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8.1 Cytotoxic drugs

8.1 Cytotoxic drugs

 8.1 Cytotoxic drugs

Drugs for cytotoxic-induced side-effects  
RED           Calcium Folinate
                   injection 3mg/1ml, 10mg/ml, 15mg/2mL
AMBER     Calcium Folinate tablets 15mg
RED           Calcium Levofolinate injection 10mg/mL
RED           Dexrazoxane (Savene®) intravenous infusion
RED           Mesna injection 1g/10mL 
RED           Mesna tablets 400mg
 
8.1.1 Alkylating drugs 
RED           Busulphan tablets 2mg
RED           Carmustine implant 7.7mg
RED           Chlorambucil tablets 2mg
RED           Cyclophosphamide 
                   tablets (25mg Named Patient), 50mg
                   injection 200mg, 500mg, 1g,
                   infusion 2g, 4g
 
RED           Estramustine capsules 140mg
RED           Ifosfamide injection 1g, 2g 
RED           Lomustine capsules 40mg
RED           Melphalan tablets 2mg, injection 50mg
 
8.1.2 Cytotoxic antibiotics  
RED           Bleomycin injection 15000units/vial
RED           Doxorubicin injection 10mg/5ml, 50mg/25mL 
RED           Doxorubicin liposomal injection 50mg/25mL     (NICE indication only) 
RED           Doxorubicin beads (DebTox® TACE) 
RED           Epirubicin injection 50mg/25mL
RED           Idarubicin capsules 10mg
RED           Liposomal cytarabine-daunorubicin - recommended as an option for untreated therapy-related acute myeloid
                   leukaemia with myelodysplasia-related changes in adults - as per NICE TA552                   NHS England Commissioned 
RED           Mitomycin injection 40mg
RED           Mitoxantrone injection 20mg/10mL
RED           Pixantrone Injection 29mg (NICE TAG306 use only) 
RED           Pegylated liposomal doxorubicin hydrochloride (Caelyx®) - as monotherpay recommended (within its marketing 
                  authorisation) as an option for treating recurrent ovarian cancer NICE   TA389) 
RED           Pegylated liposomal doxorubicin hydrochloride (Caelyx®) - in combination with platinum recommended as an option
                  for treating recurrent ovarian cancer NICE TA389   
 
8.1.3 Antimetabolites
RED           Capecitabine tablets 150mg, 500mg (NICE indication only)
 

RED           Cladribine                                                                                                                                                NHS England Commissioned 
NICE TA493 - replaced by NICE TA616
RED           Cladribine tablets 10mg [Mavenclad}                                                                                               NHS England Commissioned 
NICE TA616  an option  for treating highly active multiple sclerosis in adults, only if the person has:
                     > rapidly evolving severe relapsing-remitting multiple sclerosis, that is with at least:
                            >  2 relapses in the previous year and
                            >  1T1 gadolinium-enhancing lesion at baseline MRI or a significant increase in T2 lesion load compared with a previous MRI, or
                     > relapsing-remitting multiple sclerosis  that has responded inadequately to ttreatment with disease-modifying therapy, defined as  
                        1 relapse in the previous year and MRI evidence of disease activity.

RED           Cytarabine injection 100mg/1mL
RED           Fludarabine tablets 10mg, injection 50mg
RED           Fluorouracil injection 500mg/20mL, 2.5g/100mL
RED           Fluorouracil cream 5% - for use in Basal cell carcinoma
RED           Gemcitabine injection 200mg, 1g
RED           Mercaptopurine tablets 50mg  NB (AMBER for Crohn's and UC only, otherwise RED)
AMBER     Methotrexate tablets 2.5mg
Shared Care
RED           Methotrexate injection 50mg/2mL, 5mg/2mL,  tablets 10mg
RED           Azacitidine injection 100mg
RED           Pemetrexed (disodium) injection 100mg, 500mg   recommended as an option for maintenance treatment of  locally 
                   advanced or metastatic non‑squamous non‑small‑cell lung cancer in adults as per NICE  TA402  (replacing TA309) 
RED           Pemetrexed (disodium) - maintenance treatment of non-small-cell lung cancer as per NICE TA190 (updated August 2017) 
 
8.1.4 Vinca alkaloids and etoposide 
RED            Etoposide capsules 50mg, 100mg, injection 100mg/5mL
RED           Vinblastine injection 10mg
RED           Vincristine injection 2mg/2mL
RED           Vinorelbine injection 10mg/1mL, capsules 20mg, 30mg
 
 
8.1.5 Other antineoplastic drugs  

RED  Abemaciclib
 
 
NICE TA563    Recommended, within its marketing authorisation, with an aromatse inhibitor, as an option for treating locally
                       advanced or metastatic, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2) - negative
                       breast cancer as first endocrine-based therapy in adults. (only recommended if the company provides it according to
                       the commercial arrangement.                                                                                                   (NHS England Cancer Drugs Fund)
NICE TA579   Abemaciclib with fulvestrant is recommended for use within the Cancer Drugs Fund as an option for treating hormone
                       receptor-positive, human epidermal growth factor receptor 1(HER2) -negative locally advanced or metastatic breast
                       cancer in people who have had endocrine therapy only if: exemestane plus everolimus would be the most 
                       appropriate alternative and the conditions in the managed access agreement for abemaciclib with fulvestrant are
                       followed.                                                                                                                                       (NHS England Cancer Drugs Fund)

