NICE NG14: Melanoma: assessment and management
NICE NG35: Myeloma: diagnosis and management
NICE NG85: Pancreatic cancer in adults: diagnosis and management
NICE NG122: Lung cancer: diagnosis and management
NICE NG131: Prostate cancer: diagnosis and management
NICE NG151: Colorectal cancer
NICE CG164: Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer
Cancer Drug Fund List http://www.england.nhs.uk/ourwork/pe/cdf/
North of England Cancer Network http://www.necn.nhs.uk/
The County Durham and Tees Valley APC Do Not Prescribe List and Grey List can be accessed online at: https://medicines.necsu.nhs.uk/download/tees-prescribing-grey-list/
CD&D Patient Decision Aids Resource available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/
500mg vials (with diluent)
Approved for use in line with NECN Extravasation Policy – only through specialist Cancer Centre
Commissioner: NHS England – Anthracycline Extravasation - Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
15mg tablets
3mg, 15mg, 30mg & 300mg injections
For Methotrexate-Induced Mucositis and Myelosuppression
25mg & 100mg injections
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
The following indications are funded through Cancer Drugs Fund
MHRA Drug Safety Update (July 2017): Bendamustine (Levact): increased mortality observed in recent clinical studies in off-label use; monitor for opportunistic infections, hepatitis B reactivation
MHRA Drug Safety Update (March 2021): Bendamustine (Levact): increased risk of non-melanoma skin cancer and progressive multifocal encephalopathy (PML)
2mg tablets; 25mg capsules u
60mg in 10ml inj
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
2mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
50mg tablets
1g injection
For treatment of inflammatory conditions unresponsive to other agents, only in accordance with a locally agreed drug protocol.
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
140mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1g and 2g powder for concentrate for solution for injection vials
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
10mg u & 40mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
2mg tablets; 50mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1g and 5g powder for solution for injection
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
15,000 units injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (July 2020): Liposomal and lipid-complex formulations: name change to reduce medication errors
50mg injection
20mg & 50mg pegylated liposomal injection
Commissioner: NHS England
Approved for use in accordance with the following NICE TA OR if indication funded from the Cancer Drugs Fund:
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (July 2020): Liposomal and lipid-complex formulations: name change to reduce medication errors
50mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
5mg & 10mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
10mg, 20mg & 40mg injections
0.04% preservative free eye drops (unlicensed)
Intravenous Injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Bladder Installation
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Opthalmic Use (injection or drops)
Only prescribed by a consultant ophthalmologist for use in theatre.
20mg in 10ml injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
29mg powder for concentrate for solution for infusion
Commissioner: NHS England
Approved for use in accordance with the following NICE TA:
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100mg vial
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
Not approved for use in accordance with the following NICE TA:
150mg, 300mg & 500mg tablets
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update January 2014: Capecitabine: risk of severe skin reactions - discontinue treatment
MHRA Drug Safety Update (Oct 2020): 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
10mg in 10ml solution for preparing infusions,
2mg in 1ml subcutaneous injection
10mg tablets
NHS England – Multiple Sclerosis - as per NICE TA616
NHS England - not routinely commissioned - Pulmonary Langerhans Histiocytosis
Litak formulation
Commissioner: NHS England - Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (Dec 2017): Cladribine (Litak, Leustat) for leukaemia: reports of progressive multifocal encephalopathy (PML); stop treatment if PML suspected
MHAR Drug Safety Update (Mar 2022): Cladribine (Mavenclad): new advice to minimise risk of serious liver injury
Commissioner: NHS England - Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm OR if indication funded from the Cancer Drugs Fund.
100mg in 5ml & 1g in 10ml injections
50mg vial- Intrathecal injection , cytarabine encapsulated in liposomes
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Intravenous injections only
Intravenous administration would normally only be part of Level 2 or higher haematology protocols and should be undertaken at a specialist haematology centre.
50mg vial intrathecal injection , cytarabine encapsulated in liposomes
Prescribing MUST be in accordance with intrathecal prescribing policies.
MHRA Drug Safety Update (July 2020): Liposomal and lipid-complex formulations: name change to reduce medication errors
10mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
2.5g in 50ml & 2.5g in 100ml injections
10mg in 0.4ml subconjunctival injection u
Intravenous injection or infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
For ophthalmic use
Only when prescribed by a consultant ophthalmologist for use in opthalmology theatre.
MHRA Drug Safety Update (Oct 2020): 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
200mg & 1g & 2g injection
Commissioner: NHS England - Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
The following indication is funded via Cancer Drugs Fund
50mg tablets
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
AMBER when used for inflammatory bowel disease (see chapter 1)
2.5mg tablets
10mg in 5ml oral solution u
Injections (various strengths) – including prefilled syringesu
5mg in 2ml intrathecal injection
For medical management of ectopic pregnancy / pregnancy of unknown origin only where prescribed by a consultant obstetrician.
Otherwise only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
When prescribed as intrathecal chemotherapy only in accordance with intrathecal prescribing policies.
AMBER when used in chronic inflammatory conditions, e.g. Crohn’s disease, rheumatoid arthritis. Prescriptions will be for ONCE WEEKLY administration ONLY.
