausea, vomiting, mucositis Delayed: myelosuppression, nephrotoxicity, hepatotoxicity, neurotoxicity, photosensitivity, pulmonary toxicity |
Pemetrexed (Alimta) | 500 mg/m2 intravenously every 3 weeks | Acute: nausea, vomiting, diarrhea, rash Delayed: myelosuppression, fatigue, mucositis |
Pralatrexate (Folotyn) | 30 mg/m2 intravenous bolus once weekly for 6 weeks in 7-week cycle | Acute: nausea, constipation Delayed: mucositis, myelosuppression, edema, fever, fatigue, cough |
Antimetabolites—Purine Analogs |
Cladribine (Leustatin) | 0.1 mg/kg/day subcutaneously daily for 5 days or 0.09 mg/kg/day intravenously via continuous infusion for 7 days | Acute: nausea, injection site reaction Delayed: myelosuppression, immunosuppression, fever, fatigue, rash |
Clofarabine (Clolar) | 52 mg/m2 intravenously daily for 5 days every 2–6 weeks (for patients < 21 years of age) | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, hepatotoxicity, nephrotoxicity, rash, capillary leak syndrome |
Fludarabine (Fludara) | 25 mg/m2 intravenously for 5 days every 4 weeks | Acute: fever, nausea, vomiting Delayed: asthenia, myelosuppression, immunosuppression, neurotoxicity, anorexia |
Mercaptopurine (6-MP; Purinethol) | Induction: 2.5–5 mg/kg/day orally Maintenance: 1.5–2.5 mg/kg/day orally | Acute: nausea, vomiting, diarrhea, rash Delayed: myelosuppression, immunosuppression, hepatotoxicity, mucositis |
Pentostatin (Nipent) | 2–4 mg/m2 intravenously every 2–3 weeks | Acute: nausea, vomiting, rash Delayed: myelosuppression, fever, myalgia, immunosuppression, hepatotoxicity, cough |
Antimetabolites—Pyrimidine Analogs |
Azacitidine (Vidaza) | 75–100 mg/m2 subcutaneously or intravenously for 7 days every 4 weeks | Acute: injection site reaction (subcutaneously), nausea, diarrhea, fever Delayed: myelosuppression, dyspnea, arthralgia |
Capecitabine (Xeloda) | 1000–1250 mg/m2 orally twice a day for 14 days every 3 weeks | Acute: nausea, vomiting, diarrhea Delayed: hand-foot syndrome, mucositis, hyperbilirubinemia, myelosuppression |
Cytarabine (Ara-C, Cytosar U) | Standard dose: 100 mg/m2/day intravenously via continuous infusion for 7 days High dose: 1000–3000 mg/m2 intravenously every 12 hours for 2–6 days | Acute: nausea, vomiting, rash, flu-like syndrome Delayed: myelosuppression High-dose: neurotoxicity, ocular toxicities |
Decitabine (Dacogen) | 15 mg/m2 intravenously every 8 hours for 3 days every 8 weeks; 20 mg/m2 intravenously daily for 5 days | Acute: nausea, vomiting, hyperglycemia Delayed: myelosuppression, fever, fatigue, cough |
Fluorouracil (Adrucil) | 400 mg/m2 intravenous bolus followed by 2400 mg/m2 intravenously over 46 hours every 2 weeks; 1000 mg/m2 intravenously via continuous infusion for 4–5 days every 3–4 weeks; various doses | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, hand-foot syndrome, mucositis, photosensitivity, cardiotoxicity (rare) |
Gemcitabine (Gemzar) | 1000–1250 mg/m2 intravenously on days 1 and 8 every 3 weeks or days 1, 8, 15 every 4 weeks | Acute: nausea, vomiting, rash, flu-like symptoms, fever, diarrhea Delayed: myelosuppression, edema, elevated transaminases |
Antimicrotubules—Vinca Alkaloids |
Vinblastine (Velban) | 6 mg/m2 intravenously on days 1 and 15 every 4 weeks; various doses | Acute: constipation Delayed: myelosuppression, alopecia, bone pain, malaise |
Vincristine (Oncovin) | 0.5–1.4 mg/m2 intravenously every 3 weeks; various doses; maximum single dose usually limited to 2 mg | Acute: constipation, nausea Delayed: peripheral neuropathy, alopecia |
Liposomal Vincristine (Marqibo) | 2.25 mg/m2 intravenously every 7 days | Acute: constipation, nausea Delayed: fatigue, neurotoxicity, myelosuppression |
