Drug Formulary information is intended for use by healthcare professionals. It is not intended to be medical advice. Some of the information, including information about funding for cancer drugs, does not apply to all patients. Cancer treatment plans are unique to each patient. If you are a patient, please speak with your healthcare team to understand how this information applies to you.

regimen-monograph

A - Regimen Name

CISPFULCVR Regimen
CISplatin-Fluorouracil-Leucovorin


Disease Site
Gastrointestinal - Esophagus

Intent
Palliative
(Adjuvant to radiotherapy)

Regimen Category
Local : A regimen not widely used by Regional Cancer Centres in this disease site.

Rationale and Uses
Can be used as part of multimodality regimens where infusional FLUOROURACIL cannot be used
 
B - Drug Regimen

CISplatin

(Round to nearest 1mg)
20 mg /m² IV Days 1-5
fluorouracil

(Round to nearest 25mg)
325 mg /m² IV Days 1 to 5
leucovorin

(Round to nearest 1mg)
20 mg /m² IV Days 1 to 5
(may be given prior to 5FU)
back to top
 
C - Cycle Frequency

REPEAT EVERY 28 DAYS

For a Usual Total of 6 Cycles

 
D - Premedication and Supportive Measures

Antiemetic Regimen:

Moderate

Other Supportive Care:

May advise patients to suck on ice chips during bolus injection, to reduce stomatitis
 
E - Dose Modifications

Doses should be modified according to the protocol by which the patient is being treated. The following recommendations are in use at some centres.

Dosage with toxicity

Hematologic Toxicities

See appendix 6 for general recommendations.

GI Toxicities

Toxicity Action
If Mucositis or Diarrhea ≥ Grade 3 in previous course REDUCE to 2/3 dose of 5-FU



Hepatic Impairment

If Bilirubin > 4 x ULN, OMIT 5FU dose.

Renal Impairment

Creatinine Clearance or Serum Creatinine Action
If CrCl = 0.5 - 1 mL/sec or
Serum Creatinine = 136-185 µmol/L
REDUCE Cisplatin* to 50% dose

 

If CrCl < 0.5 mL/sec or Serum Creatinine >185 µmol/L OMIT Cisplatin dose

*Upon discretion of the prescriber, less dose reduction may be suggested.  See Dosing section of Cisplatin drug monograph. 


 
F - Adverse Effects
Refer to CISplatin, fluorouracil, leucovorin drug monograph(s) for additional details of adverse effects

Bolus 5FU regimens have more myelosuppression and GI effects but less Hand-Foot Syndrome, compared to prolonged infusions.

Most Frequently Occurring Adverse Effects
  • Nausea and vomiting
  • Nephrotoxicity
  • Neurotoxicity (ototoxicity)
  • Fatigue
  • Stomatitis and diarrhea
  • Myelosuppression
 
G - Interactions
Refer to CISplatin, fluorouracil, leucovorin drug monograph(s) for additional details
 
H - Drug Administration and Special Precautions
Refer to CISplatin, fluorouracil, leucovorin drug monograph(s) for additional details
 
I - Recommended Clinical Monitoring

Recommended Clinical Monitoring

  • Clinical toxicity assessment (including stomatitis, neurotoxicity, ototoxicity).
  • CBC before each cycle. Interim counts should be done in first cycle and repeated if dose modifications necessary.
  • Baseline and regular liver and renal function tests (including electrolytes and magnesium).
  • Grade toxicity using the current NCI-CTCAE (Common Terminology Criteria for Adverse Events) version

back to top
 
J - Administrative Information

Approximate Patient Visit
2.5 hours
Pharmacy Workload (average time per visit)
16.4 minutes
 
K - References

Lehnert. Multimodal therapy for squamous carcinoma of the oesophagus. Br J Surgery. 1999. 86:727-739.

 


back to top
 
L - Other Notes

December 2011: Modified sections F, K

 
M - Disclaimer

Regimen Abstracts
A Regimen Abstract is an abbreviated version of a Regimen Monograph and contains only top level information on usage, dosing, schedule, cycle length and special notes (if available). It is intended for healthcare providers and is to be used for informational purposes only. It is not intended to constitute or be a substitute for medical advice, and all uses of the Regimen Abstract are subject to clinical judgment. Such information is provided on an “as-is” basis, without any representation, warranty, or condition, whether express, or implied, statutory or otherwise, as to the information’s quality, accuracy, currency, completeness, or reliability, and Cancer Care Ontario disclaims all liability for the use of this information, and for any claims, actions, demands or suits that arise from such use.
Information in regimen abstracts is accurate to the extent of the ST-QBP regimen master listings, and has not undergone the full review process of a regimen monograph.  Full regimen monographs will be published for each ST-QBP regimen as they are developed.
Regimen Monographs
Refer to the New Drug Funding Program or Ontario Public Drug Programs websites for the most up-to-date public funding information.
The information set out in the drug monographs, regimen monographs, appendices and symptom management information (for health professionals) contained in the Drug Formulary (the "Formulary") is intended for healthcare providers and is to be used for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects of a particular drug, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for a given condition. The information in the Formulary is not intended to constitute or be a substitute for medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.
The format and content of the drug monographs, regimen monographs, appendices and symptom management information contained in the Formulary will change as they are reviewed and revised on a periodic basis. The date of last revision will be visible on each page of the monograph and regimen. Since standards of usage are constantly evolving, it is advised that the Formulary not be used as the sole source of information. It is strongly recommended that original references or product monograph be consulted prior to using a chemotherapy regimen for the first time.
Some Formulary documents, such as the medication information sheets, regimen information sheets and symptom management information (for patients), are intended for patients. Patients should always consult with their healthcare provider if they have questions regarding any information set out in the Formulary documents.
While care has been taken in the preparation of the information contained in the Formulary, such information is provided on an “as-is” basis, without any representation, warranty, or condition, whether express, or implied, statutory or otherwise, as to the information’s quality, accuracy, currency, completeness, or reliability.
CCO and the Formulary’s content providers shall have no liability, whether direct, indirect, consequential, contingent, special, or incidental, related to or arising from the information in the Formulary or its use thereof, whether based on breach of contract or tort (including negligence), and even if advised of the possibility thereof. Anyone using the information in the Formulary does so at his or her own risk, and by using such information, agrees to indemnify CCO and its content providers from any and all liability, loss, damages, costs and expenses (including legal fees and expenses) arising from such person’s use of the information in the Formulary.


Last Updated: July 27, 2026