benefit drug list 3may2018 - bc cancer and forms...bc cancer benefit drug list may 2018 page 1 of 55...

BC Cancer Benefit Drug ListJuly 2018

of 70

Class I

Restricted Funding (R)

DRUGDOSAGE

FORMTUMOUR

SITEAPPROVED INDICATIONS

PROTOCOL CODES

CLASS NOTES

abiraterone tablet Genitourinary palliative therapy for metastatic, castration-resistant prostate cancer UGUPABI R

acitretin capsule Lymphoma reversal of early dysplastic and neoplastic stem changes LYNOS I

afatinib tablet Lungfirst-line treatment of epidermal growth factor receptor mutation-positive advanced non-small cell lung cancer with afatinib

LUAVAFAT I

aldesleukin injectable Pediatricpediatric patients with high risk neuroblastoma treated on the ANBL0032 study

I

alemtuzumab injectable Lymphomatreatment of fludarabine-refractory B-chronic lymphocytic leukemia and T-prolymphocytic leukemia

LYALEM I

aminolevulinic acid (LEVULAN® KERASTICK®)

topical solution Skin & Melanoma topical therapy for skin cancer with PDT (Photodynamic Therapy) SMPDT I

Only reimbursable when prescribed by physicians in the

Skin Tumour Group within the Skin PDT Program of the BC Cancer

Agencyamsacrine injectable Leukemia LKNOS I

anagrelide capsule Leukemiapatients with thrombocytosis related to a myeloproliferative disorder who have had an inadequate response to or are intolerant of hydroxyurea and/or interferon

LKANAG I

anastrozole tablet Breastneoadjuvant or adjuvant therapy for breast cancer using anastrozole in postmenopausal women

BRAJANAS I

anastrozole tablet Breastadjuvant ovarian suppression and aromatase inhibitor in premenopausal women with high-risk early stage breast cancer

BRAJLHRHAI I

anastrozole tablet Breastfirst or second line hormonal treatment for advanced breast cancer in postmenopausal women

BRAVANAS I

anastrozole tablet Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I

anastrozole tablet Breasttherapy of advanced breast cancer using palbociclib with aromatase inhibitor

UBRAVPALAI I

anastrozole (cont'd) tablet Gynecologyhormonal treatment for advanced endometrial cancer in postmenopausal women with contraindications to tamoxifen or intolerant of tamoxifen

GOENDAI I

4. For queries regarding other indications not specified, please contact the BC Cancer Compassionate Access Program Office at 604.877.6000 x 6277 or [email protected]

DEFINITIONSReimbursed for active cancer or approved treatment or approved indication only.Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to provide the appropriate clinical information for each patient.

2. Not Otherwise Specified (NOS) code only applicable to Class I drugs where indicated.

NOTES1. BC Cancer will reimburse, to the Communities Oncology Network hospital pharmacy, the actual acquisition cost of a Benefit Drug, up to the maximum price as determined by BC Cancer, based on the current brand and contract price. Please contact the OSCAR Hotline at 1-888-355-0355 if more information is required.

3. Intrahepatic use of chemotherapy drugs is not reimbursable unless specified.

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

anastrozole (cont'd) tablet Gynecology therapy for advanced ovarian cancer using an aromatase inhibitor GOOVAI I

arsenic trioxide injectable Leukemiafirst-line induction and consolidation therapy of acute promyelocytic leukemia using arsenic trioxide and tretinoin

LKATOATRA I

arsenic trioxide injectable Leukemiafirst-line induction and consolidation therapy of acute promyelocytic leukemia using arsenic trioxide, tretinoin and daunorubicin

LKATOP I

arsenic trioxide injectable Leukemiainduction and consolidation therapy of relapsed acute promyelocytic leukemia using arsenic trioxide

LKATOR I

asparaginase (KIDROLASE®)

injectable Lymphomatreatment of refractory or relapsing extranodal natural killer or T-cell lymphoma using asparaginase, methotrexate and dexamethasone

LYASPMEDEX I


injectable Lymphomatreatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I


injectable Leukemia LKNOS, LYNOS I

asparaginase-erwinia (ERWINASE®)

injectable Lymphomatreatment of refractory or relapsing extranodal natural killer or T-cell lymphoma using asparaginase, methotrexate and dexamethasone

LYASPMEDEX I


injectable Lymphomareatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I


injectable Leukemia patients allergic to KIDROLASE® LKNOS, LYNOS I

axitinib tablet Genitourinary therapy for metastatic renal cell carcinoma using axitinib UGUAXIT Razacitidine injectable Leukemia therapy of acute myeloid leukemia using azacitidine and sorafenib ULKAMLAS Razacitidine injectable Leukemia therapy of myelodysplastic syndrome ULKMDSA R

bacillus calmette guerin (BCG)

injectable Genitourinary therapy for high risk superficial transitional cell bladder cancer GUBCG I

bacillus calmette guerin (BCG) (cont'd)

injectable Genitourinarypalliative therapy for BCG-refractory superficial high-grade transitional cell carcinoma bladder with BCG and Interferon

GUBCGIFN I

bacillus calmette guerin (BCG)

injectable Skin & Melanoma malignant melanoma SMILBCG I

bendamustine injectable Lymphoma treatment of Non-Hodgkin Lymphoma with bendamustine ULYBEND R

bendamustine injectable Lymphoma treatment of Non-Hodgkin Lymphoma with bendamustine and rituximab ULYBENDR R

The three substrains of BCG available are considered

interchangeable by BC Cancer for the treatment of bladder cancer

(i.e., Montreal [PACIS] 120 mg = TICE [OncoTICE] 1 to 8 x 108

CFU = Connaught [ImmuCyst] 81 mg) BUT only the current contract brand is reimbursed at the current

contract price

patients allergic to KIDROLASE®

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

treatment of relapsed chronic lymphocytic leukemia with bendamustine ULYCLLBEND R

bendamustine injectable Lymphomatreatment of previously untreated chronic lymphocytic leukemia (CLL) with bendamustine and rituximab

ULYCLLFBR R

bendamustine injectable Lymphomatreatment of rituximab-refractory follicular lymphoma with obinutuzumab in combination with bendamustine

ULYOBBEND* R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

bevacizumab injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, bevacizumab and capecitabine

GICIRB I

bevacizumab injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, bevacizumab and capecitabine

GICOXB I

bevacizumab (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, folinic acid (leucovorin) and bevacizumab

GIFFIRB I

bevacizumab (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and bevacizumab

GIFFOXB I

bevacizumab (cont'd) injectable Neuro-Oncology patients with relapsed malignant gliomas CNBEV I

bevacizumab injectable Gynecologyprimary treatment of metastatic/recurrent cancer of the cervix with bevacizumab, carboplatin and paclitaxel

GOCXCATB I

bevacizumab injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and gemcitabine UGOOVBEVG R

bevacizumab injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and pegylated liposomal doxorubicin (CAELYX) UGOOVBEVLD R

bevacizumab injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and paclitaxel UGOOVBEVP R

bevacizumab injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and vinorelbine UGOOVBEVV R

bevacizumab (cont'd) injectable Sarcomatherapy for advanced solitary fibrous tumours and hemangiopericytoma using temozolomide and bevacizumab

USATEMBEV R

bexarotene capsule Lymphoma patients with refractory cutaneous T-cell lymphoma ULYMFBEX RApproval from Health Canada Special Access Programme is

required for each patient.

bicalutamide tablet Genitourinary nonsteroidal treatment of prostate cancer, at 50 mg po daily GUPNSAA INot reimbursed for vasomotor symptoms (hot flashes) or high

dose monotherapy

bleomycin injectable Gynecologytherapy of non-dysgerminomatous ovarian germ cell cancer using bleomycin, etoposide, and cisplatin

GOBEP I

bleomycin injectable Genitourinarycurative therapy for germ cell cancer using with bleomycin, etoposide, cisplatin for germ cell cancers

GUBEP I

bleomycin injectable Kaposi's Sarcomapalliative therapy for kaposi’s sarcoma using vinblastine alternating with vincristine

KSVB I

bleomycin injectable Lymphomatreatment of Hodgkin lymphoma with doxorubicin, bleomycin, vinblastine, and dacarbazine

LYABVD I

bleomycin injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. LYNOS)

I

blinatumomab injectable Leukemiatreatment of Philadelphia chromosome negative refractory or relapsed pre-B-cell acute lymphoblastic leukemia with blinatumomab

ULKBLIN R

Not reimbursed for pleurodesis

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

bortezomib injectable Myelomamaintenance therapy for multiple myeloma using bortezomib for patients with the high-risk chromosome abnormality

MYBORMTN I

injectable Myelomatreatment of multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide as induction pre-stem cell transplant

MYBORPRE I

bortezomib injectable Myelomatreatment of relapsed multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide

MYBORREL I

bortezomib (cont'd) injectable Myelomatreatment of multiple myeloma using melphalan, prednisone and weekly bortezomib with the option of substituting cyclophosphamide for melphalan

MYMPBOR I

bosutinib tablet Leukemia treatment of chronic myeloid leukemia using bosutinib ULKCMLB R

brentuximab vedotin injectable Lymphomatreatment of Hodgkin lymphoma and anaplastic large cell lymphoma with brentuximab vedotin

ULYBRENTUX R

adjuvant therapy post-autologous stem cell transplant (ASCT) for Hodgkin Lymphoma using brentuximab vedotin

ULYAJBV R

bromocriptine tablet, capsule Neuro-Oncology therapy for pituitary adenomas using bromocriptine CNB I

buserelininjectable, long-acting injectable

Breastadjuvant ovarian suppression and aromatase inhibitor in premenopausal women with high-risk early stage breast cancer

BRAJLHRHAI I

buserelin (cont'd) injectable Breastneoadjuvant or adjuvant therapy for breast cancer using a LHRH agonist and tamoxifen

BRAJLHRHT I

buserelin injectable Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I

buserelin injectable Breastcombination therapy with tamoxifen as palliative therapy for metastatic breast cancer

BRAVLHRHT I

buserelin (cont'd) injectable Genitourinary therapy for prostate cancer using LHRH agonist GUPLHRH I

busulfan tabletNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. LKNOS)

I

busulfan injectable BMTmyeloablative conditioning therapy prior to hematopoietic stem cell transplantation for myeloid malignancies

BMTIVBUCY I

busulfan injectable Pediatric pediatric patients who cannot swallow oral busulfan I

cabazitaxel injectable Genitourinarypalliative therapy for metastatic castration resistant prostate cancer using cabazitaxel and prednisone

UGUPCABA R

cabergoline tablet Neuro-Oncology therapy for pituitary adenomas using cabergoline CNCAB I

Not reimbursed for endometriosis

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

capecitabine tablet Breast therapy of adjuvant breast cancer using capecitabine BRAJCAP I

capecitabine tablet Breast

metastatic breast cancer as first line treatment if anthracyclines and taxanes contraindicated, or where sidfect profile and/or treatment delivery concerns favour initial use of BRAVCAP; second or third line treatment of metastatic breast cancer that has previously responded to an anthracycline and taxane

BRAVCAP I

capecitabine tablet Breast

combination with lapatinib in advanced breast cancer patients with HER-2 expressing breast cancer whose cancer has progressed on one prior therapy with trastuzumab (HERCEPTIN)-based protocol in the advanced setting or who has relapsed on or within 12 months of adjuvant trastuzumab (HERCEPTIN)

UBRAVLCAP R

capecitabine tablet Breastcombination with trastuzumab (HERCEPTIN) as second-line treatment of HER-2 positive metastatic breast cancer after prior treatment with trastuzumab (HERCEPTIN)

UBRAVTCAP R

capecitabine tablet Gastrointestinal adjuvant therapy of colon cancer using capecitabine GIAJCAP I

capecitabine tablet Gastrointestinaladjuvant combination chemotherapy for stage III and IIB colon cancer with oxaliplatin

GIAJCAPOX I

capecitabine (cont'd) tablet Gastrointestinalfirst line palliative therapy of metastatic or unresectable colorectal adenocarcinoma in a patient either not suitable for or refusing GIIRFUFA

GIAVCAP I

capecitabine tablet Gastrointestinalpalliative therapy of metastatic neuroendocrine cancer using temozolomide and capecitabine

GIAVTZCAP I

capecitabine (cont'd) tablet Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan and capecitabine in patients unsuitable for GIFOLFIRI

GICAPIRI I

capecitabine (cont'd) tablet Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin and capecitabine

GICAPOX I

capecitabine (cont'd) tablet Gastrointestinalcombination with mitomycin and radiation therapy as curative combined modality therapy for carcinoma of the anal canal

GICART I

capecitabine (cont'd) tablet Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, bevacizumab and capecitabine

GICIRB I

capecitabine (cont'd) tablet Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, bevacizumab and capecitabine

GICOXB I

capecitabine (cont'd) tablet Gastrointestinalcurative-intent combined modality therapy for cancer of the anal canal, using cisplatin, capecitabine and radiation therapy

GICPART I

capecitabine (cont'd) tablet Gastrointestinaladjuvant chemotherapy of gastric cancer patients with D2 resection (node negative) or ineligible for adjuvant chemoradiation using oxaliplatin and capecitabine

GIGAJCOX I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

capecitabine (cont'd) tablet Gastrointestinaladjuvant chemotherapy of gastric cancer patients with completely resected gastric cancer using cisplatin and capecitabine and radiation therapy

GIGAJCPRT I

capecitabine (cont'd) tablet Gastrointestinal

palliative therapy of metastatic or locally advanced gastric, gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, or anal squamous cell carcinoma using cisplatin and capecitabine

GIGAVCC I

capecitabine (cont'd) tablet Gastrointestinalpalliative treatment of metastatic or locally advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma using cisplatin, capecitabine and trastuzumab (HERCEPTIN)