(Note Subcutaneous injection in chronic inflammatory conditions is RED drug in Tees)
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100mg & 500mg injection
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not recommended for use in accordance with the following NICE TA:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Teysuno®
MHRA Drug Safety Update (Oct 2020): 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
Uftoral®
MHRA Drug Safety Update (Oct 2020): 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
15mg/6.14mg & 20mg/8.19mg film-coated tablets
Commissioner – NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs:
Not approve for use in accordance with the following NICE TAs:
50mg & 100mg capsules
100mg in 5ml & 500mg in 25ml injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
10mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Administration MUST be by the intravenous route only. Infusions MUST be diluted to 50ml.
2mg in 2ml injection
2mg in 20ml prefilled syringe
2mg in 50ml infusion bags
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Administration MUST be by the intravenous route only. Infusions MUST be diluted to 50ml.
5mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Administration MUST be by the intravenous route only. Infusions MUST be diluted to 50ml
20mg, 30mg and 80mg capsules
10mg in 1ml & 50mg in 5ml injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Administration MUST be by the intravenous or oral route only. Infusions MUST be diluted to 50ml.
ORAL doses are not equivalent to intravenous.
50mg, 100mg and 150mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (June 2021): CDK4/6 inhibitors (abemaciclib▼, palbociclib▼, ribociclib▼): reports of interstitial lung disease and pneumonitis, including severe cases
5mg in 1ml powder for suspension for infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
Not approved in accordance with the following NICE TA:
20mg, 30mg, 40mg, 50mg film coated tablets
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
NICE TA310: as a treatment option in adults with locally advanced or metastatic non-small-cell lung cancer only if:
40mg/ml solution for injection
25mg/ml concentrate for solution for infusion ▼
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved in accordance with the following NICE TA:
MHRA Drug Safety Update (April 2016): Aflibercept (Zaltrap▼): minimising the risk of osteonecrosis of the jaw
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
150mg capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1mg/ml conc for soln for infusion.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
YESCARTA 0.4 – 2 x 108 cells dispersion for infusion.
YESCARTA (axicabtagene ciloleucel) is a CD19-directed genetically modified autologous T cell immunotherapy. To prepare YESCARTA, patient's own T cells are harvested and genetically modified ex vivo by retroviral transduction to express a chimeric antigen receptor (CAR) comprising a murine anti-CD19 single chain variable fragment (scFv) linked to CD28 and CD3-zeta co-stimulatory domains. The anti-CD19 CAR-positive viable T cells are expanded and infused back into the patient, where they can recognize and eliminate CD19-expressing target cells.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
• NICE TA559: Axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1mg, 3mg, 5mg and 7mg film coated tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
NICE TA333: as a treatment option for adults with advanced renal cell carcinoma after failure of treatment with a first‑line tyrosine kinase inhibitor or a cytokine, only if the company provides axitinib with the discount agreed in the patient access scheme.
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
For ophthalmological uses in accordance with NTAG recommendations (see chapter 11)
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Various indications funded via Cancer Drugs Fund
Not approved for use in accordance with the following NICE TAs:
NICE TA285: as a treatment option for first recurrence of platinum-sensitive advanced ovarian cancer (including fallopian tube and primary peritoneal cancer) who have not received prior therapy with bevacizumab or other vascular endothelial growth factor (VEGF) inhibitors or VEGF receptor-targeted agents.
NICE TA284: as a first-line treatment option for advanced ovarian cancer in combination with paclitaxel and carboplatin.
NICE TA353: as a treatment option for relapsed, platinum‑resistant epithelial ovarian, fallopian tube or primary peritoneal cancer because no evidence submission was received from Roche Products for the technology.
NICE TA436: as a treatment option for epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer because no evidence submission was received from Roche for the technology.
NICE TA560: Bevacizumab with carboplatin, gemcitabine and paclitaxel for treating the first recurrence of platinum-sensitive advanced ovarian cancer (terminated appraisal)
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
Biosimilars are available – note that indications can differ between different products – prescribe by brand. Consult with individual trust pharmacy department for details of preferred biosimilar brand.
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
38.5 micrograms powder for concentrate and solution for solution for infusion.
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with following NICE TAs:
NICE TA450: as a treatment option for Philadelphia-chromosome-negative relapsed or refractory precursor B-cell acute lymphoblastic leukaemia in adults, only if the company provides it with the discount agreed in the patient access scheme.
NICE TA589: Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity
Not approved in accordance with the following NICE TAs:
3.5mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
100mg and 500mg film-coated tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
NICE TA401: as a treatment option for chronic, accelerated and blast phase Philadelphia chromosome positive chronic myeloid leukaemia in adults, when:
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (May 2016): BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Not approved in accordance with the following NICE TAs:
30mg, 90mg and 180mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
40mg/1ml concentrate for IV infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA
NICE TA391: as a treatment option in combination with prednisone or prednisolone for metastatic hormone‑relapsed prostate cancer in people whose disease has progressed during or after docetaxel chemotherapy under the circumstances specified within the TA.
MHRA Drug Safety Update (Nov 2013): Cabazitaxel - risk of medication error resulting in overdose. .