RED  Alectinib 
NICE TA536   Recommended as an option for untreated anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell
                       cancer in adults.                                                                                                                            (NHS England Commissioned)

RED  Arsenic trioxide
NICE TA526   Recommended, within its marketing authorisation, as an option for inducing remission and consolidation in
                      acute promyelocytic leukaemia  (characterised by the presence of the t[15;17] translocation or the PML/RAR-alpha 
                      gene) in adults with:   
                            >  untreated, low-to-intermediate risk disease (defined as a white blood cell count of 10x10³ per microlitre or less),
                                when given with all-trans-retinoic acid (ATRA)
                            >  relapsed or refractory disease, after a retinoid and chemotherapy                           (NHS England Commissioned) 

RED  Atezolizumab 
NICE TA492  For use within the Cancer Drugs Fund as an option for untreated locally advanced or metastatic  urothelial carcinoma
                      in adults, for  whom cisplatin-based chemotherpay is unsuitable , only if conditions of  the managed access agreement
                      are followed.  (Guidance updated July 2018:  The European medicines Agency restricted the use of Atezolizumab for
                      untreated urothelial carcinoma. It should now only be used in adults with high levels of PD-L1. For more information, see 
                      the summary of product characteristics for atezolizumab.                                                  (NHS England Cancer Drugs Fund) 
NICE TA520  For treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy.
                      Recommended as an option in  in adults who have had chemotherapy (and targeted treatment if they have
                      an EGFR- or ALK‑positive tumour), only if:
                          >     atezolizumab is stopped at 2 years of uninterrupted treatment or earlier if the disease progresses and
                          >     the company provides atezolizumab with the discount agreed in the patient access scheme. 
                                                                                                                                                                                (NHS England Commissioned)   
NICE TA525  For treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
                      Recommended as an option in  only if:
                          >     atezolizumab is stopped at 2 years of interrupted treatment or earlier if the disease progresses and   
                          >     the company provides atezolizumab with discount agreed in the patient access scheme
                                                                                                                                                                              (NHS England Commissioned)
NICE TA584 Atezolizumab plus bevacizumab, carboplatin and paclitaxel is recommended as an option for metastatic non- 
                      squamous on-small-cell lung cancer (NSCLC)in adults:
                         >   who have not had treatment for their metastatic NSCLC before and whose PD-L1 tumour proportion score is
                              between 0% and 49% or
                        >   when targetted therapy for epidermal growth factor receptor (EGFR)-positive or anaplastic lymphoma kinase 
                              (ALK)-positive NSCLC has failed.
                      It is recommended only if:
                        >   atezolizumab and bevacizumab are stopped at 2 years of uninterrupted treatment, or earlier if there is loss of
                             clinical benefit (for atezolizumab) or if the disease progresses (for bevacizumab) and
                       >    if the company provides atezolizumab and bevacizumab according to the commercial arrangements.
 

RED   Axicabtagene ciloleucel therapy
NICE TA559   For use within the Cancer Drugs Fund as an option for treating relapsed or refractory diffuse large B‑cell lymphoma
                      or primary mediastinal large B‑cell lymphoma in adults after 2 or more systemic therapies, only if the conditions in
                      the managed access agreement are followed.                                          (NHS England Cancer Drugs Fund) 

RED  Axitinib 
NICE TA333   Recommended as an option for treating adults with advanced renal cell carcinoma after failure of treatment  with a
                       first line tyrosine kinase inhibitor or a cytokine, only if the compant provides axitinib with the discount agreed in the
                       patient access scheme.

RED   Bortezomib 
NICE TA129  Recommended as an option for the treatment of progressive multiple myeloma in people who are at first relapse 
                      having received one prior therapy and who have undergone, or are unsuitable for, bone marrow transplant, under the
                      circumstances listed in the guidance.
NICE TA228  Bortezomib and thalidomide for the first-line treatment of multiple myeloma:
                      1. Thalidomide in combination with an alkylating agent and a corticosteroid is recommendaed as an option for the first
                      line treatment of multiple myeloma in people for whom high-dose chemotherapy with stem cell transplantation is 
                      considered inappropriate
                      2. Bortezomib in combination with an alkylating agent and a cortiscosteroid is recommended as an option for the
                      first-line treatment of multiple myeloma if:
                                      > a high dose chemotherapy with stem cell transplantation is considered inappropraite and
                                      > the person is unable to tolerate or has contraindications to thalidomide
NICE TA311  Recommended as an option within its marketing authorisation, that is, in combination with dexamethasone, or with
                      dexamethasone and thalidomide, for the induction treatment of adults with previously untreated multiple myeloma,
                      who are eligible for high-dose chemotherapy with haematopoietic stem cell transplant.
NICE TA370  Recommended, within its marketing authorisation, as an option for previously untreated mantle cell lymphoma in 
                      adults for whom haemotopoietic stem cell transplantation is unsuitable.

