Pancreatic, thyroid, and other endocrine cancers:
Indications for ZANOSAR:
Symptomatic or progressive metastatic pancreatic islet cell cancer.
1g/m2 IV once weekly for 2 weeks; may repeat weekly; max 1.5g/m2 per dose. Or, 500mg/m2 IV daily for 5 days every 6 weeks until max benefit or toxicity.
Should be administered under the supervision of an experienced physician. Have access to a facility with laboratory and supportive resources sufficient to monitor drug tolerance and toxicity. Mutagenic, tumorigenic, or carcinogenic.
Renal dysfunction or disease. Monitor renal function (eg, urinalysis, BUN, creatinine, electrolytes) before, weekly during, and for 4 weeks after therapy; discontinue or reduce dose if significant renal toxicity occurs (see full labeling). Obtain CBCs, liver function tests weekly. Avoid extravasation. Ensure adequate hydration. Elderly. Pregnancy (Cat.D). Nursing mothers: not recommended.
Avoid concomitant nephrotoxic agents. Additive toxicity with other cytotoxic drugs. Severe bone marrow toxicity with doxorubicin. Phenytoin may reduce cytotoxicity.
GI upset (may be severe); hematological, hepatic and renal (cumulative and dose-related; may be fatal) toxicity; glucose intolerance, nephrogenic diabetes insipidus, inj site reactions, CNS effects (eg, confusion, lethargy, depression).