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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 8 - Malignant disease and immunosuppression 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
08.01.05 Other antineoplastic drugs
08.01.05 Amsacrine
08.01.05 Arsenic trioxide
08.01.05 Bevacizumab
08.01.05 Bexarotene
08.01.05 Bortezomib
08.01.05 Brentuximab vedotin
08.01.05 Cetuximab
08.01.05 Crisantaspase
08.01.05 Dacarbazine and Temozolomide
08.01.05 Erlotinib
08.01.05 Hydroxycarbamide
08.01.05 Imatinab
08.01.05 Ipilimumab
08.01.05 Mitotane
08.01.05 Panitumumab
08.01.05 Pentostatin
08.01.05 Platinum compounds
08.01.05 Porfimer sodium and temoporfin
08.01.05 Procarbazine
08.01.05 Protein kinase inhibitors

Acalabrutinib (Calquence®)
(100mg Capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA 689 Acalabrutinib for treating chronic lymphocytic leukaemia

Afatinib (Giotrif®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
20mg, 30mg, 40mg & 50mg Tablets

Approved in accordance with NICE TA310 for the treatment of metastatic non-small-cell lung cancer.

BNF BNFc SPC
NICE TA310: Lung cancer (non small cell, EGFR mutation positive) - afatinib

Alectinib 150mg (Alecsena®)
(Capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.


Approved in accordance with the following NICE TAs:

BNF BNFc SPC
NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer NICE TA1014: Alectinib for adjuvant treatment of ALK-positive non-small-cell lung cancer

Asciminib (Scemblix®)
(20mg and 40mg f/c tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA813: Asciminib for treating chronic myeloid leukaemia after 2 or more tyrosine kinase inhibitors

Avapritinib (Ayvakyt®)
(25mg, 50mg, 100mg & 200mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA for the treatment of advanced systemic macrocytosis only:

BNF BNFc SPC
NICE TA1012: Avapritinib for treating advanced systemic mastocytosis

Cabozantinib (Cabometyx®)
(Tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved according to NICE TA's below.

BNF BNFc SPC
NICE TA463: Cabozantinib for previously treated advanced renal cell carcinoma NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma NICE TA849: Cabozantinib for previously treated advanced hepatocellular carcinoma NICE TA928: Cabozantinib for previously treated advanced differentiated thyroid cancer unsuitable for or refractory to radioactive iodine (NOT RECOMMENDED) NICE TA964: Cabozantinib with nivolumab for untreated advanced renal cell carcinoma

Cabozantinib (Cometriq®)
(Capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved according to NICE TA516.

BNF BNFc SPC
NICE TA516: Cabozantinib for treating medullary thyroid cancer

Erdafitinib (Balversa®)
(3mg, 4mg, 5mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA1062: Erdafitinib for treating unresectable or metastatic urothelial cancer with FGFR3 alterations after a PD-1 or PD-L1 inhibitor

Erlotinib (Tarceva®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
100mg & 150mg Tablets

Restricted to prescribing in line with NICE TA258 & TA374.
BNF BNFc SPC
NICE TA258: Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy

Everolimus (Afinitor®)

RED
Restricted Drug Restricted
Commissioned by Not NHSNHSEngland for some indications.
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

To be prescribed by specialists in line with NICE TA421, TA432 & TA449.
BNF BNFc SPC
NICE TA421: Everolimus with Exemestane for treating advanced breast cancer after endocrine therapy NICE TA432: Everolimus for advanced renal cell carcinoma after previous treatment NICE TA449: Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease

Fruquintinib (Fruzaqla®)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA1079: Fruquintinib for previously treated metastatic colorectal cancer

Futibatinib (Lytgobi®)
(4 mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s) only:

BNF BNFc SPC BlueTeq
NICE TA1005: Futibatinib for previously treated advanced cholangiocarcinoma with FGFR2 fusion or rearrangement

Gefitinib (Iressa®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
250mg Film Coated Tablets

Approved in accordance with NICE TA192 for the treatment of locally advanced or metastatic non-small-cell lung cancer.
BNF BNFc SPC
NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib

Gilteritinib (Xospata®)
(40 mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High Cost drug form required - see link from Formulary homepage.

Ristricted for use in accordance with the following NICE TA(s):-

BNF BNFc SPC BlueTeq
NICE TA 642 Gilteritinib for treating relapsed or refractory acute myeloid leukaemia

Imatinib (Gilvec®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
100mg & 400mg Tablets

Approved in accordance with the NICE TA's below.

Restricted - must only be prescribed by staff with specialist training in Oncology or Haematology
BNF BNFc SPC
NICE TA209: Gastrointestinal stromal tumours (unresectable/metastatic) - imatinib NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating resistant CML NICE TA426: Dasatinib, nilotinob and imatinib for untreated CML NICE TA70: Leukaemia (chronic myeloid) - imatinib NICE TA86: Gastro-intestinal stromal tumours (GIST) - imatinib

Mobocertinib (Exkivity®)
(40mg capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA855: Mobocertinib for treating EGFR exon 20 insertion mutation-positive advanced non-small-cell lung cancer after platinum-based chemotherapy

Momelotinib (Omjjara®)
(100mg, 150mg, 200mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA957: Momelotinib for treating myelofibrosis-related splenomegaly or symptoms

Nilotinib (Tasigna®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
150mg & 200mg Capsules

Approved in accordance with NICE TA425 and 426 for untreated chronic myeloid leukaemia.