RED   Bosutinib (Bosulif)
NICE TA401  Recommended as an option, within its marketing authorisation, for chronic accelerated and blast phase Philadelphia
                       chromosome positive chronic myeloid leukaemia in  adults, when:
                            >    they have previously had 1 or more tyrosine kinase inhibitor and    
                            >    imatinib, nilotinib and dasatinib are not appropriate and              
                            >    the company provides bosutinib with the discount agreed in the patient access scheme (as revised in 2016)

RED   Brentuximab vedotin (Adcetris®)
NICE TA524  Recommended  as an option for treating CD30- positive Hodgkin Lymphoma in adults with relapsed or refractory
                      disease only as specified in NICE TA524 
                      This guidance is a Cancer Drugs Fund reconsideration of NICE TA446  and replaces TA446 
                                                                                                                                                                        (NHS England Cancer Drugs Fund) 
NICE TA478  Recommended as an option for treating relapsed or refractory systemic anapplastic large cell  lymphoma in adults 
                                                                                                                                                                                (NHS England Commissioned)
NICE TA577 Recommended as an option for treating CD30-positive cutaneous T-cell lymphoma (CTCL) after at least 1 systemic
                     therapy in adults, only if:
                     >      they have mycosis fungoides stage IIB or over, primary cutaneous anaplastic large cell lymphoma 
                             or Sézary syndrome and
                     >      the company prvides brentuximab vedotin according to the commercial arrangement


RED     Brigatinib (Alunbrig)
NICE TA571  Recommended, within its marketing authoristaion, for treating anaplastic lymphoma kinase (ALK)-positive advanced 
                      non-small-cell lung cancer in  adults who have already had crizotinib, It is recommended only if the company
                      provides it according to the commercial arrangement.                                                          (NHS England Commissioned)

RED   Cabazitaxel 
NICE TA391  In combination with prednisone or prednisolone is recommended an option for treating metastatic hormone-relapsed
                     prostate cancer in people whose disease has progressed during or after docetaxel chemotherapy.

RED   Cabozantinib 
NICE TA463  An option for treating advanced renal cell carcinoma in adults after vascular endothelial growth factor- targeted
                      therapy.                                                                                                                                             (NHS England Commissioned)  
NICE TA516  Recommended , within its marketing authorisation, as an option for treating progressive medullary thyroid cancer in 
                      adults with unresectable, locally advanced or metastatic disease.                                    (NHS England Cancer Drugs Fund)
NICE TA542  Recommended, within its marketing authorisation, for adults with untreated advanced renal cell  carcinoma that is 
                      intermediate - or poor- risk as defined in the International Metaststaic Renal Cell Carcinoma Database Consortium
                      criteria.                                                                                                                                                 (NHS England Commissioned)

RED   Carboplatin injection 150mg/15mL, 450mg/45mL 

RED   Carfilzomib powder For solution for infusion
NICE TA457  Recommended as an option in combination with dexamethasone for treating multiple myeloma in adults only if:
                         > they have had only 1 previous therapy, which did not include bortezomib and
                         > the company provides carfilzomib with the discount agreed in the patient access scheme.

RED   Ceritinib 
NICE TA395  Recommended within its marketing authorisation, as an option for treating advanced anaplastic lymphoma 
                      kinase positive non-small-cell lung  cancer in adults who have previously had crizotinib. The drug is recommended
                      only if the company provides it with the discount agreed in the patient access scheme.
NICE TA500  Recommended within its marketing authorisation, as an option for untreated anaplastic kinase (ALK)-positive  
                      advanced non-small-cell cancer in adults, only if the company provides it with the discount agreed in the patient
                      access scheme.                                                                                                                                (NHS England Commissioned) 

RED   Cetuximab infusion 5mg/mL  
NICE TA439  (updated Sept 2017)  Cetuximab and panitumumab is recommended, as an option for previously untreated 
                      metastatic  colorectal cancer
NICE TA473  In combination with platinum based chemotherapy is recommended as an option for treating recurrent or metastatic   
                      squamous cell cancer of the head and neck in adults only.                                                  (NHS England Commissioned)  

RED   Cisplatin injection 50mg 

RED   Crizotininb  capsules 200mg, 250mg                                                                        
NICE TA406  Recommended as an option, within its marketing authorisation, for untreated anaplastic lymphoma kinase-positive 
                      advanced non-small-cell cancer in adults.                                                                        (NHS England Commissioned) 
NICE TA422  An option in previously treated anaplastic lymphoma kinase-positive advanced on-small-cell lung cancer in adults 
NICE TA529  Recommended for use within the Cancer Drugs Fund as an option for treating ROS1- positive advanced                    
                      non-small-cell lung cancer in adults only if the conditions in the managed access agreement are followed. 
                                                                                                                                                                        (NHS England Cancer Drugs Fund)

RED  Dabrafenib   
NICE TA321   Recommended as an option, within its marketing authorisation, for treating unrescectable or metastatic BRAF V600
                      mutation-positive melanoma [only if the company provides darafenib with the discount agreed in the patient access
                      scheme.
NICE TA544   Dabrafenib with trametinib is recommended, within its marketing authorisation, an option for the adjuvant treatment 
                      of resected stage III BRAF V600 mutation-positive melanoma in adults as per                 (NHS England Commissioned)   
 

RED   Dacomitinib tablets 45mg (Vizimpro®)
NICE TA595  Recommended, within its marketing authorisation, as an option for untreated locally advanced or metastatic
                      epidermal growth factor receptor [EGFR] mutation-positive non-small-cell lung cancer in adults. It is recommended
                      only if the company provides it according to the commercial arrangement.                      (NHS England Commissioned)

