netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:
Please also refer to the Cancer Drugs Fund list
 Details...
08.01.05  Expand sub section  Other antineoplastic drugs
 note  Use in accordance with local guidelines
Axitinib tabs

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High Cost Medicine
Red

Link  NICE TA333: Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment    
Bosutinib tabs

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High Cost Medicine
Red

Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia    
Brentuximab injection

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High Cost Medicine
Cancer Drugs Fund
Red
Approved as per NICE Technology Appraisal guidance

Link  NICE TA446: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
Link  NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma    
Carfilzomib injection

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High Cost Medicine
Red

Link  NICE TA457: Carfilzomib for previously treated multiple myeloma    
Ceritinib caps

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High Cost Medicine
Red

Link  NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer    
Dabrafenib caps

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High Cost Medicine
Red

Link  NICE TA321: Dabrafenib for treating unresectable or metastatic BRAF V600 mutation‑positive melanoma    
Eribulin injection

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High Cost Medicine
Red

Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens    
Ibrutinib caps

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High Cost Medicine
Red
Pending confirmation of commissioning from NHSE (awaited)

Link  MHRA Aug 17: Ibrutinib (Imbruvica▼): reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and of opportunistic infections
Link  NICE TA429: Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation    
Idelalisib tabs

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Red

Link  NICE TA359: Idelalisib for treating chronic lymphocytic leukaemia    
Ketoconazole tabs

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Restricted Drug Restricted
Red
Approved off-label indication:
Management of castration refractory prostate cancer
Dose = 200-400mg three times daily
   
Olaparib caps

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High Cost Medicine
Red

Link  NICE TA381: Olaparib for relapsed, platinum-sensitive, BRCA positive ovarian, fallopian tube and peritoneal cancer after response to second-line or subsequent platinum-based chemotherapy    
Olaratumab injection

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High Cost Medicine
Cancer Drugs Fund
Red
Approved for treating advanced soft tissue sarcoma as per NICE TA465

Link  NICE TA465: Olaratumab in combination with doxorubicin for treating advanced soft tissue sarcoma    
Panitumumab injection

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High Cost Medicine
Red
Approved as per restrictions in the NICE guidance

Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer    
Panobinostat caps

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High Cost Medicine
Red

Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments    
Pegaspargase injection

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High Cost Medicine
Red

Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia    
Pembrolizumab injection (lung cancer indications)

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High Cost Medicine
Cancer Drugs Fund
Red
For non-small-cell lung cancer as per NICE Technology appraisals below

Link  MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Link  NICE TA428: Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy
Link  NICE TA447: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer    
Pembrolizumab injection (skin cancer indications)

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High Cost Medicine
Red
For skin cancer indications as per NICE technology appraisals below

Link  MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Link  NICE TA357: Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab
Link  NICE TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab    
Pertuzumab injection

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High Cost Medicine
Red

Link  NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer    
Ponatinib tabs

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High Cost Medicine
Red
Approved for CML and ALL as per NICE TA451

Link  MHRA Apr 2017: Ponatinib (Iclusig▼): risk of vascular occlusive events—updated advice on possible dose reduction
Link  NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia    
Ruxolitinib tabs

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High Cost Medicine
Red

Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis    
Trametinib tabs

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High Cost Medicine
Red

Link  NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma    
Streptozocin injection

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Restricted Drug Unlicensed
Red
Locally advanced and metastatic neuroendocrine tumours (predominantly pancreas but also small/large bowel and lung)

For named supervising consultants only in accordance with the prescribing protocol and proforma
   
08.01.05  Expand sub section  Amsacrine
Cytotoxic Drug  Amsacrine injection

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Red
   
08.01.05  Expand sub section  Bevacizumab
Bevacizumab injection

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High Cost Medicine
Red
Approved off-label indication:
Treatment of neurofibromatosis type 2

For consultant specialists in accordance with a nationally commissioned service protocol
   
08.01.05  Expand sub section  Bexarotene
Bexarotene caps

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Formulary
Red
Use in accordance with LCNDG guidance
   
08.01.05  Expand sub section  Bortezomib to top
Cytotoxic Drug  Bortezomib injection

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High Cost Medicine
Red

Link  NICE TA129: Bortezomib monotherapy for relapsed multiple myeloma
Link  NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
Link  NICE TA311: Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation
Link  NICE TA370: Bortezomib for previously untreated mantle cell lymphoma    
08.01.05  Expand sub section  Cetuximab
Cetuximab injection

