The correct answer is 4.
Based on GIPGEM protocol, the dose for gemcitabine in Cycle 2 and subsequent cycles is 1000 mg/m2/week x 3 weeks, followed by 1 week rest.
Calculation of acceptable dose:
Our dose based on our calculated BSA (from question 1): 1000 mg/m2 x 1.34 m2 = 1340 mg gemcitabine. The dose ordered by the physician is 1400 mg, which is correct because initial BSA of 1.39 should continue to be used for subsequent cycles, as per BCCA Policy III-10.
Calculation of acceptable interval:
Patient has already received, as Cycle 1, 7 weeks of gemcitabine (September 3 – October 15). According to the protocol treatment plan, she is scheduled for a one week rest period before resuming treatment. Therefore, the patient should not be receiving any treatment on October 21 or 22. Next scheduled treatment date should be October 29.