RED   Daratumumab
NICE TA510  Daratumumab monotherapy is recommended for use within the Cancer Drugs Fund as an option for treating
                      relapsed and refractory multiple myeloma in adults whose previous therapy included a proteasome inhibitor
                      and an immunomodulator, whose disease progressed on the last therapy only if:
                      > they have daratumumab after 3 previous therapies and > the conditions in the managed access agreement are 
                         followed                                                                                                                          (NHS England  Cancer Drugs Fund)
NICE TA573   Daratumumab plus bortezomib plus dexamethasone is recommended as an option for use withing the Cancer
                      Drugs Fund as an option for treating relapsed multiple myeloma in people who have had 1 previous treatment.
                      It is recommended only if the conditions in the managed access agreement for daratumumab plus bortezomib plus
                      dexamethasone are followed.                                                                                                (NHS England  Cancer Drugs Fund) 

RED  Dasatinib 
NICE TA425   Dasatininb is recommended as an option in treating only chronic- or accelerated-phase Philadelphia-chromosome-
                      positive chronic myeloid leukaemia in adults. [Replaces NICE TA241]                                     (NHS England Commissioned)
NICE TA426 Dasatinib is recommended as an  option for untreated chronic-phase Philadelphia- chromosome-positive   
                      chronic myeloid leukaemia in  adults [Replaces NICE TA251}                                                    (NHS England Commissioned) 

RED              Dacarbazine injection 1g 

RED  Dinutuximab beta
NICE TA538  Dinutuximab is recommended as an option for treatin g high-risk neuroblastoma in people aged 12 months and
                     over whose disease has at least partially responded to induction chemotherapy, followed by myeloablative therapy 
                     and stem cell transplant                                                                                                                    (NHS England Commissioned) 

RED   Docetaxel injection 20mg/0.5ml, 80mg/2ml (NICE indications only) 

RED   Encorafenib 
NICE TA562  Encorafenib with binimetinib is recommended, within its marketing authorisation, as an option for treating           
                     unresectable or metastatic BRAF V600 mutation-positive melanoma in adults.                   (NHS England Commissioned)

RED   Eribulin solution for injection 0.8mg/2ml, 1.32mg/3ml.  
NICE TA423  Eribulin is recommended as an option for treating  locally advanced or metastatic breast cancer in adults who have
                      had 2 or more courses  of chemotherapy.    (replaces NICE TA250)                                            (NHS England Commissioned)  

RED  Erlotinib tablets 25mg, 100mg, 150mg (NICE indication only) 
NICE TA374  Erlotinib is recommended as an option for treating  locally advanced or metastatic non-small-cell lung cancer 
                      that has progressed after prior chemotherapy.                                                                           (NHS England Commissioned)  

RED              Everolimus 2.5mg, 5mg, 10mg  tablets, in combination with exemestane is recommended as an option for treating                            advanced breast cancer  after endocrine therapy - NICE TA421                                                  (NHS England Commissioned)  
RED             Everolimus tablets 2.5mg, 5mg, 10mg recommended as an option for treating  advanced renal cell carcinoma that has                       progressed during or after treatment  with vascular endothelial growth factor targeted therapy, only if the company                           provides it with the discount agreed in the patient access scheme. NICE TA432                   (NHS England Commissioned)   
RED              Everolimus  2.5mg, 5mg, 10mg  tablets,
NICE TA421  in combination with exemestane is recommended as an option for treating  advanced breast cancer after
                     endocrine therapy                                                                                                                             (NHS England Commissioned)
NICE TA432  recommended as an option for treating  advanced renal cell carcinoma that has progressed during or after treatment 
                     with vascular endothelial growth factor targeted therapy, only if the company provides it with the discount agreed in
                     the patient access scheme.                                                                                                              (NHS England Commissioned)   
NICE TA 449 unresectable or metastatic neuroendocrine tumours (NETs) of pancreatic origin in adults with progressive  disease.
                                                                                                                                                                                    (NHS England Commissioned) 
RED           Everolimus NICE TA481, TA482

AMBER     Hydroxycarbamide capsules 500mg - unlicensed use for psoriasis in adults. Specialist  initiation only. 
                  See Drug Monitoring in Primary Care for monitoring  requirements.

RED           Gefitinib tablets 250mg 

RED           Gemtuzumab oxogamicin, with daunorubicin and cytarabine is recommended as an option for untreated de novo 
                   CD33-positive acute myeloid leukaemia in people aged 15 years and over - as in NICE TA545 
                                                                                                                                                                                (NHS England Commissioned)  

RED           Ibrutinib capsules 140mg as an option for treating chronic lymphocytic leukaemia in adults who have had at least 1
                  prior therapy or, who have a 17p deletion or TP53 mutation, and in whom chemotherapy is unsuitable as per
                  NICE TA429                                                                                                                                         (NHS England Commissioned)   
RED           Ibrutinib is recommended for use in the Cancer drugs Fund as an option for treating Waldenstrom's 
                  macroglobulinaemia in adults who have at least 1 prior therapy, only if the conditions is in the managed access
                  agreement for ibrutinib  are followed - as per NICE TA491                                                    (NHS England Cancer Drug Fund)
RED           Ibrutinib is recommended as an option for treating relapsed or refractory mantle cell lymphoma in adults  only if they 
                  have had 1 previous line of therapy and the company provides ibrutinib with the agreed discount in the commercial
                  access agreement with NHS England  as in NICE TA502                                                            (NHS England Commissioned) 

