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Regimen Taxonomy

There are 2 objectives for creating a regimen taxonomy. The first is to establish standard terms for regimen monographs to improve consistency, patient safety, data quality and standardization of practice. The second is to support evolving clinical practice.

Overview of Approach

A procedure to help with decision-making was developed based on a review of regimen taxonomy from other cancer institutions, and from inconsistencies in the previous Cancer Care Ontario regimen language. A working group made recommendations for a standardized approach to regimen naming, accommodating historical preferences and data reporting requirements.

Taxonomy Guidelines

RULE EXAMPLE
Use generic names. (e.g., doxorubicin)
Standard rules are used to truncate drug names. (e.g., DOXO; refer to Truncating Drug Names section)
For drugs with multiple common names, use the name as it appears on the product packaging. (e.g., LCVR for leucovorin)
Maximum of 16 characters in regimen name. (e.g., CISPDOXOETOPMTTN; for Cisplatin-Doxorubicin-Etoposide-Mitotane)
Regimen name does not include disease site and treatment intent. (e.g., CISP)
Keep commonly used regimen acronyms (defined by the working group — refer to Suffixes section). (e.g., FOLFIRI for Leucovorin-Fluorouracil-Irinotecan)
For other regimens, use truncated drug names.  
Within a regimen name, the drugs are arranged in alphabetical order. (e.g., CISPGEMC for Cisplatin-Gemcitabine)
Monoclonal antibody treatment options appear after the chemotherapy component. (e.g., FOLFIRI+BEVA for FOLFIRI with Bevacizumab)
Use the plus sign (+) to indicate a concurrently given regimen. (e.g., CHOP+R for CHOP with Rituximab)
Use a dash ( - ) to indicate a sequentially given regimen. (e.g., AC-PACL for AC followed by Paclitaxel)
Use suffix(es) in brackets to indicate supplementary information. (e.g., (PO); refer to Suffixes section)
Separate multiple suffixes with dashes ( - ). (e.g., FU(IV-CIV-RT-IV), for Fluorouracil bolus, then continuous infusion with radiation treatment, followed by bolus)

Method for Truncating Drug Names

When truncating a drug name, we follow several general guidelines:

  • Names are kept to a maximum of 4 characters if possible
  • Only the 4 letters of the drug name are used (e.g., DOXO)
  • Abbreviations already in common use are maintained: FU (fluorouracil), BCG (Bacillus Calmette-Guerin)
  • Special formulations are indicated as:
    • Pegylated = PG
    • Liposomal = L
    • Nanoparticle albumin bound = N
    • Erwinia = ER

There are instances where one drug name could potentially have the same abbreviation as another. To make sure every drug name has a unique abbreviation, we have outlined potential issues as well as solutions.

Potential Issues

  • The first 3 letters of 2 or more full drug names are the same (e.g., vincristine, vinorelbine, vinblastine).
  • Three letters are in the same positions for 2 or more truncated drug names.
  • The truncated name appears similar to a commonly used abbreviation (e.g., fulvestrant (FULV) versus fluorouracil-leucovorin; methotrexate versus mitoxantrone (MTXN)).
  • Two or more truncated drug names are made of the same 4 consonants, and the first 2 letters are identical and in the same positions (e.g., MTTN and MTNT for mitotane, mitoxantrone).

Possible Solutions

  1. Use the first 4 consonants for each of these similar drug names.
  2. If any issues occur, use the next consonant available in its full name to make the truncated version unique.
  3. If any issues persist, keep the first 4 letters for one of the names, and then use the first 4 consonants for the other similar names. Try to use the next consonant in the sequence until a unique truncated name is formed.

Regimen Suffixes

Suffixes added on to a drug name provide other information related to the regimen. They are added when required.

REGIMEN DETAIL SUFFIX
Intensive I
Dose Dense DD
High Dose HD
Intermediate Dose ID
Low Dose LD
With Radiotherapy RT
Continuous Infusion CIV
Oral PO
Intravenous IV
Intra-arterial IA
Intramuscular IM
Intrathecal IT
Subcutaneous SC
Topical TOP
Intraperitoneal IP
Every “x” week cycle QxW,

where x = a number
For a certain number of days

(e.g., 5d vs 3d)		 xD,

where x = a number
Weekly W
Daily D
Alternate with /
Induction IND
Intensification INT
Maintenance MNT
Modified MOD
Sequential add-on regimen/drug “-“ (dash, as in AC- PACL
Concurrent add-on regimen/drug “+” (as in FOLFIRI+BEVA)

Abbreviated Drug Name Examples

DRUG NAME TRUNCATED NAME
Abiraterone ABIR
Degarelix DGRL
Dexamethasone DEXA
Doxorubicin DOXO
Fulvestrant FLVS
Methotrexate MTRX
Methylprednisolone MTPR
Mitomycin MTMC
Mitoxantrone MXNT
Nab-paclitaxel NPAC
Paclitaxel PACL
Pegylated Liposomal- Doxorubicin PGLDX
Pomalidomide POMA
Ponatinib PNAT

Commonly Used Acronyms

Drugs are referred to by their generic names where possible. Trade names and manufacturers are noted where applicable. For ease of use and consistency, we have used some common acronyms for multi-drug regimens, even though an acronym may refer to the trade name of one or more drugs.

e.g., CAF: cyclophosphamide, doxorubicin, fluorouracil

In these cases, we list the drug's generic name (instead of the trade name) next to the acronym.

Use of trade names does not constitute endorsement by the Drug Formulary of any particular brand of drug in circumstance where multiple generic equivalents are available.