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High Cost Medicine
Red
Approved for use as per NICE technology appraisal guidance (see links below)

Link  MHRA Feb 2014: Cetuximab: Importance of establishing wild type RAS (KRAS and NRAS) status before treatment of metastatic colorectal cancer
Link  NICE TA176: Cetuximab for the first-line treatment of metastatic colorectal cancer
Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer    
Cetuximab injection

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High Cost Medicine
Red
Approved for use as per NICE technology appraisal guidance (see links below)

Link  NICE TA145: Cetuximab for the treatment of locally advanced squamous cell cancer of the head and neck
Link  NICE TA473: Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck    
08.01.05  Expand sub section  Crisantaspase
Crisantaspase injection

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Formulary
Red
   
Asparaginase injection

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Restricted Drug Unlicensed
Red
Acute lymphoid leukaemia
   
08.01.05  Expand sub section  Dacarbazine and Temozolomide
Cytotoxic Drug  Dacarbazine injection

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Formulary
Red
   
Cytotoxic Drug  Temozolomide caps

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High Cost Medicine
Red

Link  NICE TA121: Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma
Link  NICE TA23: Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer)    
Cytotoxic Drug  Temozolomide caps

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Restricted Drug Restricted
High Cost Medicine
Red
Approved off-label indication:
Treatment of pituitary adenomas refractory to surgery and radiotherapy

Initiation restricted to Consultant Endocrinologists who are part of the Trust MDM, in accordance with a treatment protocol at KCH
   
08.01.05  Expand sub section  Erlotinib
Erlotinib tabs

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High Cost Medicine
Red

Link  NICE TA258: Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy    
08.01.05  Expand sub section  Hydroxycarbamide to top
Cytotoxic Drug  Hydroxycarbamide caps, tabs

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Formulary Red Traffic Light
Cancer indications

Amber Traffic Light
Non-cancer licensed indications
   
08.01.05  Expand sub section  Imatinab
Imatinib tabs

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High Cost Medicine
Red

Link  NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
Link  NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
Link  NICE TA70: Guidance on the use of imatinib for chronic myeloid leukaemia
Link  NICE TA86: Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours    
08.01.05  Expand sub section  Ipilimumab
Ipilimumab injection

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High Cost Medicine
Red

Link  NICE TA268: Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma
Link  NICE TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma    
08.01.05  Expand sub section  Mitotane
Mitotane tabs

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Restricted Drug Restricted
Red
Treatment of patients with:
DotBiochemical or radiological evidence of persistent or relapsed adrenocortical carcinoma
DotApparent complete resection of adrenocortical carcinoma for adjuvant therapy
   
08.01.05  Expand sub section  Pentostatin
Cytotoxic Drug  Pentostatin injection

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Formulary
Red
   
08.01.05  Expand sub section  Platinum compounds to top
Cytotoxic Drug  Carboplatin injection

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Formulary
Red

Link  NICE CG121: Lung cancer: diagnosis and management    
Cytotoxic Drug  Cisplatin injection

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Formulary
Red

Link  NICE CG121: Lung cancer: diagnosis and management    
Cytotoxic Drug  Oxaliplatin injection

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Formulary
Red

Link  NICE CG131: Colorectal cancer: diagnosis and management
Link  NICE TA100: Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes’ C) colon cancer    
08.01.05  Expand sub section  Procarbazine
Cytotoxic Drug  Procarbazine caps

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Formulary
Red
   
08.01.05  Expand sub section  Protein kinase inhibitors
Afatinib tabs

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High Cost Medicine
Red

Link  NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer    
Cabozantinib tablets

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Formulary
High Cost Medicine
Red
Approved for previously treated advanced renal cell carcinoma as per NICE TA463

Link  NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma    
Crizotinib caps

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Formulary
High Cost Medicine
Red

Link  NICE TA406: Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
Link  NICE TA422: Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer    
Dasatinib tabs

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Formulary
High Cost Medicine
Red

Link  NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
Link  NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia    
Everolimus tabs (breast cancer and renal cancer)

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Formulary
High Cost Medicine
Red
Approved as per NICE TA guidance (see links below)

Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
Link  NICE TA432: Everolimus for advanced renal cell carcinoma after previous treatment    
Everolimus tabs (neuroendocrine tumours)

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High Cost Medicine
Red
Approved for use in neuroendocrine tumours as per NICE TA449

Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease    
Gefitinib tabs

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High Cost Medicine
Red

Link  NICE TA192: Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer    
Nilotinib caps