RED           Idelalisib (Zydelig®) tablets 100mg, 150mg - as an option in NICE TA359 for treating chronic  lymphocytic leukaemia

RED           Imatinib tablets 100mg, 400mg (NICE TAG326) 
RED           Imatinib tablets 100mg, 400mg  option in treating only chronic- or accelerated- phase Philadelphia-chromosome-
                  positive chronic myeloid leukaemia in adults as per NICE TA425   Replaces NICE TA241    
                                                                                                                                                                                 (NHS England Commissioned)  
RED           Imatinib tablets 100mg, 400mg is recommended as an option for untreated,  chronic-phase Philadelphia-chromosome-                    positive chronic myeloid leukaemia in adults. NICE TA426   Replaces NICE TA251

RED           Ipilimumab IV infusion 5mg/mL (NICE indications only as below) 
                  NICE TAG319 - as an possible treatment in previously untreated advanced (unresectable or metastatic)  melanoma 
                  NICE TA268 as a possible treatment for people with previously treated  advanced (unresectable or metastatic) 
                   melanoma.

RED           Irinotecan concentrate for infusion 20mg/mL (NICE indication only) 

RED           Ixazomib with lenalinomide and dexamethasone an option for use within the Cancer Drugs Fund for the treatment of 
                  relapsed or refractory multiple  myeloma in adults as per NICE TA505                                  (NHS England Commissioned)   

RED           Lenvatinib is recommended as an option for untreated, advanced, unrescetable hepatocellular carcinoma in adults,
                  as per NICE TA551                                                                                                                             (NHS England Commissioned) 
RED           Lenvatinib with everolimus for previously treated advanced renal cell carcinoma as an option as per NICE TA498 
                                                                                                                                                                                (NHS England Commissioned)
RED           Levatininb and sorafenib recommended as options for treating progressive, locally advanced or metastatic
                  differentiated thyroid cancer (papillary, follicular or Hurthle cell) in adults whose disease does not respond to radioactive
                  iodine - as per NICE TA535                                                                                                               (NHS England Commissioned) 

RED          Lutetium (177Lu) oxodotreotide recommended as an option for treating unresectable or metastatic, 
                  progressive, well-differentiated  (grade 1 or grade 2), somatostatin receptor-positive gastroenteropancreatic 
                  neuroendocrine tumours in adults - as per NICE TA539                                                             (NHS England Commissioned)

RED          Midostaurin - recommended, within its marketing authorisation, as an option in adults for treating newly diagnosed
                  acute FLT3-mutation-positive myeloid leukaemia with standard daunorubicin and cytarabine as induction therapy,
                  with high-dose cytarabine as consolidation therapy, and alone after complete response as maintenance therapy
                  (patient access scheme)                                                                                                                   (NHS England Commissioned) 
 

RED   Neratinib tablets 40mg (Nerlynx)
NICE TA612    Neratinib is recommended as an option for the extended adjuvant treatment of hormone receptor-positive,
                        human epidermal growth factor receptor 2 (HER2)-positive early stage breast cancer in adults who completed 
                        adjuvant trastuzumab-based therapy less than 1 year ago only if:
                           > trastuzumab is the only HER2‑directed adjuvant treatment they have had, and
                           > if they had neoadjuvant chemotherapy-based regimens, they still had residual invasive disease in the breast or
                              axilla following the neoadjuvant treatment, and
                           > the company provides neratinib according to the commercial arrangement.     (NHS England Cancer Drug Fund)

RED          Nilotinib capsules 150mg, 200mg as an option for untreated chronic-phase Philadelphia-chromosome- positive chronic 
                  myeloid leukaemia in adults as per NICE TA426   Replaces NICE TA251                                  (NHS England Commissioned) 
RED          Nilotinib capsules 150mg, 200mg option in treating only chronic- or accelerated- phase Philadelphia-
                  chromosome-positive chronic myeloid leukaemia in adults as per NICE TA425  Replaces NICE TA241
                                                                                                                                                                                (NHS England Commissioned) 

RED          Niraparib - recommended for use within the cancer drugs fund as an option for treating relapsed, platinum-sensitive
                  high-grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer - as per NICE TA 52
                                                                                                                                                                                (NHS England Cancer Drug Fund)