20mg, 40mg and 60mg tablets
20mg and 80mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
50mg in 5ml & 450mg in 45ml injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
10 mg powder for solution for infusion
30 mg powder for solution for infusion
60 mg powder for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (Aug 2019): Carfilzomib (Kyprolis▼): reminder of risk of potentially fatal cardiac events
MHRA Drug Safety Update (Dec 2019): Carfilzomib (Kyprolis▼): risk of reactivation of hepatitis B virus
350mg concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
150mg capsule
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
NICE TA395: as a treatment option for advanced anaplastic lymphoma kinase positive non‑small‑cell lung cancer in adults who have previously had crizotinib.only if the company provides it with a discount agrees in patient access scheme
NICE TA500: as a treatment option for untreated anaplastic lymphoma kinase (ALK)‑positive advanced non-small-cell lung cancer in adults, only if the company provides it with the discount agreed in the patient access scheme.
100mg in 20ml & 500mg in 100ml vials for IV infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
Not approved for use in accordance with the following NICE TA
NICE TA242: as a treatment option for monotherapy or combination therapy for metastatic colorectal cancer that has progressed after first-line chemotherapy.
MHRA Alerts
50mg in 50mL injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved for use in accordance with the following NICE TA
NICE TA414: as a treatment option for unresectable or metastatic melanoma in adults with a BRAF V600 mutation.
200mg and 250mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
MHRA Drug Safety Update November 2015: Risk of cardiac failure
50mg and 75mg capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
500mg injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
15mg, 30mg, and 45mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
20mg/ml solution for infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (Aug 2019): Daratumumab (Darzalex▼): risk of reactivation of hepatitis B virus
20mg,50mg, 80mg, 100mg and 140mg film-coated tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs or in indication funded from Cancer Drugs Fund:
Not approved in accordance with the following NICE TAs:
MHRA Drug SafetyUpdate May 2016: BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation
Daunorubicin/cytarabine 44mg/100mg powder for conc for soln for inf in vial
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
• NICE TA552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
20mg & 80mg injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
50mg/ml conc for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
50mg and 75mg capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
0.44mg/ml solution for injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA or if indication funded through Cancer Drugs Fund
NICE TA423: as a treatment option for locally advanced or metastatic breast cancer under the conditions specified within the TA
Not approved for use in accordance with the following NICE TA
NICE TA515: as a treatment option for locally advanced or metastatic breast cancer in adults who have had only 1 chemotherapy regimen
25mg, 100mg & 150mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
Not approved for use in accordance with the following NICE TA
NICE TA227: as a maintenance treatment option in people with locally advanced or metastatic non-small-cell lung cancer who have stable disease after platinum-based first-line chemotherapy
Roche Healthcare Professional Letter (January 2016): Tarceva® (erlotinib): First line maintenance indication now restricted to treatment of patients whose tumors harbor an EGFR-activating mutation
2.5mg, 5mg and 10mg tablets
2mg, 3mg and 5mg dispersible tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
Everolimus for the following indications is not routinely commissioned by NHS England
250mg tablets
Commissioner: NHS England once if used in accordance with NICE TA192
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA192: as a first-line treatment option for locally advanced or metastatic non-small-cell lung cancer (NSCLC) if the conditions specified within the TA are met.
Not approved for use in accordance with the following NICE TA
NICE TA374: as a treatment option for locally advanced or metastatic non‑small‑cell lung cancer that has progressed after non‑targeted chemotherapy in people with tumours that are EGFR‑TK mutation‑positive.
5mg powder for conc for soln for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
• NICE TA545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100mg and 1000mg tablets
500mg capsules
500mg in 5ml suspension u
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
AMBER when used to treat non-malignant conditions in accordance with a clearly documented shared care protocol. https://medicines.necsu.nhs.uk/download/county-durham-and-darlington-hydroxycarbamide-hydroxyurea-shared-care-guideline/
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs or if indication funded from the Cancer Drugs Fund
Not approved for use in accordance with the following NICE TAs
MHRA Drug Safety Update (August 2017): Ibrutinib (Imbruvica▼): reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and of opportunistic infections
100mg & 150mg film coated tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA359: as a treatment option with rituximab for the following indications only if the company provides the drug with discount agreed in the simple discount agreement
Not approved for use in accordance with the following NICE TAs
MHRA Alerts
MHRA Drug Safety Update (May 2016): Idelalisib (Zydelig▼): interim measures following signal of serious infection and deaths related to infection found in clinical trials.
MHRA Drug Safety Update (September 2016): Idelalisib (Zydelig▼): updated indications and advice on minimising the risk of infection
100mg ▼ and 400mg tablets (only Gilvec brand is ▼)
100mg and 400mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
Philadelphia-chromosome-positive chronic myeloid leukaemia (CML) who initially present in the accelerated phase or with blast crisis.
Philadelphia-chromosome-positive chronic myeloid leukaemia (CML) who initially present in the chronic phase and then progress to accelerated phase or blast crisis if they have not received imatinib before.
