TEXTBOOK AND PUBLICATION ERRATA

Oxaliplatin (ELOXATIN) dosing error in Lexi-comp’s Drug Information for Oncology (6th edition) and 2007-08 Drug Information Handbook (15th edition)

Lexi-comp’s Drug Information for Oncology (6th edition, pg 792) and 2007-08 Drug Information Handbook (15th edition, pg 1278) contain a dosing error (in dosage adjustments for toxicity) in the oxaliplatin  (ELOXATIN) monograph. The dosages for the indications (stage III colon cancer and advanced colorectal cancer) were reversed.  The monograph previously read:

Dosage adjustments for toxicity: In patients experiencing persistent neurosensory events (grade 2) which do not resolve, a dose reduction (65 mg/m2 for stage III colon cancer; 75 mg/m2 for advanced colorectal cancer) may be considered. Grade 3 neurosensory events may prompt consideration to discontinue oxaliplatin (while fluorouracil/leucovorin are continued or decreased). After recovery from grade 3/4 gastrointestinal toxicity, grade 4 neutropenia, or grade 3/4 thrombocytopenia, a dosage reduction (65 mg/m2 for stage III colon cancer; 75 mg/m2 for advanced colorectal cancer) is recommended.

It has been changed to (changes in bold):

Dosage adjustments for toxicity: Acute toxicities: Longer infusion times may mitigate acute toxicities.

Neurosensory events:

Persistent grade 2 neurosensory events: Consider oxaliplatin dose reduction if symptoms do not resolve:

Stage III colon cancer: Reduce dose to 75 mg/m2

Advanced colorectal cancer: Reduce dose to 65 mg/m2

Grade 3 neurosensory events: Consider discontinuing oxaliplatin

Other toxicities (grade 3/4 gastrointestinal toxicity, grade 4 neutropenia, or grade 3/4 thrombocytopenia): After recovery from toxicity, oxaliplatin dose reductions are recommended:

Stage III colon cancer: Reduce dose to 75 mg/m2

Advanced colorectal cancer: Reduce dose to 65 mg/m2