829 Targeted therapy responsive malignancy - Milton Keynes Formulary

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8.2.9 Targeted therapy responsive malignancy

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First line drugs

Second line drugs

Specialist drugs

Secondary care drugs

Traffic light status (TLS) explained:

• Green: Routine prescribing within licensed indication
• Amber 1: specialist recommendation followed by GP initiation and continuation
• Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
• Amber 3: specialist initiation and stabilisation followed by GP continuation
• Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
• Red: Hospital or specialist prescribing only

 

Proteasome Inhibitors

 

Bortezomib

• Injection 3.5mg

Note:

• Use as per NICE TA370 Bortezomib for previously untreated mantle cell lymphoma (December 2015)
• Use as per NICE TA311 Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation (April 2014)
• Use as per NICE TA228 Bortezomib and thalidomide for the first‑line treatment of multiple myeloma (July 2011)
• Use as per NICE TA129 Bortezomib monotherapy for relapsed multiple myeloma (October 2007)

 

Ixazomib

• Ninlaro^® Capsules 2.3mg, 3mg, 4mg

Note:

• Use as per NICE TA505: Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma (February 2018)

 

Protein Kinase Inhibitors

 

Abemaciclib

• Tablet 150mg
• Note:
• Use as per NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy (May 2019)
•  
• Use as per NICE TA563 Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer (May 2019)

 

Afatinib

• Tablet 20mg, 30mg, 40mg, 50mg

Note:

• Use as per NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer (April 2014)

 

Alectinib

• Capsules 150mg

Note:

• Use as per NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer (Aug 2018) 

 

 

Axitinib

• Inlyta^® Tablet 1mg, 3mg, 5mg, 7mg

Notes:

• Use as per NICE TA333: Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment(February 2015)
•  

Binimetinib

• Tablet 45mg

Notes:

• Use as per NICE TA562 Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma (May 2019)

 

Bosutinib

• Bosulif^® Tablets 100mg, 500mg

Notes: 

• MHRA/CHM Advice: BCR-ABL tyrosine kinase inhibitors: risk of hepatitis B reactivation (May 2016)
• Use as per NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia (August 2016)

Brigatinib

• Alunbrig^® 30 mg, 90mg, 180mg film coated tablets

•  
• Note:
• Use as per NICE TA571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib (March 2019)

 

Cabozantinib

• Cometriq^® Capsules 20mg, 80mg

• Cabometyx® 20mg, 40mg, 60mg tablets

Notes:

• Use as per NICE TA542: Cabozantinib (Cabometyx®) for untreated advanced renal cell carcinoma (October 2018)
• Use as per NICE TA516: Cabozantinib (Cometriq) for treating medullary thyroid cancer (March 2018).
• Use as per NICE TA463: Cabozantinib (Cabozantinib) for previously treated advanced renal cell carcinoma (August 2017)
• NHSE Position Statement.

 

Ceritinib

• Zykadia^® Capsule 150mg

Note:

• Use as per NICE TA500: Ceritinib for untreated ALK-positive non-small-cell lung cancer (January 2018)

• Use as per NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer (June 2016)

 

Crizotinib

• Xalkori^® Capsules 200mg, 250mg 

Notes:

• Use as per NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer (July 2018)

• Use as per NICE TA422: Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer (December 2016)

• Use as per NICE TA406: Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer (September 2016)

 

 

Dabrafenib

• Capsule 50mg, 75mg

Notes:

• Use as per NICE TA544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma (October 2018)
• Use as per NICE TA321: Dabrafenib for treating unresectable or metastatic BRAF V600 mutation positive melanoma(October 2014)

 

Dasatinib

• Sprycel^® Tablets film-coated 20mg, 50mg, 80mg, 100mg, 140mg  

Notes:

• Use as per NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia (December 2016)

• Use as per NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia (December 2016)

• MHRA/CHM advice: Risk of hepatitis B virus reactivation with BCR-ABL tyrosine kinase inhibitors (May 2016)

 

Encorafenib

• Capsule 300mg

Notes:

• Use as per NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma (May 2019)

 

 

Erlotinib

• Tarceva^® Tablet film coated 25mg, 100mg, 150mg 

Notes:

• Use as per NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy (December 2015)

• Use as per NICE TA258: Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small cell lung cancer (June 2012)

• MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

• Use as per NICE TA227: Erlotinib monotherapy for maintenance treatment of non-small-cell lung cancer (June 2011)

 

Everolimus

• Afinitor^® Tablets 2.5mg, 5mg, 10mg
• Certican^® Tablets 250 microgram, 750 microgram 

Notes:

• Use as per NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people (October 2017)

• Use as per NICE TA481: Immunosuppressive therapy for kidney transplant in adults (October 2017)

• Use as per NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease (June 2017)

• Use as per NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy (December 2016)

• Use as per NICE: TA432 Everolimus for advanced renal cell carcinoma after previous treatment (February 2017)  

 

 

Gefitinib

• Tablets 250mg

Notes:

• Use as per NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy (December 2015)

• MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

• Use as per NICE TA192: Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer (July 2010)

 

 

Ibrutinib 

• Imbruvica^®Capsules 140mg

Notes:

• Use as per NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma (January 2018)

• Use as per NICE TA491: Ibrutinib for treating Waldenstrom’s macroglobulinaemia (November 2017)