RED          Nivolumab  intravenous infusion 10mg/ml is recommended as an option by NICE for treating advanced (unresectable or 
                  metastatic) melanoma. NICE TA384 
RED          Nivolumab in combination with ipilimumab is recommended, within itsmarketing authorisation, as an option for treating                   advanced (unresectable or metastatic)  melanoma in adults, only when the company provides ipilimumab with the 
                 discount agreed in the patient access scheme. NICE TA400.    
RED          Nivolumab is recommended as an option for previously treated advanced renal  cell carcinoma in adults.  NICE TA417.                          (updated September 2017 after a change  to the commercial arrangements)
RED          Nivolumab  is recommended as an option for treating relapsed or refractory classical Hodgkin lymphoma in adults
                  after autologous stem cell transplant and treatment with brentuximab vedotin as per NICE TA462
                   (updated September 2017 after a change to the commercial arrangements)
RED           Nivolumab is recommended for use within the Cancer Drugs Fund as an option for treating locally advanced or 
                   metastatic squamous non-small-cell lung cancer in adults as per NICE TA483
RED           Nivolumab is recommended for use within the Cancer drugs Fund as an option  for treating locally advanced or 
                  metastatic non-squamous non-small-cell lung cancer in adults after chemotherapy as per NICE TA484
RED           Nivolumab is recommended for use within the Cancer Drugs Fund as an option for treating squamous cell carcinoma
                   of the head and neck in adults whose disease has progressed on platinum-based chemotherapy as per NICE TA490
RED           Nivolumab is recommended for use within the Cancer Drugs Fund as an option for the adjuvant treatment of 
                   completely resected melanoma in adults with lymph node involvement or metastatic disease. It is recommended
                   only if the conditions in the managed access agreement are followed.                           (NHS England Cancer Drug Fund)
NICE TA581  Nivolumab with ipilimumab is recommended for use within the Cancer Drugs Fund as an option for adults with
                       untreated advanced renal cell carcinoma that is intermediate - or poor- risk as defined in the International 
                       Metastatic Renal cell carcinoma Database Consortium Criteria. It is recommended only if the conditions in the 
                       managed access agreement for nivolumab with ipilimumab are followed.                         (NHS England Cancer Drug  Fund)
 

RED           Obinutuzumab - recommended as an option for untreated advanced follicular lymphoma as per NICE TA513
                                                                                                                                                                      (NHS England Commissioned)
 
 

RED   Olaparib [Lynparza]
NICE TA381   Recommended as an option by NICE for maintenance  treatment of relapsed, platinum- sensitive, BRCA mutation-
                       positive ovarian, fallopian tube and peritoneal cancer after response to second-line or subsequent platinum-based 
                       chemotherapy, 
NICE TA598   Recommended as an option for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian
                       tube or peritoneal cancer after response to first-line platinum-based chemotherapy 
                                                                                                                                                                       (NHS England Cancer Drug Fund)
NICE TA620   Recommended as an option for the maintenance treatment of relapsed, platinum-sensitive, high grade epithelial 
                      ovarian, fallopian tube or primary peritoneal cancer in adults whose disease has responded to platinum-based 
                      chemotherapy  only if:
                         > they have a BRCA1 or BRCA2 mutation
                         > they have had 3 or more courses of platinum-based chemotherapy and 
                         > the company provides olaparib according to the commercial arrangement         (NHS England Cancer Drug Fund) 

RED          Osimertinib 40mg, 50mg f/c tablets - recommended as an option for use within the Cancer Drugs Fund for  treating                            locally advanced or metastatic EGFR T790M mutation-positive non-small-lung cancer NICE TA416 
                                                                                                                                                                             (NHS England Commissioned )

RED            Oxaliplatin injection 50mg, 100mg (NICE indication only)                           

RED           Paclitaxel injection 30mg/5ml (NICE indication only)                     
RED           Paclitaxel Iv infusion - in combination with platinum as an option for treating recurrent ovarian cancer  in - NICE TA389
RED           Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer 
                   - an option by NICE TA476 (replaces TA360)

RED           Palbociclib 
NICE TA495   Recommended within its marketing authroisation, with an aromatase inhibitor, as an option for treating
                       hormone receptor-positive , human epidermal growth receptor 2-negative, locally advanced or metastatic breast 
                       cancer as initial endocrine-based therapy in adults.
NICE TA619   Recommended as an option with fulvestrant for use  within the Cancer Drugs Fund for treating hormone receptor-
                      positive, human epidermai growth factor receptor 2 (HER2) - negative, locally advanced or metastatic breast cancer
                      in people who have had previous endocrine therapy only if:
                         >  examestane 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 palbociclib with fulvestrant are followed.

RED           Panitumumab is recommended, as an option for previously untreated metastatic colorectal cancer as per NICE TA 439 
                  (updated Sept 2017)

RED            Panobinostat 20mg tablets - recommended as an option by NICE for treating v multiple myeloma after at least two 
                   previous treatments. NICE TA380 

RED           Pazopanib Tablets, f/c - recommended as a first-line treatment option for people with advanced renal cell carcinoma 
                   in NICE TA215 

RED           Pegaspargase as an option for treating acute lymphoblastic leukaemia in children, young people and adults only when 
                   they have untreated newly diagnosed disease, (as part of antineoplastic combination therapy) as recommended                                   in NICE TA408 

