Postby Rock_Robster » Wed Aug 19, 2020 7:40 am
Firstly, doses are not necessarily different between curative and palliative treatment. They can be, but these terms generally refer to the intent of the treatment, not the protocol itself. Of course palliative patients may choose to go for a lower dose, but this isn’t automatic. The only way to be clear on this is to ask the oncologist (which I would encourage if you want to know!).
Secondly, my standard advice is it’s always best to clarify medication questions with the oncologist or pharmacist (or chemo nurse), but we can say a few things from what you’ve provided.
Avastin dosing is usually different depending on whether it’s given every 2 or 3 weeks. For example, the standard 2-week dose is often 5 mg per kg of body weight, and the 3-week dose is often 7.5 mg per kg of body weight. So in this way the “weekly” dose is the same (ie “2.5 mg per kg per week”), but it’s given at different intervals.
Next, it’s difficult to see an actual dosage in what you’ve shown. What is there is a concentration - the injection he was first given had 25 ml of Avastin in every 1 ml of solution. The second injection had 100 ml of Avastin in every 4 ml of solution; which you’ll notice is actually the same solution strength (ie 1:25).
So to work out his dose, we need to know his weight. At the top it says “bevacizumab 10mg per” and then a quantity of 40 in total. This might suggest 400mg of bev, which is about the right fortnightly dose for an 80kg (175 lb) person.
In the second line it says 4 ml of a solution 100mg/4ml; so 100mg of bevacizumab. It then has a quantity of 20, which is 2000 mg of bevacizumab. I can only assume this isn’t all to be administered at once, and they have ordered for use over time. No-where in this does it actually seem to say how much he is to be given in a single dosage (as I say that would need his weight as an input too). Someone else here may be able to interpret that line better than me however.
The short answer on how to have his regime reviewed is to talk to his oncologist. If you don’t have faith in this oncologist, then it sounds like it’s time for a second opinion.
Best of luck,
Rob
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial