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

CRBPETOP(PO) Regimen
CARBOplatin-Etoposide (oral)


Disease Site
Central Nervous System
(recurrent medulloblastoma, recurrent malignant glioma)

Intent
Neoadjuvant
Adjuvant

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

Supplementary Public Funding

etoposide
ODB - General Benefit (etoposide - oral capsules)

 
B - Drug Regimen

CARBOplatin

(Round to nearest 1mg)
500 mg /m² IV over 1 hour 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.
etoposide
50 mg PO Days 1 to 14

 

 

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C - Cycle Frequency

REPEAT EVERY 28 DAYS

4 cycles concurrent with Radiotherapy and 4 cycles post-Radiotherapy

 
D - Premedication and Supportive Measures

Antiemetic Regimen:

Moderate (Carboplatin)
Low (Etoposide)

 
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:  Refer to appendix 6 for general recommendations.
If platelets < 100 x 109/L, ADJUST Carboplatin dose as described in Egorin Formula



Hepatic Impairment

Bilirubin Etoposide (% of usual dose)
1-2 x ULN REDUCE Etoposide to 50% dose
2-4 x ULN REDUCE Etoposide to 25% dose
>4 x ULN STOP treatment with Etoposide

 

 


Renal Impairment

Carboplatin (suggested):

Creatinine Clearance (ml/min)

Carboplatin

(% previous dose)

 

20 - 50

Use Calvert or Chatelut formula

 

< 20

Discontinue

 

Etoposide (suggested):

Creatinine clearance (mL/min)

% usual dose

15-50

75

<15

50, or discontinue


 
F - Adverse Effects
Refer to CARBOplatin, etoposide drug monograph(s) for additional details of adverse effects
 
G - Interactions
Refer to CARBOplatin, etoposide drug monograph(s) for additional details
 
H - Drug Administration and Special Precautions

Refer to CARBOplatin, etoposide drug monograph(s) for additional details

 

 
I - Recommended Clinical Monitoring

Recommended Clinical Monitoring


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J - Administrative Information

Approximate Patient Visit
1 to 1.5 hours
Pharmacy Workload (average time per visit)
28.262 minutes
Nursing Workload (average time per visit)
49.167 minutes
 
K - References

Gentet JC, Doz F, Bouffett E, et al. Carboplatin and VP 16 I medulloblastoma: a phase II study of the French Society of Peditric Oncology (SFOP). Med Pediatric Oncology 1994; 23 (5): 422-7.

Lopez-Aguilar E, Sepulveda-Vildosola AC, Rivera-Marques H , et al. Survival of patients with medulloblastoma treated with carboplatin and etoposide before and after radiotherapy. ArchMed Res 29(4): 313-7, 1998 Winter.

October 2017 Formatted public funding and renal impairment sections


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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 21, 2026