BNF BNFc SPC
NICE TA425: Dasatinib, nilotinib and high-dose imatinib for treating resistant CML NICE TA426: Dasatinib, nilotinib and imatinib for untreated CML

Nintedanib

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
100mg & 150mg Capsules

Approved in accordance with NICE TA347 for the treatment of metastatic non-small-cell lung cancer.
BNF BNFc SPC
NICE TA347: Nintedanib for previously treated locally advanced, metastatic, or locally recurrent non‑small‑cell lung cancer

Osimertinib 40mg, 80mg (Tagrisso® )
(Tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from formulary homepage

Prescribe according to criteria from the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA653: Osimertinib for treating EGFR T790M mutation-positive advanced non-small-cell lung cancer NICE TA654: Osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer NICE TA761: Osimertinib for adjuvant treatment of EGFR mutation-positive non-small-cell lung cancer after complete tumour resection NICE TA1043: Osimertinib for adjuvant treatment of EGFR mutation-positive non-small-cell lung cancer after complete tumour resection NICE TA1060: Osimertinib with pemetrexed and platinum-based chemotherapy for untreated EGFR mutation-positive advanced non-small-cell lung cancer

Palbociclib 75mg, 100mg, 125mg (Ibrance®)
(Capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage. 

Approved in accordance with the following NICE TAs:

NB : TA 619 is funded via the Cancer Drugs Fund

BNF BNFc SPC
NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer NICE TA619: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer NICE TA836: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy

Pazopanib (Votrient®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in line with NICE TA215.
BNF BNFc SPC
NICE TA215: Renal cell carcinoma (first line metastatic) - pazopanib

Quizartinib (Vanflyta®)
(17.7 mg, 26.5 mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA1013: Quizartinib for induction, consolidation and maintenance treatment of newly diagnosed FLT3-ITD-positive acute myeloid leukaemia

Regorafenib 40mg (Stivarga® )
(Tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with the NICE TAs below.

BNF BNFc SPC
NICE TA488:Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours NICE TA514: Regorafenib for previously treated advanced hepatocellular carcinoma NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma NICE TA866: Regorafenib for previously treated metastatic colorectal cancer

Ribociclib 200mg
(Tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage. 

Approved in accordance with the following NICE TA(s):-

 

BNF BNFc SPC
NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer NICE TA593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer (replaced by TA687) NICE TA687: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy NICE TA1086: Ribociclib with an aromatase inhibitor for adjuvant treatment of hormone receptor-positive HER2-negative early breast cancer at high risk of recurrence

Sorafenib 200mg (Nexavar®)
(Tablets)

RED
Restricted Drug Restricted

HIgh cost drug (Cancer Drug Fund).

Prescribing by specialists in line with NICE TA474 and TA535.

BNF BNFc SPC
NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine

Sunitinib (Sutent®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in line with NICE TA's below.
BNF BNFc SPC
NICE TA169: Renal cell carcinoma - sunitinib NICE TA178: Renal cell carcinoma NICE TA179: Gastrointestinal stromal tumours - sunitinib NICE TA449:Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease

Tepotinib (Tepmetko ®)
(225mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.


Approved in accordance with NICE TA789:

BNF BNFc SPC
NICE TA789: Tepotinib for treating advanced non-small-cell lung cancer with MET gene alterations

Tucatinib (Tukysa®)
(50mg, 150mg film coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.


Approved in accordance with NICE TA786:

BNF BNFc SPC
NICE TA786 Tucatinib with trastuzumab and capecitabine for treating HER2-positive advanced breast cancer after 2 or more anti-HER2 therapies

Vemurafenib (Zelboraf®)

RED
Restricted Drug Restricted
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in line with NICE TA176 & TA269.
BNF BNFc SPC
MHRA Drug Safety Update (November 2015) - Vemurafenib (Zelboraf▼): risk of potentiation of radiation toxicity NICE TA176: Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma NICE TA269: Melanoma (BRAF V600 mutation positive, unresectable metastatic) - vemurafenib

Zanubrutinib (Brukinsa®)
(80 mg hard capsules)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or High cost drug form required - see link from Formulary homepage.

For use in acordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA833: Zanubrutinib for treating Waldenstrom’s macroglobulinaemia NICE TA931: Zanubrutinib for treating chronic lymphocytic leukaemia NICE TA978: Zanubrutinib with obinutuzumab for treating relapsed or refractory B-cell follicular lymphoma after 2 or more treatments (TERMINATED APPRAISAL) NICE TA1001: Zanubrutinib for treating marginal zone lymphoma after anti-CD20-based treatment NICE TA1081: Zanubrutinib for treating relapsed or refractory mantle cell lymphoma

Larotrectinib (Vitrakvi® )
(20mg/mL oral solution)

RED
Restricted Drug Restricted

 FOR ALL PRESCRIBING - Blueteq or High Cost drug form required - see link from Formulary homepage.

Restricted use in accordance with the following NICE TA as part of the Cancer Drugs Fund

BNF BNFc SPC
NICE TA 630 Larotrectinib for treating NTRK fusion-positive solid tumours
08.01.05 Taxanes
08.01.05 Topoisomerase I inhibitors
08.01.05 Trabectedin
08.01.05 Trastuzumab
08.01.05 Tretinoin
08.01.05 Vismodegib
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.