Modified IRS-III Protocol

We thought we'd post a summary of Emmett's treatment protocol for those who want to track his progress.  The protocol was created by Dr. Mark Kieran at Dana Farber Cancer Institute.  The protocol is largely based on a clinical trial for treating rhabdomyosarcoma written in 1983, the "Third Intergroup Rhabdomyosarcoma Study" (IRS-III).  Because Dr. Kieran made several slight changes to the rhabdomyosarcoma protocol, the Dana Farber AT/RT protocol is commonly referred to as the "modified IRS-III".  Members of the AT/RT community often refer to it as simply "IRS-III". The full version of the protocol is available here.

We've included several excerpts from the modified IRS-III protocol below including the chemotherapy / radiation schedule along with a list of chemotherapy drugs.  The numbers in the top row of the schedule denote weeks and the letters in each column designate chemo drugs administered each week.  The I and L on the bottom two rows indicate where intrathecal chemo is administered either by lumbar puncture or omaya reservoir (ideally alternate each dose).

Emmett completed his 4th week of radiation today (which is week 10 on the protocol).  However, his chemo is behind a week because low blood counts delayed administering week 7 chemo until week 8.  So we'll finish chemo week 9 today before we leave the hospital (we're currently in the MGH pediatric clinic awaiting vincristine).  The doctors say delays like these are expected and not to worry. 

The modified IRS-III protocol is something of an enigma.  More details coming soon.