RED           Pembrolizumab as an option for treating locally advanced or metastatic PD-L1-positive non-small-cell lung cancer in                           adults who have had at least one chemotherapy as per NICE TA428                                 (NHS England Commissioned)  
RED           Pembrolizumab is recommended as an option for untreated PD-L1 positive metastatic non-small-cell lung cancer
                   in adults whose tumours express PD-L1 (with at least 50% tumour proportion score) and have no epidermal growth
                   factor receptor- or anaplastic lymphoma kinase-positive mutations as per NICE TA531 (replaces NICE TA447)
                                                                                                                                                                            (NHS England Commissioned)  
RED           Pembrolizumab - recommended as an option for treating locally advanced or metastatic urothelial carcinoma after 
                   platinum-containing chemotherapy as per NICE TA519
RED           Pembrolizumab - recommended for use within the Cancer drugs Fund as an option for untreated locally advanced
                   or metastatic carcinoma in adults when cisplatin-containing chemotherapy is unsuitable - as per NICE TA522
                   (Guidance updated July 2018: The European medicines Agency restricted the use of pembrolizumab for untreated
                   urothelial carcinoma. It should now only be used in adults with high levels of PD-L1. For more information, see the 
                   summary of product characteristics for pembrolizumab).                                                           (NHS England Cancer Drug Fund)
RED           Pembrolizumab is receommended as an option for treating relapsed or refractory classical Hodgkin lymphoma in adults
                  who have has brentuximab vedotin and cannot have autologous stem cell transplant  as in NICE TA540
                                                                                                                                                                               (NHS England Cancer Drug Fund) 
RED           Pembrolizumab with pemetrexed and platinum chemotherapy is recommended for use within the Cancer Drugs Fund, 
                   as an option for  untreated, metastatic, non-squamous non-small-cell lung cancer (NSCLC) in adults whose tumours
                   have no epidermal growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)-positive mutations. NICE TA557 
                                                                                                                                                                                (NHS England Cancer Drug Fund) 
RED          Pembrolizumab is recommended for use within the Cancer Drug Fund as an option for the adjuvant  treatment of 
                  Stage III melanoma with lymph node involvement ih adults who have had complete resection - as per NICE TA553
                                                                                                                                                                                 (NHS England Cancer Drug Fund) 
NICE TA600 Pembrolizumab, with carboplatin and paclitaxel, is recommended for use within the Cancer Drugs Fund as an 
                     option for untreated metastatic squamous non-small-cell lung cancer in adults only if:
                       > pembrolizumab is stopped at 2 years of uninterrupted treatment, or earlier if disease progresses, and
                       > the company provides pembrolizumab according to the managed access agreement
 

RED         Pentostatin injection 10mg  

RED           Pertuzumab solution for infusion 30mg/mL - an option for the neoadjuvant treatment of adults with human epidermal 
                  growth factor receptor 2 (HER2)‑positive breast cancer, in combination with trastuzumab and chemotherapy, 
                  as per NICE TA424 
RED           Pertuzumab  HER2-positive metastatic or locally recurrent unrescetable breast  cancer in adults who have not had
                  previous anti‑HER2 therapy or chemotherapy for their metastatic disease (in combination with trastuzumab and 
                  docetaxel -  NICE TA509
RED           Pertuzumab - NICE TA569  - Recommended, with intarvenous tarstuzumab and chemotherpay, for the adjuvant 
                   treatment of human epidermal growth factor receptor 2 (HER2)-positive early stage breast cancer in adults, only if:
                          > they have lymph node-positive disease
                          > the company provides it according to the commercial arrangement
                                                                                                                                                                             (NHS England Commissioned) 

RED           Ponatinib -  Recommended as per NICE TA451 as an option for treating chronic-accelerated  -or blast - phase chronic 
                  myeloid leukaemia in adults.                                                                                                        (NHS England Commissioned)

RED           Procarbazine capsules 50mg 

RED           Radium-223 dichloride recommended as an option by NICE for treating  hormone-relapsed pro state cancer   
                  with bone metastases. NICE TA376  

RED           Regorafenib recommended as an option for treating unresectable or metastatic gastrointestinal stromal tumours
                  in adults whose disease has progressed on,  or who are intolerant to, prior treatment with imitinib and sunitinib
                  as per NICE TA488                                                                                                                       (NHS England Commissioned)
RED           Regorafenib is recommended as an option for treating advanced unrescetable hepatocellular carcinoma in adults 
                  who have had sorafenib, only if:
                       > they have Child-Pugh grade A liver impairment and an Eastern Cooperative Oncology Group (ECOG) performance 
                          status of 0 or 1 and
                       > the company provides it according to the commercial arrangement. NICE TA555

RED                Ribociclib
NICE TA496    with an aromatase inhibitor, is recommended within its marketing authorisation, as an option for treating             
                        hormone receptor-positive, human epidermal growth factor receptor 2‑negative, locally advanced or metastatic
                        breast cancer as initial endocrine-based therapy in adults. Ribociclib is recommended only if the company provides
                        it with the discount agreed  in the patient access scheme. 
NICE TA593    with fulvestrant, is recommended for use within the Cancer Drug Fund as an option for treating hormone receptor-
                       positive, human epidermal growth factor receptor (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.
 

