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8.1 Cytotoxic drugs

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
 
RED           Treosulfan with fuldabrine [Trecondi]
NICE TA640  Recommended as an option for conditioning treatment before allogenic haematopoietic stem cell transplant (all-HSCT)
                      for people with malignant diseases for whom a reduced intensity regimen, such as low-dose busulfan with fludabrine,
                      would be suitable.
 
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
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 treatment 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.
NICE TA638 Atezolizumab with carboplatin and etoposide is recommended as an option for untreated extensive-stage small-cell
                      lung cancer in adults, only if:
                      >    they have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and
                      >    the company provides atezolizumab according to thecommercial arrangement
 
NICE TA639 Atezolizumab with nab-paclitaxel is recommended, within its marketing authorisation, for treating triple negative, 
                     unresectable, PD-L1-positive, locally advanced or metastatic breast cancer in adults whose tumours express PD-L1 at a 
                     level of 1% or more and who have not had previous chemotherapy for metastatic disease. It is recommended only if 
                     the company provides atezolizumab according to the commercial arrangement
NICE TA666 Atezolizumab plus bevacizumab is recommended as an option for treating advanced or unresectable hepatocellular 
                     carcinoma [HCC] in adults who have not had previous systemic treatment, only if:
                     >  they have Child-Pugh grade 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                               (NHS England Commissioned) 
 

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
NICE TA641  Recommended within its marketing authorisation, with cyclophosphamide, doxorubicin and prednisolone, as an 
                      option for untreated systemic anaplastic large cell lymphoma in adults.                          (NHS England Commissioned)
 

RED     Brigatinib (Alunbrig)
NICE TA571  Recommended, within its marketing authorisation, 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)
NICE TA670  Recommended, within its marketing authorisation, for treating anaplastic lymphoma kinase [ALK]-positive advanced
                     non-small-cell lung cancer that has not been previously treated with an ALK inhibitor in adults
                                                                                                                                                                                 (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 TA657  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.
                     NICE TA657 updates and replaces TA457                                                                                          (NHS England Commissioned)

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 within 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)
NICE TA668  Encorafenib plus cetuximab is recommended, within its marketing authorisation, as an option for treating 
                      BRAF V600E mutation-positive metastatic colorectal cancer in adults who have had previous systemic treatment.
                                                                                                                                                                                    (NHS England Commissioned)

RED    Entrectinib [Rozlytek]
NICE TA643  Recommended within its marketing authorisation, as an option for treating ROS1-positive advanced non-small-cell 
                      lung cancer in adults who have not had ROS1 inhibitors.                                                      (NHS England Commissioned)
NICE TA644  Recommended for use within the Cancer Drugs Fund as an option for treating neurotropic tyrosine receptor kinase
                      [NTRK] fusion-positive solid tumours in adults and children 12 years and older if;
                           > the disease is locally advanced or metastatic or surgery could cause severe health problems and 
                           > they have not had and NTRK inhibitor before and
                           > they have no satisfactory treatment options                                                                         (Cancer Drugs Fund)

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,
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 TA449  unresectable or metastatic neuroendocrine tumours (NETs) of pancreatic origin in adults with progressive  disease.
                                                                                                                                                                                    (NHS England Commissioned) 

RED   Gilteritinib [Xospata] 40mg tablets
NICE TA642  recommended as an option for treating relapsed or refractory FLY3-mutation-positive acute myeloid leukaemia in 
                      adults only if the company provides gilteritinib according to the commercial arrangement.
                                                                                                                                                                                    (NHS England Commissioned)

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
NICE TA545  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.                                                                            (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 [Glivec]
NICE TA326  Recommended as an option as adjuvant treatment for up to 3 years for adults who are at high risk of relapse
                      after surgery for KIT (CD117)-positive gastrointestinal stromal tumours, as defined by the Miettinen 2006 crtieria
                      (based on tumour size, location and mitotic rate).
NICE TA425  This guidance replaces NICE TA421                                                                                          (NHS England Commissioned)  
                
NICE TA426  Recommended as an option for untreated,  chronic-phase Philadelphia-chromosome- positive chronic myeloid 
                      leukaemia in adults
                      [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    Isatuximab [Sarclisa®]
NICE TA658    Isatuximab plus pomalidomide and dexamethasone is recommended for use within the Cancer Drugs fund,  as an  
                       option for treating relapsed and refractory multiple myeloma in adults who have had lenalidomide and a 
                       proteasome inhibitor, and whose disease has progressed on their last treatment, only if:
                           >  they have had 3  previous lines of treatment
                           >  the conditions in the managed access agreement for isatuximab plus pomalidomide and dexamethasone are 
                               followed.                                                                                                                                                     
                                                                                                                                                                              (NHS England Commissioned)    
  

