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

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

 Details...
08.01.05  Expand sub section  Other antineoplastic drugs
 note  Use in accordance with local guidelines
Abemaciclib tabs
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved as per NICE technology appraisal guidance

 
Link  NICE TA563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
   
Alectinib caps
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Formulary
Red
High Cost Medicine

Approved as per NICE Technology Appraisal guidance

 
Link  NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer
   
Arsenic trioxide injection
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Formulary
Red
High Cost Medicine

Approved as per NICE Technology Appraisal guidance

Approved as per licensed dosing, or dosing in the AML17 trial protocol (off-label). Refer to local guidelines and treatment protocols.

 
Link  NICE TA526: Arsenic trioxide for treating acute promyelocytic leukaemia
   
Atezolizumab injection (lung cancer indications)
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance below

 
Link  NICE TA520: Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
Link  NICE TA584: Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer
   
Atezolizumab injection (urothelial cancer indications)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE technology appraisal guidance below

 
Link  NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Link  NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
   
Avelumab injection
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

 Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA517: Avelumab for treating metastatic Merkel cell carcinoma
   
Axicabtagene ciloleucel cells dispersion for infusion
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Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE technology appraisal guidance

A minimum of four doses of tocilizumab are required to be available for use in the event of cytokine release syndrome and emergency equipment must be available prior to infusion.

Refer to SPC for information on management of cytokine release syndrome.

 
Link  NICE TA559: Axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies
   
Axitinib tabs
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA333: Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment
   
Binimetinib tabs
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Formulary
Red
High Cost Medicine

Approved as per NICE technology appraisal guidance

 
Link  NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
   
Bosutinib tabs
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Formulary
Red
High Cost Medicine
BlueTeq

Approved as per NICE Technology Appraisal guidance

 
Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
   
Brentuximab injection
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund
BlueTeq

Approved as per NICE Technology Appraisal guidance

 
Link  NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma
Link  NICE TA524: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
Link  NICE TA577: Brentuximab vedotin for treating CD30-positive cutaneous T-cell lymphoma
   
Brigatinib tabs
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Red
High Cost Medicine

Approves as per NICE technology appraisal guidance

 
Link  NICE TA571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib
   
Carfilzomib injection
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  MHRA Aug 2019: Carfilzomib (Kyprolis▼): reminder of risk of potentially fatal cardiac events
Link  NICE TA457: Carfilzomib for previously treated multiple myeloma
   
Cemiplimab injection
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Formulary
Red
Cancer Drugs Fund
BlueTeq

Approved for treating metastatic or locally advanced cutaneous squamous cell carcinoma as per NICE TA592 (see link below)

 
Link  NICE TA592: Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma
   
Ceritinib caps
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE Technology Appraisal guidance (see links below):

 
Link  NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer
Link  NICE TA500: Ceritinib for untreated ALK-positive non-small-cell lung cancer
   
Dabrafenib caps
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA 544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma
Link  NICE TA321: Dabrafenib for treating unresectable or metastatic BRAF V600 mutation‑positive melanoma
   
Dacomitinib caps
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Formulary
Red

Approved for untreated EGFR mutation-positive non-small-cell lung cancer as per NICE TA595 (see link below)

 
Link  NICE TA595: Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer
   
Durvalumab injection
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA578: urvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation
   
Encorafenib caps
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Formulary
Red
High Cost Medicine

Approved as per NICE technology appraisal guidance

 
Link  NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
   
Eribulin injection
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
   
Ibrutinib caps
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund
BlueTeq

Approved for use as per NICE technology appraisal guidance below

 
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
Link  NICE TA491: Ibrutinib for treating Waldenstrom’s macroglobulinaemia
Link  NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma
   
Idelalisib tabs
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Formulary
Red

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA359: Idelalisib for treating chronic lymphocytic leukaemia
   
Inotuzumab ozogamicin injection
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Formulary
Red

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic 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

 
   
Lutetium (177Lu) oxodotreotide injection
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA539: Lutetium (177Lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours
   
Midostaurin caps
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Formulary
Red

