Table A8.

Dose Modification or Delay for Asymptomatic Hypophosphatemia

Toxicity Grade	Dose Interruption	Dose Modification	Dose for Subsequent Cycles
0-2	Treat on time	No change	Initiate phosphorous replacement and repeat phosphorous approximately every 3 to 5 days until within normal limits
3 or 4	Delay until < grade 2*	Reduce 1 dose level	If toxicity remains < grade 2, dose re-escalation can be considered at discretion of treating investigator; if dose is re-escalated and grade 4 toxicity recurs, institute permanent dose reduction†

^*Patients requiring delay of > 4 weeks should go off protocol therapy.

^†Dose reductions below dose level − 3 were not allowed; if dose reductions below dose level − 3 were required, study drug administration was discontinued.