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   Larotrectinib
NICE TA630     Recommended for use within the Cancer Drugs Fund as an option for treating neurotrophic tyrosine receptor kinase
                         (NTRK) fusion-positive solid tumours in adults and children if:
                             > the disease is locally advanced or metastatic or surgery could cause severe health problems and 
                             > they have no satisfactory treatment options
                         It is recommended only if the conditions in the managed access agreement for larotrectinib are followed

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   Lorlatinib tablets 25mg, 100mg {Lorviqua)                                                                                   (NHS England Commissioned) 
NICE TA628     Recommended, within its marketing authorisation, as an option for treating anaplastic lymphoma kinase (ALK) - 
                         positive advanced small-cell lung cancer in adults whose disease has progressed after:
                                >  alectinib or ceritinib as the first ALK tyrosine kinase inhibitor or
                                >  crizotinib and at least 1 other ALK tyrosine kinase inhibitor

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     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 Drugs 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   
NICE TA528    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 that has responded to the most
                        recent course of platinum-based chemotherapy in adults. see guidance for further information.    (Cancer Drugs Fund)  
NICE TA673    Recommended for use within the Cancer Drugs Fund as an option for maintenance treatment for advanced 
                        (FIGO stages 3 and 4) high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer after response to
                        first-line platinum-based chemotherapy in adults. It is recommended only if the managed access agreement
                        for niraparib.                                                                                                                                                   (Cancer Drugs Fund)

RED   Nivolumab 
NICE TA384     intravenous infusion 10mg/ml is recommended as an option by NICE for treating advanced (unresectable or  
                         metastatic) melanoma. 
NICE TA400.    in combination with ipilimumab is recommended, within its marketing 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 TA417    recommended as an option for previously treated advanced renal  cell carcinoma in adults.
                        (updated September 2017 after a change  to the commercial arrangements)
NICE TA462    recommended as an option for treating relapsed or refractory classical Hodgkin lymphoma in adults after autologous                         stem cell transplant and treatment with brentuximab vedotin. (updated September 2017 after a change to the 
                        commercial arrangements)    
NICE TA484     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
NICE TA490    recommended for use as an option for treating squamous cell carcinoma of the head and neck in 
                        adults whose disease has progressed on platinum-based chemotherapy.               (NHS England Cancer Drug Fund)
NICE TA581    with ipilimumab is recommended for use 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)
NICE TA655    Recommended as an option for treating locally advanced  or metastatic squamous non-small-cell lung cancer in 
                        adults after chemotherapy, only if:
                            > it is stopped at 2 years of uninterrupted treatment, or earlier if their disease progresses and 
                            > they have not had a PD-1 or PD-L1 inhibitor before.                                              
                        [Replaces NICE TA483]                                                                                                                 (NHS England Commissioned)
NICE TA558    recommended 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 TA684   Recommended as an option, within its marketing authorisation, 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
                       company provides nivolumab according to the commercial arrangement.                       (Cancer Drug Fund)

RED   Obinutuzumab [Gazyvaro]
NICE TA513    Recommended as an option for untreated advanced follicular lymphoma (that is, first as induction treatment
                        with chemotherapy, then alone as maintenance therapy), only if:
                          > the person has a Follicular Lymphoma International Prognostic Index score of 2 or more
                          > the company provides obinutuzumab with the discount agreed in the patient access scheme
                                                                                                                                                                                 (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  [Tagrisso]             
NICE TA653   Recommended as an option for treating epidermal growth factor receptor T790M mutation-positive locally advanced
                       or metastatic non-small-cell lung cancer in adults only if:
                          > their disease has progressed after first-line treatment with an EGFR tyrosine kinase inhibitor and
                          > the company provides osimertinib according to the commercial arrangement
                       [Replaces NICE TA416]                                                                                                             (NHS England Commissioned )
 
