VAC (vincristine, dactinomycin, cyclophosphamide)
Checked 2026-09-09
Backbone chemotherapy for childhood rhabdomyosarcoma in the Intergroup and Children's Oncology Group trials, with surgery and radiotherapy
Also called VAC.
One cycle
every 21 days × 14 · about 42 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Vincristine Vinca alkaloid (microtubule inhibitor) | 1.5 mg/m² (maximum 2 mg) | IV | D1, 8, 15 | |
Dactinomycin Actinomycin antibiotic (transcription inhibitor) | 0.045 mg/kg (maximum 2.5 mg) | IV | D1 | |
Cyclophosphamide Alkylating agent (oxazaphosphorine prodrug) | 2.2 g/m² with mesna | IV | D1 |
Cycles
14 (about 42 weeks) in IRS-IV
21-day cycle
Emetogenicity
High (>90%)
G-CSF
Recommended
Notes
- Later COG trials reduced the cyclophosphamide dose (1.2 g/m²) and added irinotecan (VAC/VI) for intermediate-risk disease.
- Radiotherapy is given to the primary site for all but completely resected embryonal tumours.
Used in
Source
Crist (IRS-IV), JCO 2001: VAC versus VAI versus VIE in non-metastatic rhabdomyosarcoma
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.