Oncology Calculations Workshop

Cindy Vo PHAR – 802L (Spring 2025) Friday due Calculations Workshop 5 pm 04/04 Please round all calculations to the nearest one-tenth decimal point. Doxorubicin 60mg/m2 cyclophosphamide 600mg/m2 Patient Case # 1) AB is a 45-year old female who was diagnosed with HR+, HER2- Stage IIIB breast cancer. Following surgery and radiation, she received 4 cycles of AC (doxorubicin and cyclophosphamide) followed by T (paclitaxel) x 12 weeks and achieved a complete remission of her disease. She had received no anthracycline prior to this, nor has she received any since. It is now five years later, and she has been diagnosed with AML (Acute Myelogenous Leukemia), and will now be treated with a protocol called “7 + 3”, this version contains idarubicin. These chemo regimens are attached for your use. Assume patient will receive 100 mg/m2 of cytarabine daily. Mosteller Formula Pertinent Patient Information : M : wtSk BSA 54 (m2) (1In (m) Height: 60 inches 152 4 cm Current weight: 164 pounds Mu 5 kg Weight 5 years ago when she received AC followed by T: 85.3 kg = 2 . I . = o (in) x ( 1bs) 3131 . = 187 7 . lbs 1. First, calculate the Day 1 doses of chemotherapy for the AC she received 5 years ago. BSA(m2) 152 = . 4 x 85 3 kg . 1 = . 9 m2 3608 Adriamyan 60 mg 1 x 9 . m2= my Adriamyan 114 m2 cyclophosphamide 200mg m2 1 9 x = . 1140 cyclophosphamide my a 2. She received 4 cycles of AC. What is her current lifetime doxorubicin dose expressed in mg/m2? (Prior to receiving the 7 + 3) 450 mg/m2 lifetimecose max doxorubicin = 117 mg x + cycles = 156 1 my . = 240 9 m2 mg/m2 100 mg/m2 12 mg/m2 3. Now calculate the daily doses of chemotherapy (Idarubicin and Cytarabine) she will receive in I 3 days days the current 7 + 3 regimen. BSA = 152 4 . x 74 . 5 = 1 8 m2 . 3600 Idarubicin 12 mg 1 x . 8 m2 = m2 uytarabine 100 mg m2 x 1 8 m2 . = 21 . 6 my 180 my darubian cytarabine Calculations Packet 1 PHAR – 802L (Spring 2025) 4. Assume she will only receive one cycle of 7 + 3. What is the lifetime doxorubicin equivalent that she will have received after receiving the 7 + 3, expressed in mg/m2? may lifetime Idamblan / cycle only dose 12 = 225mg/m2 (doxorubicin = mg/m2 (x2 factor) = conversion = 2) mg/m2 doxorubian zu = factor 5. May she receive more anthracycline after this? Yes , she lifetime doxorubicin dose max she only anthracycline receive more may received 240 24 + 267 = mg/m2 450 = . mg/m2 lifetime total Patient Case # 2) A patient has received 360 mg/m2 of doxorubicin equivalents in his lifetime. He is going to receive 40mg/m2 of doxorubicin today. His BSA is 1.8 m2. Is this patient a candidate for use of dexrazoxane? If so, what dose of dexrazoxane expressed in mg (i.e., actual dose) should he receive? 10 ratio 1 : (dexrazoxane : mg/m2 500 : 50 mg/m2 : 4000 4000my total doxorubicin) 1 . 400 = mg/m2 mg/m2 400 x doxorubicin mg/m2 8 m2 dexrazoxane 7200 my = M2 Calculate the Day 1 doses for the following regimens, based on the patient parameters given: 62 in = 157 . 5 cm BSA(m2) 113 3 kg 1. Ht: 5ft.,2in. Wt: 250 lb 2 Cisplatin 50mg/m IV on Days 1,8,29, and 36 Etoposide 50mg/m2 IV on Days 1-5 and 29-33 = Tong m2 2 2 x . = 110 m2 110 182 9 . . xky Cm = 3600 m2 157 = . 5 x 113 . 6 = 2 . 2 m2 3600 my asplatin my etoposide cm 2. Ht: 6ft. Wt: 140 kg Cisplatin 100 mg/m2 IV on Day 1 Vinblastine 4mg/m2 IV on Days 1,8,15, 22, and 29, then every 2 weeks after day 43 Repeat cycle every 28 days for 4 cycles BSA 182 9 = . x 140 100 my = 2 . 7 m2 x m2 3600 4 m9x2 2 . . 7 m2 7m2 = = 270 10 . 8 my displatin my vinblastine Calculations Packet 2 PHAR – 802L (Spring 2025) 3. Ht: 178 cm, Wt: 88 lb 40kg Pemetrexed 500 mg/m2 IV on Day 1 Cisplatin 80 mg/m2 IV on Day 1 Repeat cycle every 21 days for 6 cycles BSA = 500mg 1 4 x 80mg m2 . 1 x 700 CrCl 6 CM . 93 . . 4 m2 asplatin my 112 = Demetrexeda my m2 167 1 = 3600 = Ym2 . 178x40 = kg 2 4. Ht: 5ft, 6in., Wt: 205 lb, SCr=0.7, Female, 60y/o Carboplatin AUC of 6, IV on Day 1 Nab-paclitaxel 100 mg/m2 IV on Days 1, 8, and 15 Repeat cycle every 21 days 140 = - 60 93 x 72x0 Carboplatin close = x 2 0 . 125 = 85 . mL/min 7 7 . 6 900 = . (125 x my . 