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Formulary
High Cost Medicine
Red

Link  NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
Link  NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia    
Nintedanib caps (Vargatef®)

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Formulary
High Cost Medicine
Red

Link  NICE TA347: Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer    
Osimertinib tabs

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Formulary
High Cost Medicine
Cancer Drugs Fund
Red

Link  NICE TA416: Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer    
Pazopanib tabs

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High Cost Medicine
Red

Link  NICE TA215: Pazopanib for the first-line treatment of advanced renal cell carcinoma    
Sorafenib tablets

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Formulary
High Cost Medicine
Red
Approved as per NICE Technology Appraisal guidance

Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma    
Sunitinib caps (neuroendocrine tumours)

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Formulary
High Cost Medicine
Red
Approved for use in neuroendocrine tumours as per NICE TA449

Link  MHRA Jan 2011: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw
Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease    
Sunitinib caps (renal cell, and gastrointestinal stromal tumours)

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High Cost Medicine
Red
Approved for use in renal cell and gastrointestinal stromal tumours as per NICE TA169 and NICE TA179

Link  MHRA Jan 2011: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw
Link  NICE TA169: Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma
Link  NICE TA179: Sunitinib for the treatment of gastrointestinal stromal tumours    
Vemurafenib tabs

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Formulary
High Cost Medicine
Red

Link  NICE TA269: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation‑positive malignant melanoma    
08.01.05  Expand sub section  Taxanes
Cytotoxic Drug  Cabazitaxel injection

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Formulary
High Cost Medicine
Red

Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel    
Cytotoxic Drug  Docetaxel injection

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Formulary
Red

Link  NICE CG121: Lung cancer: diagnosis and management
Link  NICE CG81: Advanced breast cancer: diagnosis and treatment
Link  NICE TA101: Docetaxel for the treatment of hormone-refractory metastatic prostate cancer
Link  NICE TA109: Docetaxel for the adjuvant treatment of early node-positive breast cancer    
Cytotoxic Drug  Paclitaxel albumin injection (Abraxane)

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Formulary
High Cost Medicine
Red
Approved as per NICE Technology Appraisal guidance

Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer    
Cytotoxic Drug  Paclitaxel injection

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Formulary
Red

Link  NICE CG121: Lung cancer: diagnosis and management
Link  NICE CG81: Advanced breast cancer: diagnosis and treatment
Link  NICE TA389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
Link  NICE TA55: Guidance on the use of paclitaxel in the treatment of ovarian cancer    
08.01.05  Expand sub section  Topoisomerase I inhibitors
Cytotoxic Drug  Irinotecan Hydrochloride injection

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Formulary
Red

Link  NICE CG131: Colorectal cancer: diagnosis and management    
Cytotoxic Drug  Topotecan injection

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Formulary
Red

Link  NICE TA183: Topotecan for the treatment of recurrent and stage IVB cervical cancer
Link  NICE TA184: Topotecan for the treatment of relapsed small-cell lung cancer    
08.01.05  Expand sub section  Trabectedin to top
Cytotoxic Drug  Trabectedin injection

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Formulary
Red

Link  NICE TA185: Trabectedin for the treatment of advanced soft tissue sarcoma    
08.01.05  Expand sub section  Trastuzumab
Cytotoxic Drug  Trastuzumab emtansine injection

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Formulary
High Cost Medicine
Red

Link  NICE TA458: Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane    
Cytotoxic Drug  Trastuzumab injection

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Formulary
High Cost Medicine
Red

Link  NICE TA107: Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer
Link  NICE TA208: Trastuzumab for the treatment of HER2-positive metastatic gastric cancer
Link  NICE TA34: Guidance on the use of trastuzumab for the treatment of advanced breast cancer    
08.01.05  Expand sub section  Tretinoin
Tretinoin caps

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Formulary
Red
   
 ....
Key
note Notes First Choice Item First Choice item
Section Title Section Title (top level) Non Formulary Item Non Formulary section
Section Title Section Title (sub level)
Cytotoxic Drug
Cytotoxic Drug
Restricted Drug
Restricted Drug
CD
Controlled Drug
Unlicensed Drug
Unlicensed
High Cost Medicine
High Cost Medicine
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Link to SPCs
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Link to adult BNF
Track Changes
Display tracking information
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Cancer Drugs Fund
Cancer Drugs Fund
   

 

Traffic Light Status Information

Status Description
  Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
  Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
  Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
  Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
  Green   Specialist and non-specialist initiation  
  Grey   Not recommended for prescribing  

netFormulary