Vinorelbine (Navelbine) | 25–30 mg/m2 intravenously weekly | Acute: nausea, vomiting Delayed: myelosuppression, peripheral neuropathy, constipation, alopecia, asthenia |
Antimicrotubules—Taxanes |
Cabazitaxel (Jevtana) | 25 mg/m2 intravenously every 3 weeks | Acute: diarrhea, nausea, vomiting, hypersensitivity Delayed: myelosuppression, peripheral neuropathy, fatigue |
Docetaxel (Taxotere) | 60–100 mg/m2 intravenously every 3 weeks | Acute: nausea, vomiting, diarrhea, hypersensitivity, rash Delayed: myelosuppression, asthenia, peripheral neuropathy, alopecia, edema, mucositis |
Paclitaxel (Taxol) | 135–175 mg/m2 intravenously every 3 weeks; 50–80 mg/m2 intravenously weekly; various doses | Acute: diarrhea, nausea, vomiting, hypersensitivity Delayed: myelosuppression, peripheral neuropathy, alopecia, mucositis, arthralgia |
Paclitaxel protein-bound (Abraxane) | 100–125 mg/m2 on days 1, 8, 15 every 3–4 weeks; 260 mg/m2 intravenously every 3 weeks | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, peripheral neuropathy, alopecia, asthenia |
Antimicrotubules—Epothilone |
Ixabepilone (Ixempra) | 40 mg/m2 intravenously every 3 weeks | Acute: nausea, vomiting, diarrhea, hypersensitivity Delayed: peripheral neuropathy, fatigue, alopecia, myelosuppression, mucositis, arthralgia |
Enzyme Inhibitors—Anthracyclines |
Daunorubicin (Cerubidine) | 30–60 mg/m2 intravenously for 3 days | Acute: nausea, vomiting, diarrhea, red/orange discoloration of urine, infusion-related reactions (liposomal products) Delayed: myelosuppression, mucositis, alopecia, hand-foot syndrome (liposomal doxorubicin), cardiotoxicity (dose related) |
Doxorubicin (Adriamycin) | 45–75 mg/m2 intravenously every 3 weeks; various doses | |
Epirubicin (Ellence) | 60–120 mg/m2 intravenously every 3–4 weeks | |
Idarubicin (Idamycin) | 10–12 mg/m2 intravenously for 3 days | |
Liposomal daunorubicin (Daunoxome) | 40 mg/m2 intravenously every 2 weeks | |
Liposomal doxorubicin (Lipodox) | 20–50 mg/m2 intravenously every 3–4 weeks | |
Enzyme Inhibitors—Topoisomerase Inhibitors |
Etoposide (Vepesid) | 50–100 mg/m2 intravenously for 3–5 days every 3 weeks | Acute: nausea, vomiting, diarrhea, hypersensitivity, fever, hypotension Delayed: myelosuppression, alopecia, fatigue |
Etoposide phosphate (Etopophos) | 35–100 mg/m2 intravenously for 3–5 days every 3–4 weeks | |
Irinotecan (Camptosar) | 180 mg/m2 intravenously every other week; various doses | Acute: diarrhea, cholinergic syndrome, nausea, vomiting Delayed: myelosuppression, alopecia, asthenia |
Irinotecan liposome (Onivyde) | 70 mg/m2 intravenously over 90 minutes every 2 weeks; prior to leucovorin and fluorouracil | Acute: diarrhea, nausea, vomiting Delayed: myelosuppression, fatigue, decrease in appetite |
Topotecan (Hycamtin) | 1.5 mg/m2 intravenously for 5 days every 3 weeks; 2.3 mg/m2 orally for 5 days every 3 weeks | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, alopecia, asthenia |
Immunomodulatory Therapy |
Lenalidomide (Revlimid) | 5–25 mg orally once daily on days 1–21 of 28-day cycle; or continuously | Acute: diarrhea, rash Delayed: myelosuppression, fatigue, venous thromboembolism, potential for birth defects |
Pomalidomide (Pomalyst) | 4 mg orally once daily on days 1–21 of 28-day cycle | Acute: nausea, diarrhea, dizziness Delayed: myelosuppression, fatigue, neuropathy, upper respiratory tract infections, venous thromboembolism, potential for birth defects |
Thalidomide (Thalomid) | 50–800 mg orally once daily | Acute: sedation, constipation, rash Delayed: edema, peripheral neuropathy, venous thromboembolism, potential for birth defects |
Proteasome Inhibitors |
Bortezomib (Velcade) | 1.3 mg/m2 intravenous bolus or subcutaneously on days 1, 4, 8, 11 followed by a 10-day rest, or weekly for 4 weeks followed by 13-day rest | Acute: nausea, vomiting, diarrhea Delayed: peripheral neuropathy, fatigue, myelosuppression |