RED                Rucaparib
NICE TA611    Recommended for use within the Cancer Drugs Fund as an option for maintenance treatment of relapsed platinum-
                       sensitive high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer that has responded to
                       platinum-based chemotherapy in adults, only if the conditions in the managed access agreement for rucaparib 
                       are followed.                                                                                                                           (NHS England Cancer Drug Fund)

RED            Ruxolitinib tablets 5mg,10mg.15mg,20mg NICE TA386  

RED           Sorafenib tablets 200mg  recommended as an option for treating hepatocellularcarcinoma only for people with
                   Child-Pugh A liver impairment as per NICE TA474

RED           Sunitinib capsules 12.5mg, 25mg, 50mg 
RED           Sunitinib capsules 12.5mg, 25mg, 50mg recommended as an option treating well, or moderately differentiated 
                   unresectable or metastatic neuroendocrine tumours (NETs) of pancreatic origin in adults with progressive  disease.
                   as per NICE TA 449                                                                                                                            (NHS England Commissioned)

RED           Temozolomide capsules 5mg, 20mg, 100mg,140mg, 180mg,250mg NICE TA23                          (updated March 2016) 

RED           Tisagenlecleucal is recommended for use within the cancer drug fund as an option for treating relapsed or refractory
                   B-cell acute lymphoblastic leukaemia in people aged up to 25 years , as per NICE TA554   (NHS England Cancer Drug Fund)

RED           Tivozanib - an option in advanced renal cell carcinoma in adults as per NICE TA512            (NHS England Commissioned)

RED           Topotecan infusion Ovarian cancer (NICE TA91)  
RED           Topotecan infusion cervical cancer, recurrent                                                                           (NHS England Commissioned) 

RED           Trabectedin powder for concentrate 0.25mg, 1mg (Yondelis®) as an treatment  option  for people with advanced soft 
                   tissue sarcoma as per NICE TA185 

RED           Trametininb tablets 0.5mg, 2mg as an option by NICE for treating unresectable  or metastatic melanoma in 
                   combination with darbrafenib - NICE TA396 

RED           Trastuzumab injection 150mg (NICE indications only)  
RED           Trastuzumab emtansine (Kadcyla) NICE TA458
RED           Trastuzumab emtansine (Kadcyla) - recommended , within its marketing uthorisation, as an option for treating 
                   a human epidermal growth factor receptor (HER2) - positive, unrescetable, locally advanced or metastatic  breast 
                   cancer in adults who previously received trastuzumab and a taxane, separately or in combination as per NICE TA458
                   updated (replaces TA371).                                                                                                     (NHS England Cancer Drug Fund)
 

RED           Tretinoin capsules 10mg 
                  (Consultant haematologist only – use whilst waiting transfer to specialist centre - see relevant protocol)

RED           Trifluridine-tipiracil tablets 15mg, 20mg - as per NICE TA405  

RED           Vemfurafenib tablets 240mg 

RED           Venetoclax - as an option within the Cancer Drugs Fund , within its marketing  authorisation, for treating chronic
                   lymphocytic leukaemia as per NICE TA487
RED           Venetoclax with rituximab - recommended, within its marketing authorisation, as an option for treating chronic
                   lymphocyticleukaemia in adults who have had at least 1 previous therapy. NICE TA561   (NHS England Cancer Drugs Fund)
 
 
 
Caption
 
 



RED  Alectinib
NICE TA536  recommended as an option for untreated anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell
                      cancer in adults.                                                                                                                            (NHS England Commissioned)
 
RED  Arsenic trioxide (Trisenox)
NICE TA526  recommended, within its marketing authorisation, as an option for inducing remission and consolidation in
                      acute promyelocytic leukaemia (characterised by the presence of the t[15;17] translocation or the PML/RAR-alpha                                gene) in adults with:                                                                            
                            >  untreated, low-to-intermediate risk disease (defined as a white blood cell count of 10x10³ per microlitre or less),
                                when given with all-trans-retinoic acid (ATRA)
                            >  relapsed or refractory disease, after a retinoid and chemotherapy                           (NHS England Commissioned) 
 
 
RED               Pembrolizumab
NICE TA428   an option for treating locally advanced or metastatic PD-L1-positive non-small-cell lung cancer in adults who have had 
                      at least one chemotherapy                                                                                                        (NHS England Commissioned)   
NICE TA519   an option for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy 
 
NICE TA531  (replaces NICE TA447 as an option for untreated PD-L1 positive metastatic non-small-cell lung cancer  in adults whose
                      tumours express PD-L1 (with at least 50% tumour proportion score) and have no epidermal growth actor receptor -
                      or anaplastic lymphoma kinase-positive mutations.                                                               (NHS England Commissioned)  
NICE TA522   recommended for use within the Cancer Drugs Fund as an option for untreated locally advanced or metastatic 
                      carcinoma in adults when cisplatin-containing chemotherapy is unsuitable. (Guidance updated July 2018: The European 
                      medicines Agency restricted the use of pembrolizumab for untreated urothelial carcinoma. It should now only be
                      used in adults with high levels of PD-L1. For more information, see the  summary of product characteristics for 
                      pembrolizumab).                                                                                                                           (NHS England Cancer Drug Fund) 
NICE TA540   recommended as an option for treating relapsed or refractory classical Hodgkin lymphoma in adults who have had
                       brentuximab vedotin and cannot have autologous stem cell transplant                         (NHS England Cancer Drug Fund) 
NICE TA553   recommended for use within the Cancer Drug Fund as an option for the adjuvant  treatment of Stage III melanoma
                       with lymph node involvement ih adults who have had complete resection                       (NHS England Cancer Drug Fund)
NICE TA557   with pemetrexed and platinum chemotherapy is recommended for use within the Cancer Drugs Fund, as an option for

                       untreated, metastatic, non-squamous non-small-cell lung cancer (NSCLC) in adults whose tumours have no epidermal
                 
   growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)-positive mutations. (NHS England Cancer Drug Fund)

8.1.5 Other antineoplastic drugs

 Atezolizumab