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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

Chemotherapy drugs are frequently given in combination.

Disease specific protocols are approved at local and network level.

Only approved protocols should be used. All chemotherapy treatment decisions should be made by a consultant grade oncologist or haematologist, with input from the relevant multidisciplinary team. 

 Chemotherapy drugs, including oral therapies must be prescribed, dispensed and administered only by suitably trained staff. 

Paediatric cancer therapies are initiated and prescribed from tertiary cancer centres. The exception is maintenance treatment for some cancers, which is prescribed by designated paediatricians only.

Cancer Drugs Fund (CDF) - Drug List

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08.03  Expand sub section  Sex hormones and hormone antagonists in malignant disease
08.03.01  Expand sub section  Oestrogens
Diethylstilbestrol
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08.03.02  Expand sub section  Progestogens
Megestrol Acetate
(Megace®)
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08.03.03  Expand sub section  Androgens
08.03.04  Expand sub section  Hormone antagonists to top
08.03.04.01  Expand sub section  Breast cancer
Anastrozole
(Breast cancer)
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Exemestane
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Letrozole
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Palbociclib (Ibrance®)
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Red
High Cost Medicine
Cancer Drugs Fund
 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Ribociclib (Kisqali®)
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Red
High Cost Medicine
Cancer Drugs Fund
 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Tamoxifen
(Breast cancer/ mastocytosis)
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08.03.04.02  Expand sub section  Gonadorelin analogues
Degarelix (Firmagon®)
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Link  Degarelix Shared Care Agreement (SCA)
Link  IMOC Degarelix Letter
Link  NICE TA404: Degarelix for treating advanced hormone-dependent prostate cancer
08.03.04.02  Expand sub section  Anti-androgens
Abiraterone (Zytiga®)
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Red
High Cost Medicine
 
Link  NICE TA259: Abiraterone for castration resistant prostate cancer
Link  NICE TA387:Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
Bicalutamide
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Cyproterone
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Enzalutamide (Xtandi®) Black Triangle
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Red
High Cost Medicine
 
Link  NICE TA316: Enzalutamide for prostate cancer
Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
Flutamide (Drogenil®)
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Goserelin (Zoladex®)
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Leuprorelin Acetate
(Prostap® SR)
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Triptorelin
(Gonapeptyl Depot®)
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08.03.04.03  Expand sub section  Somatostatin analogues
Lanreotide
(Somatuline Autogel®)
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Red
High Cost Medicine
NHS England

NHSE funded

 
Lanreotide
(Somatuline® LA)
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Red
NHS England

NHSE funded

 
Octreotide
(Sandostatin Lar®)
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Red
High Cost Medicine
NHS England

NHSE funded

 
Octreotide
(Sandostatin®)
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Red
High Cost Medicine
NHS England

NHSE funded

 
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Drugs that may be initiated, stabilised and maintained by primary, secondary or tertiary care Secondary and tertiary care prescribing may be continued by primary care. [this does not indicate first/second line choice]  

Green Hospital

Items used by the Hospital but would not normally be continued into primary care. Primary care prescribers can change to GREEN first or second.   

Green plus

Initiation of drugs by primary care following written advice from secondary/ tertiary care advice.  

Yellow

Drugs that may be continued in primary care following initiation and stabilisation in secondary/tertiary care  

Amber

Items requiring a shared care agreement. These items should be initiated and stabilised by secondary or tertiary care. The GP should only be asked to take over prescribing through a formal shared care agreement. Secondary care will be expected to continue prescribing until the agreement is made.  

Red

Hospital/ Trust ONLY. These are items the secondary and tertiary care are responsible for prescribing and will need to continue to prescribe for long term maintenance. These items will NOT be prescribed in primary care. But primary care should be informed the patient is receiving these items. This will include NHSE funded items requiring repatriation.  

GP - Black

Items covered by NHSE ‘Should not prescribe in primary care list’ – See CCG policy on Drugs of limited clinical value  

GP - Grey

Grey List: Items covered by NHSE ‘Should not prescribe in primary care list’ that are not to be routinely prescribed but may be suitable in a defined population – See CCG policy on Drugs of limited clinical value  

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