| 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. |
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| Details... |
| 08.01.05 |
Other antineoplastic drugs |
|
|
 |
Use in accordance with local guidelines
|
|
Alectinib caps
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
|
 NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer
|
Arsenic trioxide injection
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
|
NICE TA526: Arsenic trioxide for treating acute promyelocytic leukaemia
|
Atezolizumab injection (lung cancer indications)
|
Formulary
|
 Approved for use as per NICE technology appraisal guidance below
|
NICE TA520: Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
|
Atezolizumab injection (urothelial cancer indications)
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
|
Avelumab injection
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA517: Avelumab for treating metastatic Merkel cell carcinoma
|
Axitinib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA333: Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment
|
Bosutinib tabs
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
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NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
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Brentuximab injection
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Formulary
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Approved as per NICE Technology Appraisal guidance
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NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma
NICE TA524: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
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Carfilzomib injection
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Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA457: Carfilzomib for previously treated multiple myeloma
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Ceritinib caps
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Formulary
|
Approved for use as per NICE Technology Appraisal guidance (see links below):
|
NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer
NICE TA500: Ceritinib for untreated ALK-positive non-small-cell lung cancer
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Dabrafenib caps
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA321: Dabrafenib for treating unresectable or metastatic BRAF V600 mutation‑positive melanoma
|
Eribulin injection
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Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
|
Ibrutinib caps
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
MHRA Aug 17: Ibrutinib (Imbruvica▼): reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and of opportunistic infections
NICE TA429: Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation
NICE TA491: Ibrutinib for treating Waldenstrom’s macroglobulinaemia
NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma
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Idelalisib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
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NICE TA359: Idelalisib for treating chronic lymphocytic leukaemia
|
Ketoconazole tabs
|
 Restricted
|
Approved off-label indication:
Management of castration refractory prostate cancer
Dose = 200-400mg three times daily
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|
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Lenvatinib injection (thyroid cancer - Lenvima)
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
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Midostaurin caps
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Formulary
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Approved as per NICE Technology Appraisal guidance
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NICE TA523: Midostaurin for untreated acute myeloid leukaemia
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Niraparib caps
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
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Nivolumab injection (GSTFT and KCH)
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Formulary
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Approved for use as per NICE technology appraisal guidance below
|
MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma
NICE TA462: Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma
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Nivolumab injection (lung, head and neck cancers - GSTFT only)
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Formulary
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Approved for use as per NICE technology appraisal guidance below
|
NICE TA483: Nivolumab for previously treated squamous non-small-cell lung cancer
NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer
NICE TA490: Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy
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Nivolumab injection (urothelial cancer - GSTFT only)
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Formulary
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Approved for use as per NICE technology appraisal guidance below
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NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy
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Olaparib caps, tabs
|
Formulary
|
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.
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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
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Olaratumab injection
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Formulary
|
Approved for treating advanced soft tissue sarcoma as per NICE TA465
|
NICE TA465: Olaratumab in combination with doxorubicin for treating advanced soft tissue sarcoma
|
Palbociclib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
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Panitumumab injection
|
Formulary
|
Approved as per restrictions in the NICE guidance
|
NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
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Panobinostat caps
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
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Pegaspargase injection
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
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Pembrolizumab injection (lung cancer indications)
|
Formulary
|
For non-small-cell lung cancer as per NICE Technology appraisals below
|
MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
NICE TA428: Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy
NICE TA447: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
NICE TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
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Pembrolizumab injection (skin cancer indications)
|
Formulary
|
For skin cancer indications as per NICE technology appraisals below
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MHRA Jul 17: Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
NICE TA357: Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab
NICE TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab
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Pembrolizumab injection (urothelial cancer indications)
|
Formulary
|
For urothelial cancer indications as per NICE Technology appraisals below
|
NICE TA519: Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
|
Pertuzumab injection
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer
NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
|
Ponatinib tabs
|
Formulary
|
Approved for CML and ALL as per NICE TA451
|
MHRA Apr 2017: Ponatinib (Iclusig▼): risk of vascular occlusive events—updated advice on possible dose reduction
MHRA Oct 2018: Ponatinib (Iclusig▼): reports of posterior reversible encephalopathy syndrome
NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
|
Regorafenib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
NICE TA488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
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Ribociclib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance below
|
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
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
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Trametinib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
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Streptozocin injection
|
 Unlicensed
|
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
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|
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| 08.01.05 |
Amsacrine |
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Amsacrine injection
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Formulary
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|
|
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| 08.01.05 |
Bevacizumab |
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|
Bevacizumab injection
|
Formulary
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Approved off-label indication:
Treatment of neurofibromatosis type 2
For consultant specialists in accordance with a nationally commissioned service protocol
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|
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Bevacizumab injection
|
Formulary
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Approved as per indications in the Cancer Drugs Fund
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| 08.01.05 |
Bexarotene |
|
|
Bexarotene caps
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Formulary
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Use in accordance with LCNDG guidance
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|
|
| 08.01.05 |
Bortezomib |
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Bortezomib injection
|
Formulary
|
For relapsed multiple myeloma as per criteria in the Cancer Drugs Fund
|
NICE TA129: Bortezomib monotherapy for relapsed multiple myeloma
NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
NICE TA311: Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation
NICE TA370: Bortezomib for previously untreated mantle cell lymphoma
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| 08.01.05 |
Cetuximab |
|
|
Cetuximab injection (colorectal cancer)
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below)
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MHRA Feb 2014: Cetuximab: Importance of establishing wild type RAS (KRAS and NRAS) status before treatment of metastatic colorectal cancer
NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
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Cetuximab injection (head and neck cancer)
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below)
|
NICE TA145: Cetuximab for the treatment of locally advanced squamous cell cancer of the head and neck
NICE TA473: Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck
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| 08.01.05 |
Crisantaspase |
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Crisantaspase injection
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Formulary
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|
|
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Asparaginase injection
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Unlicensed
|
Acute lymphoid leukaemia
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| 08.01.05 |
Dacarbazine and Temozolomide |
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Dacarbazine injection
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Formulary
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Temozolomide caps
|
Formulary
|
|
NICE TA121: Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma
NICE TA23: Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer)
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Temozolomide caps
|
Restricted
|
 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
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|
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| 08.01.05 |
Erlotinib |
|
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Erlotinib tabs
|
Formulary
|
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NICE TA258: Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer
NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
|
| 08.01.05 |
Hydroxycarbamide |
|
|
Hydroxycarbamide caps, tabs
|
Formulary
|
Cancer indications
 Non-cancer licensed indications
|
|
|
| 08.01.05 |
Imatinab |
|
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Imatinib tabs
|
Formulary
|
|
NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
NICE TA70: Guidance on the use of imatinib for chronic myeloid leukaemia
NICE TA86: Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours
|
| 08.01.05 |
Ipilimumab |
|
|
Ipilimumab injection
|
Formulary
|
|
NICE TA268: Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma
NICE TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma
NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
|
| 08.01.05 |
Mitotane |
|
|
Mitotane tabs
|
Restricted
|
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 |
Pentostatin |
|
|
Pentostatin injection
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Formulary