Carfilzomib (Kyprolis) | 20–56 mg/m2 intravenously on days 1, 2, 8, 9, 15, 16 of a 28-day cycle or 20–70 mg/m2 intravenously on days 1, 8, 15 of a 28-day cycle | Acute: nausea, dyspnea, diarrhea, infusion-related reaction Delayed: fatigue, myelosuppression, elevated serum creatinine |
Ixazomib (Ninlaro) | 4 mg orally on days 1, 8, 15 of a 28-day treatment cycle | Acute: diarrhea, constipation, nausea, vomiting Delayed: myelosuppression, peripheral neuropathy, peripheral edema, rash, hepatotoxicity (rare) |
Targeted Therapy—Monoclonal Antibodies |
Ado-trastuzumab emtansine (Kadcyla) | 3.6 mg/kg intravenously every 3 weeks | Acute: infusion-related reaction, nausea Delayed: fatigue, musculoskeletal pain, thrombocytopenia, cardiotoxicity, heptatotoxicity |
Alemtuzumab (Campath) | 3–10 mg intravenously or subcutaneously three times weekly | Acute: infusion-related reaction, nausea, vomiting, hypotension, rash Delayed: myelosuppression, immunosuppression |
Atezolizumab (Tecentriq) | 1200 mg intravenously every 3 weeks | Acute: infusion-related reaction Delayed: immune-mediated reactions, fatigue, decreased appetite |
Avelumab (Bavencio) | 800 mg intravenously every 2 weeks | Acute: infusion-related reaction Delayed: fatigue, immune-mediated reactions |
Bevacizumab (Avastin) | 5–15 mg/kg intravenously every 2–3 weeks | Acute: infusion-related reaction Delayed: hypertension, proteinuria, wound healing complications, gastrointestinal perforation, hemorrhage |
Blinatumomab (Blincyto) | 9 mcg/day intravenously via continuous infusion on days 1 through 7; 28 mcg/day on days 8 through 28 of the first 42-day cycle; subsequent cycles: 28 mcg/day for 4 weeks followed by at least 2 weeks of no treatment | Acute: infusion-related reaction, nausea, headache, cytokine release syndrome, tumor lysis syndrome Delayed: pyrexia, peripheral edema, myelosuppression, hypokalemia, rash, neurologic toxicity, constipation |
Brentuximab vedotin (Adcetris) | 1.8 mg/kg intravenously every 3 weeks | Acute: infusion-related reaction, nausea, vomiting, diarrhea Delayed: myelosuppression, peripheral neuropathy, fatigue, rash, cough |
Cemiplimab-rwlc (Libtayo) | 350 mg intravenously every 3 weeks | Acute: infusion-related reaction, diarrhea Delayed: fatigue, rash, immune-mediated adverse reactions |
Cetuximab (Erbitux) | Loading dose 400 mg/m2 intravenously, maintenance dose 250 mg/m2 intravenously weekly | Acute: infusion-related reaction, nausea, diarrhea Delayed: acneiform skin rash, hypomagnesemia, asthenia, paronychial inflammation, dyspnea |
Daratumumab (Darzalex) | 16 mg/kg intravenously weekly for weeks 1–8, every 2 weeks for weeks 9–24, and every 4 weeks from week 25 until disease progression | Acute: infusion-related reaction, nausea Delayed: myelosuppression, fatigue, upper respiratory tract infection |
Elotuzumab (Empliciti) | 10 mg/kg intravenously every week for the first 2 cycles and every 2 weeks thereafter | Acute: infusion-related reaction, diarrhea Delayed: fatigue, peripheral neuropathy, risk for opportunistic infections |
Gemtuzumab ozogamicin (Mylotarg) | 2–6 mg/m2 intravenously; various dosing schedules | Acute: infusion-related reaction, fever, nausea Delayed: hemorrhage, infection, hepatotoxicity |
Ibritumomab tiuxetan (Zevalin) | 0.4 mCi/kg intravenously on day 7, 8, or 9 | Acute: infusion-related reaction, nausea, diarrhea Delayed: myelosuppression, asthenia, nasopharyngitis |
Inotuzumab ozogamicin (Besponsa) | 1.5–1.8 mg/m2 (administered in 3 divided doses) intravenously per cycle every 3 or 4 weeks | Acute: infusion-related reaction Delayed: myelosuppression, infection, hepatotoxicity, prolonged QT interval |