NICE TA654   Recommended within its marketing authorisation, as an option for untreated locally advanced or metastatic 
                       epidermal growth factor receptor mutation-positive non-small-cell lung cancer in adults.
                       [Replaces NICE TA621]                                                                                                             (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
NICE TA428   Recommended 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.                                                            (NHS England Commissioned) 
NICE TA519   Recommended as an option for treating locally advanced or metastatic urothelial carcinoma after 
                       platinum-containing chemotherapy. 
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 TA531   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.
                       (replaces NICE TA447)                                                                                                           (NHS England Commissioned)  
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 in adults who have had complete resection.             (NHS England Cancer Drug Fund)
NICE TA557   Recommended for use within the Cancer Drugs Fund, with pemetrexed and platinum chemotherapy, as an option 
                       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) 
NICE TA600   Recommended for use within the Cancer Drugs Fund, with carboplatin and paclitaxel, 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
                                                                                                                                                                          (NHS England Cancer Drug Fund) 
NICE TA661  Recommended as an option for untreated metastatic or unresectable recurrent head and neck squamous cell 
                     carcinoma in adults whose tumours express PD-L1 with a combined positive score of 1 or more. 
                                                                                                                                                                           (NHS England Commissioned)  
NICE TA683  Recommended as an option with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous 
                      non-small-cell lung cancer in adults whose tumours have no epidermal growth factor receptor-positive or anaplastic
                      lymphoma kinase-positive mutations. This is only if:
                          > it is stopped at 2 years of uninterrupted treatment, or earlier if the disease progresses and
                          > the company provides pembrolizumab according to the commercial arrangement     (Cancer Drug Fund)

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 (Kisqali)
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.
NICE TA687   Recommended as an option, plus fulvestrant , for treating hormone receptor-positive, human epidermal growth factor
                       receptor 2 (HER-2) - negative, locally advanced or metastatic breast cancer in adults who have had previous 
                       endocrine therapy only if:
                           > examestane plus everolimus is the most appropriate alternative to a cyclin-depnedent kinase 4 and 6 (CDK 4/6)
                              inhibitor, and
                           > the company provides ribociclib according to the commercial arrangement                          (Cancer Drug Fund)

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.                                                                                                                                                 (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®)
NICE TA185  [updated February 2021]
                     Recommended as a treatment option for people with advanced soft tissue sarcoma if:
                     >    treatment with anthracyclines and ifosfamide has failed or
                     >    they are intolerant of or have contraindications for treatment with anthracyclines and ifosfamide
                     >    Trabdectedin is only recommended if the company provides it according to the commercial arramgement
                                                                                                                                                                                  (NHS England Commissioned) 

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 
NICE TA34     Trastuzumab in combination with paclitaxel (combination trastuzumab is currently only licensed for use with                
                       paclitaxel) is recommended as an option for people with tumours expressing human epidermal growth factor
                       receptor 2 (HER2) scored at levels of 3+ who have not received chemotherapy for metastatic breast cancer and in
                       whom anthracycline treatment is inappropriate.
NICE TA208  Trastusumab [Herceptin], in combination with cisplatin and capecitabine or 5-fluorouracil, is recommended as an
                       option for the treatment of people with human epidermal growth factor receptor 2 (HER2_-positive metastatic
                       adenocarcinoma of the stomach or gastro-oesophageal junction who:
                          °  have not received prior treatment for their metastatic disease and 
                          °  have tumours expressing hig levels of HERs as defined by a positive immunohistochemistry score of 3 (IHC3 
                              positive)

RED    Trastuzumab emtansine [Kadcyla®]
NICE TA458   Trastuzumab emtansine is recommended, within its marketing authorisation, 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 - updated (replaces TA371).   
                                                                                                                                                                       (NHS England Cancer Drug Fund)
NICE TA632  Trastuzumab emtansine is recommended, within its marketing authorisation, as an option for the adjuvant 
                       treatment of human epidermal growth g=factor receptor 2 (HER2)- positive early breast cancer in adults who have had
                       residual invasive disease in the breast or lymph nodes after neoadjuvant taxane-based and HER2-targeted therapy.
                       It is recommended only if the company provides trastuzumab emtansine according to the commercial arrangement
                                                                                                                                                                     NHS England Commissioned

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  [Venclyxto]
NICE TA487  Recommended as an option within the Cancer Drugs Fund , within its marketing  authorisation, for treating 
                      chronic lymphocytic leukaemia
NICE TA561  Venetoclax with rituximab - recommended, within its marketing authorisation, as an option for treating chronic
                      lymphocytic leukaemia in adults who have had at least 1 previous therapy.    (NHS England Cancer Drugs Fund)
NICE TA663   Venetoclax plus obinutuzumab is recommended as an option for untreated chronic lymphocytic leukaemia [CLL] in    
                       adults, only if:
                             >  there is a 17p deletion or TP53 mutation, or
                             >  there is no 17p deletion ot TP53 mutation, and fludarabine plus cyclophosphamide and rituximab [FCR], or 
                                 bendamustine plus rituximab [BR], is unsuitable, and
                             >  the companies provide the drugs according to the commercial arrangements.
                        Venetoclax plus obinutuzumab is recommended for use within the Cancer drugs Fund as an option for untreated CLL
                        in adults, only if:
                            >  there is no 17p deletion or TP53 mutation, and FCR or BR is suitable, and
                            >  the conditions in the managed access agreement for venetoclax plus obinutuxumab are followed