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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.01.05  Expand sub section  Other antineoplastic drugs
08.01.05  Expand sub section  Amsacrine
08.01.05  Expand sub section  Arsenic trioxide
08.01.05  Expand sub section  Bevacizumab
08.01.05  Expand sub section  Bexarotene to top
08.01.05  Expand sub section  Bortezomib
08.01.05  Expand sub section  Brentuximab vedotin
08.01.05  Expand sub section  Cetuximab
08.01.05  Expand sub section  Crisantaspase
08.01.05  Expand sub section  Dacarbazine and Temozolomide to top
08.01.05  Expand sub section  Erlotinib
08.01.05  Expand sub section  Hydroxycarbamide
08.01.05  Expand sub section  Imatinab
08.01.05  Expand sub section  Ipilimumab
08.01.05  Expand sub section  Mitotane to top
08.01.05  Expand sub section  Panitumumab
08.01.05  Expand sub section  Pentostatin
08.01.05  Expand sub section  Platinum compounds
08.01.05  Expand sub section  Porfimer sodium and temoporfin
08.01.05  Expand sub section  Procarbazine to top
08.01.05  Expand sub section  Protein kinase inhibitors
Afatinib
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Formulary
Red
 
   
Crizotinib (Xalkori®)
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Formulary
Red
 
Link  NICE TA296: Crizotinib for previously treated non-small-cell lung cancer associated with an anaplastic lymphoma kinase fusion gene
   
Dasatinib (Sprycel®)
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Restricted Drug Restricted
Red
 
Link  NICE TA241: CML for whom treatment with imatinib has failed because of intolerance
   
Erlotinib (Tarceva®)
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Formulary
Red
 
   
Cytotoxic Drug Everolimus (Afinitor®)
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Restricted Drug Restricted
Red
Cancer Drugs Fund
Available VIA CDF 
Link  NICE TA219: Everolimus for second-line treatment of renal cell cancer
Link  NICE TA294: Breast cancer (HER2 negative, oestrogen receptor positive, locally advanced or metastatic) - everolimus (with an aromatase inhibitor):
Link  NICE TA449 Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
   
Cytotoxic Drug Gefitinib (Iressa®)
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Formulary
Red
Available via a patient access scheme, please register patients when initiating treatment 
Link  NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib
   
Ibrutinib  (Imbruvica®)
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Restricted Drug Restricted
Red
Cancer Drugs Fund
  • For use in line with NICE TA429

  • Complete full hepatitis B serology including hepatitis B core antibody status before initiation. If this is positive please refer to Dr Moreea/Dr Southern for advice (see MHRA Drug Safety Update below)
     
  • Link  MHRA Drug Safety Update (August 2017); 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
       
    Cytotoxic Drug Imatinib (Gilvec®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Restricted Drug Restricted
    Red
     
    Link  NICE TA196: Gastrointestinal stromal tumours - imatinib (adjuvant): guidance
    Link  NICE TA209: Gastrointestinal stromal tumours (unresectable/metastatic) - imatinib
    Link  NICE TA241: Leukaemia (chronic myeloid) - dasatinib, nilotinib, imatinib (intolerant, resistant): guidance
    Link  NICE TA70: Leukaemia (chronic myeloid) - imatinib
    Link  NICE TA86: Gastro-intestinal stromal tumours (GIST) - imatinib
       
    Cytotoxic Drug Lapatinib (Tyverb®)
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    Formulary
    Red
    Cancer Drugs Fund
    Lapatinib with capecitabine - VIA CDF - for locally reccurent or metastatic breast cancer 
    Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
       
    Nilotinib (Tasigna®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
     
    Link  NICE TA241: Dasatinib, nilotinib and high dose imatinib for CML
       
    Ponatinib (Iclusig®)
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    Restricted Drug Restricted
  • For use in line with NICE TA451 
  • Link  MHRA Drug Safety Update (April 17): Risk of vascular occlusive events—updated advice on possible dose reduction
    Link  MHRA Drug Safety Update (May 16): BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation
    Link  NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
       
    Sunitinib (Sutent®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
  • For use in line with NICE TA169, TA178, TA179 & TA449 
  • Link  NICE TA169: Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma
    Link  NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma
    Link  NICE TA179: Sunitinib for the treatment of gastrointestinal stromal tumours
    Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
       
    08.01.05  Expand sub section  Taxanes
    08.01.05  Expand sub section  Topoisomerase I inhibitors
    08.01.05  Expand sub section  Trabectedin
    08.01.05  Expand sub section  Trastuzumab to top
    08.01.05  Expand sub section  Tretinoin
    08.01.05  Expand sub section  Vismodegib
     ....
     Non Formulary Items
    Everolimus  (Votubia®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Red
     
    Pazopanib  (Votrient®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Red
    Link  NICE TA215: Renal cell carcinoma (first line metastatic) - pazopanib
     
    Sorafenib  (Nexavar®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Red
    Link  NICE TA189: Hepatocellular carcinoma (advanced and metastatic) - sorafenib (first line)
     
    Cytotoxic Drug  Temsirolimus  (Torisel®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Red
    Link  NICE TA178: temsirolimus for first-line treatment of advanced and/or metastatic renal cell carcinoma
    Link  NICE TA207: Mantle cell lymphoma (relapsed) - temsirolimus (terminated appraisal)
     
    Cytotoxic Drug  Vandetanib  (Caprelsa®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Vemurafenib  (Zelboraf®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Red
    Link  NICE TA176: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma
     
      
    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 children's 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

    Amber

    Medicines suitable to be prescribed in primary care after Specialist* recommendation or initiation. A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust D&TC(s). *Specialist is defined as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice.   

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (D&TC) * All drugs awaiting the production or approval of a shared care guideline default to RED   

    Cancer Drug Fund

    Cancer Drug Fund   

    Green

    Medicines suitable for routine use and can be prescribed within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.  

    Green Specialist Initiation

    These drugs should be initiated only by a hospital or specialist clinician (GPSi) but there is no requirement for additional monitoring over the general requirements for all medicines. Some may require short or medium specialist monitoring of efficacy or dose titration before transferring in Primary care. The GP should have all the information they require to support continued prescribing.   

    Green Specialist Recomendation

      

    Grey

    Grey - Medicines, which the Drug & therapeutics Committee has actively reviewed and does not recommend for use at present following a review of clinical and/or cost effective data. Grey (assessment in progress) - will be reviewed at a future D&T meeting. Grey (awaiting submission) - The D&T are awaiting a submission from an appropriate practitioner. If you wish to make a submission for this medicine to be added to the formulary please email drug.information@bthft.nhs.uk .   

    Non Formulary

    Not recommended for prescribing as initial therapy, but can be continued if patient already stable on treatment   

    Red

    Medicines which should normally be prescribed by specialists only. ** For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care   

    RED ULM

    Unlicensed Medication  

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