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.
Severe weather warning in your area. Please stay indoors and stay safe. Read more
regimen-monograph
CRBPPACL
A - Regimen Name
CRBPPACL Regimen
PACLItaxel-CARBOplatin
(UPSC)
Disease Site
Gynecologic - Endometrial
Uterine Papillary Serous Carcinoma (UPSC)
Uterine Papillary Serous Carcinoma (UPSC)
Intent
Palliative
Regimen Category
Standard : Standard therapy endorsed by the Disease Site Group or a regimen widely used by most Regional Cancer Centres in this disease site. The category is unrelated to the source or availability of funding.
Rationale and Uses
For the treatment of advanced or recurrent uterine papillary serous carcinoma
Supplementary Public Funding
PACLitaxel
New Drug Funding Program (Paclitaxel - First Line - Uterine Papillary Serous Carcinoma (UPSC))
PACLitaxel
New Drug Funding Program (Paclitaxel - Recurrent - Uterine Papillary Serous Carcinoma (UPSC))
B - Drug Regimen
| PACLitaxel
(Round to nearest 3 mg) |
175 mg /m² | IV | Day 1 (give before carboplatin) |
| CARBOplatin
(Round to nearest 5 mg) |
AUC 5-7 | IV | Day 1 |
|
Adjust Carboplatin dose to AUC target (using Calvert formula) or in response to platelet counts (using Egorin formula -if previously treated with thrombocytopenic agent), as outlined in Other Notes section.
|
|||
D - Premedication and Supportive Measures
Antiemetic Regimen:
Moderate
Other Supportive Care:
- Patients should be pretreated with a corticosteroid, as well as an antihistamine and a H2 Blocker: For example:
- DEXAMETHASONE 20mg PO 12 & 6 hours before Paclitaxel OR 20mg IV 30 minutes before Paclitaxel
- DIPHENHYDRAMINE 50mg IV 30 minutes before Paclitaxel
- RANITIDINE 50mg IV 30 minutes before Paclitaxel
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.
Neurotoxicity
Grade 3 or 4 : REDUCE Paclitaxel to 80% dose
Hepatic Impairment
|
Bilirubin |
Dose |
|
If Bilirubin 2-4 x ULN
|
Give MAXIMUM dose of Paclitaxel 135mg/m2
|
|
If Bilirubin > 4 x ULN
|
OMIT Paclitaxel dose or
Give MAXIMUM dose of Paclitaxel 50mg/m2
|
Renal Impairment
As creatinine clearance changes, adjust dosage of Carboplatin using the Calvert Formula. (See Other Notes section.)
F - Adverse Effects
Refer to PACLitaxel, CARBOplatin drug monograph(s) for additional details of adverse effects
Most Common Side Effects |
Less Common Side Effects, but may be Severe or Life-Threatening |
|
|
H - Drug Administration and Special Precautions
Refer to PACLitaxel, CARBOplatin drug monograph(s) for additional details
I - Recommended Clinical Monitoring
Recommended Clinical Monitoring
- Clinical toxicity assessment (including hypersensitivity, neurotoxicity, local toxicity).
- CBC before each cycle
- Baseline and regular liver function tests
- Baseline and regular renal function tests
- Grade toxicity using the current NCI-CTCAE (Common Terminology Criteria for Adverse Events) version
back to top
K - References
Hoskins PJ, Swenerton KD, Pike JA, et al. Paclitaxel and carboplatin, alone with irradiation, in advanced or recurrent endometrial cancer: a phase II study. J Clin Oncol 2001; 19(20): 4048-4053.
Kwon JS, Elit L, Finn M et al. A comparison of two prophylactic regimens for hypersensitivity reactions to paclitaxel. Gynecol Oncol 2002 Mar; 84(3): 420-5.
Ramondetta L, Burke TW, Levenback C, Bevers M, Bodurka-Bevers D, Gershenson DM. Treatment of uterine papillary serous carcinoma with paclitaxel. Gynecol Oncol 2001;82:156-61.
Zanotti KM, Belinson JL, Kennedy AW, Webster KD, Markman M. The use of paclitaxel and platinum-based chemotherapy in uterine papillary serous carcinoma. Gynecol Oncol 1999; 74:272-277.
PEBC Advice Documents or Guidelines
October 2017 Formatted public funding info
L - Other Notes
Calvert Formula
DOSE (mg) = target AUC X (GFR + 25)
- Target AUC of 4 to 6 mg/mL·min (previously treated patients) or 6 to 8 mg/mL·min (previously untreated patients)
- AUC = product of serum concentration (mg/mL) and time (min)
- GFR (glomerular filtration rate) expressed as measured Creatinine Clearance or estimated from Serum Creatinine (by Cockcroft and Gault method or Jelliffe method)
(Calvert AH, Newell DR, Gumbrell LA, et al, Carboplatin dosage: Prospective evaluation of a simple formula based on renal function. J Clin Oncol, 1989; 7: 1748-1756)
Egorin Formula
Previously Untreated Patients-
DOSE (mg/m²) = 317{ ([pre - nadir]/ pre) 100 - 82.1} X (BSA / Cr Cl) + 447
Previously Treated Patients-
DOSE (mg/m²) = 317{ ([pre - nadir]/ pre) 100 - 92.4} X (BSA / Cr Cl) + 447
- Pre = pretreatment platelet count
- Nadir = platelet nadir desired
- BSA = Body Surface Area
- Cr Cl = Creatinine Clearance
(Egorin MJ, Van Echo DA, Tiping SJ, et al, Pharmacokinetics and dosage reduction of carboplatin in patients with impaired renal function. Cancer Res, 1984; 44: 5432-5438)
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