GIGAVCCT I

capecitabine (cont'd) tablet Gastrointestinaltreatment of operable cancer of the stomach, stomach-esophagus junction or lower 1/3 esophagus, given before and after surgery, using epirubicin, cisplatin and capecitabine

GIGECC I

capecitabine (cont'd) tablet Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and capecitabine

GIGAVEOCAP I

capecitabine (cont'd) tablet Gastrointestinaladjuvant chemotherapy for resected pancreatic adenocarcinoma using capecitabine and gemcitabine

GIPAJGCAP I

capecitabine (cont'd) tablet Gastrointestinalsecond line treatment of metastatic or unresectable pancreatic adenocarcinoma using capecitabine GIPAVCAP I

capecitabine (cont'd) tablet Gastrointestinaladjuvant combination chemotherapy for stage III rectal cancer with oxaliplatin

GIRAJCOX I

capecitabine (cont'd) tablet Gastrointestinaladjuvant capecitabine therapy for stage II and III rectal cancer previously treated with preoperative radiotherapy

GIRCAP I

capecitabine (cont'd) tablet Gastrointestinalcombined modality adjuvant therapy for high risk rectal carcinoma using capecitabine and radiation therapy

GIRCRT I

capecitabine (cont'd) tablet Gastrointestinalcombined modality adjuvant therapy for high risk rectal carcinoma using capecitabine, infusional fluorouracil and radiation therapy

GIRINFRT I

capecitabine (cont'd) tablet Head and Necktreatment of recurrent or metastatic nasopharyngeal cancer with capecitabine

HNNAVCAP I

carboplatin injectable Breastadjuvant treatment of HER-2 positive breast cancer using carboplatin, docetaxel and trastuzumab (HERCEPTIN)

BRAJDCARBT I

carboplatin (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using cisplatin and gemcitabine

BRAVGEMP I

carboplatin (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using trastuzumab (HERCEPTIN), paclitaxel and carboplatin as first-line treatment for advanced breast cancer

BRAVTPCARB I

carboplatin injectable Neuro-Oncology carboplatin and etoposide in the treatment of recurrent ependymoma CNCARV I

carboplatin injectable Gastrointestinalfirst-line palliative chemotherapy for advanced gallbladder cancer and cholangiocarcinoma using gemcitabine and cisplatin

GIAVPG I

carboplatin injectable Gastrointestinalneoadjuvant treatment of esophageal and gastroesophageal carcinomas using carboplatin, paclitaxel and radiation therapy

GIENACTRT I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

carboplatin (cont'd) injectable Gynecologyprimary adjuvant treatment of adenocarcinoma/adenosquamous cancer of the cervix with carboplatin and paclitaxel preceding or following irradiation with or without cisplatin

GOCXAJCAT I

carboplatin (cont'd) injectable Gynecologytreatment of advanced/recurrent non-small cell cancer of the cervix with carboplatin and docetaxel

GOCXCAD I

carboplatin (cont'd) injectable Gynecologyprimary treatment of advanced/recurrent non-small cell cancer of the cervix with carboplatin and paclitaxel

GOCXCAT I

carboplatin injectable Gynecologyprimary treatment of metastatic/recurrent cancer of the cervix with bevacizumab, carboplatin and paclitaxel

GOCXCATB I

carboplatin injectable Gynecologytreatment of primarily advanced or recurrent endometrial cancer using carboplatin and docetaxel

GOENDCAD I

carboplatin (cont'd) injectable Gynecologytreatment of primary advanced or recurrent endometrial cancer using carboplatin and paclitaxel

GOENDCAT I

carboplatin injectable Gynecologyprimary treatment of invasive epithelial ovarian, fallopian tube and primary peritoneal cancer, with no visible residual tumour (moderate-high risk) using carboplatin and docetaxel

GOOVCADM I

carboplatin injectable Gynecologysecond line treatment using docetaxel and carboplatin for epithelial ovarian cancer relapsing after primary treatment

GOOVCADR I

carboplatin (cont'd) injectable Gynecologyprimary treatment of visible residual (extreme risk) invasive epithelial ovarian cancer using carboplatin and docetaxel

GOOVCADX I

carboplatin (cont'd) injectable Gynecologytreatment of advanced ovarian cancer in patients who have progressed or recurred following first-line platinum-based treatment using carboplatin and gemcitabine

GOOVCAG I

carboplatin (cont'd) injectable Gynecologyfirst or second line therapy for invasive epithelial ovarian cancer using single-agent carboplatin

GOOVCARB I

carboplatin (cont'd) injectable Gynecologyprimary treatment of invasive epithelial ovarian, fallopian tube and primary peritoneal cancer, with no visible residual tumour (moderate-high risk) using carboplatin and paclitaxel

GOOVCATM I

carboplatin (cont'd) injectable Gynecologysecond line treatment using paclitaxel and carboplatin for epithelial ovarian cancer relapsing after primary treatment

GOOVCATR I

carboplatin (cont'd) injectable Gynecologyprimary treatment of visible residual (extreme risk) invasive epithelial ovarian cancer in ambulatory care settings using paclitaxel and carboplatin

GOOVCATX I

carboplatin (cont'd) injectable Gynecologyprimary treatment of advanced epithelial ovarian, primary peritoneal, or fallopian tube carcinoma using carboplatin and weekly paclitaxel

GOOVDDCAT I

carboplatin (cont'd) injectable Gynecology

primary treatment of stage III less than or equal to 1 cm visible residual invasive epithelial ovarian cancer or stage 1 grade 3 or stage II grade 3 papillary serous ovarian cancer using intravenous and intraperitoneal paclitaxel and intraperitoneal carboplatin

GOOVIPPC I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

carboplatin (cont'd) injectable Gynecologysecond line treatment for epithelial ovarian cancer relapsing after primary treatment using pegylated liposomal doxorubicin (PLD) and carboplatin

GOOVPLDC I

carboplatin (cont'd) injectable Gynecologytreatment of small cell or neuroendocrine carcinoma of gynecologic system origin using paclitaxel, cisplatin, etoposide and carboplatin with radiation

GOSMCCRT I

carboplatin (cont'd) injectable Genitourinary palliative therapy for urothelial carcinoma using cisplatin and gemcitabine GUAVPG I

carboplatin (cont'd) injectable Genitourinary therapy for transitional cell cancers using carboplatin-vinblastine GUBCV Icarboplatin (cont'd) injectable Genitourinary adjuvant therapy for stage I high risk seminoma using carboplatin GUSCARB I

carboplatin (cont'd) injectable Genitourinary therapy of genitourinary small cell tumors with a platin and etoposide GUSCPE I

carboplatin (cont'd) injectable Genitourinarytherapy of genitourinary small cell tumors with a platin and etoposide with radiation

GUSCPERT I

carboplatin (cont'd) injectable Head and Necktreatment of advanced squamous cell carcinoma of the head and neck cancer using fluorouracil and platinum

HNAVFUP I

carboplatin (cont'd) injectable Head and Necktreatment for unresectable, locoregionally recurrent or metastatic squamous cell carcinoma of the head and neck using paclitaxel and cisplatin or carboplatin

HNAVPC I

carboplatin (cont'd) injectable Head and Necktreatment of recurrent or metastatic squamous cell carcinoma of the head and neck with platinum and docetaxel

HNAVPD I

carboplatin (cont'd) injectable Head and Necktreatment of recurrent and metastatic squamous cell cancer with platinum and etoposide

HNAVPE I

carboplatin (cont'd) injectable Head and Neckcombined chemotherapy (carboplatin and fluorouracil) and radiation treatment for locally advanced squamous cell carcinoma of the head and neck

HNLACAFRT I

carboplatin (cont'd) injectable Head and Necktreatment for advanced nasopharyngeal cancer of the head and neck using platinum and fluorouracil

HNNAVFUP I

carboplatin (cont'd) injectable Head and Necktreatment of recurrent and/or metastatic nasopharyngeal cancer with platinum and etoposide

HNNAVPE I

carboplatin (cont'd) injectable Head and Necktreatment of locoregionally recurrent and/or metastatic nasopharyngeal cancer with platinum and gemcitabine

HNNAVPG I

carboplatin (cont'd) injectable Head and Necktreatment of recurrent or metastatic nasopharyngeal carcinoma with carboplatin and paclitaxel

HNNAVPC I

carboplatin (cont'd) injectable Lungadjuvant carboplatin and paclitaxel following resection of stage I, II and IIIA non-small cell lung cancer

LUAJPC I

carboplatin (cont'd) injectable Lungfirst-line treatment of advanced non-small cell lung cancer with carboplatin and paclitaxel

LUAVPC I

carboplatin (cont'd) injectable Lungtreatment of advanced non-small cell lung cancer with platinum and gemcitabine

LUAVPG I

carboplatin (cont'd) injectable Lungfirst-line treatment of advanced non-small cell lung cancer with platinum and pemetrexed

LUAVPP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

carboplatin (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using carboplatin and paclitaxel with radiation therapy

LULACATRT I

carboplatin (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using cisplatin and etoposide with radiation therapy

LULAPERT I

carboplatin (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using alternative dosing of cisplatin and etoposide with radiation therapy

LULAPE2RT I

carboplatin (cont'd) injectable Lung treatment of thymoma with cisplatin and etoposide LUOTPE I

carboplatin (cont'd) injectable Lung treatment of thymoma using cisplatin and etoposide with radiation therapy LUOTPERT I

carboplatin (cont'd) injectable Lungtherapy of extensive stage small cell lung cancer with cisplatin and etoposide

LUSCPE I

carboplatin (cont'd) injectable Lungtherapy of limited stage small cell lung cancer using cisplatin and etoposide with radiation

LUSCPERT I

carboplatin (cont'd) injectable Lungsecond line treatment of extensive stage small cell lung cancer (SCLC) with irinotecan with or without platinum

LUSCPI I

carboplatin (cont'd) injectable Lymphomatreatment of avanced stage large B-cell non-Hodgkin’s lymphoma with ifosfamide, carboplatin, etoposide and rituximab

ULYRICE R

carboplatin (cont'd) injectable Primary Unknownprimary treatment of cancer of unknown primary origin using carboplatin and paclitaxel

PUCAT I

carboplatin (cont'd) injectable Skin & Melanomatreatment of recurrent or metastatic Merkel cell carcinoma with cisplatin and etoposide

SMMCCPE I

carboplatin (cont'd) injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. HNNOS)

I

carfilzomib injectable Myelomatherapy of multiple myeloma using carfilzomib and dexamethasone with or without cyclophosphamide

UMYCARDEX R

carfilzomib injectable Myelomatherapy of multiple myeloma using carfilzomib, lenalidomide with dexamethasone

UMYCARLD R

carmustine injectable Lymphoma topical therapy in cutaneous T-cell lymphoma LYCARTOP I

carmustine injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. LKNOS)

I

cetuximab injectable Gastrointestinalpalliative third line treatment of metastatic colorectal cancer with wild-type KRAS using cetuximab and irinotecan

GIAVCETIR I

cetuximab (cont'd) injectable Head and Neckcombined cetuximab and radiation treatment for locally advanced squamous cell carcinoma of the head and neck

HNLACETRT I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

chlorambucil tablet Lymphoma low grade lymphoma and chronic lymphocytic leukemia LYCHLOR I

chlorambucil tablet Lymphomatreatment of indolent B-cell lymphoma and chronic lymphocytic leukemia with chlorambucil and rituximab

LYCHLRR I

chlorambucil tablet Lymphoma lymphoma palliative chemotherapy LYPALL I

chlorambucil (cont'd) tablet Lymphomatreatment of previously untreated chronic lymphocytic leukemia using obinutuzumab in combination with chlorambucil

ULYOBCHLOR R

chlorambucil (cont'd) tabletNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. LKNOS, LYNOS)

I

cisplatin injectable Breastpalliative therapy for metastatic breast cancer using cisplatin and gemcitabine

BRAVGEMP I

cisplatin injectable Neuro-Oncologyadjuvant lomustine, cisplatin and vincristine in adult high-risk medulloblastoma or other primitive neuroectodermal tumour

CNCCV I

cisplatin injectable Gastrointestinalfirst-line palliative chemotherapy for advanced gallbladder cancer and cholangiocarcinoma using gemcitabine and cisplatin

GIAVPG I

cisplatin injectable Gastrointestinalcurative-intent combined modality therapy for cancer of the anal canal, using cisplatin, capecitabine and radiation therapy

GICPART I

cisplatin injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using fluorouracil and cisplatin

GIEFUPRT I

cisplatin (cont'd) injectable Gastrointestinalhepatic trans-arterial chemoembolization for primary liver cancer or liver metastasis

GIEMBOL I

Note: cisplatin solution and cisplatin powder (SAP) only funded when prescribed by

specialists at BC Cancer VC and Royal Jubilee Hospital

cisplatin (cont'd) injectable Gastrointestinalpalliative chemotherapy for upper gastrointestinal tract cancer (gastric, esophageal, gall bladder carcinoma and cholangiocarcinoma) and metastatic anal cancer using infusional fluorouracil and cisplatin

GIFUC I

cisplatin (cont'd) injectable Gastrointestinalcombined modality curative therapy for carcinoma of the anal canal using cisplatin, infusional fluorouracil and radiation therapy

GIFUPART I

cisplatin (cont'd) injectable Gastrointestinaladjuvant chemotherapy of gastric cancer patients with completely resected gastric cancer using cisplatin and capecitabine and radiation therapy

GIGAJCPRT I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cisplatin (cont'd) injectable Gastrointestinal

palliative therapy of metastatic or locally advanced gastric, gastroesophageal junction adenocarcinoma, esophageal squamous cell carcinoma, or anal squamous cell carcinoma using cisplatin and capecitabine

