Kidney Cancer

Gemcitabine/CARBOplatin

KDN5
INDICATION:

Metastatic or Relapsed – Collecting Duct/Medullary Subtypes
REFERENCES:

NCCN SUPPORTIVE CARE:

Emetic Risk:

Day 1 Moderate

Day 8 Low
Fever Neutropenia Risk:
Refer to NCCN Guidelines for Myeloid Growth Factors. V.2.2014
CHEMOTHERAPY REGIMEN

21-day cycle for 6 cycles
Gemcitabine 1250 mg/m² IV over 30 minutes on Days 1 and 8
CARBOplatin AUC 5 IV over 30 minutes on Day 1

  
    
      
      
      
        
          
          
          
        
        
      
      
        
        
          
            
            
          
        
        
          
        
        
          
          
            
          
          
        
      
    
  

  
    
    
  
  
  
  <type>
    <text value="Chemotherapy Order Template"/>
  </type>
  <status value="draft"/>
  <experimental value="true"/>
  <publisher value="National Comprehensive Cancer Network, Inc."/>
  <approvalDate value="2016-07-27"/>
  <lastReviewDate value="2016-07-27"/>
  <!--  Indications  -->
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="A"/>
		</extension>
		<code>
			<system value="http://example.org/fhir/CodeSystem/indications"/>
			<code value="treamentSetting-or-diseaseStatus"/>
		</code>
		<valueCodeableConcept>
			<text value="Metastatic"/>
		</valueCodeableConcept>
	</useContext>
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="A"/>
		</extension>
		<code>
			<system value="http://example.org/fhir/CodeSystem/indications"/>
			<code value="disease-or-histology"/>
		</code>
		<valueCodeableConcept>
			<text value="Collecting Duct/Medullary Subtypes"/>
		</valueCodeableConcept>
	</useContext>
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="A"/>
		</extension>
		<code>
			<system value="http://hl7.org/fhir/usage-context-type"/>
			<code value="focus"/>
		</code>
		<valueCodeableConcept>
			<text value="Kidney Cancer"/>
		</valueCodeableConcept>
	</useContext>
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="B"/>
		</extension>
		<code>
			<system value="http://example.org/fhir/CodeSystem/indications"/>
			<code value="treatmentSetting-or-diseaseStatus"/>
		</code>
		<valueCodeableConcept>
			<text value="Relapsed"/>
		</valueCodeableConcept>
	</useContext>
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="B"/>
		</extension>
		<code>
			<system value="http://example.org/fhir/CodeSystem/indications"/>
			<code value="disease-or-histology"/>
		</code>
		<valueCodeableConcept>
			<text value="Collecting Duct/Medullary Subtypes"/>
		</valueCodeableConcept>
	</useContext>
	<useContext>
		<extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
			<valueString value="B"/>
		</extension>
		<code>
			<system value="http://hl7.org/fhir/usage-context-type"/>
			<code value="focus"/>
		</code>
		<valueCodeableConcept>
			<text value="Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"/>
		</valueCodeableConcept>
	</useContext>
  <contributor>
    <type value="author"/>
    <name value="Lee Surprenant"/>
  </contributor>
  <copyright value="All rights reserved."/>
  <!--  list of references for the order template  -->
  <relatedArtifact>
    <type value="derived-from"/>
    <display value="NCCN Guidelines for Kidney Cancer. V.2.2016"/>
    <url value="http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation">
      <extension url="http://example.org/fhir/regimenReferenceType">
        <valueCode value="a"/>
      </extension>
    </type>
    <citation value="Oudard S, et al. J Urol. 2007;177(5):1698-702"/>
    <url value="http://www.ncbi.nlm.nih.gov/pubmed/17437788"/>
  </relatedArtifact>

  <action>
    <!--  list of regimen options. in this case only one  -->
    <selectionBehavior value="exactly-one"/>
    <action>
      <!--  list of regimen parts. in this case only one  -->
      <selectionBehavior value="all"/>
      <action>
        <!--  list of cycle definitions. in this case only one  -->
        <groupingBehavior value="sentence-group"/>
        <selectionBehavior value="exactly-one"/>
        <action id="cycle-definition-1">
          <textEquivalent value="21-day cycle for 6 cycles"/>

          <timingTiming>
            <repeat>
              <count value="6"/>
              <duration value="21"/>
              <durationUnit value="d"/>
            </repeat>
          </timingTiming>

          <!--  list of regimen entry references for this regimen part  -->
          <!--  references would duplicated in each cycle definition option
          (see http://hl7.org/fhir/STU3/codesystem-action-grouping-behavior.html#sentence-group) -->
          <action id="action-1">
            <extension url="http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle">
              <extension url="day">
                <valueInteger value="1"/>
              </extension>
              <extension url="day">
                <valueInteger value="8"/>
              </extension>
            </extension>
            <textEquivalent value="Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8"/>
            <definition>
              <reference value="#1111"/>
            </definition>
          </action>
          <action id="action-2">
            <extension url="http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle">
              <extension url="day">
                <valueInteger value="1"/>
              </extension>
            </extension>
            <textEquivalent value="CARBOplatin AUC 5 IV over 30 minutes on Day 1"/>
            <relatedAction>
              <actionId value="action-1"/>
              <relationship value="concurrent-with-start"/>
            </relatedAction>
            <definition>
              <reference value="#2222"/>
            </definition>
          </action> <!--  end of regimen entries  -->
        </action> <!--  end of cycle definitions  -->
      </action> <!--  end of regimen parts  -->
    </action> <!--  end of regimen options  -->
  </action>
</PlanDefinition>