Approved as per NICE Technology Appraisal guidance

 
Link  NICE TA523: Midostaurin for untreated acute myeloid leukaemia
   
Niraparib caps
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
   
Nivolumab injection (haematological cancer)
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE technology appraisal guidance below

 
Link   MHRA Oct 19: Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
Link  MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Link  NICE TA462: Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma
   
Nivolumab injection (lung and urothelial cancer)
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Red
High Cost Medicine
Cancer Drugs Fund
BlueTeq

Approved for use as per NICE technology appraisal guidance below

 
Link  MHRA Oct 19: Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
Link  MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Link  NICE TA483: Nivolumab for previously treated squamous non-small-cell lung cancer
Link  NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer
Link  NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy
   
Nivolumab injection (skin, head and neck and renal cancers)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund
BlueTeq

Approved for use as per NICE technology appraisal guidance below

 
Link  MHRA Oct 19: Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
Link  MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Link  NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
Link  NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma
Link  NICE TA490: Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy
Link  NICE TA558: Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease
Link  NICE TA581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma
   
Olaparib caps, tabs
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below)

Due to differences in dosing and bioavailability, capsules and tablets should not be substituted on a milligram-to-milligram basis.

To avoid medication errors, prescribers should specify formulation and dose on each prescription.

 
Link  NICE TA598: Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy
   
Palbociclib tabs
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Formulary
Red
High Cost Medicine
Approved for use as per NICE technology appraisal guidance below 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Panitumumab injection
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Formulary
Red
High Cost Medicine
BlueTeq

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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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
   
Pegaspargase injection
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
   
Pembrolizumab injection (Hodgkin lymphoma)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE Technology appraisals below

 
Link  NICE TA540: Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma
   
Pembrolizumab injection (lung cancer indications)
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund
BlueTeq

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 TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
Link  NICE TA557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer
Link  NICE TA600: Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer
   
Pembrolizumab injection (skin cancer indications)
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Formulary
Red
High Cost Medicine

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 TA 553: Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence
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
   
Pembrolizumab injection (urothelial cancer indications)
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Red
Cancer Drugs Fund

For urothelial cancer indications as per NICE Technology appraisals below

 
Link  NICE TA519: Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
Link  NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
   
Pertuzumab injection
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer
Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
Link  NICE TA569: Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer
   
Ponatinib tabs
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Formulary
Red
High Cost Medicine
BlueTeq

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  MHRA Oct 2018: Ponatinib (Iclusig▼): reports of posterior reversible encephalopathy syndrome
Link  NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
   
Regorafenib tabs (gastrointestinal stromal tumours)
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance below

 
Link  NICE TA488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
   
Regorafenib tabs (hepatocellular carcinoma)
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance below

 
Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
   
Ribociclib tabs
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance below

 
Link  NICE TA593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Ruxolitinib tabs
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Formulary
Red
High Cost Medicine

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
   
Talimogene laherparepvec injection
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Formulary
Red
High Cost Medicine

Approved for use as per NICE TA guidance

 
Link  NICE TA410: Talimogene laherparepvec for treating unresectable metastatic melanoma
   
Tisagenlecleucel cells dispersion for infusion
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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

Approved for use as per NICE technology appraisal guidance

A minimum of four doses of tocilizumab are required to be available for use in the event of cytokine release syndrome and emergency equipment must be available prior to infusion.

Refer to SPC for information on management of cytokine release syndrome.

 
Link  NICE TA554: Tisagenlecleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years
Link  NICE TA567:Tisagenlecleucel for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies
   
Trametinib tabs
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Formulary
Red
High Cost Medicine
BlueTeq

Approved for use as per NICE technology appraisal guidance (see links below):

 
Link  NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
Link  NICE TA544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma
   
Streptozocin injection
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Unlicensed 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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Formulary
Red
 
   
08.01.05  Expand sub section  Bevacizumab
Bevacizumab injection
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Formulary
Red
High Cost Medicine

Approved off-label indication:

Treatment of neurofibromatosis type 2

For consultant specialists in accordance with a nationally commissioned service protocol

 
   
Bevacizumab injection
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Formulary
Red
Cancer Drugs Fund

Approved as per indications in the Cancer Drugs Fund

 
   
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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Formulary
Red
High Cost Medicine
Cancer Drugs Fund