GIGAVCC I

cisplatin (cont'd) injectable Gastrointestinalpalliative treatment of metastatic or locally advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma using cisplatin, capecitabine and trastuzumab (HERCEPTIN)

GIGAVCCT I

cisplatin (cont'd)injectable Gastrointestinal

palliative treatment of metastatic or inoperable, locally advanced gastric or gastroesophageal junction adenocarcinoma using cisplatin, infusional fluorouracil and trastuzumab (HERCEPTIN)

GIGAVCFT I

cisplatin (cont'd) injectable Gastrointestinaltreatment of operable cancer of the stomach, stomach-esophagus junction or lower 1/3 esophagus, given before and after surgery, using epirubicin, cisplatin and capecitabine

GIGECC I

cisplatin (cont'd) injectable Gastrointestinalpalliative therapy of neuroendocrine tumours using cisplatin and etoposide

GIPE I

cisplatin (cont'd)injectable

Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal mesothelioma using doxorubicin, cisplatin and paclitaxel

GIPMHIPEC I

cisplatin (cont'd) injectable Gynecologytherapy of non-dysgerminomatous ovarian germ cell cancer using bleomycin, etoposide and cisplatin

GOBEP I

cisplatin (cont'd) injectable Gynecologyalternative treatment of gynecological malignancies using cisplatin and paclitaxel

GOCISP I

cisplatin (cont'd) injectable Gynecologytreatment of high risk squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix with concurrent cisplatin and radiation

GOCXCRT I

cisplatin (cont'd) injectable Gynecologytherapy of dysgerminomatous ovarian germ cell cancer using cisplatin and etoposide

GOEP I

cisplatin (cont'd) injectable Gynecology invasive epithelial ovarian cancer GOOVCIS I

cisplatin (cont'd) injectable Gynecologytreatment of small cell or neuroendocrine carcinoma of gynecologic system origin using paclitaxel, cisplatin, etoposide and carboplatin with radiation

GOSMCCRT I

cisplatin (cont'd) injectable Genitourinary adjuvant therapy for urothelial carcinoma using cisplatin and gemcitabine GUAJPG I

cisplatin (cont'd) injectable Genitourinary palliative therapy for urothelial carcinoma using cisplatin and gemcitabine GUAVPG I

cisplatin (cont'd) injectable Genitourinarycurative therapy for germ cell cancer using bleomycin, etoposide and cisplatin

GUBEP I

cisplatin (cont'd) injectable Genitourinarytreatment of locally advanced bladder cancer with weekly cisplatin and concurrent radiation

GUBPWRT I

cisplatin (cont'd) injectable Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I

cisplatin (cont'd) injectable Genitourinary therapy for nonseminoma germ cell cancer using etoposide-cisplatin GUEP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cisplatin (cont'd) injectable Genitourinarycombined modality therapy for squamous cell cancer of the genitourinary system using fluorouracil and cisplatin with radiation

GUFUPRT I

cisplatin (cont'd) injectable Genitourinarytherapy for transitional cell cancers of the urothelium using methotrexate, vinblastine, doxorubicin and cisplatin

GUMVAC I

cisplatin (cont'd) injectable Genitourinaryneo-adjuvant therapy for urothelial carcinoma using cisplatin and gemcitabine

GUNAJPG I

cisplatin (cont'd) injectable Genitourinary therapy of genitourinary small cell tumors with a platin and etoposide GUSCPE I

cisplatin (cont'd) injectable Genitourinarytherapy of genitourinary small cell tumors with a platin and etoposide with radiation

GUSCPERT I

cisplatin (cont'd) injectable Genitourinarytherapy for relapsed testicular germ cell cancer using paclitaxel, ifosfamide and cisplatin

UGUTIP R

cisplatin (cont'd) injectable Genitourinaryconsolidation/ salvage treatment for germ cell cancer using vinblastine, cisplatin, ifosfamide and mesna

GUVEIP I

cisplatin (cont'd) injectable Genitourinarynonseminoma consolidation/salvage protocol using etoposide, cisplatin, ifosfamide, mesna

GUVIP2 I

cisplatin (cont'd) injectable Head and Necktreatment of advanced squamous cell carcinoma of the head and neck cancer using fluorouracil and platinum

HNAVFUP I

cisplatin (cont'd) injectable Head and Neckpalliative chemotherapy for advanced head and neck squamous cell carcinoma with weekly cisplatin

HNAVP I

cisplatin (cont'd) injectable Head and Necktreatment for unresectable, locoregionally recurrent or metastatic squamous cell carcinoma of the head and neck using paclitaxel and cisplatin or carboplatin

HNAVPC I

cisplatin (cont'd) injectable Head and Necktreatment of recurrent or metastatic squamous cell carcinoma of the head and neck with platinum and docetaxel

HNAVPD I

cisplatin (cont'd) injectable Head and Necktreatment of recurrent and metastatic squamous cell cancer with platinum and etoposide

HNAVPE I

cisplatin (cont'd) injectable Head and Necktreatment of locally advanced (alternate) head and neck cancer using cisplatin during radiation therapy

HNLAALTPRT I

cisplatin (cont'd) injectable Head and Necktreatment of locally advanced squamous cell carcinoma of the head and neck with docetaxel, cisplatin and infusional fluorouracil

UHNLADCF R

cisplatin (cont'd) injectable Head and Neckcombined chemotherapy (cisplatin) and radiation treatment for locally advanced squamous cell carcinoma of the head and neck

HNLAPRT I

cisplatin (cont'd) injectable Head and Necktreatment for advanced nasopharyngeal cancer of the head and neck using platinum and fluorouracil

HNNAVFUP I

cisplatin (cont'd) injectable Head and Neckpalliative chemotherapy for advanced head and neck nasopharyngeal carcinoma with weekly cisplatin

HNNAVP I

cisplatin (cont'd) injectable Head and Necktreatment of recurrent and/or metastatic nasopharyngeal cancer with platinum and etoposide

HNNAVPE I

cisplatin (cont'd) injectable Head and Necktreatment of locoregionally recurrent and/or metastatic nasopharyngeal cancer with platinum and gemcitabine

HNNAVPG I

cisplatin (cont'd) injectable Head and Neckinduction treatment of locally advanced nasopharyngeal cancer with cisplatin and gemcitabine

HNNLAPG I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cisplatin (cont'd) injectable Head and Necktreatment of locally advanced nasopharyngeal cancer with concurrent cisplatin and radiation

HNNLAPRT I

cisplatin (cont'd) injectable Head and Necktreatment of advanced head and neck cancer using cisplatin and fluorouracil

HNSAVFUP I

cisplatin (cont'd) injectable Head and Necktreatment of advanced salivary gland cancers with cisplatin and vinorelbine

HNSAVNP I

cisplatin (cont'd) injectable Head and Necktreatment of advanced salivary gland cancers with platinum, doxorubicin and cyclophospahmide

HNSAVPAC I

cisplatin (cont'd) injectable Lungadjuvant cisplatin and vinorelbine following resection of non-small cell lung cancer

LUAJNP I

cisplatin (cont'd) injectable Lungfirst-line treatment of advanced non-small cell lung cancer with cisplatin and docetaxel

LUAVDC I

cisplatin (cont'd) injectable Lungtreatment for advanced non-small cell lung cancer with cisplatin and vinorelbine

LUAVNP I

cisplatin (cont'd) injectable Lungtreatment of advanced non-small cell lung cancer with platinum and gemcitabine

LUAVPG I

cisplatin (cont'd) injectable Lungfirst-line treatment of advanced non-small cell lung cancer with platinum and pemetrexed

LUAVPP I

cisplatin (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using cisplatin and etoposide with radiation therapy

LULAPERT I

cisplatin (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using alternative dosing of cisplatin and etoposide with radiation therapy

LULAPE2RT I

cisplatin (cont'd) injectable Lung treatment of malignant mesothelioma with platinum and gemcitabine LUMMPG I

cisplatin (cont'd) injectable Lung treatment of malignant mesothelioma with platinum and pemetrexed LUMMPP I

cisplatin (cont'd) injectable Lung treatment of thymoma with platinum, doxorubicin and cyclophosphamide LUOTPAC I

cisplatin (cont'd) injectable Lung treatment of thymoma with cisplatin and etoposide LUOTPE I

cisplatin (cont'd) injectable Lung treatment of thymoma using cisplatin and etoposide with radiation therapy LUOTPERT I

cisplatin (cont'd) injectable Lungtreatment of cancer of unknown primary involving the thorax with cisplatin and etoposide

LUPUPE I

cisplatin (cont'd) injectable Lungtherapy of extensive stage small cell lung cancer with cisplatin and etoposide

LUSCPE I

cisplatin (cont'd) injectable Lungtherapy of limited stage small cell lung cancer using cisplatin and etoposide with radiation

LUSCPERT I

cisplatin (cont'd) injectable Lungsecond line treatment of extensive stage small cell lung cancer (SCLC) with irinotecan with or without platinum

LUSCPI I

cisplatin (cont'd) injectable Lymphoma treatment of lymphoma with gemcitabine, dexamethasone and cisplatin LYGDP I

cisplatin (cont'd) injectable Lymphomatreatment of lymphoma with gemcitabine, dexamethasone and cisplatin with rituximab

LYGDPR I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cisplatin (cont'd) injectable LymphomaTreatment of newly diagnosed nasal, extranodal natural killer (NK) or T-cell lymphoma, stage IE to IIE using concurrent radiation and weekly cisplatin followed by etoposide, ifosfamide, cisplatin and dexamethasone

LYVIPDRT I

cisplatin (cont'd) injectable Sarcoma adjuvant therapy for osteosarcoma using doxorubicin and cisplatin SAAJAP I

cisplatin (cont'd) injectable Sarcoma therapy of advanced osteosarcoma using doxorubicin and cisplatin SAAVAP I

cisplatin (cont'd) injectable Sarcomahyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal desmoplastic small round cell tumour (DSRCT) using CISplatin

SAHIPEC I

cisplatin (cont'd) injectable Skin & Melanomatreatment of recurrent or metastatic Merkel cell carcinoma with cisplatin and etoposide

SMMCCPE I

cisplatin (cont'd) injectableNot Otherwise Specified


I

cladribine injectable Lymphoma hairy cell leukemia LYCDA I

clodronate capsule Breastbony metastases associated with breast cancer or acute bone pain secondary to metastatic breast cancer

BRAVCLOD I Not reimbursed for hypercalcemia

cobimetinib tablet Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using vemurafenib and cobimetinib

USMAVVC R

cortisone tablet Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I

cortisone tablet Genitourinary treatment of adrenal cortical cancer using mitotane GUMITO I

cortisone tabletNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. GUNOS)

I

crizotinib tablet Lungsecond-line treatment of ALK-positive advanced non-small cell lung cancer (NSCLC) with crizotinib

ULUAVCRIZ R

crizotinib (cont'd) tablet Lungfirst-line treatment of ALK-positive advanced non-small cell lung cancer (NSCLC) with crizotinib

ULUAVCRIZF R

cyclophosphamide tablet, injectable BMTmyeloablative conditioning therapy prior to autologous and allogeneic hematopoietic stem cell transplantation for myeloid malignancies using IV busulfan and cyclophosphamide

BMTIVBUCY I

cyclophosphamide tablet, injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide

BRAJAC I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel

BRAJACT I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel

BRAJACTG I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTT I

cyclophosphamide tablet, injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTTG I

cyclophosphamide tablet, injectable Breastadjuvant therapy for early breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRAJACTW I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for high-risk breast cancer using cyclophosphamide (oral), methotrexate and fluorouracil

BRAJCMFPO I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using cyclophosphamide, doxorubicin and docetaxel

UBRAJDAC R

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using docetaxel and cyclophosphamide

BRAJDC I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide

BRAJFEC I

cyclophosphamide (cont'd) tablet, injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide and docetaxel

BRAJFECD I

cyclophosphamide (cont'd) tablet, injectableBreast

adjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRAJFECDT I

cyclophosphamide (cont'd) tablet, injectable Breastcombination with docEtaxel and concurrent trastuzumab (HERCEPTIN) as adjuvant treatment of HER-2 positive breast cancer

BRAJTDC I

cyclophosphamide (cont'd) tablet, injectable Breastpalliative therapy for metastatic breast cancer using doxorubicin and cyclophosphamide

BRAVAC I

cyclophosphamide (cont'd) tablet, injectable Breastpalliative therapy for advanced breast cancer using cyclophosphamide, methotrexate and fluorouracil

BRAVCMF I

cyclophosphamide (cont'd) tablet, injectable Breastpalliative therapy for metastatic breast cancer using metronomic low-dose oral cyclophosphamide and methotrexate

BRAVCMPO I

cyclophosphamide (cont'd) tablet, injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel

BRLAACD I

cyclophosphamide (cont'd) tablet, injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRLAACDT I

cyclophosphamide (cont'd) injectable Breastneoadjuvant therapy for breast cancer using dose dense therapy: paclitaxel followed by doxorubicin and cyclophosphamide

BRLATACG I

cyclophosphamide (cont'd) injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRLATWAC I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cyclophosphamide (cont'd) tablet, injectable Breasttherapy for locally advanced breast cancer using cyclophosphamide, epirubicin and fluorouracil

UBRLACEF R

cyclophosphamide (cont'd) tablet, injectable Gynecologypalliative therapy for relapsed/progressing epithelial ovarian, primary peritoneal, or fallopian tube carcinoma using metronomic low-dose oral cyclophosphamide

GOOVCYCPO I

cyclophosphamide (cont'd) tablet, injectable Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I

cyclophosphamide (cont'd) tablet, injectable Head and Neckpalliative therapy for advanced salivary gland cancers using cyclophosphamide, doxorubicin and fluorouracil