Ipilimumab (Yervoy) | 1–10 mg/kg intravenously every 3 weeks for a total of four doses | Acute: infusion-related reaction Delayed: immune-related reactions, fatigue |
Mogamulizumab-kpkc (Poteligeo) | 1 mg/kg intravenously on days 1, 8,15, and 22 of first 28-day cycle and on days 1 and 15 of each subsequent cycle | Acute: infusion-related reaction, diarrhea Delayed: rash, fatigue, infection, autoimmune complications |
Moxetumomab pasudotox-tdfk (Lumoxiti) | 0.04 mg/kg intravenously on days 1, 3, and 5 of a 28-day treatment cycle | Acute: infusion-related reaction Delayed: peripheral edema, electrolyte abnormalities, capillary leak syndrome, nephrotoxicity, hemolytic uremic syndrome |
Nivolumab (Opdivo) | 240 mg intravenously every 2 weeks or 480 mg every 4 weeks | Acute: vomiting Delayed: fatigue, musculoskeletal pain, rash, pruritus, cough, elevated transaminases |
Obinutuzumab (Gazyva) | Cycle 1: 100 mg intravenously on day 1, 900 mg on day 2, 1000 mg on days 8 and 15 of a 28-day cycle; cycles 2–6: 1000 mg intravenously on day 1 | Acute: infusion-related reaction, tumor lysis syndrome Delayed: myelosuppression, pyrexia, cough, musculoskeletal disorder, potential hepatitis B reactivation |
Ofatumumab (Arzerra) | 300 mg initial dose intravenously, followed 1 week later by 2000 mg intravenously weekly for 7 doses, followed 4 weeks later by 2000 mg intravenously every 4 weeks for four doses; or 300 mg initial dose intravenously, followed 1 week later by 1000 mg intravenously, then 1000 mg intravenously every 4 weeks | Acute: infusion-related reaction, diarrhea, nausea Delayed: neutropenia, infections, pyrexia, rash, fatigue, potential hepatitis B reactivation |
Olaratumab (Lartruvo) | 15 mg/kg intravenously on days 1 and 8 of a 21-day cycle | Acute: nausea, vomiting, infusion-related reaction Delayed: fatigue, musculoskeletal pain, mucositis, alopecia |
Panitumumab (Vectibix) | 6 mg/kg intravenously every 2 weeks | Acute: infusion-related reaction, nausea Delayed: acneiform skin rash, hypomagnesemia, asthenia, paronychia, fatigue, dyspnea |
Pembrolizumab (Keytruda) | 200 mg intravenously every 3 weeks | Acute: infusion-related reaction, nausea Delayed: immune-mediated reactions, fatigue, cough |
Pertuzumab (Perjeta) | 840 mg intravenously once followed by 420 mg intravenously every 3 weeks | Acute: infusion-related reaction, diarrhea, nausea Delayed: fatigue, alopecia, neutropenia, rash, peripheral neuropathy, cardiomyopathy |
Ramucirumab (Cyramza) | 8 mg/kg intravenously every 2 weeks or 10 mg/kg intravenously every 3 weeks | Acute: infusion-related reaction, hypertension, diarrhea Delayed: fatigue, neutropenia, epistaxis |
Rituximab (Rituxan) | 375 mg/m2 intravenously weekly for 4 weeks, or every 3–4 weeks | Acute: infusion-related reaction, tumor lysis syndrome Delayed: lymphopenia, asthenia, rash, potential hepatitis B reactivation |
Siltuximab (Sylvant) | 11 mg/kg intravenously every 3 weeks | Acute: infusion-related reaction, hyperuricemia Delayed: pruritus, edema, weight gain, rash, upper respiratory tract infection, diarrhea |
Trastuzumab (Herceptin) | Initial dose 4 mg/kg intravenously, then 2 mg/kg intravenously weekly; or initial dose 8 mg/kg then 6 mg/kg, intravenously every 3 weeks | Acute: headache, nausea, diarrhea, infusion-related reaction Delayed: myelosuppression, pyrexia, cardiomyopathy, pulmonary toxicity (rare) |
Targeted Therapy—Kinase Inhibitors |
Abemaciclib (Verzenio) | 150–200 mg orally twice daily | Acute: diarrhea, nausea, vomiting Delayed: fatigue, anorexia, infections, myelosuppression, hepatotoxicity, venous thromboembolism |
Acalabrutinib (Calquence) | 100 mg orally every 12 hours | Acute: diarrhea Delayed: myelosuppression, infection, hemorrhage, second primary malignancies |
Afatinib (Gilotrif) | 40 mg orally once daily without food | Acute: diarrhea Delayed: acneiform rash, stomatitis, paronychia |
