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Bedfordshire and Luton Joint Formulary
Bedford Hospital NHS Trust
Bedfordshire CCG
Luton & Dunstable University Hospital NHS Foundation Trust
Luton CCG
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

 Details...
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 (Giotrif)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
20mg, 30mg, 40mg & 50mg Tablets

Approved in accordance with NICE TA310 for the treatment of metastatic non-small-cell lung cancer.

 
Link  NICE TA310: Lung cancer (non small cell, EGFR mutation positive) - afatinib
   
Cytotoxic Drug Alectinib 150mg (Alecsena)
(Capsules)
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Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
Approved in accordance with NICE TA536.

 
Link  NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer
   
Cabozantinib (Cabometyx)
(Tablets)
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Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved according to NICE TA's below.

 
Link  NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma
Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
   
Cytotoxic Drug Cabozantinib (Cometriq)
(Capsules)
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Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved according to NICE TA516.

 
Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
   
Erlotinib (Tarceva)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
100mg & 150mg Tablets

Restricted to prescribing in line with NICE TA258 & TA374. 
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
   
Everolimus (Afinitor)
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Restricted Drug Restricted
Red
High Cost Medicine
Commissioned by Not NHSNHSEngland for some indications.
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.

To be prescribed by specialists in line with NICE TA421, TA432 & TA449. 
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
Link  NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
   
Gefitinib (Iressa)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
250mg Film Coated Tablets

Approved in accordance with NICE TA192 for the treatment of locally advanced or metastatic non-small-cell lung cancer.  
Link  NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib
   
Cytotoxic Drug Imatinib (Gilvec)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
100mg & 400mg Tablets

Approved in accordance with the NICE TA's below.

Restricted - must only be prescribed by staff with specialist training in Oncology or Haematology  
Link  NICE TA209: Gastrointestinal stromal tumours (unresectable/metastatic) - imatinib
Link  NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
Link  NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating resistant CML
Link  NICE TA426: Dasatinib, nilotinob and imatinib for untreated CML
Link  NICE TA70: Leukaemia (chronic myeloid) - imatinib
Link  NICE TA86: Gastro-intestinal stromal tumours (GIST) - imatinib
   
Nilotinib (Tasigna)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
150mg & 200mg Capsules

Approved in accordance with NICE TA425 and 426 for untreated chronic myeloid leukaemia.

 
Link  NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating resistant CML
Link  NICE TA426: Dasatinib, nilotinib and imatinib for untreated CML
   
Nintedanib
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.
100mg & 150mg Capsules

Approved in accordance with NICE TA347 for the treatment of metastatic non-small-cell lung cancer.  
Link  NICE TA347: Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer
   
Palbociclib 75mg, 100mg, 125mg (Ibrance)
(Capsules)
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Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage. 

Approved in accordance with the following NICE TAs:

NB : TA 619 is funded via the Cancer Drugs Fund

 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA619 Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
   
Pazopanib (Votrient)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.

Approved in line with NICE TA215. 
Link  NICE TA215: Renal cell carcinoma (first line metastatic) - pazopanib
   
Regorafenib 40mg (Stivarga )
(Tablets)
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Restricted Drug Restricted
Red
High Cost Medicine
Cancer Drugs Fund

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with the NICE TA's below.

 
Link  NICE TA488:Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
Link  NICE TA514: Regorafenib for previously treated advanced hepatocellular carcinoma
Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
   
Ribociclib 200mg
(Tablets)
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Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage. 

Approved in accordance with the following NICE TA(s):-

(NB For TA593, funding is via the Cancer Drugs Fund)

 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  TA593 Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
   
Sorafenib 200mg (Nexavar)
(Tablets)
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Restricted Drug Restricted
Red
High Cost Medicine
Cancer Drugs Fund

HIgh cost drug (Cancer Drug Fund).

Prescribing by specialists in line with NICE TA474 and TA535.

 
Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
   
Sunitinib (Sutent)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.

Approved in line with NICE TA's below.  
Link  NICE TA169: Renal cell carcinoma - sunitinib
Link  NICE TA178: Renal cell carcinoma
Link  NICE TA179: Gastrointestinal stromal tumours - sunitinib
Link  NICE TA449:Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
   
Vemurafenib (Zelboraf)
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Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage.

Approved in line with NICE TA176 & TA269.  
Link  MHRA Drug Safety Update (November 2015) - Vemurafenib (Zelboraf▼): risk of potentiation of radiation toxicity
Link  NICE TA176: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma
Link  NICE TA269: Melanoma (BRAF V600 mutation positive, unresectable metastatic) - vemurafenib
   
Larotrectinib  (Vitrakvi )
(20mg/mL oral solution)
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Restricted Drug Restricted
Red
Cancer Drugs Fund
NHS England

 

FOR ALL PRESCRIBING - Blueteq or High Cost drug form required - see link from Formulary homepage.

Restricted use in accordance with the following NICE TA as part of the Cancer Drugs Fund

 
Link  NICE TA 630 Larotrectinib for treating NTRK fusion-positive solid tumours
   
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
Lapatinib  (Tyverb)

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Non Formulary
High Cost Medicine
Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
 
Cytotoxic Drug  Temsirolimus  (Torisel)

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Non Formulary
High Cost Medicine
Cancer Drugs Fund
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)

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Non Formulary
High Cost Medicine
Cancer Drugs Fund
 
  
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
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Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
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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

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations   

Amber SCG

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.   

Black

A decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.   

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