HNSAVFAC I

cyclophosphamide (cont'd) tablet, injectable Head and Necktreatment of advanced salivary gland cancers with platinum, doxorubicin and cyclophospahmide

HNSAVPAC I

cyclophosphamide (cont'd) tablet, injectable Lungtreatment of thymoma/thymic carcinoma with cyclophosphamide, doxorubicin and vincristine

LUOTCAV I

cyclophosphamide (cont'd) tablet, injectable Lung treatment of thymoma with platinum, doxorubicin and cyclophosphamide LUOTPAC I

cyclophosphamide (cont'd) tablet, injectable Lungtreatment of extensive small cell lung cancer with cyclophosphamide, doxorubicin and vincristine

LUSCCAV I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of Hodgkin's disease using cyclophosphamide, vincristine and prednisone

LYCCOP I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine and prednisone

LYCHOP I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab

LYCHOPR I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of Burkitt’s Lymphoma and Leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

cyclophosphamide (cont'd) tablet, injectable Lymphomaadvanced indolent lymphoma using cyclophosphamide, vincristine and prednisone

LYCVP I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of Hodgkin's disease with cyclophosphamide, vinblastine, procarbazine and prednisone

LYCVPPABO I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of advanced indolent lymphoma using cyclophosphamide, vincristine, prednisone and rituximab

LYCVPR I

cyclophosphamide (cont'd) tablet, injectable Lymphomatherapy of lymphoma, Hodgkin's disease, chronic lymphocytic leukemia or multiple myeloma using cyclophosphamide

LYCYCLO I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I

cyclophosphamide (cont'd) tablet, injectable Lymphomatreatment of chronic lymphocytic leukemia (CLL) or prolymphocytic leukemia with fludarabine, cyclophosphamide and rituximab

LYFCR I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cyclophosphamide (cont'd) tablet, injectable Lymphoma lymphoma palliative chemotherapy LYPALL I

cyclophosphamide (cont'd) tablet, injectable Myelomatreatment of multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide as induction pre-stem cell transplant

MYBORPRE I

cyclophosphamide (cont'd) tablet, injectable Myelomatreatment of relapsed multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide

MYBORREL I

cyclophosphamide (cont'd) tablet, injectable Myelomatherapy of multiple myeloma using carfilzomib and dexamethasone with or without cyclophosphamide

UMYCARDEX R

cyclophosphamide (cont'd) tablet, injectable Myelomatreatment of multiple myeloma using melphalan, prednisone and weekly bortezomib with the option of substituting cyclophosphamide for melphalan

MYMPBOR I

cyclophosphamide (cont'd) tablet, injectable Myelomasingle dose cyclophosphamide priming therapy for multiple myeloma prior to autologous stem cell transplant

MYHDC I

cyclophosphamide (cont'd) tablet, injectable Sarcoma

SAIME alternating with SAVAC or SAVACM with filgrastim support at a TWO weekly interval for newly diagnosed Ewing's Sarcoma/Ewing’s Family of Tumours, Desmoplastic Intra-Abdominal Small Round Blue Cell Tumour or Rhabdomyosarcoma

SAALT2W I


SAIME alternating with SAVAC or SAVACM with filgrastim support at a THREE weekly interval for newly diagnosed Ewing's Sarcoma/Ewing’s Family of Tumours, Desmoplastic Intra-Abdominal Small Round Blue Cell Tumour or Rhabdomyosarcoma

SAALT3W I

cyclophosphamide (cont'd) tablet, injectable Sarcomasummary for treatment of recurrent/refractory neuroblastoma, ewing’s sarcoma, osteogenic sarcoma or rhabdomyosarcoma with topotecan/cyclophosphamide

SAAVTC I

cyclophosphamide (cont'd) tablet, injectable Sarcomatreatment of sarcomas with vincristine, doxorubicin and cyclophosphamide

SAVAC I

cyclophosphamide (cont'd) tablet, injectable Sarcomatreatment of sarcomas with pelvic primaries or chemotherapy induced hematuria using vincristine, doxorubicin, cyclophosphamide and mesna

SAVACM I

cyclophosphamide (cont'd) tablet, injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin and cyclophosphamide

SAVDC I

cyclophosphamide (cont'd) tablet, injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin, cyclophosphamide and mesna

SAVDCM I

cyclophosphamide (cont'd) tablet, injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. BRNOS)

I

cyclosporine capsule Lymphomacytopenias associated with lymphoproliferative disorder of large granular lymphocytes

LYCSPA I

cyclosporine capsule Lymphomatreatment of hemophagocytic lymphohistiocytosis with etoposide, dexamethasone and cycloSPORINE

HLHETCSPA I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

cytarabine injectable Leukemia Therapy of Acute Myeloid Leukemia Using Low dose Cytarabine LKAMLCYT I

cytarabine injectable Lymphomatreatment of Burkitt’s Lymphoma and Leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

cytarabine injectable Lymphoma treatment of lymphoma using intrathecal methotrexate and cytarabine LYIT I

cytarabine injectable LymphomaTreatment of Burkitt’s Lymphoma and Leukemia with Ifosfamide, Mesna, Etoposide, Cytarabine and Rituximab

LYIVACR I

cytarabine (cont'd) injectable Miscellaneous Originstherapy for solid tumours using intrathecal methotrexate and/or thiotepa and/or cytarabine

MOIT I

cytarabine (cont'd) injectableNot Otherwise Specified


I

dabrafenib capsule Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using dabrafenib

USMAVDAB R

dabrafenib capsule Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using dabrafenib and trametinib

USMAVDT R

dacarbazine injectable Lymphomatreatment of Hodgkin's disease with doxorubicin, bleomycin, vinblastine and dacarbazine

LYABVD I

dacarbazine (cont'd) injectable Sarcomaadjuvant treatment of patients with soft tissue sarcoma using doxorubicin and dacarbazine

SAAJADIC I

dacarbazine injectable Sarcomatreatment of patients with soft tissue sarcoma using doxorubicin and dacarbazine

SAAVADIC I

dacarbazine injectable Sarcoma high dose single agent dacarbazine for metastatic soft tissue sarcoma SADTIC I

dacarbazine injectable Skin & Melanomatherapy for metastatic malignant melanoma using high dose single agent dacarbazine

SMDTIC I

dacarbazine (cont'd) injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. SMNOS)

I

dactinomycin injectable Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I

dactinomycin injectable Gynecologytherapy for low risk gestational trophoblastic neoplasia using methotrexate, leucovorin and actinomycin-D

GOTDLR I

dactinomycin injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin and cyclophosphamide

SAVDC I

dactinomycin (cont'd) injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin, cyclophosphamide and mesna

SAVDCM I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

dactinomycin injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. SANOS)

I

dasatinib tablet Leukemia chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia ULKCMLD R

daunorubicin injectable Leukemiafirst-line induction and consolidation therapy of acute promyelocytic leukemia using arsenic trioxide, tretinoin and daunorubicin

LKATOP I

daunorubicin injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. KSNOS)

I

degarelix injectable Genitourinary therapy for prostate cancer using LHRH antagonist GUPLHRHA I

denosumab (XGEVA®) injectable Sarcomaneoadjuvant use in patients with non-metastatic operable giant cell tumour of the bone

USANADENO R

dexamethasone tablet Genitourinarypalliative therapy for metastatic castration resistant prostate cancer using abiraterone and prednisone after failure of docetaxel therapy

UGUPABI R

dexamethasone tablet Lymphomatreatment of hemophagocytic lymphohistiocytosis with etoposide, dexamethasone and cycloSPORINE

HLHETCSPA I

dexamethasone tablet Lymphomatreatment of refractory or relapsing extranodal natural killer or T-cell lymphoma using asparaginase, methotrexate and dexamethasone

LYASPMEDEX I

dexamethasone tablet Lymphoma treatment of lymphoma with gemcitabine, dexamethasone and cisplatin LYGDP I

dexamethasone tablet Lymphomatreatment of lymphoma with gemcitabine, dexamethasone and cisplatin with rituximab

LYGDPR I

dexamethasone tablet Lymphoma lymphoma palliative chemotherapy LYPALL I

dexamethasonetablet

Lymphomatreatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I

dexamethasone

tablet

Lymphomatreatment of newly diagnosed nasal, extranodal natural killer (NK) or T-cell lymphoma, stage IE to IIE using concurrent radiation and weekly cisplatin followed by etoposide, ifosfamide, cisplatin and dexamethasone

LYVIPDRT I

dexamethasone (cont'd) tablet Myelomatreatment of multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide as induction pre-stem cell transplant

MYBORPRE I

dexamethasone tablet Myelomatreatment of relapsed multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide

MYBORREL I

dexamethasone tablet Myelomatherapy of multiple myeloma using carfilzomib and dexamethasone with or without cyclophosphamide

UMYCARDEX R

dexamethasone tablet Myelomatherapy of multiple myeloma using carfilzomib, lenalidomide with dexamethasone

UMYCARLD R

Not reimbursed for:anti-emetic treatment, steroid

replacement therapy, pre-taxane use, or appetite stimulation

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

dexamethasonetablet Myeloma

treatment of previously untreated multiple myeloma and not eligible for stem cell transplant using lenalidomide with low-dose dexamethasone

UMYLDF R

dexamethasone (cont'd) tablet Myelomatherapy of relapsed multiple myeloma using lenalidomide with dexamethasone

UMYLDREL R

dexamethasone (cont'd)tablet Myeloma

treatment of multiple myeloma using melphalan, prednisone and weekly bortezomib with the option of substituting cyclophosphamide for melphalan

MYMPBOR I

dexamethasone tablet Myeloma therapy of multiple myeloma using pomalidomide with dexamethasone UMYPOMDEX R

dexamethasone (cont'd) tablet Supportive Carepatients with primary or metastatic disease exhibiting cerebral edema or CNS swelling; management of malignant brain tumours; management of CNS lymphoma

MODEXA I

dexamethasone (cont'd) tabletNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (for e.g. CNNOS)

I

dexamethasone injectableNot Otherwise Specified


I

dexrazoxane injectable Pediatricpediatric patients with neuroblastoma treated on the CCG AEWS1031 protocol

I

dexrazoxane (cont'd) injectable Pediatricpediatric patients with rhabdomyosarcoma treated on the COG ARST08P1 protocol

I

docetaxel injectable Breastadjuvant therapy for breast cancer using cyclophosphamide, doxorubicin and docetaxel

UBRAJDAC R

docetaxel (cont'd) injectable Breastadjuvant treatment for high-risk node negative or node positive patients who are not considered candidates for a standard 6-8 cycle anthracycline or anthracycline plus taxane regimen

BRAJDC I

docetaxel (cont'd) injectable Breastadjuvant treatment of HER-2 positive breast cancer using carboplatin, docetaxel and trastuzumab (HERCEPTIN)

BRAJDCARBT I

docetaxel (cont'd) injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide and docetaxel

BRAJFECD I

docetaxel (cont'd) injectable Breastcombination with trastuzumab (HERCEPTIN) after FEC regimen as adjuvant therapy for breast cancer

BRAJFECDT I

docetaxel (cont'd) injectable Breastcombination with cycylophosphamide and concurrent trastuzumab (HERCEPTIN) as adjuvant treatment of HER-2 positive breast cancer

BRAJTDC I

docetaxel (cont'd) injectable Breastcombination with doxorubicin and cyclophosphamide as treatment of locally advanced breast cancer

BRLAACD I

Not reimbursed for:anti-emetic treatment, steroid

replacement therapy, pre-taxane use, or appetite stimulation

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

docetaxel (cont'd) injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRLAACDT I

docetaxel (cont'd) injectable Breastfirst, second, or third line treatment of metastatic breast cancer patients with ECOG performance status 0, 1, or 2, and greater than 3 month life expectancy

BRAVDOC I

docetaxel (cont'd) injectable Breastweekly docetaxel regimen for metastatic breast cancer patients with poor tolerance to 3-weekly docetaxel regimen (BRAVDOC) or high doses of dexamethasone used in BRAVDOC

BRAVDOC7 I

docetaxel (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using gemcitabine and docetaxel

BRAVGEMD I

docetaxel (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN) and docetaxel as first-line treatment for advanced breast cancer

BRAVPTRAD I

docetaxel (cont'd) injectable Breastwith trastuzumab (HERCEPTIN) as first-line treatment for advanced breast cancer refractory to anthracycline adjuvant chemotherapy

BRAVTRAD I

docetaxel (cont'd) injectable Gastrointestinalpalliative treatment of metastatic esophagogastric adenocarcinoma with docetaxel

GIAVDOC I

docetaxel (cont'd) injectable Gastrointestinalperioperative treatment of resectable adenocarcinoma of the stomach, gastroesophageal junction or lower 1/3 esophagus using docetaxel, oxaliplatin, infusional fluorouracil, and leucovorin

UGIGFLODOC R

docetaxel (cont'd) injectable Gynecologycombination with carboplatin as primary treatment of advanced/recurrent non-small cell cancer of the cervix in ambulatory care settings

GOCXCAD I

docetaxel (cont'd) injectable Gynecologytreatment of primarily advanced or recurrent endometrial cancer using carboplatin and docetaxel

GOENDCAD I

docetaxel (cont'd) injectable Gynecologyprimary treatment of invasive epithelial ovarian, fallopian tube and primary peritoneal cancer, with no visible residual tumour (moderate-high risk)

GOOVCADM I

docetaxel (cont'd) injectable Gynecologysecond line treatment using docetaxel and carboplatin for epithelial ovarian cancer relapsing after primary treatment

GOOVCADR I

docetaxel (cont'd) injectable Gynecologyprimary treatment of visible residual (extreme risk) invasive epithelial ovarian cancer