Not recommended for use in accordance with the following NICE TAs
MHRA Drug Safety Update (May 2016): BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation
1mg powder for conc for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
• NICE TA541:Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
50mg vial for preparing IV infusion
Commissioner NHS England
Approved in accordance with the following NICE TAs
NICE TA268: as a treatment option for advanced (unresectable or metastatic) melanoma in people who have received prior therapy, only if the manufacturer provides ipilimumab with the discount agreed in the patient access scheme. Patient are referred to tertiary centre for treatment.
NICE TA319: as a treatment option for previously untreated advanced (unresectable or metastatic) melanoma, only if the manufacturer provides ipilimumab with the discount agreed in the patient access scheme. Patients are referred to tertiary centre for treatment.
NICE TA400: as a treatment option with nivolumab for advanced (unresectable or metastatic) melanoma in adults, only when the company provides ipilimumab with the discount agreed in the patient access scheme. Patients are referred to tertiary centre for treatment.
MHRA Drug Safety Update (July 2017): Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
MHRA Drug Safety Update (Jan 2019): Ipilimumab (Yervoy): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
Related NICE guidance: NG14: Melanoma: assessment and management
40mg in 2ml & 100mg in 5ml injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
50mg (5 mg/ml) concentrate for solution for infusion
Not approved as per NICE TA440
MHRA Drug Safety Update (March 2019): Onivyde (irinotecan, liposomal formulations): reports of serious and fatal thromboembolic events
MHRA Drug Safety Update (July 2020): Liposomal and lipid-complex formulations: name change to reduce medication errors
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
2.3mg, 3mg and 4mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
250mg tablet
Commissioner: NHS England - Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
4mg and 10mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
25mg capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved for use in accordance with the following NICE TA
NICE TA411: as a treatment option along with gemcitabine for locally advanced or metastatic epidermal growth factor receptor (EGFR)-expressing squamous non-small-cell lung cancer that has not been treated with chemotherapy in adults.
40mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
150mg & 200mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
MHRA Drug Safety Update (May 2016): BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation
100mg and 150mg soft capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
NICE TA347: as a treatment option in combination with docetaxel for locally advanced, metastatic or locally recurrent non‑small‑cell lung cancer of adenocarcinoma histology that has progressed after first‑line chemotherapy, only if the company provides nintedanib with the discount agreed in the patient access scheme.
Also approved for use in idiopathic pulmonary fibrosis in accordance with the following TA.
Commissioned by NHS England
NICE TA747: Nintedanib for treating progressive fibrosing interstitial lung diseases
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
1mg powder for conc for soln for inf in vial
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
50mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
40mg and 80mg tablets
Commissioner: NHSE or Cancer Drugs Fund
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA:
Not approved in accordance with the following NICE TAs:
50mg & 100mg injections
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs.
NICE TA100: as an adjuvant treatment option in combination with 5-flurouracil and folinic acid for stage III (Dukes' C) colon cancer following surgery for the condition.
30mg in 5ml, 100mg in 16.7ml and 150mg in 25ml concentrate for preparing IV infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs.
MHRA Drug Safety Update (Jan 2022): Paclitaxel formulations (conventional and nab-paclitaxel): caution required due to potential for medication error
75mg, 100mg and 125mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update (June 2021): CDK4/6 inhibitors (abemaciclib▼, palbociclib▼, ribociclib▼): reports of interstitial lung disease and pneumonitis, including severe cases
20mg/ml injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA439: as a treatment option for previously untreated RAS wild-type metastatic colorectal cancer in adults in combination with FOLFOX or FOLFIRI only when the companies provide them with the discount agreed in the patient access scheme
MHRA Alerts
10mg, 15mg and 20mg hard capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA380: as a treatment option in combination with bortezomib and dexamethasone for relapsed or refractory multiple myeloma in patients who have received at least 2 prior regimens including bortezomib and an immunomodulatory agent when the manufacturer provides panobinostat with the discount agreed in the patient access scheme.
200mg & 400mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA215: as a first-line treatment option for advanced renal cell carcinoma under the conditions specified within the TA.
3750 units/5ml solution for injection vials
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA408: as part of antineoplastic combination therapy for treating acute lymphoblastic leukaemia only in patients with untreated newly diagnosed disease.
50mg vial for preparing IV infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs OR if indication funded from Cancer Drugs Fund
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2017): Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA427: as a treatment option with low-dose dexamethasone for multiple myeloma in adults at third or subsequent relapse; that is, after 3 previous treatments including both lenalidomide and bortezomib, only when the company provides pomalidomide with the discount agreed in the patient access scheme.
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (June 2020): Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA451: as a treatment options for chronic-, accelerated or blast-phase chronic myeloid leukaemia and Philadelphia-chromosome-positive acute lymphoblastic leukaemia under conditions specified within the TA for each type of leukaemia.
MHRA Alerts
50mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
110 kBq/ml solution for injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA or if indication funded from Cancer Drugs Fund
NICE TA412: as a treatment option for hormone-relapsed prostate cancer, symptomatic bone metastases and no known visceral metastases in adults, under conditions specified within the TA.
