Parenteral Manual

Cilengitide (INVESTIGATIONAL)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
EMD 121974, Cyclo-[Arg-Gly-Asp-DPhe-(NMeVal)], NSC# 707544
Classification: 
Angiogenesis inhibitor, Antineoplastic
Original Date: 
August 2009
Revised Date: 
January 2011
Indications: 
  • Angiogenesis inhibitor under investigation in the treatment of high-grade gliomas, pancreatic cancer, and non-small cell lung cancer

THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.

Reconstitution and Stability: 
  • Available as a 15 mg/mL solution. Each vial contains 500 mg (33.3 mL).
  • Store vials in refrigerator without any specific precautions against light exposure. Stable until retest date.
  • Undiluted solution is stable for 7 days at room temperature.
  • Diluted solution is stable for 72 hours at room temperature diluted in 0.9% NaCl and for 24 hours at room temperature diluted in D5W.
Compatibility: 
  • Solutions Compatible:  D5W , NS

Incompatible:  DO NOT mix with any other drugs

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion

YES
Usual Dilution: undiluted by central line
                     -in 250 - 500 ml D5W or NS by peripheral line
Infusion time:  1 hour

IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • ACNS0621: 1800 mg/m2 IV twice weekly (at least 2 days between doses) x 4 weeks. Repeat cycle every 28 days
  • Maximum Dose from ACNS0621-75 mg/kg/dose

 

Potential hazards of parenteral administration: 

Immediate (within 1-2 days of receiving drug):

  • Common (> 20 %): Fatigue and nausea
  • Occasional (5- 20%): anorexia, constipation or diarrhea, xerostomia, dyspepsia, dysgeusia (taste alteration) vomiting, rash/desquamation, shortness of breath, cough, pain (back, chest, head, joint, muscle), headache, somnolence, depressed level of consciousness, insomnia.
  • Rare (< 5%): severe bleeding (CNS, dermal, renal, GI), seizures, respiratory failure, thromboembolic events, anaphylaxis (in combination with gemcitabine), increased bleeding time (secondary to transient thrombocyte aggregation).

 Prompt (within 2-3 weeks, prior to next cycle):

  • Occasional (5- 20%): mucositis/stomatitis, petechiae/purpura,  haemoglobin, ¯ WBC, lymphopenia, thrombocytopenia, ­ ALT/AST ­ alk phos, hyperglycemia, hypophosphatemia, hypokalemia, hyponatremia.
  • Rare (< 5%): DVT and DVT with PE (in combination with temozolomide), intratumoral hemorrhage.  

 

Delayed 

  • Occasional (5- 20%): Neuropathy

 

Unknown frequency and timing

  • Fetal and teratogenic toxicities

Treatment of unusual side effects is available through the study chair identified on the front page of the protocol and/or pharmacy.   

Notes: 
  • Mechanism of action: avß3 and avß5 integrin receptor antagonist.
  • Predominantly excreted unchanged in urine.
  • Has not been found to inhibit main cytochrome P450 enzymes.
  • Administration (if peripheral) through a new peripheral intravenous catheter is recommended
  • Administer through a 0.22 micron in-line filter

 

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