Treatment
➤ Full weight-based dosing of cytotoxic chemotherapy should
be offered regardless of obesity status.
(Moderate Recommendation; EB-L)
➤ The Panel recommends limiting fixed dosing of
chemotherapy to select cytotoxic agents (e.g., bleomycin).
While fixed dosing of other cytotoxic chemotherapeutic
agents has been used in clinical trials, evidence remains
limited that fixed dosing strategies are equivalent to weight-
or BSA-based dosing in terms of toxicity and efficacy.
(Moderate Recommendation; EB-L)
➤ FDA-approved prescribing information for checkpoint
inhibitors should be used in all patients, regardless of
obesity status. (Moderate Recommendation; EB-L)
➤ FDA-approved prescribing information for targeted therapies
should be used in all patients, regardless of obesity status.
(Moderate Recommendation; EB-L)
➤ If an obese patient experiences high-grade toxicity from
systemic antineoplastic therapy, clinicians should follow
the same guidelines for dose reduction for all patients,
regardless of obesity status. (Weak Recommendation; IC-Ins)
➤ The Panel recommends that BSA be calculated using any of
the standard formulae. There is no evidence to support one
formula for calculating BSA over another.
(Moderate Recommendation; EB-L)