GOOVCADX I

docetaxel (cont'd) injectable Gynecologytreatment of progressive, platinum-refractory epithelial ovarian carcinoma, primary peritoneal

GOOVDOC I

docetaxel (cont'd) injectable Gynecologycombination with gemcitabine for advanced or recurrent uterine sarcoma cancer

GOSADG I

docetaxel (cont'd) injectable Genitourinary intravesical use for bladder cancer if BCG and mitomycin C not available GUNOS I

docetaxel (cont'd) injectable Genitourinary palliative therapy for metastatic hormone refractory prostate cancer GUPDOC I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

docetaxel (cont'd) injectable Genitourinaryfirst-line treatment of castration sensitive, metastatic prostate cancer using docetaxel and androgen deprivation therapy with LHRH agonist or LHRH antagonist with or without antiandrogen, or surgical castration

GUPDOCADT I

docetaxel (cont'd) injectable Head and Necktreatment of recurrent or metastatic squamous cell carcinoma of the head and neck with docetaxel

HNAVDOC I

docetaxel (cont'd) injectable Head and Necktreatment of recurrent or metastatic squamous cell carcinoma of the head and neck with platinum and docetaxel

HNAVPD I

docetaxel (cont'd) injectable Head and Necktreatment of locally advanced squamous cell carcinoma of the head and neck with docetaxel, cisplatin and infusional fluorouracil

UHNLADCF R

docetaxel (cont'd) injectable Lungcombination with cisplatin as first line treatment of advanced non-small lung cancer

LUAVDC I

docetaxel (cont'd) injectable Lung second-line treatment of non-small cell lung cancer LUAVDOC I

docetaxel (cont'd) injectable Sarcomacombination with gemcitabine as second or third line therapy for soft tissue sarcomas

SAAVGEMD I

doxorubicin injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide

BRAJAC I

doxorubicin injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel

BRAJACT I

doxorubicin injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel

BRAJACTG I

doxorubicin injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTT I

doxorubicin (cont'd) injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTTG I

doxorubicin injectable Breastadjuvant therapy for early breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRAJACTW I

doxorubicin (cont'd) injectable Breastadjuvant therapy for breast cancer using cyclophosphamide, doxorubicin and docetaxel

UBRAJDAC R

doxorubicin injectable Breast palliative therapy for metastatic breast cancer using weekly doxorubicin BRAVA7 I

doxorubicin (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using doxorubicin and cyclophosphamide

BRAVAC I

doxorubicin (cont'd) injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel

BRLAACD I

doxorubicin (cont'd) injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRLAACDT I

doxorubicin (cont'd) injectable Breastneoadjuvant therapy for breast cancer using dose dense therapy: paclitaxel followed by doxorubicin and cyclophosphamide

BRLATACG I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

doxorubicin (cont'd) injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRLATWAC I

doxorubicin (cont'd) injectable Gastrointestinal palliative therapy for hepatoma using doxorubicin GIA I

doxorubicin (cont'd) injectable Gastrointestinaltransarterial chemoembolization (TACE) of hepatocellular carcinoma using drug-eluting bead (DEB) loaded with doxorubicin

UGIDEBTACE R

doxorubicin (cont'd) injectable Gastrointestinalhepatic trans-arterial chemoembolization for primary liver cancer or liver metastasis

GIEMBOL INote: only funded when prescribed by specialists at BC Cancer VC &

Royal Jubilee Hospital

doxorubicin (cont'd) injectable Gastrointestinalpalliative therapy for pancreatic endocrine tumours using streptozocin and doxorubicin

GIENDO2 I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

doxorubicin (cont'd) injectable Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal mesothelioma using doxorubicin, cisplatin and paclitaxel

GIPMHIPEC I

doxorubicin (cont'd) injectable Genitourinary palliative therapy for advanced adrenal cortical cancer using doxorubicin GUAVD I

doxorubicin (cont'd) injectable Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I

doxorubicin (cont'd) injectable Genitourinarytherapy for transitional cell cancers of the urothelium using methotrexate, vinblastine, doxorubicin and cisplatin

GUMVAC I

doxorubicin (cont'd) injectable Gynecology for use in patients with advanced endometrial cancer GOENDD Idoxorubicin (cont'd) injectable Gynecology for use in patients with advanced uterine sarcoma GOSAD Idoxorubicin (cont'd) injectable Head and Neck palliative therapy for advanced thyroid cancers using doxorubicin HNOTAVD I

doxorubicin (cont'd) injectable Head and Neckpalliative therapy for advanced salivary gland cancers using cyclophosphamide, doxorubicin and fluorouracil

HNSAVFAC I

doxorubicin (cont'd) injectable Head and Necktreatment of advanced salivary gland cancers with platinum, doxorubicin and cyclophospahmide

HNSAVPAC I

doxorubicin (cont'd) injectable Lungtreatment of thymoma/thymic carcinoma with cyclophosphamide, doxorubicin and vincristine

LUOTCAV I

doxorubicin (cont'd) injectable Lung treatment of thymoma with platinum, doxorubicin, and cyclophosphamide LUOTPAC I

doxorubicin (cont'd) injectable Lungtreatment of extensive small cell lung cancer with cyclophosphamide, doxorubicin and vincristine

LUSCCAV I

doxorubicin (cont'd) injectable Lymphomatreatment of Hodgkin's disease with doxorubicin, bleomycin, vinblastine and dacarbazine

LYABVD I

doxorubicin (cont'd) injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine and prednisone

LYCHOP I

doxorubicin (cont'd) injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab

LYCHOPR I

doxorubicin (cont'd) injectable Lymphomacentral nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

doxorubicin (cont'd) injectable Lymphomatreatment of burkitt’s lymphoma and leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

doxorubicin (cont'd) injectable Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I

doxorubicin (cont'd) injectable Lymphoma lymphoma palliative chemotherapy LYPALL I

doxorubicin (cont'd) injectable Sarcomatherapy for advanced soft tissue sarcoma using doxorubicin, ifosfamide-mesna

SAAI I

doxorubicin (cont'd) injectable Sarcomadoxorubicin for adjuvant use for patients with non-metastatic operable large high grade soft tissue sarcoma

SAAJA I

Not reimbursed for bladder instillations

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

doxorubicin (cont'd) injectable Sarcomaadjuvant treatment of patients with soft tissue sarcoma using doxorubicin and dacarbazine

SAAJADIC I

doxorubicin (cont'd) injectable Sarcoma adjuvant therapy for osteosarcoma using doxorubicin and cisplatin SAAJAP I

doxorubicin (cont'd) injectable Sarcoma


SAALT2W I



SAALT3W I

doxorubicin (cont'd) injectable Sarcoma therapy for advanced soft tissue sarcoma using doxorubicin SAAVA I

doxorubicin (cont'd) injectable Sarcomatreatment of patients with soft tissue sarcoma using doxorubicin and dacarbazine

SAAVADIC I

doxorubicin (cont'd) injectable Sarcoma therapy of advanced osteosarcoma using doxorubicin and cisplatin SAAVAP I

doxorubicin (cont'd) injectable Sarcomatreatment of sarcomas with vincristine, doxorubicin and cyclophosphamide

SAVAC I

doxorubicin (cont'd) injectable Sarcomatreatment of sarcomas with pelvic primaries or chemotherapy induced hematuria using vincristine, doxorubicin, cyclophosphamide and mesna

SAVACM I

doxorubicin (cont'd) injectableNot Otherwise Specified


I

doxorubicin – pegylated liposomaL (CAELYX®)

injectable Gynecology treatment of platinum resistant epithelial ovarian cancer with bevacizumab and pegylated liposomal doxorubicin (CAELYX)

UGOOVBEVLD R


injectable Gynecologytreatment of epithelial ovarian cancer relapsing after primary treatment using pegylated liposomal doxorubicin (CAELYX)

GOOVLDOX I


injectable Gynecology treatment of epithelial ovarian cancer relapsing after primary treatment using pegylated liposomal doxorubicin (CAELYX) and carboplatin

GOOVPLDC I


injectable Kaposi's Sarcoma Kaposi’s sarcoma KSLDO I

drug-eluting bead (DEB) loaded with doxorubicin

other Gastrointestinaltransarterial chemoembolization (TACE) of hepatocellular carcinoma using drug-eluting bead (DEB) loaded with doxorubicin

UGIDEBTACE R

enzalutamide tablet Genitourinarypalliative therapy for metastatic castration resistant prostate cancer using enzalutamide

UGUPENZ R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

epirubicin injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide

BRAJFEC I

epirubicin injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide and docetaxel

BRAJFECD I

epirubicin (cont'd) injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRAJFECDT I

epirubicin (cont'd) injectable Breasttherapy for locally advanced breast cancer using cyclophosphamide, epirubicin and fluorouracil

UBRLACEF R

epirubicin (cont'd) injectable Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and capecitabine

GIGAVEOCAP I

epirubicin (cont'd) injectable Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and infusional fluorouracil

GIGAVEOF I

epirubicin (cont'd) injectable Gastrointestinaltreatment of operable cancer of the stomach, stomach-esophagus junction or lower 1/3 esophagus, given before and after surgery, using epirubicin, cisplatin and capecitabine

GIGECC I

epirubicin (cont'd) injectable Genitourinary intravesical use for bladder cancer if BCG and mitomycin C not available GUNOS I

epirubicin (cont'd) injectableNot Otherwise Specified


I

eribulin injectable Breast palliative therapy for metastatic breast cancer using eribulin UBRAVERIB R

erlotinib tablet Lung second or third line treatment of advanced non-small cell lung cancer LUAVERL I

erlotinib tablet Lungmaintenance therapy of advanced non-small cell lung cancer after first-line chemotherapy

LUAVMTNE I

estramustine capsule Genitourinary hormone-independent prostate cancer GUEMCYT I

etoposidecapsule/ injectable

Neuro-Oncology carboplatin and etoposide in the treatment of recurrent ependymoma CNCARV I


Neuro-Oncologypalliative treatment of patients with recurrent malignant gliomas and ependymoma using low dose etoposide

CNETO I


Neuro-Oncologytherapy for recurrent malignant brain tumours using temozolomide and etoposide

CNTMZETO I


Gastrointestinalpalliative therapy of neuroendocrine tumours using cisplatin and etoposide

GIPE I


Gynecologytherapy of non-dysgerminomatous ovarian germ cell cancer using bleomycin, etoposide and cisplatin

GOBEP I


Gynecologytherapy of dysgerminomatous ovarian germ cell cancer using cisplatin and etoposide

GOEP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES


Gynecologytreatment of relapsed/progressing epithelial ovarian, primary peritoneal, or fallopian tube carcinoma using etoposide

GOOVETO I


Gynecologytreatment of small cell or neuroendocrine carcinoma of gynecologic system origin using paclitaxel, cisplatin, etoposide and carboplatin with radiation

GOSMCCRT I

etoposide (cont'd)capsule/ injectable

Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I


Genitourinarycurative therapy for germ cell cancer using bleomycin, etoposide and cisplatin

GUBEP I


Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I


Genitourinary therapy for nonseminoma germ cell cancer using etoposide-cisplatin GUEP I


Genitourinary therapy of genitourinary small cell tumours with a platin and etoposide GUSCPE I


Genitourinarytherapy of genitourinary small cell tumors with a platin and etoposide with radiation

GUSCPERT I


Genitourinarynonseminoma consolidation/salvage protocol using etoposide, cisplatin, ifosfamide, mesna

GUVIP2 I


Head and Necktreatment of recurrent and metastatic squamous cell cancer with platinum and etoposide

HNAVPE I


Head and Necktreatment of recurrent and/or metastatic nasopharyngeal cancer with platinum and etoposide

HNNAVPE I


Lungtreatment of locally advanced non-small cell lung cancer using cisplatin and etoposide with radiation

LULAPERT I


Lungtreatment of locally advanced non-small cell lung cancer using alternative dosing of cisplatin and etoposide with radiation therapy

LULAPE2RT I


Lung treatment of thymoma with cisplatin and etoposide LUOTPE I


Lung treatment of thymoma using cisplatin and etoposide with radiation therapy LUOTPERT I


Lungtreatment of cancer of unknown primary involving the thorax with cisplatin and etoposide

LUPUPE I


Lungtherapy of extensive stage small cell lung cancer with cisplatin and etoposide

LUSCPE I


Lungtherapy of limited stage small cell lung cancer using cisplatin and etoposide with radiation

LUSCPERT I


Lungpalliative therapy of extensive stage small cell lung cancer with oral etoposide

LUSCPOE I


Lymphomatreatment of hemophagocytic lymphohistiocytosis with etoposide, dexamethasone and cycloSPORINE

HLHETCSPA I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES


Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I


Lymphomatreatment of burkitt’s lymphoma and leukemia with ifosfamide, mesna, etoposide, cytarabine and rituximab

LYIVACR I


Lymphoma lymphoma palliative chemotherapy LYPALL I


Lymphomatreatment of advanced stage Large B-Cell Non-Hodgkin’s Lymphoma with ifosfamide, carboplatin, etoposide and rituximab

ULYRICE R


Lymphomatreatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I


Lymphomatreatment of newly diagnosed nasal, extranodal natural killer (NK) or T-cell lymphoma, stage IE to IIE using concurrent radiation and weekly cisplatin followed by etoposide, ifosfamide, cisplatin and dexamethasone

LYVIPDRT I


Sarcoma


SAALT2W I



SAALT3W I


Sarcoma3-Day etoposide & ifosfamide-mesna for patients with advanced soft tissue or bony sarcomas

SAAVIME3 I


Sarcoma etoposide, ifosfamide-mesna (SAIME) for use in sarcomas SAIME I


Skin & Melanomatreatment of recurrent or metastatic Merkel cell carcinoma with cisplatin and etoposide

