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.
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regimen-monograph
CAP
A - Regimen Name
CAP Regimen
Cyclophosphamide-ADRIAMYCIN ® (DOXOrubicin)-PLATINOL ® (CISplatin)
Disease Site
Unknown Primary
Adenocarcinoma of Unknown Origin
Adenocarcinoma of Unknown Origin
Intent
Palliative
Regimen Category
Local : A regimen not widely used by Regional Cancer Centres in this disease site.
B - Drug Regimen
| cyclophosphamide
(Round to nearest 10mg) |
500 mg /m² | IV | Day 1 |
| DOXOrubicin
(Round to nearest 1mg) |
50 mg /m² | IV | Day 1 |
| CISplatin
(Round to nearest 1mg) |
50 mg /m² | IV | Day 1 |
|
|
|||
D - Premedication and Supportive Measures
Antiemetic Regimen:
High
Other Supportive Care:
Inadequate total hydration may result in dose-related hemorrhagic cystitis.
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 | Doxorubicin Dose* (% previous dose) |
| 1-2 x ULN | REDUCE to 50% dose |
| >2-4 x ULN | REDUCE to 25% dose |
| >4 x ULN | OMIT |
*Doxorubicin is contraindicated in patients with severe hepatic impairment, especially with elevated bilirubin. Consideration should be given to dose modification for patients with severe increases in transaminases; limited data exists on the use of doxorubicin in this setting as these patients are routinely excluded from clinical trials.
Renal Impairment
| Creatinine Clearance or Serum Creatinine | Action |
| If CrCl = 0.5 to 1 mL/sec or Serum Creatinine = 136-185 µmol/L | Reduce Cisplatin** to 50% dose |
| If CrCl < 0.5 mL/sec or Serum Cr > 185 µmol/L | OMIT Cisplatin** dose |
| If CrCl < 0.3 mL/sec | Reduce Cyclophosphamide to 50% dose |
**Upon the discretion of the prescriber, less dose reduction may be suggested. See Cisplatin drug monograph.
F - Adverse Effects
Refer to cyclophosphamide, DOXOrubicin, CISplatin drug monograph(s) for additional details of adverse effects
G - Interactions
Refer to cyclophosphamide, DOXOrubicin, CISplatin drug monograph(s) for additional details
H - Drug Administration and Special Precautions
Refer to cyclophosphamide, DOXOrubicin, CISplatin drug monograph(s) for additional details
I - Recommended Clinical Monitoring
Recommended Clinical Monitoring
- Clinical toxicity (including stomatitis, neurotoxicity, ototoxicity, cardiotoxicity, cystitis, local toxicity) assessment.
- 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 (including electrolytes and magnesium) tests, and urinalysis.
- Cardiac examination especially with risk factors (including prior mitoxantrone, epirubicin or other cardiotoxic drugs), 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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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 21, 2026