MHRA Drug Safety Update (December 2017): Radium-223 dichloride (Xofigo▼): do not use in combination with abiraterone and prednisone/prednisolone, following clinical trial signal of increased risk of death and fractures
10mg/ml concentrate for solution for infusion
Commissioner: NHS England (Not routinely commissioned)
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Not approved for use in accordance with the following NICE TAs. Individual funding requests needed for commissioning:
NICE TA378: as a treatment option in combination with paclitaxel for advanced gastric cancer or gastro–oesophageal junction adenocarcinoma previously treated with chemotherapy.
NICE TA403: as a treatment option in combination with docetaxel for locally advanced or metastatic non-small-cell lung cancer in adults whose disease has progressed after platinum-based chemotherapy
NICE TA609: Ramucirumab for treating unresectable hepatocellular carcinoma after sorafenib (terminated appraisal)
NICE TA635: Ramucirumab with erlotinib for untreated EGFR-positive metastatic non-small-cell lung cancer (terminated appraisal)
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
40mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA:
Not approved for use in accordance with the following NICE TAs
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
200mg tablet
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs:
NICE TA496: as a treatment option with an aromatase inhibitor for hormone receptor-positive, human epidermal growth factor receptor 2‑negative, locally advanced or metastatic breast cancer as initial endocrine-based therapy in adults. only if the company provides it with the discount agreed in the patient access scheme.
NICE TA593: ribociclib with fulvestrant is recommended for use within the Cancer Drugs Fund as an option for treating hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer in people who have had previous endocrine therapy only if exemestane plus everolimus is the most appropriate alternative to a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor and the conditions in the managed access agreement for ribociclib with fulvestrant are followed.
NICE TA687: Ribociclib plus fulvestrant is recommended as an option for treating hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer in adults who have had previous endocrine therapy only if exemestane plus everolimus is the most appropriate alternative to a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor, and the company provides ribociclib according to the commercial arrangement.
MHRA Drug Safety Update (June 2021): CDK4/6 inhibitors (abemaciclib▼, palbociclib▼, ribociclib▼): reports of interstitial lung disease and pneumonitis, including severe cases
200mg, 250mg and 300mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
5mg, 15mg and 20mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA386: as a treatment option for disease-related splenomegaly or symptoms in adults with primary myelofibrosis (also known as chronic idiopathic myelofibrosis), post polycythaemia vera myelofibrosis or post essential thrombocythaemia myelofibrosis, under conditions specified within the TA.
200mg tablet
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
1g injection (only available on a named patient basis)u
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
12.5 mg, 25mg, 37.5mg and 50mg hard capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
NICE TA169: as a first-line treatment option for advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 under the conditions specified within the TA.
NICE TA179: as a treatment option for people with unresectable and/or metastatic malignant gastrointestinal stromal tumours under conditions specified within the TA.
NICE TA449: as a treatment option for well- or moderately differentiated unresectable or metastatic neuroendocrine tumours (NETs) of pancreatic origin in adults with progressive disease.
MHRA Drug Safety Update (January 2011): Bevacizumab and sunitinib: risk of osteonecrosis of the jaw.
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Kymriah® 1.2 x 106 – 6 x 108 cells dispersion for infusion
Kymriah is an immunocellular therapy containing tisagenlecleucel, autologous T cells genetically modified ex vivo using a lentiviral vector encoding an anti-CD19 chimeric antigen receptor (CAR).
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1.34mg capsule
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA:
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
0.25mg & 1mg capsules
1mg & 4mg vials
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
NICE TA183: as a treatment option in combination with cisplatin for recurrent or stage IVB cervical cancer only if they have not previously received cisplatin. Patients are referred to tertiary centre for treatment.
NICE TA184: as a oral treatment option for relapsed small-cell lung cancer under conditions specified within the TA
Not to be used in accordance with the following NICE TA
NICE TA389: as a treatment option for recurrent platinum‑resistant or platinum‑refractory ovarian cancer.
250microgram injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA185: as a treatment option for advanced soft tissue sarcoma under conditions specified within the TA. Patients are referred to tertiary centre for treatment.
500microgram and 2mg film coated tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
NICE TA396: as a treatment option in combination with dabrafenib for unresectable or metastatic melanoma in adults with a BRAF V600 mutation only when the company provides trametinib and dabrafenib with the discounts agreed in the patient access schemes.
MHRA Drug Safety Update (May 2016): Trametinib (Mekinist▼): risk of gastrointestinal perforation and colitis.
150mg vial for preparing IV infusion
600mg s/c injection
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TAs
NICE TA34: as a treatment option for the following cancers under the conditions specified within the TA
NICE TA107: as a treatment option for women with early-stage HER2-positive breast cancer following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) under conditions specified within the TA.
NICE TA208: as a treatment option for human epidermal growth factor receptor 2 (HER2)-positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction under conditions specified within the TA.
Biosimilars are available – note that indications can differ between different products – prescribe by brand. Consult with individual trust pharmacy department for details of preferred biosimilar brand.
100 mg powder for concentrate for solution for infusion.
160 mg powder for concentrate for solution for infusion.