SMMCCPE I


Not Otherwise Specified


I

everolimus tablet Breast therapy for advanced breast cancer using everolimus and exemestane BRAVEVEX I

everolimus tablet Gastrointestinaltreatment of advanced neuroendocrine tumours of gastrointestinal origin (non-functional) using everolimus

UGINETEV R

everolimus tablet Gastrointestinal palliative treatment of advanced pancreatic neuroendocrine tumours UGIPNEVER R

everolimus tablet Genitourinary therapy for advanced renal cancer using everolimus GUEVER I

everolimus tablet Lungtreatment of advanced neuroendocrine tumours of lung origin (non-functional) using everolimus

ULUNETEV R

Note: AFINITOR® DISPERZTM

formulation not funded

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

exemestane tablet Breastneoadjuvant or adjuvant therapy for breast cancer using exemestane in postmenopausal women

BRAJEXE I

exemestane tablet Breastadjuvant ovarian suppression and aromatase inhibitor in premenopausal women with high-risk early stage breast cancer

BRAJLHRHAI I

exemestane tablet Breast therapy for advanced breast cancer using everolimus and exemestane BRAVEVEX I

exemestane tablet Breastfirst or second line hormonal treatment for advanced breast cancer in postmenopausal women

BRAVEXE I

exemestane (cont'd) tablet Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I

exemestane (cont'd) tablet Gynecologyhormonal treatment for advanced endometrial cancer in postmenopausal women

GOENDAI I

filgrastim (GRASTOFIL®) injectablefor inpatient administration only - see BC PharmaCare Special Authority Form for indications covered

FILGRASTIM(Note: NEUPOGEN® brand will only be reimbursed for inpatient administration for pediatric use)

fludarabine injectable/ tablet Lymphomatreatment of chronic lymphocytic leukemia (CLL) or prolymphocytic leukemia with fludarabine, cyclophosphamide and rituximab

LYFCR I

fludarabine injectable/ tablet Lymphoma chronic lymphocytic leukemia or low grade lymphoma LYFLU I

fludarabine injectable/ tablet Lymphomacombination with rituximab for treatment of chronic lymphocytic leukemia or prolymphocytic leukemia and relapsed indolent lymphoma

LYFLUDR I

fludarabine injectable/ tablet Pediatric pediatric patients with AML treated on the CCG-2961 study I

fludrocortisone tablet Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I

fludrocortisone (cont'd) tablet Genitourinary mineralocorticoid deficiency associated with mitotane use GUMITO I

fluorouracil injectable Breastadjuvant therapy for high-risk breast cancer using cyclophosphamide (oral), methotrexate and fluorouracil

BRAJCMFPO I

fluorouracil (cont'd) injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide

BRAJFEC I

fluorouracil injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide and docetaxel

BRAJFECD I

fluorouracil (cont'd) injectable Breastadjuvant therapy for breast cancer using fluorouracil, epirubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRAJFECDT I

fluorouracil (cont'd) injectable Breastpalliative therapy for advanced breast cancer using cyclophosphamide, methotrexate and fluorouracil

BRAVCMF I

fluorouracil (cont'd) injectable Breasttherapy for locally advanced breast cancer using cyclophosphamide, epirubicin and fluorouracil

UBRLACEF R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

fluorouracil (cont'd) injectable Gastrointestinaladjuvant combination chemotherapy for stage III and stage IIB colon cancer using oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIAJFFOX I

fluorouracil (cont'd) injectable Gastrointestinaladjuvant therapy of colon cancer using fluorouracil injection and infusion and leucovorin infusion

GIAJFL I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using fluorouracil injection and infusion and folinic acid (leucovorin) infusion

GIAVFL I

fluorouracil (cont'd) injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using oxaliplatin, fluorouracil, leucovorin, and radiation therapy

GIEFFOXRT I

fluorouracil (cont'd) injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using fluorouracil and cisplatin

GIEFUPRT I

fluorouracil (cont'd) injectable Gastrointestinalhepatic trans-arterial chemoembolization for primary liver cancer or liver metastasis

GIEMBOL INote: only funded when prescribed by specialists at BC Cancer VC &


fluorouracil (cont'd) injectable Gastrointestinalpalliative therapy for pancreatic endocrine tumours using streptozocin and doxorubicin

GIENDO2 I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, folinic acid (leucovorin) and bevacizumab

GIFFIRB I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, leucovorin, and panitumumab

UGIFFIRPAN* R

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and bevacizumab

GIFFOXB I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and panitumumab

UGIFFOXPAN R

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for advanced pancreatic adenocarcinoma using irinotecan, oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFIRINOX I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil and folinic acid (leucovorin)

GIFOLFIRI I

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFOLFOX I

fluorouracil (cont'd) injectable Gastrointestinalcombined modality curative therapy for carcinoma of the anal canal using mitomycin, fluorouracil and radiation therapy

GIFUART I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

fluorouracil (cont'd) injectable Gastrointestinalpalliative chemotherapy for upper gastrointestinal tract cancer (gastric, esophageal, gall bladder carcinoma and cholangiocarcinoma) and metastatic anal cancer using infusional fluorouracil and cisplatin

GIFUC I

fluorouracil (cont'd) injectable Gastrointestinalcombined modality curative therapy for carcinoma of the anal canal using cisplatin, infusional fluorouracil and radiation therapy

GIFUPART I

fluorouracil (cont'd) injectable Gastrointestinaladjuvant chemotherapy of gastric cancer patients with D2 resection (node negative) or ineligible for adjuvant chemoradiation using oxaliplatin, fluorouracil, and leucovorin

GIGAJFFOX I

fluorouracil (cont'd) injectable Gastrointestinalpalliative treatment of metastatic or inoperable, locally advanced gastric or gastroesophageal junction adenocarcinoma using cisplatin, infusional fluorouracil and trastuzumab (HERCEPTIN)

GIGAVCFT I

fluorouracil (cont'd) injectable Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and infusional fluorouracil

GIGAVEOF I

fluorouracil (cont'd) injectable Gastrointestinalperioperative treatment of resectable adenocarcinoma of the stomach, gastroesophageal junction or lower 1/3 esophagus using docetaxel, oxaliplatin, infusional fluorouracil, and leucovorin

UGIGFLODOC R

fluorouracil (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic gastric or esophageal adenocarcinoma using irinotecan, fluorouracil and folinic acid (leucovorin)

GIGFOLFIRI I

fluorouracil (cont'd) injectable Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal carcinomatosis from limited advanced colorectal and appendiceal carcinomas using oxaliplatin and fluorouracil

GIHIPEC I

fluorouracil (cont'd) injectable Gastrointestinaladjuvant combination chemotherapy for stage III rectal cancer using oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIRAJFFOX I

fluorouracil (cont'd) injectable Gastrointestinalcombined modality adjuvant therapy for high risk rectal carcinoma using capecitabine, infusional fluorouracil and radiation therapy

GIRINFRT I

fluorouracil (cont'd) injectable Genitourinarycombined modality therapy for squamous cell cancer of the genitourinary system using fluorouracil and cisplatin with radiation

GUFUPRT I

fluorouracil (cont'd) injectable Head and Neckfluorouracil and leucovorin for recurrent head and neck cancer (squamous cell carcinoma)

HNAVFUFA I

fluorouracil (cont'd) injectable Head and Necktreatment of advanced squamous cell carcinoma of the head and neck cancer using fluorouracil and platinum

HNAVFUP I

fluorouracil (cont'd) injectable Head and Neckcombined chemotherapy (carboplatin and fluorouracil) and radiation treatment for locally advanced squamous cell carcinoma of the head and neck

HNLACAFRT I

fluorouracil (cont'd) injectable Head and Necktreatment of locally advanced squamous cell carcinoma of the head and neck with docetaxel, cisplatin and infusional fluorouracil

UHNLADCF R

fluorouracil (cont'd) injectable Head and Neckfluorouracil and leucovorin for recurrent head and neck cancer (nasopharyngeal)

HNNAVFUFA I

fluorouracil (cont'd) injectable Head and Necktreatment for advanced nasopharyngeal cancer of the head and neck using platinum and fluorouracil

HNNAVFUP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

fluorouracil (cont'd) injectable Head and Neckpalliative therapy for advanced salivary gland cancers using cyclophosphamide, doxorubicin and fluorouracil

HNSAVFAC I

fluorouracil (cont'd) injectable Head and Necktreatment of advanced head and neck cancer using cisplatin and fluorouracil

HNSAVFUP I

fluorouracil (cont'd) injectableNot Otherwise Specified


I

fluorouracil topical cream Skin & Melanoma skin cancer SMNOS I

flutamide tablet Genitourinary nonsteroidal treatment of prostate cancer GUPNSAA INot reimbursed for vasomotor

symptoms (hot flashes)

gefitinib tablet Lungfirst-line treatment of epidermal growth factor receptor mutation-positive advanced NSCLC

LUAVGEFF I

gemcitabine injectable Breast palliative therapy for metastatic breast cancer using gemcitabine BRAVGEM I

gemcitabine injectable Breastpalliative therapy for metastatic breast cancer using gemcitabine and docetaxel

BRAVGEMD I

gemcitabine (cont'd) injectable Breastas palliative therapy for metastatic breast cancer using cisplatin and gemcitabine

BRAVGEMP I

gemcitabine injectable Breast treatment of metastatic breast cancer using gemcitabine and paclitaxel BRAVGEMT I

gemcitabine (cont'd) injectable Gastrointestinalfirst-line palliative chemotherapy for advanced gallbladder cancer and cholangiocarcinoma using gemcitabine and cisplatin

GIAVPG I

gemcitabine (cont'd) injectable Gastrointestinaladjuvant chemotherapy for resected pancreatic adenocarcinoma using capecitabine and gemcitabine

GIPAJGCAP I

gemcitabine (cont'd) injectable Gastrointestinal adjuvant chemotherapy for pancreatic adenocarcinoma using gemcitabine GIPAJGEM I

gemcitabine injectable Gastrointestinalpalliative chemotherapy for pancreatic adenocarcinoma, gallbladder cancer, and cholangiocarcinoma using gemcitabine

GIPGEM I

gemcitabine (cont'd) injectable Gastrointestinalfirst line treatment of locally advanced and metastatic pancreatic cancer with paclitaxel-nab (ABRAXANE®) and gemcitabine

GIPGEMABR I

gemcitabine injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and gemcitabine

UGOOVBEVG R

gemcitabine injectable Gynecologytreatment of advanced ovarian cancer in patients who have progressed or recurred following first-line platinum-based treatment using carboplatin and gemcitabine

GOOVCAG I

gemcitabine injectable Gynecologypalliative chemotherapy for re-treatment of ovarian, tubal, and peritoneal cancer using gemcitabine

GOOVGEM I

gemcitabine (cont'd) injectable Gynecologycombination with docetaxel for advanced or recurrent uterine sarcoma cancer

GOSADG I

gemcitabine (cont'd) injectable Genitourinary adjuvant therapy for urothelial carcinoma using cisplatin and gemcitabine GUAJPG I

gemcitabine (cont'd) injectable Genitourinarycombination with cisplatin for advanced transitional cell carcinoma of the bladder

GUAVPG I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

gemcitabine (cont'd) injectable Genitourinary combination with cisplatin as neoadjuvant therapy for urothelial carcinoma GUNAJPG I

gemcitabine (cont'd) injectable Genitourinary intravesical use for bladder cancer if BCG and mitomycin C not available GUNOS I

gemcitabine (cont'd) injectable Genitourinarycombination palliative therapy with paclitaxel in patients with relapsed, cisplatin-refractory germ cell cancers not amenable to cure with surgery or chemotherapy (patients relapsed after BMT are potentially eligible)

UGUTAXGEM R

gemcitabine (cont'd) injectable Head and Necktreatment of loco-regionally recurrent and/or metastatic nasopharyngeal cancer with gemcitabine

HNNAVGEM I

gemcitabine (cont'd) injectable Head and Necktreatment of local-regionally recurrent and/or metastatic nasopharyngeal cancer with platinum and gemcitabine

HNNAVPG I

gemcitabine (cont'd) injectable Head and Neckas induction treatment of locally advanced nasopharyngeal cancer with cisplatin and gemcitabine

HNNLAPG I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

gemcitabine (cont'd) injectable Lungcombination with cisplatin or carboplatin as treatment of advanced non-small cell lung cancer

LUAVPG I

gemcitabine (cont'd) injectable Lung treatment of malignant mesothelioma with platinum and gemcitabine LUMMPG I

gemcitabine (cont'd) injectable Lymphoma treatment of lymphoma with gemcitabine, dexamethasone and cisplatin LYGDP I

gemcitabine (cont'd) injectable Lymphoma in combination with dexamethasone, cisplatin and rituximab for lymphoma LYGDPR I

gemcitabine (cont'd) injectable Lymphoma palliative chemotherapy of lymphomas LYPALL I

gemcitabine (cont'd) injectable Sarcomacombination with docetaxel as second or third line therapy for soft tissue sarcomas

SAAVGEMD I

goserelininjectable/ long acting injectable


BRAJLHRHAI I

goserelininjectable/ long acting injectable

Breastneoadjuvant or adjuvant therapy for breast cancer using a LHRH agonist and tamoxifen

BRAJLHRHT I

goserelin (cont'd)injectable/ long acting injectable

Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I


Breastcombination therapy with tamoxifen palliative therapy for metastatic breast cancer

BRAVLHRHT I


Genitourinary therapy for prostate cancer using LHRH agonist GUPLHRH I

hydrocortisone tablet, injectable Lymphomatreatment of hemophagocytic lymphohistiocytosis with etoposide, dexamethasone and cycloSPORINE