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|
|
|
| 08.01.05 |
Platinum compounds |
|
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Carboplatin injection
|
Formulary
|
|
NICE CG121: Lung cancer: diagnosis and management
|
Cisplatin injection
|
Formulary
|
|
NICE CG121: Lung cancer: diagnosis and management
|
Oxaliplatin injection
|
Formulary
|
|
NICE CG131: Colorectal cancer: diagnosis and management
NICE TA100: Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes’ C) colon cancer
|
| 08.01.05 |
Procarbazine |
|
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Procarbazine caps
|
Formulary
|
|
|
|
| 08.01.05 |
Protein kinase inhibitors |
|
|
Afatinib tabs
|
Formulary
|
|
NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer
|
Cabozantinib caps (Cometriq)
|
Formulary
|
Approved as per NICE Technology Appraisal guidance (see links below):
|
NICE TA516: Cabozantinib for treating medullary thyroid cancer
|
Cabozantinib tablets (Cabometyx)
|
Formulary
|
Approved as per NICE Technology Appraisal guidance (see links below):
|
NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma
|
Crizotinib caps
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA406: Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
NICE TA422: Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer
|
Dasatinib tabs
|
Formulary
|
|
NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
|
Everolimus tabs (breast cancer and renal cancer)
|
Formulary
|
Approved as per NICE TA guidance (see links below)
|
NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
NICE TA432: Everolimus for advanced renal cell carcinoma after previous treatment
NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
|
Everolimus tabs (neuroendocrine tumours)
|
Formulary
|
Approved for use in neuroendocrine tumours as per NICE TA449
|
NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
|
Gefitinib tabs
|
Formulary
|
Approved for use as per NICE technology appraisal guidance (see links below):
|
NICE TA192: Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer
|
Lenvatinib caps (renal cancer)
|
Formulary
|
Approved as per NICE TA guidance (see links below)
|
NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
|
Nilotinib caps
|
Formulary
|
|
NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
|
Nintedanib caps (Vargatef® Non-small-cell lung cancer)
|
Formulary
|
Approved for use in NSCLC as per NICE TA347
|
NICE TA347: Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer
|
Osimertinib tabs
|
Formulary
|
|
NICE TA416: Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer
|
Pazopanib tabs
|
Formulary
|
|
NICE TA215: Pazopanib for the first-line treatment of advanced renal cell carcinoma
|
Sorafenib tablets (Hepatocellular carcinoma)
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
|
NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
|
Sorafenib tablets (thyroid cancer)
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
|
NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
|
Sunitinib caps (neuroendocrine tumours)
|
Formulary
|
Approved for use in neuroendocrine tumours as per NICE TA449
|
MHRA Jan 2011: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw
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)
|
Formulary
|
Approved for use in renal cell and gastrointestinal stromal tumours as per NICE TA169 and NICE TA179
|
MHRA Jan 2011: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw
NICE TA169: Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma
NICE TA179: Sunitinib for the treatment of gastrointestinal stromal tumours
|
Tivozanib caps
|
Formulary
|
Approved as per NICE TA guidance (see links below)
|
NICE TA512: Tivozanib for treating advanced renal cell carcinoma
|
Vemurafenib tabs
|
Formulary
|
|
NICE TA269: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation‑positive malignant melanoma
|
| 08.01.05 |
Taxanes |
|
|
Cabazitaxel injection
|
Formulary
|
|
NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
|
Docetaxel injection
|
Formulary
|
|
NICE CG121: Lung cancer: diagnosis and management
NICE CG81: Advanced breast cancer: diagnosis and treatment
NICE TA101: Docetaxel for the treatment of hormone-refractory metastatic prostate cancer
NICE TA109: Docetaxel for the adjuvant treatment of early node-positive breast cancer
|
Paclitaxel albumin injection (Abraxane)
|
Formulary
|
Approved as per NICE Technology Appraisal guidance
|
NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
|
Paclitaxel injection
|
Formulary
|
|
NICE CG121: Lung cancer: diagnosis and management
NICE CG81: Advanced breast cancer: diagnosis and treatment
NICE TA389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
NICE TA55: Guidance on the use of paclitaxel in the treatment of ovarian cancer
|
| 08.01.05 |
Topoisomerase I inhibitors |
|
|
Irinotecan Hydrochloride injection
|
Formulary
|
|
NICE CG131: Colorectal cancer: diagnosis and management
|
Topotecan injection
|
Formulary
|
|
NICE TA183: Topotecan for the treatment of recurrent and stage IVB cervical cancer
NICE TA184: Topotecan for the treatment of relapsed small-cell lung cancer
|
| 08.01.05 |
Trabectedin |
|
|
Trabectedin injection
|
Formulary
|
|
NICE TA185: Trabectedin for the treatment of advanced soft tissue sarcoma
|
| 08.01.05 |
Trastuzumab |
|
|
Trastuzumab emtansine injection
|
Formulary
|
|
NICE TA458: Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
|
Trastuzumab injection
|
Formulary
|
Biosimilar products available, to be prescribed by brand name.
Contact pharmacy department for advice on brand for routine prescribing if unsure
|
NICE TA107: Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer
NICE TA208: Trastuzumab for the treatment of HER2-positive metastatic gastric cancer
NICE TA34: Guidance on the use of trastuzumab for the treatment of advanced breast cancer
|
| 08.01.05 |
Tretinoin |
|
|
Tretinoin caps
|
Formulary
|
|
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| .... |
Key |
|
|
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Cytotoxic Drug
|
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Controlled Drug
|
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High Cost Medicine
|
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Cancer Drugs Fund
|
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
| Status |
Description |
|
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.
|
|
Treatment can be initiated in primary care after a recommendation from an appropriate specialist |
|
Specialist initiation followed by maintenance prescribing in primary care |
|
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 |
|
Specialist and non-specialist initiation |
|
Not recommended for prescribing |
|
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|