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Approved for use in accordance with the following NICE TA
Care should be taken to ensure Kadcyla® is not confused with Herceptin®
Kadcyla should not be given at the same time as chemotherapy
10mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2020): Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
10mg, 50mg and 100mg tablets
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm. Indication funded via Cancer Drugs Fund
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
MHRA Drug Safety Update (Dec 2021): Venetoclax (Venclyxto▼): updated recommendations on tumour lysis syndrome (TLS)
25mg and 100mg film coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
20 mg/mL oral solution
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
40 mg film-coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100mg and 200mg hard capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
25mg and 100mg film coated tablets
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
30mg and 140mg powder for concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
20mg/mL concentrate for solution for infusion.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100 mg hard capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100 mg powder for concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
160 micrograms/g gel
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
4.5 mg, 9 mg tablets, and 13.5 mg tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved in accordance with the following NICE TA:
Commissioner: NHS England
40 mg and 80mg hard capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
10 mg/ml concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved in accordance with the following NICE TA:
4 mg/mL concentrate for solution for infusion.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100 mg hard capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
100mg and 150mg film-coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
500 mg concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
120 mg film-coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Not approved in accordance with the following NICE TAs:
Tertiary Centre Only: NICE TA85, NICE TA99
Tablets - 25mg, 50mg
50mg in 5ml u suspension
Shared Care (Amber) for non-cancer indications
Capsules - 250mg, 500mg
1g in 5ml (200mg/ml) oral suspension
Shared Care (Amber) for non-cancer indications
MHRA Drug Safety Update (Jan 2015): Mycophenolate mofetil (CellCept) and mycophenolic acid: risk of hypogammaglobulinaemia and risk of bronchiectasis
MHRA Drug Safety Update (Dec 2015): Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
MHRA Drug Safety Update (Feb 2018): Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
First choice for most indications
Capsules - 10mg, 25mg, 50mg & 100mg
100mg in 1ml sugar-free oral solution (oily)
Shared Care (Amber) for non-cancer indications
1mg & 2mg tablets
1mg per ml oral solution
Approved for renal transplantation in children and adolescents in line
with NICE
10mg & 20mg vial for preparing IV infusion
Commissioner: NHS England
Approved for use in accordance with the following NICE TAs
NICE TA481: as an initial treatment option for preventing organ rejection in adults having a kidney transplant as part of an immunosuppressive regimen that includes calcineurin inhibitor.
NICE TA482: : as an initial treatment option for preventing organ rejection in children and young people having a kidney transplant as part of an immunosuppressive regimen that includes calcineurin inhibitor.
NHS England – Not Routinely Commissioned
Not approved in accordance with the following NICE TAs:
NICE TA481: not recommended as initial treatment to prevent organ rejection in adults having a kidney transplant.
NICE TA482: not recommended as initial treatment to prevent organ rejection in children and young people having a kidney transplant.
25mg & 50mg tablets
50mg in 5ml suspension (unlicensed)
50mg injection
Commissioner: NHS England – New Patients Only
Commissioner: NHS England – New Patients Only
MHRA Drug Safety Update (Dec 2015): Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
MHRA Drug Safety Update (Feb 2018): Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
NICE TA481 and NICE TA482
Commissioner: NHS England – New Patients Only
MHRA Drug Safety Update (Dec 2015): Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
MHRA Drug Safety Update (Feb 2018): Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
Commissioner: NHS England [New patients only]
Approved for use in accordance with the following NICE TAs
NICE TA481: as an initial treatment option for preventing organ rejection in adults having a kidney transplant as part of an immunosuppressive regimen.
NICE TA482: : as an initial treatment option for preventing organ rejection in children and young people having a kidney transplant as part of an immunosuppressive regimen
MHRA Drug Safety Alert (November 2017): Oral tacrolimus products: reminder to prescribe and dispense by brand name only
RED drug also for non-transplant indications.
Not approved in accordance with the following NICE TAs:
30mg in 1ml concentrate for IV infusion
- for use in lymphocytic leukaemia & prevention of graft vs. host disease on bone marrow transplant patients
- approved for use in high-risk kidney and pancreas transplantation
12mg in 1.2ml concentrate for IV infusion
-for adult patients with relapsing remitting multiple sclerosis
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
MHRA Drug Safety Update (May 2019): Lemtrada (alemtuzumab) and serious cardiovascular and immune-mediated adverse reactions: new restrictions to use and strengthened monitoring requirements
MHRA Drug Safety Update (Feb 2020): Lemtrada▼ (alemtuzumab): updated restrictions and strengthened monitoring requirements following review of serious cardiovascular and immune-mediated reactions
20 mg/mL concentrate for solution for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1000mg in 40ml concentrate for IV infusion
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs
NICE TA343: as a treatment option in combination with chlorambucil, for untreated chronic lymphocytic leukaemia under conditions specified within the TA.
NICE TA513: as a treatment option for untreated advanced follicular lymphoma under conditions specified within the TA
NICE TA629: Obinutuzumab with bendamustine followed by obinutuzumab maintenance is recommended, within its marketing authorisation, as an option for treating follicular lymphoma that did not respond or progressed up to 6 months after treatment with rituximab or a rituximab-containing regimen
The indication for treating follicular lymphoma ib patients refractory to rituximab is funded by the Cancer Drugs Fund in accordance with the following NICE TA
NICE TA472: as a treatment option in combination with bendamustine followed by obinutuzumab maintaince therapy under conditions specified within the TA.
