8.1.5 Other Antineoplastic Drugs
Amsacrine (concentrate for intravenous infusion).
Bexarotene (capsules) is accepted for second line treatment of advanced cutaneous T-cell lymphoma [SMC 14/02].
Bortezomib (injection for intravenous or subcutaneous administration [SMC 822/12]) is accepted: as an option for the first-line treatment of multiple myeloma (in combination with an alkylating agent and a corticosteroid) as per NICE TA228; as monotherapy for progressive multiple myeloma in patients who have received at least one prior therapy and who have already undergone or are unsuitable for bone marrow transplantation [SMC 302/06], [SMC 126/04].
Carboplatin (injection).
Cetuximab (intravenous infusion, Erbitux®)
is accepted for locally advanced squamous cell cancer of the head and neck (in combination with radiation therapy), see SMC 276/06 for restrictions; for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, Kirsten rat sarcoma (KRAS) wild-type metastatic colorectal cancer in combination with chemotherapy SMC 543/09, subject to the continuing availability of the PAS in NHS Scotland.
Cisplatin (injection).
Crisantaspase (Asparaginase).
Dacarbazine (injection) is indicated for the treatment of patients with metastasized malignant melanoma.
Further indications for dacarbazine as part of a combination chemotherapy are:
- advanced Hodgkin's disease,
- advanced adult soft tissue sarcomas (except mesothelioma, Kaposi's sarcoma).
Docetaxel (concentrate for intravenous infusion) is accepted for restricted use for the induction treatment of patients (in whom induction chemotherapy is appropriate) with resectable locally advanced squamous cell carcinoma of the head and neck in combination with cisplatin and 5-fluorouracil [SMC 481/08]; restricted off-label use under specialist supervision as monotherapy for patients with advanced oesophagogastric cancer who progress after standard first-line chemotherapy with platinum-based regimens and are not eligible for, or decline clinical trial participation; as a treatment option for men with hormone-refractory metastatic prostate cancer only if their Karnofsky performance-status score is 60% or more [NICE TA101].
Bexarotene (capsules) is accepted for second line treatment of advanced cutaneous T-cell lymphoma [SMC 14/02].
Bortezomib (injection for intravenous or subcutaneous administration [SMC 822/12]) is accepted: as an option for the first-line treatment of multiple myeloma (in combination with an alkylating agent and a corticosteroid) as per NICE TA228; as monotherapy for progressive multiple myeloma in patients who have received at least one prior therapy and who have already undergone or are unsuitable for bone marrow transplantation [SMC 302/06], [SMC 126/04].
Carboplatin (injection).
Cetuximab (intravenous infusion, Erbitux®)
is accepted for locally advanced squamous cell cancer of the head and neck (in combination with radiation therapy), see SMC 276/06 for restrictions; for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, Kirsten rat sarcoma (KRAS) wild-type metastatic colorectal cancer in combination with chemotherapy SMC 543/09, subject to the continuing availability of the PAS in NHS Scotland.
Cisplatin (injection).
Crisantaspase (Asparaginase).
Dacarbazine (injection) is indicated for the treatment of patients with metastasized malignant melanoma.
Further indications for dacarbazine as part of a combination chemotherapy are:
- advanced Hodgkin's disease,
- advanced adult soft tissue sarcomas (except mesothelioma, Kaposi's sarcoma).
Erlotinib (25mg, 100mg, 150mg tablets, Tarceva®)
is accepted for:
- locally advanced or metastatic non-small cell lung cancer, after failure of at least one prior chemotherapy regimen see SMC 220/05 for restrictions,
- first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) activating mutations [SMC 749/11, subject to the continuing availability of the PAS in NHS Scotland].
Everolimus (5mg, 10mg tablets, Afinitor®)
is accepted for the treatment of unresectable or metastatic, well- or moderately-differentiated neuroendocrine tumours of pancreatic origin (pNET) in adults with progressive disease. Prescribing and monitoring within the acute service [SMC 777/12].
Hydroxycarbamide (hydroxyurea) 500mg capsules.
