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

DOXOSTRE Regimen
Streptozocin-DOXOrubicin


Disease Site
Gastrointestinal - Pancreatic Neuroendocrine

Intent
Palliative

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

Rationale and Uses
Alternate regimen to FUSTRE for the palliative treatment of Islet Cell Tumours
 
B - Drug Regimen

streptozocin

(Round to nearest 10 mg)
500 mg /m² IV Daily for 5 days
DOXOrubicin

(Round to nearest 1 mg)
50 mg /m² IV Days 1 & 22
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C - Cycle Frequency

REPEAT EVERY 42 DAYS
Until evidence of disease progression or limited by toxicity

 
D - Premedication and Supportive Measures

Antiemetic Regimen:

Moderate

 
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.



Hepatic Impairment

 

Bilirubin Dose
If Bilirubin 1-2 x ULN REDUCE Doxorubicin to 50% dose
If Bilirubin 2-4 x ULN
REDUCE Doxorubicin to 25% dose
If Bilirubin >4 x ULN
OMIT Doxorubicin dose (Suggested action)


Renal Impairment

Creatinine Clearance
Dose
If CrCl = 0.2-0.8mL/sec REDUCE Streptozocin to 75% dose
If CrCl < 0.2mL/sec
OMIT Streptozocin or treat at investigator’s discretion


 
F - Adverse Effects
Refer to streptozocin, DOXOrubicin drug monograph(s) for additional details of adverse effects
 
G - Interactions
Refer to streptozocin, DOXOrubicin drug monograph(s) for additional details
 
H - Drug Administration and Special Precautions
Refer to streptozocin, DOXOrubicin drug monograph(s) for additional details
 
I - Recommended Clinical Monitoring

Recommended Clinical Monitoring

  • Clinical toxicity assessment (including stomatitis, local toxicity, cardiotoxicity, glucose tolerance).
  • CBC before each cycle.
  • Baseline and regular glucose, liver & renal function tests.
  • Cardiac examination especially with risk factors (including prior therapy with Epirubicin, Mitoxantrone or other cardiac drug), or a cumulative Doxorubicin dose of > 450mg/m2
  • Grade toxicity using the current NCI-CTCAE (Common Terminology Criteria for Adverse Events) version

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J - Administrative Information

Approximate Patient Visit
Day 1: 1 hour; Days 2-5 and 22: 0.5 hour
 
K - References
Moertel CG, Lefkopulo M, Lipsitz S, et al, Streptozocin-doxorubicin, streptozocin-fluorouracil, or chlorozotocin in the treatment of islet-cell carcinoma. N Engl J Med, 1992; 326: 519-523.

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L - Other Notes
Revised June 2010
 
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.
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Last Updated: July 27, 2026