100mg in 10ml & 500mg in 50ml concentrate for IV infusion
1400 mg solution for subcutaneous injection
Treatment of rheumatological conditions in line with NICE guidance otherwise Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Commissioner: NHS England
Approved for use in accordance with the following NICE TAs
NICE TA137: as a treatment option in combination with chemotherapy for the induction of remission in relapsed stage III or IV follicular non-Hodgkin's lymphoma. Additionally, rituximab is licensed as a monotherapy treatment option for follicular non-Hodgkin’s lymphoma. Please see the TA for full details.
NICE TA174: as a treatment option in combination with fludarabine and cyclophosphamide for chronic lymphocytic leukaemia in patients for whom fludarabine in combination with cyclophosphamide is considered appropriate.
NICE TA193: as a treatment option in combination with fludarabine and cyclophosphamide for people with relapsed or refractory chronic lymphocytic leukaemia under conditions specified within the TA.
NICE TA226: as a treatment option for follicular non‑Hodgkin's lymphoma that has responded to first-line induction therapy with rituximab in combination with chemotherapy.
NICE TA243: as a treatment option for symptomatic stage III and IV follicular lymphoma in previously untreated patients according to various combinations specified within the TA.
MHRA Drug Safety Update Decmeber 2013: Rituximab: screen for hepatitis B virus before treatment.
Biosimilars are available – note that indications can differ between different products – prescribe by brand. Consult with individual trust pharmacy department for details of preferred biosimilar brand.
10 mg powder and solvent for solution for injection
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
1200mg in 20ml concentrate for solution for infusion
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (June 2021): Atezolizumab (Tecentriq▼) and other immune-stimulatory anti-cancer drugs: risk of severe cutaneous adverse reactions (SCARs)
300 mg film-coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
20mg/4.5ml vail conc for soln for infusion
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Capsules -2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg and 25mg capsules
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (February 2011): Lenalidomide: risk of thrombosis and thromboembolism
MHRA Drug Safety Update (November 2011): Lenalidomide (Revlimid▼): update on risk of second primary malignancy
MHRA Drug Safety Update (January 2013): Lenalidomide (Revlimid): risk of serious hepatic adverse drug reactions
Letter sent to healthcare professionals (November 2016): lenalidomide (Revlimid▼): new advice about viral reactivation
MHRA Drug Safety Update (June 2020): Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
100mg capsules
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
MHRA Drug Safety Update (Oct 2020): Niraparib (Zejula▼): reports of severe hypertension and posterior reversible encephalopathy syndrome (PRES), particularly in early treatment
10mg in 1ml concentrate for IV infusion (4ml & 10ml vials)
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not approved in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2017): Nivolumab (Opdivo▼), pembrolizumab (Keytruda▼): reports of organ transplant rejection
MHRA Drug Safety Update (Oct 2019): Nivolumab (Opdivo): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
106 and 108 PFU (Plaque Forming Units)/ml solution for injection
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TA
NICE TA410: as a treatment option for unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs under conditions specified within the TA.
50mg hard capsules
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update (July 2011): Thalidomide: risk of arterial and venous thromboembolism
MHRA Drug Safety Update (May 2013): Thalidomide: risk of second primary malignancies
MHRA Drug Safety Update (December 2015): Thalidomide: reduced starting dose in patients older than age 75 years
Letter sent to healthcare professionals in June 2016: Thalidomide Celgene®: New important advice regarding viral reactivation and pulmonary hypertension
MHRA Drug Safety Update (June 2020): Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
60 mg film-coated tablets
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Treatment via tertiary centres.
120mg and 240mg gastro-resistant hard capsules
Commissioner: NHS England
Approved for use in accordance with the following NICE TAs:
MHRA Drug Safety Update (March 2015): Dimethyl fumarate (Tecfidera): fatal PML in an MS patient with severe, prolonged lymphopenia
MHRA Drug safety Update (April 2016): Dimethyl fumarate (Tecfidera): updated advice on risk of progressive multifocal leukoencephalopathy.
MHRA Drug Safety Update (January 2021): Dimethyl fumarate (Tecfidera): updated advice on the risk of progressive multifocal leukoencephalopathy (PML) associated with mild lymphopenia
500microgram hard capsules
Commissioner – NHS England
Approved for use in accordance with the following NICE TA:
Also approved for use in accordance with NHS England Policy NHS ENGLAND / D04/P/b for management of multiple sclerosis within a tertiary centre.
