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Luavbri Pppo

This document outlines the treatment protocol LUAVBRI for administering brigatinib, including dosage instructions and necessary monitoring requirements. It emphasizes the importance of verifying the information against BC Cancer treatment protocols and includes reminders for documenting allergies. Additionally, it specifies follow-up appointment orders and tests to be conducted during treatment cycles.

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Eunice Finch
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27 views1 page

Luavbri Pppo

This document outlines the treatment protocol LUAVBRI for administering brigatinib, including dosage instructions and necessary monitoring requirements. It emphasizes the importance of verifying the information against BC Cancer treatment protocols and includes reminders for documenting allergies. Additionally, it specifies follow-up appointment orders and tests to be conducted during treatment cycles.

Uploaded by

Eunice Finch
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Information on this form is a guide only.

User will
be solely responsible for verifying its currency and
accuracy with the corresponding BC Cancer
treatment protocols located at
www.bccancer.bc.ca and according to acceptable
standards of care

PROTOCOL CODE: LUAVBRI


Page 1 of 1

DOCTOR’S ORDERS Ht____________cm Wt___________kg BSA____________m2

REMINDER: Please ensure drug allergies and previous bleomycin are documented on the Allergy & Alert Form
DATE: To be given: Cycle #:

Date of Previous Cycle:

TREATMENT:
Start or restart cycle: (if possible, start early in the week)
brigatinib 90 mg PO once daily for 7 days, then take 180 mg once daily for 21 days. Do NOT increase dose until
approval received.
OR
brigatinib ______ mg PO once daily for 7 days, then take _______ mg once daily for 21 days. Do NOT increase
dose until approval received.

Subsequent cycles:
brigatinib 180 mg PO once daily. Supply for: _________ days

Dose modification if required:


brigatinib 120 mg PO once daily. Supply for: _________ days (dose level -1)
brigatinib 90 mg PO once daily. Supply for: _________ days (dose level -2)
brigatinib 60 mg PO once daily. Supply for: _________ days (dose level -3)

RETURN APPOINTMENT ORDERS


Return in 1 week for Doctor
Return in _______ weeks for Doctor
Alkaline phosphatase, ALT, total bilirubin, LDH every 2 weeks for the first 3 cycles

Alkaline phosphatase, ALT, total bilirubin, LDH, creatine phosphokinase, lipase,


blood pressure, heart rate at each doctor’s visit

Imaging (approx. every 4-8 weeks): Chest X-ray or CT Scan (chest)

If clinically indicated:
CBC & Diff sodium, potassium magnesium CEA
fasting glucose creatinine ECG
Other tests:
Consults:
See general orders sheet for additional requests.
DOCTOR’S SIGNATURE: SIGNATURE:
UC:

BC Cancer Provincial Preprinted Order LUAVBRI


Created: 1 Jun 2022 Revised: 1 Oct 2024 (Tests updated)

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