Indications & Dose: SMALL-CELL LUNG CANCER Combination therapy IV Adult 35mg/m2/day as inf over 5-210min for 4 days, then max 50mg/m2/day for 5 days q3-4wk with other anti-cancer drugs | TESTICULAR CANCER Combination therapy IV Adult 50-100mg/m2/day as inf over 5-210min on days 1-5 or 100mg/m2 on days 1, 3 & 5 with course repeated q3-4wk for 3 or 4 courses of therapy

Precautions: Hypoalbuminemia, renal/hepatic impairment, elderly

ADR: Serious: Hepatotoxicity, peripheral neuropathy, blood disorders, SJS, TEN, interstitial pneumonitis, pulmonary fibrosis, MI, HF, hypotension, bone marrow depression, optic neuritis, ovarian failure, laryngospasm, Others: nausea, vomiting, stomatitis, amenorrhea, muscle cramps, hyperpigmentation, facial swelling, alopecia, fever, phlebitis at IV site, allergic reactions, erythema, diaphoresis, dysphagia, constipation, weakness, malaise

DDI: Serious Warfarin effects increases, Phenobarbital/Carbamazepine/Phenytoin increases drug clearance & result in decreased efficacy, Atovaquone leads to secondary acute myeloid leukemia, Prednisone markedly increases drug clearance, Cisplatin/Carboplatin/Ketoconazole modestly reduces drug clearance, Ciclosporin raises drug level & increases suppression of WBC production

Monitor: CBC, platelet count, Hb, LFTs, renal function tests, vital signs