HLHETCSPA I

hydrocortisone (cont'd) tablet, injectableNot Otherwise Specified


I

hydroxyurea capsule Leukemia

Myeloid neoplasms, including but not limited to: Acute myeloid leukemia, Myelodysplastic syndromes (e.g. Refractory anemia), Myeloproliferative disease (e.g. Chronic myeloid leukemia, Polycythemia, Essential thrombocythemia)

LKNOS I

hydroxyurea capsule LymphomaLymphoid neoplasms, including but not limited to: Lymphoproliferative disease, Myeloma

LYNOS I

ibritumomab 90Y (ZEVALIN®)

injectable LymphomaPalliative therapy for lymphoma using radioimmunotherapy: rituximab-priming for ibritumomab 90Y (ZEVALIN®) ULYRITZ R

ibrutinib capsule Lymphomatreatment of previously untreated chronic lymphocytic leukemia or small lymphocytic lymphoma with chromosome 17p deletion

ULYFIBRU R

Not reimbursed for endometriosis

Not reimbursed for supportive care

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

ibrutinib capsule Lymphomatreatment of relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma

ULYIBRU R

ibrutinib capsule Lymphoma treatment of relapsed/refractory mantle-cell lymphoma using ibrutinib ULYMIBRU R

idarubicin injectableNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. BRNOS)

I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

idelalisib tablet Lymphomatreatment of relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma using idelalisib and rituximab

ULYIDELAR R

ifosfamide injectable Genitourinarytherapy for relapsed testicular germ cell cancer using paclitaxel, lfosfamide and cisplatin

UGUTIP R

ifosfamide injectable Genitourinaryconsolidation/ salvage treatment for germ cell cancer using vinblastine, cisplatin, ifosfamide and mesna

GUVEIP I

ifosfamide injectable Genitourinarynonseminoma consolidation/salvage protocol using etoposide, cisplatin, ifosfamide, mesna

GUVIP2 I

ifosfamide (cont'd) injectable Lymphomatreatment of burkitt’s lymphoma and leukemia with ifosfamide, mesna, etoposide, cytarabine and rituximab

LYIVACR I

ifosfamide (cont'd) injectable Lymphomatreatment of advanced stage Large B-Cell Non-Hodgkin’s Lymphoma with ifosfamide, carboplatin, etoposide and rituximab

ULYRICE R

ifosfamide (cont'd) injectable Lymphomatreatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I

ifosfamide (cont'd) injectable Lymphomatreatment of newly diagnosed nasal, extranodal natural killer (NK) or T-cell lymphoma, stage IE to IIE using concurrent radiation and weekly cisplatin followed by etoposide, ifosfamide, cisplatin and dexamethasone

LYVIPDRT I

ifosfamide injectable Sarcomatherapy for advanced soft tissue sarcoma using doxorubicin, ifosfamide-mesna

SAAI I

ifosfamide (cont'd) injectable Sarcoma


SAALT2W I

ifosfamide (cont'd) injectable Sarcoma


SAALT3W I

ifosfamide injectable Sarcoma therapy for advanced soft tissue sarcoma using ifosfamide SAAVI I

ifosfamide injectable Sarcoma3-Day etoposide & ifosfamide-mesna for patients with advanced soft tissue or bony sarcomas

SAAVIME3 I

ifosfamide injectable Sarcoma etoposide, ifosfamide-mesna (SAIME) for use in sarcomas SAIME I

ifosfamide (cont'd) injectableNot Otherwise Specified


I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

imatinib capsule/tablet Leukemiatherapy for chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia

LKCMLI I

imatinib capsule/tablet Pediatricpediatric patients with Philadelphia chromosome positive acute lymphoblastic leukemia

I

imatinib capsule/tablet Sarcomaadjuvant therapy of C-Kit positive high risk gastrointestinal stromal cell tumours

SAAJGI I

imatinib capsule/tablet Sarcomaadvanced c-kit positive and c-kit negative gastrointestinal stromal cell tumours

SAAVGI I

capsule/tablet Sarcomaadvanced c-kit positive gastrointestinal stromal cell tumors using 800 mg dosing of imatinib

SAAVGIDD I

capsule/tablet Skin & Melanoma treatment of advanced c-kit melanoma using imatinib USMAVI R

imiquimod topical cream Skin & Melanomatopical immunotherapy for in-transit melanoma metastases, cutaneous lymphoma, basal cell carcinoma using imiquimod SMIMI I

interferon alfa injectable Genitourinarypalliative therapy for BCG-refractory superficial high-grade transitional cell carcinoma bladder with BCG and interferon bladder cancer

GUBCGIFN I

interferon alfa injectable Genitourinarymetastatic renal cell carcinoma in patients with the following characteristics: performance status 0-1; disease evaluable for response

GUKIFN I

interferon alfa injectable Leukemia LKNOS Iinterferon alfa injectable Lymphoma lymphoma palliative therapy LYPALL Iinterferon alfa (cont'd) injectable Lymphoma LYNOS Iinterferon alfa injectable Myeloma MYNOS I

interferon alfa injectable Skin & Melanomaadjuvant therapy of melanoma patients with palpable lymph nodes or fully resected recurrent disease in lymph nodes

SMAJIFN I

interferon alfa injectable Skin & Melanoma basal cell carcinoma SMNOS Iinterferon alfa eyedrops Ocular topical therapy for ocular malignancies OCIFN I

ipilimumab injectable Skin & Melanomafirst-line treatment of unresectable or metastatic melanoma using ipilimumab

USMAVFIPI R

ipilimumab injectable Skin & Melanomatreatment of advanced and metastatic melanoma after prior systemic therapy

USMAVIPI R

irinotecan injectable Gastrointestinalpalliative third line treatment of metastatic colorectal cancer with wild-type KRAS using cetuximab and irinotecan

GIAVCETIR I

irinotecan (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan and capecitabine in patients unsuitable for GIFOLFIRI

GICAPIRI I

irinotecan injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, bevacizumab and capecitabine

GICIRB I

irinotecan injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, folinic acid (leucovorin) and bevacizumab

GIFFIRB I

Not reimbursed for hepatitis, Kaposi’s Sarcoma

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

irinotecan injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, leucovorin, and panitumumab

UGIFFIRPAN* R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

irinotecan (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for advanced pancreatic adenocarcinoma using irinotecan, oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFIRINOX I

irinotecan (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil and folinic acid (leucovorin)

GIFOLFIRI I

irinotecan (cont'd) injectable Gastrointestinalsecond line palliative combination chemotherapy for metastatic gastric or esophageal adenocarcinoma using irinotecan, fluorouracil and folinic acid (leucovorin)

GIGFOLFIRI I

irinotecan injectable Gastrointestinal palliative chemotherapy for metastatic colorectal cancer using irinotecan GIIR I

irinotecan injectable Gastrointestinalpalliative therapy for metastatic colorectal cancer in patients who may not tolerate the 3-weekly irinotecan schedule of GIIR

GIIRINALT I

irinotecan injectable Lungsecond line treatment of extensive stage small cell lung cancer (SCLC) with irinotecan with or without platinum

LUSCPI I

irinotecan (cont'd) injectable Pediatricpediatric patients treated on the COG protocol ARST0531 for intermediate-risk rhabdomyosarcoma

I

irinotecan (cont'd) injectable Pediatricpediatric patients with recurrent pediatric neuroblastoma treated on the COG protocol ANBL0421

I

irinotecan (cont'd) injectable Pediatricpediatric patients with high risk renal tumors treated on the COG protocol AREN0321

I

irinotecan (cont'd) injectable Pediatricpediatric patients with high risk rhabdomyosarcoma treated on the COG protocol ARSTO431

I

irinotecan (cont'd) injectable Pediatricpediatric patients with rhabdomyosarcoma treated on the COG ARST08P1 protocol

I

irinotecan (cont'd) injectable Pediatricpediatric patients with recurrent/refractory medulloblastomas/CNS PNET of childhood treated on the COG ACNS0821 protocol

I

isotretinoin (ACCUTANE) capsule Pediatric pediatric patients with high risk neuroblastoma I

isotretinoin (ACCUTANE™) capsule Pediatricpediatric patients treated on the COG protocol ACNS0332 for above average risk medulloblastoma/PNE

I

lanreotide injectable Neuro-Oncology treatment of growth hormone secreting pituitary adenoma using lanreotide CNLAN I

lanreotide (cont'd) injectable Gastrointestinalsymptomatic management of functional carcinoid and neuroendocrine tumours of the GI Tract using lanreotide

UGILAN R

lapatinib tablet Breast

combination with lapatinib in advanced breast cancer patients with HER-2 expressing breast cancer whose cancer has progressed on one prior therapy with trastuzumab (HERCEPTIN)-based protocol in the advanced setting or who has relapsed on or within 12 months of adjuvant trastuzumab (HERCEPTIN)

UBRAVLCAP R

lenalidomide capsule Leukemia therapy of myelodysplastic syndrome using lenalidomide ULKMDSL R

lenalidomide capsule Myelomatherapy of multiple myeloma using carfilzomib, lenalidomide with dexamethasone

UMYCARLD R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

lenalidomide capsule Myelomatreatment of previously untreated multiple myeloma and not eligible for stem cell transplant using lenalidomide with low-dose dexamethasone

UMYLDF R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

lenalidomide (cont'd) capsule Myelomatherapy of relapsed multiple myeloma using lenalidomide with dexamethasone

UMYLDREL R

lenalidomide capsule Myeloma maintenance therapy of multiple myeloma using lenalidomide UMYLENMTN R

lenvatinib capsule Head and Necktherapy for locally recurrent or metastatic, RAI-refractory differentiated thyroid cancer using lenvatinib UHNOTLEN R

letrozole tablet Breastneoadjuvant or adjuvant therapy for breast cancer using letrozole in postmenopausal women

BRAJLET I

letrozole (cont'd) tablet Breastadjuvant ovarian suppression and aromatase inhibitor in premenopausal women with high-risk early stage breast cancer

BRAJLHRHAI I

letrozole tablet Breastfirst or second line hormonal treatment for advanced breast cancer in postmenopausal women

BRAVLET I

letrozole tablet Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I

letrozole tablet Breasttherapy of advanced breast cancer using palbociclib with aromatase inhibitor

UBRAVPALAI R

letrozole tablet Gynecologyhormonal treatment for advanced endometrial cancer in postmenopausal women with contraindications to tamoxifen or intolerant of tamoxifen

GOENDAI I

letrozole tablet Gynecologyhormonal treatment for advanced ovarian cancer in postmenopausal women

GOOVAI I

leucovorin calcium tablet, injectable Gastrointestinaladjuvant combination chemotherapy for Stage III and Stage IIB colon cancer using oxaliplatin, fluorouracil and folinic acid (Leucovorin)

GIAJFFOX I

leucovorin calcium tablet, injectable Gastrointestinaladjuvant therapy of colon cancer using fluorouracil injection and infusion and leucovorin infusion

GIAJFL I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using fluorouracil injection and infusion and folinic acid (leucovorin) infusion

GIAVFL I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using oxaliplatin, fluorouracil, leucovorin, and radiation therapy

GIEFFOXRT I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, folinic acid (leucovorin) and bevacizumab

GIFFIRB I

leucovorin calcium (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, leucovorin, and panitumumab

UGIFFIRPAN* R

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and bevacizumab

GIFFOXB I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and panitumumab

UGIFFOXPAN R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

leucovorin calcium tablet, injectable Gastrointestinalpalliative combination chemotherapy for advanced pancreatic adenocarcinoma using irinotecan, oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFIRINOX I

leucovorin calcium tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil and folinic acid (leucovorin)

GIFOLFIRI I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFOLFOX I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinaladjuvant chemotherapy of gastric cancer patients with D2 resection (node negative) or ineligible for adjuvant chemoradiation using oxaliplatin, fluorouracil, and leucovorin

GIGAJFFOX I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalperioperative treatment of resectable adenocarcinoma of the stomach, gastroesophageal junction or lower 1/3 esophagus using docetaxel, oxaliplatin, infusional fluorouracil, and leucovorin

UGIGFLODOC R

leucovorin calcium (cont'd) tablet, injectable Gastrointestinalpalliative combination chemotherapy for metastatic gastric or esophageal adenocarcinoma using irinotecan, fluorouracil and folinic acid (leucovorin)

GIGFOLFIRI I

leucovorin calcium (cont'd) tablet, injectable Gastrointestinaladjuvant combination chemotherapy for stage III rectal cancer using oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIRAJFFOX I

leucovorin calcium (cont'd) tablet, injectable Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I

leucovorin calcium (cont'd) tablet, injectable Gynecologytherapy for low risk gestational trophoblastic neoplasia using methotrexate, leucovorin and actinomycin-D

GOTDLR I

leucovorin calcium (cont'd) tablet, injectable Head and Neckfluorouracil and leucovorin for recurrent head and neck cancer (squamous cell carcinoma)

HNAVFUFA I

leucovorin calcium (cont'd) tablet, injectable Head and Neckfluorouracil and leucovorin for recurrent head and neck cancer (nasopharyngeal)

HNNAVFUFA I

leucovorin calcium (cont'd) tablet, injectable Lymphomacentral nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

leucovorin calcium (cont'd) tablet, injectable Lymphomatreatment of Burkitt’s Lymphoma and Leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

leucovorin calcium (cont'd) tablet, injectable Lymphomatreatment of Primary Intracerebral Lymphoma with high dose methotrexate and rituximab

LYHDMRP I

leucovorin calcium (cont'd) tablet, injectable Lymphomatreatment of Primary Intracerebral Lymphoma with high dose methotrexate

LYHDMTXP I

leucovorin calcium (cont'd) tablet, injectable Lymphomatreatment of Leptomeningeal Lymphoma or recurrent Intracerebral Lymphoma with high dose methotrexate