Alectinib (Alecensa) | 600 mg orally twice daily with food | Acute: none Delayed: myelosuppression, fatigue, edema, myalgia, dyspnea, elevated transaminases |
Axitinib (Inlyta) | 5–10 mg orally twice daily | Acute: diarrhea, nausea, vomiting Delayed: hypertension, fatigue, dysphonia, hand-foot syndrome, elevated transaminases |
Binimetinib (Mektovi) | 45 mg orally twice daily | Acute: nausea, vomiting, diarrhea Delayed: fatigue, hemorrhage, cardiomyopathy, venous thromboembolism |
Bosutinib (Bosulif) | 500–600 mg orally once daily with food | Acute: diarrhea, nausea, vomiting Delayed: myelosuppression, rash, abdominal pain, hepatotoxicity, fluid retention |
Brigatinib (Alunbrig) | 90 or 180 mg orally once daily | Acute: nausea, diarrhea Delayed: hyperglycemia, increased creatine kinase level, pancreatic enzyme elevation, pneumonitis |
Ceritinib (Zykadia) | 740 mg orally once daily | Acute: diarrhea, nausea, vomiting Delayed: elevated transaminases, abdominal pain, fatigue, decreased appetite |
Cobimetinib (Cotellic) | 60 mg orally once daily on days 1 to 21 of a 28-day cycle | Acute: diarrhea, photosensitivity reaction, nausea, vomiting Delayed: myelosuppression, hepatotoxicity, rash, cardiomyopathy (with vemurafenib) |
Copanlisib (Aliqopa) | 60 mg intravenously on days 1, 8, and 15 of a 28-day cycle | Acute: diarrhea Delayed: hyperglycemia, hypertension, myelosuppression, infections |
Crizotinib (Xalkori) | 250 mg orally twice daily | Acute: nausea, vomiting, diarrhea, constipation Delayed: vision disorder, edema, elevated transaminases, fatigue |
Dabrafenib (Tafinlar) | 150 mg orally twice daily without food | Acute: headache Delayed: hyperkeratosis, fever, hand-foot syndrome, hyperglycemia, hypophosphatemia |
Dacomitinib (Vizimpro) | 45 mg orally once daily | Acute: diarrhea Delayed: rash, paronychia, mucositis, cough, interstitial lung disease |
Dasatinib (Sprycel) | 100–180 mg orally once daily | Acute: diarrhea, nausea, vomiting Delayed: myelosuppression, fluid retention, fatigue, dyspnea, musculoskeletal pain, rash |
Duvelisib (Copiktra) | 25 mg orally twice daily | Acute: diarrhea Delayed: neutropenia, rash, cough (pneumonitis), upper respiratory infection, elevated transaminases |
Enasidenib (Idhifa) | 100 mg orally once daily | Acute: differentiation syndrome, nausea, vomiting, diarrhea Delayed: hyperbilirubinemia |
Encorafenib (Braftovi) | 450 mg orally daily | Acute: nausea, vomiting Delayed: arthralgia, hemorrhage, uveitis, new primary malignancies, prolonged QT interval (rare) |
Erlotinib (Tarceva) | 100 or 150 mg orally once daily without food | Acute: diarrhea, nausea, vomiting Delayed: acneiform skin rash, fatigue, anorexia, dyspnea |
Everolimus (Afinitor) | 10 mg orally once daily | Acute: mucositis, diarrhea, nausea Delayed: myelosuppression, fatigue, edema, hypercholesterolemia, hypertriglyceridemia, hyperglycemia |
Gefitinib (Iressa) | 250 mg orally once daily | Acute: diarrhea Delayed: acneiform skin rash |
Glasdegib (Daurismo) | 100 mg orally daily | Acute: nausea Delayed: myelosuppression, edema, rash, myalgia, potential for birth defects, prolonged QT interval |
Ibrutinib (Imbruvica) | 420 or 560 mg orally once daily | Acute: diarrhea, nausea Delayed: myelosuppression, fatigue, edema, rash, elevated serum creatinine, hemorrhage |
Idelalisib (Zydelig) | 150 mg orally twice daily | Acute: diarrhea, nausea Delayed: hepatotoxicity, pneumonitis, intestinal perforation, pyrexia, fatigue, neutropenia, hypertriglyceridemia, hyperglycemia |
Imatinib (Gleevec) | 100–800 mg orally once daily with food | Acute: nausea, vomiting, diarrhea Delayed: edema, muscle cramps, rash, myelosuppression, hepatotoxicity |