For relapsed multiple myeloma as per criteria in the Cancer Drugs Fund

 
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
Link  NICE TA573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma
   
08.01.05  Expand sub section  Cetuximab
Cetuximab injection (colorectal cancer)
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Formulary
Red
High Cost Medicine
BlueTeq

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 TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
   
Cetuximab injection (head and neck cancer)
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Formulary
Red
High Cost Medicine
BlueTeq

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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Unlicensed 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 (licensed use)
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Formulary
Red
High Cost Medicine

Approved as per NICE technology appraisal guidance

 
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 (pancreatic neuroendocrine tumours - off-label)
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Restricted Drug Restricted
Red

Approved off-label indication:

  • Unresectable or metastatic pancreatic neuroendocrine tumours (in combination with capecitabine). Follow local protocol for use. 
  •    
    Cytotoxic Drug Temozolomide caps (pituitary adenomas - off-label)
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    Restricted Drug Restricted
    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
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

     
    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
    View adult BNF View SPC online
    Formulary

    Red Traffic Light Cancer indications

    Amber Traffic Light Non-cancer licensed indications

     
       
    08.01.05  Expand sub section  Imatinab
    Imatinib tabs (licensed commissioned use)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE TA guidance (links below)

    Also approved for newly diagnosed Philadelphia chromosome positive acute lymphoblastic leukaemia (Ph+ ALL) (NHSE commissioned)

     
    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
       
    Imatinib tabs (Graft vs Host Disease - off-label)
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    Formulary
    Red
    High Cost Medicine

    Approved off-label indication:

    Treatment of Graft vs Host Disease (GvHD) following Haematopoietic Stem Cell Transplantation as per NHSE policy 16069/P

     

     
    Link  NHS England Clinical Commissioning Policy 16069/P: Treatments for Graft versus Host Disease (GvHD) following Haematopoietic Stem Cell Transplantation
       
    08.01.05  Expand sub section  Ipilimumab
    Ipilimumab injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE TA Guidance (see links below)

     
    Link  MHRA Jan 2019: Ipilimumab (Yervoy): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
    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
    Link  NICE TA581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma
       
    08.01.05  Expand sub section  Mitotane
    Mitotane tabs
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    Restricted Drug Restricted
    Red

    Treatment of patients with:

    • Biochemical or radiological evidence of persistent or relapsed adrenocortical carcinoma
    • Apparent complete resection of adrenocortical carcinoma for adjuvant therapy
     
       
    08.01.05  Expand sub section  Pentostatin
    Cytotoxic Drug Pentostatin injection (Graft vs Host Disease - off-label)
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    Formulary
    Red

    Approved off-label indication:

    Treatment of Graft vs Host Disease (GvHD) following Haematopoietic Stem Cell Transplantation as per NHSE policy 16069/P

     

     
    Link  NHS England Clinical Commissioning Policy 16069/P: Treatments for Graft versus Host Disease (GvHD) following Haematopoietic Stem Cell Transplantation
       
    Cytotoxic Drug Pentostatin injection (licensed use)
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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
     
       
    Cytotoxic Drug Cisplatin injection
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    Formulary
    Red
     
       
    Cytotoxic Drug Oxaliplatin injection
    View adult BNF View SPC online
    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
    View adult BNF View SPC online
    Formulary
    Red
     
       
    08.01.05  Expand sub section  Protein kinase inhibitors
    Afatinib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
     
    Link  NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer
       
    Cabozantinib caps (Cometriq - thyroid cancer)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE Technology Appraisal guidance (see links below): 

     

     
    Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
       
    Cabozantinib tablets (Cabometyx - renal carcinoma)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved as per NICE Technology Appraisal guidance (see links below): 

     

     
    Link  NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma
    Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
       
    Crizotinib caps
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved for use as per NICE technology appraisal guidance (see links below):


     
    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
    Link  NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer
       
    Dasatinib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    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)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved as per NICE TA guidance (see links below)

     
    Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
       
    Everolimus tabs (neuroendocrine tumours)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    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
       
    Everolimus tabs (renal cancer)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved as per NICE TA guidance (see links below)