• Use as per NICE TA429:  Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation (January 2017) 

 

Idelalisib

• Zydelig^® Tablet film-coated 100mg, 150mg 

Notes:

• Use as per NICE TA359: Idelalisib for treating chronic lymphocytic leukaemia (October 2015)

 

 

Imatinib

• Glivec^® Tablets film-coated 100mg, 400mg       

Notes:

• Use as per NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia (December 2016)

• Use as per NICE TA426: Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia (December 2016)

• Use as per NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours (review of NICE technology appraisal guidance 196) (November 2014)

• Use as per NICE TA209: Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours (November 2010)

• Use as per NICE TA86: Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours (October 2004)

• Use as per NICE TA70: Imatinib for chronic myeloid leukaemia (October 2003)
•  

 

 

Inotuzumab ozogamicin

• Besponsa® 1 mg powder for concentrate for solution for infusion

Notes:

• Use as per NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia (September 2018)

 

Lapatinib

• Tablet 250mg

Notes:

• Use as per NICE TA257: Lapatinib or trastuzumab in combination with an aromatase inhibitor for the first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2 (June 2012)

 

 

Lenvatinib

• Kisplyx^®Capsules 4mg, 10mg
• Lenvima^®Capsules 4mg, 10mg

Notes:

• Use as per NICE TA551: Lenvatinib for untreated advanced hepatocellular carcinoma (December 2018)
• Use as per NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine (Aug 2018) 
• Use as per NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma (January 2018)

 

 

Midostaurin

• Rydapt^®Capsules 25mg

Notes:

Use as per NICE TA523: Midostaurin for untreated acute myeloid leukaemia (June 2018)

 

Nilotinib

• Capsules 150mg, 200mg
  
  

Notes:

• Use as per NICE TA:425:Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia (December 2016)
• Use as per NICE TA: 426:Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia (December 2016)

 

Osimertinib

• Tablet 40mg,80mg

Notes:

• Use as per NICE TA416 Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer (October 2016) 

 

Palbociclib

• Capsules 75mg,100mg,125mg

Notes:

• Use as per NICE TA495 Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer (December 2017)

 

Pazopanib

• Tablet 200mg,400mg

Notes:

• Use as per NICE TA215 Pazopanib for the first-line treatment of advanced renal cell carcinoma (Feb 2011)

 

Ponatinib

• Tablet 15mg,30mg,45mg

Notes:

• Drug Safety Update:Ponatinib (Iclusig▼): reports of posterior reversible encephalopathy syndrome (October 2018)
• Use as per NICE TA451:Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia (June 2017)

 

 

Regorafenib

• Tablets 40mg

Notes:

Use as per NICE TA555 Regorafenib for previously treated advanced hepatocellular carcinoma (January 2019)

Use as per NICE TA488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours (November 2017) 

 

 

 

Ruxolitinib

• Tablet 5mg,10mg,15mg,20mg.

Notes:

• Use as per NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis (March 2016)

 

 

Sorafenib

• Tablet 200mg

Notes:

• Use as per NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine (Aug 2018)
• Use as per NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma (August 2009)
• Use as per NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma (September 2017)

 

 

Sunitinib

• Capsules 12.5mg,25mg,50mg

Notes:

Use as per NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease (June 2017)

Use as per NICE TA169: Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma ( March 2009

Use as per NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma (August 2009

Use as per NICE TA179: Sunitinib for the treatment of gastrointestinal stromal tumours (September 2009)

 

Temsirolimus

• Solution for infusion 25mgper 1ml

Notes:

• Use as per NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma (August 2009)

 

Trametinib

• Tablet 500 microgram, 2 mg

Notes:

• Use as per NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma (June 2016)

 

 

Tivozanib

• Fotivda® Capsules 1,340 micrograms

Notes:

• Use as per NICE TA512: Tivozanib for treating advanced renal cell carcinoma (March 2018).

Vemurafenib

• Tablet 240mg

Notes:

• Use as per NICE TA269: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation‑positive malignant melanoma (December 2012)

 

 

Protein Kinase Inhibitors - Antifibrotics

 

Nintedanib

• Capsule 100mg,150mg

Notes:

• Use as per NICE TA379 Nintedanib for treating idiopathic pulmonary fibrosis (January 2016)
• Use as per NICE TA347:Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer (July 2015)

 

 

Olaparib

• Lynparza® Capsules 50mg

Notes:

• Use as per NICE TA381: Olaparib 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 (Jan 2016)

 

Venetoclax

• Tablet 10mg,50mg,100mg

Notes:

• Use as per NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia (Feb 2019)
• Use as per NICE TA487: Venetoclax for treating chronic lymphocytic leukaemia (November 2017)

 

Vismodegib

• Capsule 150mg

Notes:

• Use as per NICE TA 489: Vismodegib for treating basal cell carcinoma (November 2017)

 

 

 

Antineovascularisation drugs

 

Aflibercept

• Solution for infusion 25mg/ml; 4ml and 8ml vials

Notes:

• Use as per NICE TA307 Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy (March2014)

 

 

 

 

 

 

 

Return to Chapter: 8. Immune System and Malignant Disease

Last updated by: Sheila Wood on 06-06-2019 13:42