Ivosidenib (Tibsovo) | 500 mg orally daily | Acute: diarrhea, nausea, differentiation syndrome Delayed: leukocytosis, prolonged QT interval |
Lapatinib (Tykerb) | 1250 or 1500 mg orally once daily | Acute: diarrhea, nausea, vomiting Delayed: hand-foot syndrome, fatigue, hepatotoxicity (rare) |
Lenvatinib (Lenvima) | 24 mg orally daily | Acute: hypertension, nausea, vomiting, diarrhea Delayed: fatigue, arthralgia/myalgia, stomatitis, hand-foot syndrome |
Lorlatinib (Lorbrena) | 100 mg orally daily | Acute: edema Delayed: arthralgia, peripheral neuropathy, cognitive effects, hyperlipidemia, AV block (rare), interstitial lung disease (rare) |
Midostaurin (Rydapt) | 50 or 100 mg orally twice daily with food | Acute: nausea, vomiting, diarrhea, mucositis Delayed: febrile neutropenia, edema, pulmonary toxicity, prolonged QT interval |
Nilotinib (Tasigna) | 300 or 400 mg orally twice daily without food | Acute: nausea, vomiting, diarrhea Delayed: rash, fatigue, myelosuppression, prolonged QT interval (rare) |
Osimertinib (Tagrisso) | 80 mg orally once daily | Acute: diarrhea Delayed: myelosuppression, rash, dry skin, nail toxicity, cardiomyopathy (rare), QTc interval prolongation (rare) |
Palbociclib (Ibrance) | 125 mg orally daily with food for 21 days followed by 7 days off | Acute: nausea, diarrhea, vomiting Delayed: myelosuppression, fatigue, upper respiratory infection, stomatitis, alopecia |
Pazopanib (Votrient) | 800 mg orally once daily without food | Acute: diarrhea, nausea, vomiting Delayed: hypertension, hair color changes, hepatotoxicity, hemorrhage |
Regorafenib (Stivarga) | 160 mg orally once daily with food (low-fat breakfast) | Acute: diarrhea Delayed: asthenia, hand-foot syndrome, anorexia, hypertension, mucositis, myelosuppression, hepatotoxicity |
Ribociclib (Kisqali) | 600 mg orally once daily for 21 days followed by 7 days off | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, infection, arthralgia, prolonged QT interval |
Sorafenib (Nexavar) | 400 mg orally twice daily without food | Acute: diarrhea and nausea Delayed: fatigue, hand-foot syndrome, rash, hypertension, hemorrhage |
Sunitinib (Sutent) | 50 mg orally once daily for 4 weeks followed by 2 weeks rest; 37.5 mg orally daily | Acute: diarrhea and nausea Delayed: hypertension, hand-foot syndrome, rash, yellow discoloration of skin, fatigue, hypothyroidism, mucositis, left ventricular dysfunction, bleeding, hepatotoxicity |
Temsirolimus (Torisel) | 25 mg intravenously weekly | Acute: hypersensitivity, rash Delayed: myelosuppression, asthenia, hyperglycemia, hyperlipidemia, elevated serum creatinine |
Trametinib (Mekinist) | 2 mg orally once daily without food | Acute: rash, diarrhea Delayed: elevated transaminases, lymphedema, cardiomyopathy |
Vandetanib (Caprelsa) | 300 mg orally once daily | Acute: diarrhea, nausea Delayed: acneiform skin rash, hypertension, prolonged QT interval |
Vemurafenib (Zelboraf) | 960 mg orally twice daily | Acute: nausea, hypersensitivity (rare) Delayed: photosensitivity, rash, arthralgia, alopecia, fatigue, prolonged QT interval, cutaneous squamous cell carcinoma |
Miscellaneous Agents |
Altretamine (Hexalen) | 260 mg/m2 orally in four divided doses for 14–21 days every 4 weeks | Acute: nausea, vomiting Delayed: neurotoxicity, myelosuppression |
Arsenic trioxide (Trisenox) | 0.15 mg/kg intravenously daily | Acute: nausea, dizziness Delayed: acute promyelocytic leukemia differentiation syndrome, prolonged QT interval |
Asparaginase Erwinia chrysanthemi (Erwinaze) | 25,000 international units/m2 intramuscularly three times weekly | Acute: hypersensitivity, nausea, vomiting Delayed: coagulation abnormalities, hepatotoxicity, pancreatitis, neurotoxicity |
Belinostat (Beleodaq) | 1000 mg/m2 intravenously on days 1 through 5, repeat every 21 days | Acute: nausea, vomiting Delayed: fatigue, pyrexia, anemia |
