Indications & Dose: CERVICAL CANCER IV Adult 0.75mg/m2 infused over 30 min for 3 consecutive days (days 1-3) & cisplastin 50mg/m2 infused after topotecan on day 1 for each 21 day course. If severe febrile neutropenia occurs dose may be reduced to 600µg/m2STAGE IVB, RECURRENT/PERSISTENT | OVARIAN/SMALL CELL LUNG CANCER IV Adult Initially 1.5mg/m2 infused over 30 min for 5 days of a 21-day course. In the absence of tumour progression, 4 courses should be given provided blood counts & Hb has recovered adequately. If severe neutropenia occurs, reduce dose by 250 µg/m2 | SMALL-CELL LUNG CANCER PO Adult 2.3mg/m2 OD 5 days, repeated q21days. If neutropenia occur/platelet count is <25, 000 cells/mm3 or severe diarrhea, reduce daily dose by 400µg/m2 for subsequent courses

Precautions: Neutropenic colitis, interstitial lung disease, hepatic impairment

ADR: Serious: neutropenia, neutropenic colitis, anaphylaxis, thrombocytopenia, anemia, leucopenia, paresthesia, liver enzymes increased, bilirubin increased, pneumonia, Others: GI disturbances, fatigue, fever, anorexia, headache, weakness, rash, dyspnea, cough, alopecia, sepsis, pruritus

DDI: Serious Ciclosporin increases drug absorption, Phenytoin increases drug clearance, Cytotoxic drugs increases myelosuppression, G-CSF prolongs duration of neutropenia

Diet: With/without food

Monitor: CBC, renal function, signs & symptoms of myelosuppression & GI disturbances