Answer
Answer
Stage IV (any T, any N, M1):
Metastatic disease is commonly treated with platinum-based chemotherapy. Regimens may include 5-FU or other agents. [2, 4]
Cisplatin + 5-FU:
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Cisplatin 60 mg/m 2 day 1 plus 5-FU 1000 mg/m 2/d IV continuous infusion on days 1–4; repeat every 3 weeks or
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Cisplatin 75 mg/m 2 day 1 plus 5-FU 750 mg/m 2/d IV continuous infusion on days 1–4; repeat every 4 weeks
mFOLFOX:
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Oxaliplatin 85 mg/m 2 IV day 1 plus
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Leucovorin 400 mg/m 2 IV day 1 plus
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5-FU 400 mg/m 2 IV bolus on day 1, then 1200 mg/m 2/d x 2 days (total 2400 mg/m 2 over 46–48 hours) IV continuous infusion
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Repeat every 2 weeks
Carboplatin + paclitaxel
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Carboplatin area under the curve (AUC) 5 (see Carboplatin AUC Dose Calculation [Calvert formula]) IV day 1 plus
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Paclitaxel 175 mg/m 2 IV day 1
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Repeat every 21 days
Subsequent therapy may include the following [2] :
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Nivolumab 240 mg or 3 mg/kg every 2 wk or
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Pembrolizumab 200 mg or 2 mg/kg every 3 wk
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