Bleomycin (Blenoxane) | 10 units/m2 intravenously on days 1 and 15 every 28 days; 30 units intravenously on days 2, 9, and 16 every 21 days | Acute: hypersensitivity, fever Delayed: skin reaction (rash, hyperpigmentation of skin, striae), mucositis, pneumonitis |
Dactinomycin (Cosmegen) | 15 mcg/kg or 400–600 mcg/m2 intravenously daily for 5 days | Acute: nausea, vomiting Delayed: myelosuppression, mucositis, rash, diarrhea, hepatoveno-occlusive disease (rare) |
Denileukin diftitox (Ontak) | 9 or 18 mcg/kg intravenously daily for 5 days every 21 days | Acute: flu-like syndrome, nausea, vomiting, hypersensitivity Delayed: diarrhea, elevated transaminases, capillary leak syndrome |
Hydroxyurea (Hydrea) | 20–30 mg/kg orally daily | Acute: none Delayed: myelosuppression |
Mitomycin (Mutamycin) | 10–20 mg/m2 intravenously every 4–8 weeks; 20–40 mg intravesically | Acute: cystitis (intravesically), nausea, vomiting Delayed: myelosuppression, mucositis, anorexia |
Mitoxantrone (Novantrone) | 12–14 mg/m2 intravenously every 3 weeks; 12 mg/m2 intravenously for 2–3 days | Acute: nausea, vomiting, diarrhea, mucositis, blue-green discoloration of urine Delayed: myelosuppression, alopecia, cardiotoxicity |
Omacetaxine mepesuccinate (Synribo) | Induction: 1.25 mg/m2 subcutaneously twice daily for 14 days every 28 days Maintenance: 1.25 mg/m2 subcutaneously twice daily for 7 days every 28 days | Acute: diarrhea, nausea, fatigue, injection site reaction Delayed: myelosuppression, infection |
Panobinostat (Farydak) | 20 mg orally per day on days 1, 3, 5, 8, 10, 12 of each 21-day cycle | Acute: diarrhea, nausea Delayed: myelosuppression, electrolyte abnormalities, infections |
Romidepsin (Istodax) | 14 mg/m2 intravenously on days 1, 8, 15 of a 28-day cycle | Acute: nausea, vomiting Delayed: myelosuppression, fatigue, anorexia, ECG changes |
Tretinoin (All-Trans-Retinoic Acid, ATRA, Vesanoid) | 45 mg/m2 orally divided twice daily for 45–90 days or 30 days past complete remission | Acute: headache, nausea Delayed: vitamin A toxicity, retinoic acid-acute promyelocytic leukemia syndrome |
Trifluridine/tipiracil (Lonsurf) | 35 mg/m2 based on trifluridine component orally twice daily within 1 hour of meal on days 1–5 and 8–12 (28-day cycle) | Acute: nausea, diarrhea, vomiting Delayed: myelosuppression, fatigue, anorexia |
Venetoclax (Venclexta) | 20 mg orally daily during week 1; 50 mg daily during week 2; 100 mg daily during week 3; 200 mg daily during week 4; then 400 mg orally daily thereafter | Acute: diarrhea, nausea, vomiting, tumor lysis syndrome Delayed: myelosuppression, upper respiratory infections, fatigue |
Vismodegib (Erivedge) | 150 mg orally once daily | Acute: fatigue, nausea, diarrhea Delayed: muscle spasms, alopecia, weight loss |
Ziv-aflibercept (Zaltrap) | 4 mg/kg intravenously every 2 weeks | Acute: diarrhea Delayed: myelosuppression, proteinuria, elevated transaminases, stomatitis, fatigue, hypertension |
Antiandrogens |
Bicalutamide (Casodex) | 50 mg orally once daily | Acute: none Delayed: hot flashes, back pain, asthenia |
Apalutamide (Erleada) | 240 mg orally daily | Acute: fatigue, diarrhea Delayed: arthralgia, hot flashes, falls, peripheral edema, seizure (rare) |
Enzalutamide (Xtandi) | 160 mg orally once daily | Acute: asthenia, diarrhea Delayed: hot flashes, arthralgia, peripheral edema, seizure (rare) |
Flutamide (Eulexin) | 250 mg orally every 8 hours | Acute: diarrhea Delayed: hot flashes, hepatotoxicity |
Nilutamide (Nilandron) | 300 mg orally for 30 days, then 150 mg orally once daily | Acute: none Delayed: visual disturbances (impaired adaptation to dark), hot flashes, disulfiram-like reaction |
Selective Estrogen Receptor Modulators |