Imatinib (100mg, 400mg tablets).
Irinotecan
Nilotinib (150mg, 200mg capsules, Tasigna®)
is accepted (subject to the continuing availability of the PAS in NHS Scotland) for the treatment of:
- newly diagnosed chronic myeloid leukaemia in the chronic phase, as per NICE TA251 and
- chronic or accelerated phase Philadelphia chromosome positive chronic myeloid leukaemia in adult patients resistant to or intolerant of at least one prior therapy including imatinib, as per NICE TA241.
Oxaliplatin infusion is accepted for use in combination with fluorouracil and folinic acid, for the adjuvant treatment of stage III (Dukes' C) colon cancer after complete resection of the primary tumour [SMC 211/05].
Oxaliplatin injection is accepted for restricted off-label for the treatment of patients with advanced oesophageal and gastric cancer, suitable to receive combination chemotherapy in the Department of Oncology at ARI.
Paclitaxel
Paclitaxel albumin (intravenous infusion Abraxane®) is accepted for the treatment of metastatic breast cancer in patients who have failed first-line treatment for metastatic disease and for whom standard anthracycline containing therapy is not indicated. Use is restricted to patients who would otherwise receive docetaxel or 3-weekly solvent-based paclitaxel as second-line treatment for metastatic breast cancer.
Note that paclitaxel albumin may have substantially different pharmacological properties compared to other formulations of paclitaxel and is licensed for use in a 3-weekly dosage schedule [SMC 556/09].
Paclitaxel albumin (intravenous infusion Abraxane®) is accepted for the treatment of metastatic breast cancer in patients who have failed first-line treatment for metastatic disease and for whom standard anthracycline containing therapy is not indicated. Use is restricted to patients who would otherwise receive docetaxel or 3-weekly solvent-based paclitaxel as second-line treatment for metastatic breast cancer.
Note that paclitaxel albumin may have substantially different pharmacological properties compared to other formulations of paclitaxel and is licensed for use in a 3-weekly dosage schedule [SMC 556/09].
Pazopanib (200mg tablets, Votrient®)
is accepted for the first-line treatment of advanced renal cell carcinoma (RCC), subject to the continuing availability of the PAS in NHS Scotland [SMC 676/10].
Procarbazine
is accepted for the first-line treatment of advanced renal cell carcinoma (RCC), subject to the continuing availability of the PAS in NHS Scotland [SMC 676/10].
Procarbazine
Sunitinib (12.5mg tablets, Sutent®)
is accepted for:
- the treatment of unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumours with disease progression in adults, subject to the continuing availability of the PAS in NHS Scotland [SMC 698/11];
- the treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) after failure of imatinib mesilate treatment due to resistance or intolerance, subject to the continuing availability of the PAS in NHS Scotland [SMC 275/06];
- as a first-line treatment option for people with advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 [NICE TA169].
is accepted for:
- the treatment of unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumours with disease progression in adults, subject to the continuing availability of the PAS in NHS Scotland [SMC 698/11];
- the treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) after failure of imatinib mesilate treatment due to resistance or intolerance, subject to the continuing availability of the PAS in NHS Scotland [SMC 275/06];
- as a first-line treatment option for people with advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 [NICE TA169].
Temozolomide
Topotecan (capsules, Hycamtin®): NICE TA184 - oral topotecan is recommended as an option only for people with relapsed small-cell lung cancer for whom:
Topotecan (capsules, Hycamtin®)
: NICE TA184 - oral topotecan is recommended as an option only for people with relapsed small-cell lung cancer for whom: - re-treatment with the first-line regimen is not considered appropriate and
- the combination of cyclophosphamide, doxorubicin and vincristine (CAV) is contraindicated (for details of the contraindications to CAV see the summary of product characteristics for each of the component drugs).
Trastuzumab infusion is accepted for the treatment of patients with HER2 positive early breast cancer following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) [SMC 278/06].
Trastuzumab infusion
is accepted for the treatment of patients with HER2 positive early breast cancer following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) [SMC 278/06].Tretinoin