7 + BSA carboplatin 25) = 901 167 6 = x . 2 . my 93 2 . 2 = . 1 m2 3600 100 x 1 . 7 m2 = m mg 7 5 . 198 1 x = x Kg . . 7 m2 = 60kg 84 I am . 136 : 172 = BSA = 198 1 . = x 2 &U . x 1 = = 210 my nab-paclitaxel 60 x = 1 . 7 m2 displatin my 450 my bevacizumab 1 kg (80 2 / m2 3600 6. Ht: 6ft., 6in., Wt: 185 lbs, SCr=1.2, Male, 57y/o Carboplatin AUC of 2, IV on Days 1, 8, 15 Paclitaxel 80 mg/m2 IV on Days 1,8,15 Repeat cycle every 28 days for 6 cycles carboplatin . my gemcitabine 2125 M2 80 mg 2 x m2 5. Ht: 172 cm, Wt: 60 kg Gemcitabine 1250 mg/m2 IV on Days 1 and 8 Cisplatin 80 mg/m2 IV on Day 1 BSA Bevacizumab 7.5 mg/kg IV on Day 1 Repeat cycle every 21 days for 6 cycles 1250mg my . . 8 + 25) 2 m2 x 2 = 211 . CrCl = 72 6 my 57x84 140 x 1 . . 14g = 80 . 8mY min 2 carboplatin 3608 80 . 2 m2 = 16 mg paclitaxe a Calculations Packet 3 PHAR – 802L (Spring 2025) 7. Ht: 165cm, Wt: 180kg, SCr=2.3, Male, 72y/o Pemetrexed 500 mg/m2 IV on Day 1 Carboplatin AUC=6, IV on Day 1 BSA Bevacizumab 15 mg/kg IV on Day 1 Repeat every 21 days for 6 cycles cr() mg x carboplatin 15 mg = 6 1450 = (73 x 180kg x ky 2.9m2 . 9 + 25) 2700 = my = 72 - 165 x . = 180 x 72x2 = 500 140 = 73 3 180 2 = . 9 . 9 mL/min m2 3600 pemetrexed 593 . 7 my carboplatin bevacizumab my Patient Case # 3) 95 8. Ht: 5ft, 8in., Wt: 210 lbs 5 ky Cyclophosphamide 1000 mg/m2 IV on Day 1 Doxorubicin 45 mg/m2 IV on Day 1 Etoposide 50 mg/m2 IV on Days 1-5 Repeat cycle every 21 days A2 1000 . zom my x . m2 2 1 . = BSA = 172 . 7 x 95 5 . = 2 . 1m 3608 2100 my cyclophosphamide mz 45gX2 50 mg m2 X 1 m2 . 2 . 1 m2 = = 94 . 5 105 my my doxombian etoposide 9. How much of his cumulative lifetime dose of doxorubicin expressed in mg/m2 will the patient in previous question have received after 6 cycles? an . 5 mg x 6 cycles = 567 2 my . = 270 1 m2 Calculations Packet mg/m2 4 PHAR – 802L (Spring 2025) 10. Make a calendar of cycle 1 and cycle 2 for the patient in question 8 below. Start Cycle 1 on Monday, the first of Month 1. Month 1 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2 3 5 6 cycle day/ 4 day 5 etoposide 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 30 31 cycle 2 day 28 29 Patient Case # 4) KC is a 34 y/o male who was successfully treated for Hodgkin Lymphoma at the age of 19. He received 4 cycles of a regimen called ABVD, along with radiation, and achieved a complete remission. He had received no anthracycline prior to this, nor has he received any since. He has now been diagnosed with AML (Acute Myelogenous Leukemia) and will now be treated with a protocol called “7 + 3”. This version of the 7 + 3 protocol contains Daunorubicin. These chemo regimens are attached for your use. Pertinent Patient Information 147 3 Height: 58 inches Current weight: 220 pounds 100kg Weight at age 19 when he received ABVD: 82 kg = . cm = Calculations Packet 5 PHAR – 802L (Spring 2025) 1. First, calculate the Day 1 doses of chemotherapy for the ABVD he received at age 19. [ lcycle 2x/caC Doxorubicin 25 mg/m2 IV on Days 1 and 15 Bleomycin 10 units/m2 IV on Days 1 and 15 Vinblastine 6 mg/m2 IV on Days 1 and 15 Dacarbazine 375 mg/m2 IV on Days 1 and 15 25mg M x 1 counts 6mg M2 . 8 m2 1 8m2 . x1 . 8 m2 = 10 . 8 147 . 3 82 x 3600 = 1 8 m2 . 375mSx 1 12 . 8 m2 675 my da carbazine = bleomyn a units 18 = = doxomblr 45 my = BSA vinblastine my 2. He received 4 cycles of ABVD. What is his current lifetime doxorubicin dose expressed in mg/m2? 45 90 mg/cycle my +2/cycle 90 my = cycles 4 x 360 = 1 . my 200mg = 8 M2 m2 doxorubicin 3 days 7 days 3. Now calculate the daily doses of chemotherapy (Daunorubicin and Cytarabine) he will receive in the current 7 + 3 regimen. Assume he will receive 100mg/m2/day of cytarabine and 45 mg/m2/day of daunorubicin. BSA 147 3 = 100 x . 2 = . 0 m2 3000 45 mg myz 100 my me x x 2 2 . . 0 0 mr m2 90 = mg/day 200 = of mg/day dannorublin of cytarabine 4. Assume he will only receive one cycle of 7 + 3. What is the lifetime doxorubicin equivalent expressed in mg/m2 that he will have received after receiving the 7 + 3? 90mg/day x 3 270 = = = dannomblan my 135 mg doxomblan 2 m2 . 0 67 5 mg . x(0 . 5 a converso equivalent doxomblan equivalent m2 Calculations Packet 6