     
    Link  NICE TA432: Everolimus for advanced renal cell carcinoma after previous treatment
    Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
       
    Everolimus tabs (seizures associated with tuberous sclerosis complex)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved for use in refractory seizures associated with tuberous sclerosis complex as per NHSE Clinical Commissioning Policy

     
    Link  NHSE Clinical Commissioning Policy 170093P: Everolimus for refractory focal onset seizures associated with tuberous sclerosis complex
       
    Gefitinib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved for use as per NICE technology appraisal guidance (see links below):

     
    Link  NICE TA192: Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer
       
    Lenvatinib caps (hepatocellular carcinoma - Lenvima®)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved for use as per NICE technology appraisal guidance below

     
    Link  NICE TA551: Lenvatinib for untreated advanced hepatocellular carcinoma
       
    Lenvatinib caps (renal cancer - Kisplyx®)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE TA guidance (see links below)

     

     
    Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
       
    Lenvatinib caps (thyroid cancer - Lenvima®)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved for use as per NICE technology appraisal guidance below

     
    Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
       
    Nilotinib caps
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    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® Non-small-cell lung cancer)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved for use in NSCLC as per NICE TA347

     
    Link  NICE TA347: Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer
       
    Osimertinib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    Cancer Drugs Fund

     
    Link  NICE TA416: Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer
       
    Pazopanib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
     
    Link  NICE TA215: Pazopanib for the first-line treatment of advanced renal cell carcinoma
       
    Sorafenib tablets (Hepatocellular carcinoma)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    Approved as per NICE Technology Appraisal guidance

     
    Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
       
    Sorafenib tablets (thyroid cancer)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE Technology Appraisal guidance

     
    Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
       
    Sunitinib caps (neuroendocrine tumours)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    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)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    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
       
    Tivozanib caps
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Approved as per NICE TA guidance (see links below)

     
    Link  NICE TA512: Tivozanib for treating advanced renal cell carcinoma
       
    Vemurafenib tabs
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
     
    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
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
       
    Cytotoxic Drug Docetaxel injection
    View adult BNF View SPC online
    Formulary
    Red
     
    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)
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

    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
    View adult BNF View SPC online
    Formulary
    Red

     
    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
    View adult BNF View SPC online
    Formulary
    Red
     
    Link  NICE CG131: Colorectal cancer: diagnosis and management
       
    Cytotoxic Drug Topotecan injection
    View adult BNF View SPC online
    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
    View adult BNF View SPC online
    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
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    Link  NICE TA458: Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
       
    Cytotoxic Drug Trastuzumab injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    Biosimilar products available, to be prescribed by brand name.

    Contact pharmacy department for advice on brand for routine prescribing if unsure

     
    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
    View adult BNF View SPC online
    Formulary
    Red
     
       
     ....
     Non Formulary Items
    Eribulin injection

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen as per NICE Technology appraisal guidance (see link below)

    Link  NICE TA515: Eribulin for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen
     
    Necitumumab injection

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London for untreated advanced or metastatic squamous non-small-cell lung cancer as per NICE Technology appraisal guidance (see link below)

    Link  NICE TA411: Necitumumab for untreated advanced or metastatic squamous non-small-cell lung cancer
     
    Cytotoxic Drug  Pegylated liposomal irinotecan injection

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London for treating pancreatic cancer as per NICE Technology appraisal guidance (see link below)

    Link  MHRA Mar 19: Onivyde (irinotecan, liposomal formulations): reports of serious and fatal thromboembolic events
    Link  NICE TA440: Pegylated liposomal irinotecan for treating pancreatic cancer after gemcitabine
     
    Vandetanib tabs

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London for treating medullary thyroid cancer as per NICE TA550 (see link below)

    Link  NICE TA550: Vandetanib for treating medullary thyroid cancer
     
    Vismodegib caps

    View adult BNF View SPC online
    Non Formulary
    Grey

    Not approved for use in SE London for treating symptomatic metastatic basal cell carcinoma, or locally advanced basal cell carcinoma that is inappropriate for surgery or radiotherapyas per NICE Technology appraisal guidance (see link below)

    Link  NICE TA489: Vismodegib for treating basal cell carcinoma
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Red

    Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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