One off loading doses and ongoing maintenance doses are not included in protocol cost calculations. The protocol cost is derived from drug dose calculations based upon a default body surface area (BSA) of 1.8 m 2 weight of 75 kg and creatinine clearance of 75 mL/min. The cost of oral continuous therapy is based on a 28 day month.

Where there are differing unit costs based on vial sizes and tablet strengths, the mean unit cost is used. These costs are reviewed and updated on eviQ at 6 monthly intervals. The cost includes anti-cancer drugs only (not antiemetics, supportive medications or consumables), unless otherwise indicated.ĭrug unit costs are taken directly from the Pharmaceutical Benefits Scheme (PBS) website (MIMS Online and other sources. The cost displayed on the protocol is intended as rudimentary guide only for the Australian context. Cost: ~ $12,270 per cycle 'How this cost is calculated' Lenvatinib is available as 4 mg and 10 mg capsules. Pembrolizumab and lenvatinib are PBS authority Radiation recall has been observed with PD1 inhibitors, consideration should be given to the timing when starting this treatment after a prolonged course of radiation therapy. While this is rare, (~5%), continuing treatment and performing a second scan 4 to 6 weeks later to confirm progression may be considered, particularly if the patient is believed to be deriving clinical benefit. In the first few months after the start of immunotherapy, some patients can have a transient tumour flare (termed 'pseudo progression' or an immune response). This may manifest as growth of existing lesions or the development of new lesions prior to later tumour regression. Lenvatinib monotherapy can be continued beyond 35 cycles until disease progression or unacceptable toxicity. r Frequency:Ĭontinuous until disease progression or unacceptable toxicity (up to 35 cycles of pembrolizumab). ** Elderly patients or patients with comorbidities should be considered for a lower lenvatinib starting dose of 14 mg ONCE a day. * Alternative pembrolizumab dosing schedule of 400 mg every 42 days may be considered. How you have radiation therapy treatment.How you have anticancer medicine treatment.Fertility, sex, pregnancy and breastfeeding.Complementary and alternative medicines.Gastric and oesophageal adjuvant and neoadjuvant.Genetic testing using cancer gene panels.Genetic testing for heritable pathogenic variants.

Keynote 775 publication