MHRA Drug Alerts and Safety Updates
Letter sent to healthcare professionals (April 2015): Fingolimod (Gilenya ▼): first reported case of progressive multifocal leukoencephalopathy (PML) in a multiple sclerosis patient taking fingolimod without previous treatment with natalizumab or other immunosuppressive medicines
Letter sent to healthcare professionals (January 2016): Fingolimod (Gilenya▼): risks related to effects on the immune system
MHRA Drug Safety Update April 2016: Fingolimod (Gilenya▼): risks of progressive multifocal leukoencephalopathy, basal-cell carcinoma, and opportunistic infections
MHRA Drug Safety Update April 2017: Multiple sclerosis therapies: signal of rebound effect after stopping or switching therapy
MHRA Drug Safety Update December 2017: Fingolimod (Gilenya▼): new contraindications in relation to cardiac risk
MHRA Drug Safety Update December 2017: Fingolimod (Gilenya▼): updated advice about risk of cancers and serious infections
MHRA Drug Safety Update (Sept 2019): Fingolimod (Gilenya▼): increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception
MHRA Drug Safety Update (January 2021): Fingolimod (Gilenya▼): updated advice about the risks of serious liver injury and herpes meningoencephalitis
20mg, 40mg prefilled syringe injection
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
30 microgram (6 million units) prefilled pen (Avonex)
22 microgram (6 million units) & 44 microgram (12 million
units injections -(Rebif), 1.5ml cartridges containing 22
microgram and 44 microgram per 0.5ml for use in
Rebismart injection device
20 microgram prefilled pen (Rebidose) - approved for use when
the cartridges and prefilled syringes are unsuitable.
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
MHRA Alert (October 2014): risk of thrombotic microangiopathy and risk of nephrotic syndrome.
Vials for preparing 750 microgram in 3ml injection
(Betaferon)
Vials for preparing 250 microgram in 1ml injection (Extavia)
Approved for use in accordance with the following NICE TAs:
Not approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
MHRA Alert (October 2014): risk of thrombotic microangiopathy and risk of nephrotic syndrome.
300mg in 15ml (20mg/ml) vial for preparing infusions
Commissioner: NHS England
Approved for use in accordance with the following NICE TA:
Commissioning Policy D04/P/b: NHSEClinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
MHRA Drug Safety Update (May 2011): Natalizumab (Tysabri▼): risk of progressive multifocal leukoencephalopathy is increased in patients who have had previous immunosuppressant treatment
MHRA Drug Safety Update (April 2016): Natalizumab (Tysabri▼): progressive multifocal leukoencephalopathy—updated advice to support early detection
30mg/ml conc for soln for inf in 10ml vial
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
20 mg solution for injection in pre-filled pen
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
125 microgram pre-filled pen (Plegridy)
Approved for use in accordance with the following NICE TAs:
Commissioner: NHS England
0.25 mg and 2mg film-coated tablets
Approved for use in accordance with the following NICE TA:
Commissioner: NHS England
14mg film coated tablets
Commissioner: NHS England
Approved for use in accordance with the following NICE TA:
Film coated tablets
Approved for use in accordance with the following NICE TAs:
10 mega units, 15 mega units & 30 mega units multidose pen injections
Commissioner: NHS England - NICE TA75
135 & 180 microgram injections in prefilled syringes & 135
&180 microgram prefilled pens
Commissioner: NHS England - NICE TA75, NICE TA96, NICE TA106, NICE TA200, NICE CG165
Tablets - 10mg, 20mg
Oral solution - 10mg/5ml
AMBER SPECIALIST RECOMMENDATION
250mg in 5ml (50mg/ml) injection in a prefilled syringe
Approved for use in accordance with the following NICE TAs OR if indication funded from the Cancer Drugs Fund :
Not approved in accordance with the following NICE TAs:
Commissioner: NHS England
Only to be used in line with a current chemotherapy protocol from the North of England Cancer Alliance in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
NICE CG175: Prostate Cancer diagnosis & treatment
First Choice
Clinicians are encouraged to prescribe the least expensive product that is clinically
appropriate e..g. Prostap DCS.
Tablets - 500mg
Commissioner: NHS England –
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not approved in accordance with the following NICE TAs:
Tablets - 50mg, 100mg
AMBER SPECIALIST INITIATION
MHRA Drug Safety Update (June 2020): Cyproterone acetate: new advice to minimise risk of meningiom
Injection - 80mg, 120mg
AMBER SPECIALIST INITIATION
Approved for use in accordance with the following NICE TA:
NICE TA404: as a treatment option for advanced hormone-dependent prostate cancer in people with spinal metastases, only if the commissioner can achieve at least the same discounted drug cost as that available to the NHS in June 2016.
40mg capsules
Commissioner: NHS England
Only when used in line with a current chemotherapy protocol from the North of England Cancer Network in line with the appropriate Network Site Specific Group’s clinical guidelines or chemotherapy algorithm.
Approved for use in accordance with the following NICE TAs:
Not approved in accordance with the following NICE TAs:
30mg long-acting injection
60mg, 90mg & 120mg autogel injections
50, 100 & 500 microg. in 1ml & 1mg in 5ml injections
10mg, 20mg & 30mg long-acting injections
300microgram and 900microgram ampoules for subcutaneous injection
10mg to 60mg vials for intramuscular injection
Cushing's Disease
NHS England commissioned
50, 100 & 500 microg. in 1ml & 1mg in 5ml injections
To be used on advice of palliative care team as per indications in Palliative Care Formulary.
Symptomatic reduction of tumour related secretions, Inoperable bowel obstruction in patients with cancer, Intractable diarrhoea related to high output ileostomies or entero-cutaneous fistulae
For all other indications, this drug is Red