Tamoxifen (Nolvadex) | 20–40 mg orally once daily | Acute: none Delayed: hot flashes, vaginal discharge, menstrual irregularities, arthralgia |
Toremifene (Fareston) | 60 mg orally once daily | Acute: nausea Delayed: hot flashes, vaginal discharge |
Aromatase Inhibitors |
Anastrozole (Arimidex) | 1 mg orally once daily | Acute: nausea Delayed: hot flashes, peripheral edema, asthenia, hypercholesterolemia, arthralgia/myalgia, osteoporosis |
Exemestane (Aromasin) | 25 mg orally once daily | |
Letrozole (Femara) | 2.5 mg orally once daily | |
Pure Estrogen Receptor Antagonist |
Fulvestrant (Faslodex) | 500 mg intramuscularly on days 1, 15, 29, then monthly | Acute: injection site reaction, nausea Delayed: hot flashes, bone pain, elevated transaminases |
LHRH Analogs |
Goserelin acetate (Zoladex) | 3.6 mg subcutaneously every month; 10.8 mg subcutaneously every 3 months | Acute: injection site discomfort Delayed: hot flashes, tumor flare, edema, decreased libido, erectile dysfunction, osteoporosis |
Leuprolide (Lupron) | 7.5 mg intramuscularly or subcutaneously every month; 22.5 mg intramuscularly or subcutaneously every 3 months; 30 mg intramuscularly or subcutaneously every 4 months; 45 mg intramuscularly or subcutaneously every 6 months | |
Triptorelin pamoate (Trelstar) | 3.75 mg intramuscularly every 4 weeks; 11.25 mg intramuscularly every 12 weeks; 22.5 mg every 24 weeks | |
LHRH Antagonist |
Degarelix (Firmagon) | 240 mg subcutaneously once, then 80 mg subcutaneously every 28 days | Acute: injection site reaction Delayed: hot flashes, weight gain, elevated transaminases, QT prolongation |
Adrenocorticosteroid |
Abiraterone (Zytiga) | 1000 mg orally once daily | Acute: diarrhea, edema Delayed: adrenal insufficiency, hepatotoxicity, joint pain, hypokalemia |
Ketoconazole | 400 mg orally three times daily | Acute: nausea and vomiting Delayed: hepatotoxicity, adrenal insufficiency |
PARP Inhibitor |
Olaparib (Lynparza) | 400 mg orally twice daily | Acute: nausea, vomiting, diarrhea Delayed: myelosuppression, elevated serum creatinine, MCV elevation, fatigue, abdominal pain |
Niraparib (Zejula) | 300 mg orally once daily | Acute: nausea, vomiting Delayed: myelosuppression, hypertension, myelodysplastic syndrome/acute myeloid leukemia (rare) |
Rucaparib (Rubraca) | 600 mg orally twice daily | Acute: nausea, vomiting, diarrhea Delayed: rash, abdominal pain, anorexia, myelosuppression, elevated transaminases, myelodysplastic syndrome/acute myeloid leukemia (rare) |
Talazoparib (Talzenna) | 1 mg orally daily | Acute: nausea, diarrhea Delayed: myelosuppression, fatigue, alopecia, myelodysplastic syndrome/acute myeloid leukemia (rare) |
Biologic Response Modifiers |
Aldesleukin (IL-2, Proleukin) | 600,000 international units/kg intravenously every 8 hours for 14 doses, repeat after 9 days rest | Acute: hypotension, nausea, vomiting, diarrhea, flu-like syndrome, capillary leak syndrome Delayed: myelosuppression, confusion, somnolence, oliguria |
Interferon-alpha-2b (Intron A) | 20 million international units/m2 intravenously 5 days a week for 4 weeks, then 10 million international units/m2 subcutaneously three times a week for 48 weeks | Acute: flu-like syndrome, nausea, vomiting, diarrhea Delayed: myelosuppression, anorexia, alopecia, depression, elevated transaminases |
Sipuleucel-T (Provenge) | One dose (minimum of 50 million autologous CD54 cells) intravenously every 2 weeks for three doses | Acute: infusion-related reaction, nausea, vomiting Delayed: fatigue, back pain, arthralgia |
Tisagenlecleucel (Kymriah) | One dose 0.6 to 6.0 × 108 CAR-positive viable T cells intravenously | Acute: hypersensitivity reaction, cytokine release syndrome Delayed: neurotoxicity, infections, myelosuppression, hypogammaglobulinemia |