LYHDMTXR I

leucovorin calcium (cont'd) tablet, injectable Miscellaneous Origins meningeal disease using high dose methotrexate with leucovorin rescue MOHDMTX I

leucovorin calcium (cont'd) tablet, injectable Sarcomatreatment of osteosarcoma using high dose methotrexate with leucovorin rescue

SAHDMTX I

leucovorin calcium (cont'd) tablet, injectableNot Otherwise Specified


I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

leuprolide injectable, long acting injectable


BRAJLHRHAI I


Breastneoadjuvant or adjuvant therapy for breast cancer using a LHRH agonist and tamoxifen

BRAJLHRHT I

leuprolide (cont'd)injectable, long acting injectable

Breasttherapy for advanced breast cancer using a LHRH agonist and an aromatase inhibitor

BRAVLHRHA I


Breastcombination therapy with tamoxifen palliative therapy for metastatic breast cancer

BRAVLHRHT I


Genitourinary therapy for prostate cancer using LHRH agonist GUPLHRH I

lomustine capsule Neuro-Oncology lomustine for treatment of recurrent malignant brain tumors CNCCNU I

lomustine capsule Neuro-Oncologyadjuvant lomustine, cisplatin and vincristine in adult high-risk medulloblastoma or other primitive neuroectodermal tumour

CNCCV I

lomustine (cont'd) capsule Neuro-Oncologymodified PCV chemotherapy of brain tumours using procarbazine, lomustine and vincristine

CNMODPCV I

lomustine (cont'd) capsule Lymphoma lymphoma palliative chemotherapy LYPALL I

lomustine capsule Skin & Melanoma second line treatment for metastatic malignant melanoma using lomustine SMCCNU I

lomustine (cont'd) capsuleNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. CNNOS)

I

mechlorethamine injectableNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. LUNOS)

I

medroxyprogesterone tablet Gynecology non-aromatase inhibitor hormonal treatment of endometrial cancer GOENDH INot reimbursed for appetite stimulation or replacement

therapy.megestrol tablet Breast breast cancer BRAVMEG Imegestrol tablet Gynecology non-aromatase inhibitor hormonal treatment of endometrial cancer GOENDH I

melphalan tablet, injectable BMTconditioning therapy for autologous stem cell transplant using high dose melphalan in the treatment of multiple myeloma

BMTMM0301 I

melphalan tablet, injectable Myeloma treatment of multiple myeloma using melphalan and prednisone MYMP I

melphalan tablet, injectable Myelomatreatment of multiple myeloma using melphalan, prednisone and weekly bortezomib with the option of substituting cyclophosphamide for melphalan

MYMPBOR I

Not reimbursed for appetite stimulation or symptom

Leuprolide acetate IM (LUPRON®) and SC (ELIGARD®) injectables are both reimbursable

for prostate cancer indications (GUPLHRH). Not reimbursed for

endometriosis.

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

melphalan tablet, injectableNot Otherwise Specified


I

6-mercaptopurine tabletNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. LKNOS)

I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

mesna injectable Genitourinaryconsolidation/ salvage treatment for germ cell cancer using vinblastine, cisplatin, ifosfamide and mesna

GUVEIP I

mesna injectable Genitourinarynonseminoma consolidation/salvage protocol using etoposide, cisplatin, ifosfamide, mesna

GUVIP2 I

mesna (cont'd) injectable LymphomaTreatment of Burkitt’s lymphoma and leukemia with ifosfamide, mesna, etoposide, cytarabine and rituximab

LYIVACR I

mesna injectable Sarcomatherapy for advanced soft tissue sarcoma using doxorubicin, ifosfamide-mesna

SAAI I

mesna (cont'd) injectable Sarcoma


SAALT2W I

mesna (cont'd) injectable Sarcoma


SAALT3W I

mesna (cont'd) injectable Sarcoma therapy for advanced soft tissue sarcoma using ifosfamide SAAVI I

mesna injectable Sarcoma3-Day etoposide & ifosfamide-mesna for patients with advanced soft tissue or bony sarcomas

SAAVIME3 I

mesna (cont'd) injectable Sarcoma etoposide, ifosfamide-mesna (SAIME) for use in sarcomas SAIME I

mesna (cont'd) injectable Sarcomatreatment of sarcomas with pelvic primaries or chemotherapy induced hematuria using vincristine, doxorubicin, cyclophosphamide and mesna

SAVACM I

mesna (cont'd) injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin, cyclophosphamide and mesna

SAVDCM I

mesna (cont'd) injectable Supportive Caremesna dosage modification for hematuria secondary to oxazaphosphorines

SCMESNA I

mesna (cont'd) injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. SANOS)

I

methotrexate tablet, injectable Breastadjuvant therapy for high-risk breast cancer using cyclophosphamide (oral), methotrexate and fluorouracil

BRAJCMFPO I

methotrexate (cont'd) tablet, injectable Breastpalliative therapy for advanced breast cancer using cyclophosphamide, methotrexate and fluorouracil

BRAVCMF I

methotrexate tablet, injectable Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I

Approved for use ONLY as an uro-protector for ifosfamide or high

dose cyclophosphamide

Not reimbursed for rheumatoid arthritis, psoriasis.

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

methotrexate (cont'd) tablet, injectable Gynecologytherapy for low risk gestational trophoblastic neoplasia using methotrexate, leucovorin and actinomycin-D

GOTDLR I

methotrexate tablet, injectable Genitourinarytherapy for transitional cell cancers of the urothelium using methotrexate, vinblastine, doxorubicin and cisplatin

GUMVAC I

methotrexate tablet, injectable Head and Necktreatment of head and neck cancer using methotrexate as standard therapy

HNAVM I

methotrexate (cont'd) tablet, injectable Kaposi's Sarcoma therapy for Kaposi's Sarcoma using vinblastine-vincristine KSVB I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of hemophagocytic lymphohistiocytosis with etoposide, dexamethasone and cycloSPORINE

HLHETCSPA I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of refractory or relapsing extranodal natural killer or T-cell lymphoma using asparaginase, methotrexate and dexamethasone

LYASPMEDEX I

methotrexate (cont'd) tablet, injectable Lymphomacentral nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of burkitt’s lymphoma and leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of primary intracerebral lymphoma with high dose methotrexate and rituximab

LYHDMRP I

methotrexate (cont'd) tablet, injectable Lymphoma treatment of primary intracerebral lymphoma with high dose methotrexate LYHDMTXP I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of leptomeningeal lymphoma or recurrent intracerebral lymphoma with high dose methotrexate

LYHDMTXR I

methotrexate (cont'd) tablet, injectable Lymphoma treatment of lymphoma using intrathecal methotrexate and cytarabine LYIT I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of Burkitt’s Lymphoma and Leukemia with ifosfamide, mesna, etoposide, cytarabine and rituximab

LYIVACR I

methotrexate (cont'd) tablet, injectable Lymphoma lymphoma palliative chemotherapy LYPALL I

methotrexate (cont'd) tablet, injectable Lymphomatreatment of natural killer or T-cell lymphoma using dexamethasone, methotrexate, ifosfamide, asparaginase and etoposide

LYSMILE I

methotrexate (cont'd) tablet, injectable Miscellaneous Origins meningeal disease using high dose methotrexate with leucovorin rescue MOHDMTX I

methotrexate (cont'd) tablet, injectable Miscellaneous Originstherapy for solid tumours using intrathecal methotrexate and/or thiotepa and/or cytarabine

MOIT I

methotrexate (cont'd) tablet, injectable Sarcomatreatment of osteosarcoma using high dose methotrexate with leucovorin rescue

SAHDMTX I

methotrexate (cont'd) tablet, injectable Sarcomapalliative therapy for aggressive fibromatosis using weekly or alternate week methotrexate and vinblastine intravenously

SAMV I


* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

methotrexate (cont'd) tablet, injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. MYNOS)

I

methoxypsoralen injectable Lymphomatreatment of Cutaneous T-cell Lymphoma (Sézary syndrome) with extracorporeal photopheresis

ULYMFECP R

methyl aminolevulinate (METVIX®)

topical cream Skin & Melanoma topical therapy for skin cancer with PDT (Photodynamic Therapy) SMPDT I

Only reimbursable when prescribed by physicians in the

Skin Tumour Group within the Skin PDT Program of the BC Cancer

Agency

mitomycin injectable Gastrointestinalcombined modality therapy for carcinoma of the anal canal using mitomycin, capecitabine and radiation therapy

GICART I

mitomycin injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using fluorouracil and cisplatin

GIEFUPRT I

mitomycin injectable Gastrointestinalhepatic trans-arterial chemoembolization for primary liver cancer or liver metastasis

GIEMBOL IOnly funded when prescribed by specialists at BC Cancer VC &


mitomycin (cont'd) injectable Gastrointestinalcombined modality curative therapy for carcinoma of the anal canal using mitomycin, fluorouracil and radiation therapy

GIFUART I

mitomycin (cont'd) injectable Gastrointestinalchemotherapy of pseudomyxoma peritonei using intraperitoneal mitomycin and fluorouracil

GIFUIP I

mitomycin (cont'd) injectable Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal carcinomatosis from limited advanced colorectal and appendiceal carcinomas using oxaliplatin and fluorouracil

GIHIPEC I

mitomycin (cont'd) injectable Genitourinarycombined modality therapy for squamous cell cancer of the genitourinary system using fluorouracil and cisplatin with radiation

GUFUPRT I

mitomycin injectable Genitourinary intravesical use for bladder cancer GUBMITO Imitomycin eye drops Ocular eye drops as topical therapy for ocular malignancies OCMITO I

mitomycin (cont'd) injectableNot Otherwise Specified


I

mitotane tablet Genitourinary treatment of advanced adrenal cortical cancer GUMITO I

mitotane tablet Genitourinarytreatment of metastatic adrenalcortical cancer with doxorubicin, etoposide, cisplatin and mitotane

GUEDPM I

mitoxantrone injectable Genitourinarypalliative therapy for hormone-refractory prostate cancer using mitoxantrone and prednisone

GUPMX I

mitoxantrone injectableNot Otherwise Specified


I

nilotinib tablet Leukemia treatment of chronic myeloid leukemia using nilotinib ULKCMLN R


* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

nilutamide tablet Genitourinaryprostate carcinoma patients who are intolerant to bicalutamide or flutamide, at 150 mg po daily

GUPNSAA INot reimbursed for vasomotor

symptoms (hot flashes)

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

nivolumab injectable Genitourinary treatment of metastatic or advanced renal cell carcinoma using nivolumab UGUAVNIV R

nivolumab injectable Head and Neckpalliative therapy for unresectable, platinum-refractory, recurrent or metastatic squamous cell cancer of the head and neck using nivolumab

UHNAVNIV R

nivolumab injectable Lung treatment of advanced non-small cell lung cancer using nivolumab ULUAVNIV R

nivolumab injectable Skin & Melanoma treatment of unresectable or metastatic melanoma using nivolumab USMAVNIV R

obinutuzumab injectable Lymphomatreatment of previously untreated chronic lymphocytic leukemia using obinutuzumab in combination with chlorambucil

ULYOBCHLOR R

obinutuzumab injectable Lymphomatreatment of rituximab-refractory follicular lymphoma with obinutuzumab in combination with bendamustine

ULYOBBEND* R

octreotide injectable Neuro-Oncology treatment of growth hormone secreting pituitary adenoma CNOCTLAR I

octreotide injectable Gastrointestinalneuroendocrine tumours of the mid-gut or pancreas (including carcinoid tumours and VIPoma) with symptoms due to ectopic hormone secretion

GINOS I

octreotidelong acting injectable

Neuro-Oncology treatment of growth hormone secreting pituitary adenoma CNOCTLAR I

octreotidelong acting injectable

Gastrointestinalneuroendocrine tumours of the mid-gut or pancreas (including carcinoid tumours and VIPoma) with symptoms due to ectopic hormone secretion

UGIOCTLAR R

oxaliplatin injectable Gastrointestinaladjuvant combination chemotherapy for stage III and IIB colon cancer with capecitabine

GIAJCAPOX I

oxaliplatin (cont'd) injectable Gastrointestinaladjuvant combination chemotherapy for stage III and IIB colon cancer with fluorouracil and folinic acid

GIAJFFOX I

oxaliplatin injectable Gastrointestinaladjuvant combination chemotherapy for node-positive colon cancer using oxaliplatin and raltitrexed in patients intolerant to fluorouracil or capecitabine

UGIAJRALOX R

oxaliplatin injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin and capecitabine

GICAPOX I

oxaliplatin injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, bevacizumab and capecitabine

GICOXB I

oxaliplatin (cont'd) injectable Gastrointestinalcombined modality therapy for locally advanced esophageal cancer using oxaliplatin, fluorouracil, leucovorin, and radiation therapy

GIEFFOXRT I

oxaliplatin injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and bevacizumab

GIFFOXB I

oxaliplatin injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and panitumumab

UGIFFOXPAN R

oxaliplatin (cont'd) injectable Gastrointestinalpalliative combination chemotherapy for advanced pancreatic adenocarcinoma using irinotecan, oxaliplatin, fluorouracil and folinic acid (leucovorin)

GIFIRINOX I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

oxaliplatin injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer with fluorouracil and folinic acid

GIFOLFOX I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

oxaliplatin (cont'd) injectable Gastrointestinaladjuvant chemotherapy of gastric cancer patients with D2 resection (node negative) or ineligible for adjuvant chemoradiation using oxaliplatin and capecitabine

GIGAJCOX I

oxaliplatin injectable Gastrointestinaladjuvant chemotherapy of gastric cancer patients with D2 resection (node negative) or ineligible for adjuvant chemoradiation using oxaliplatin, fluorouracil, and leucovorin

GIGAJFFOX I

oxaliplatin (cont'd) injectable Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and capecitabine

GIGAVEOCAP I

oxaliplatin injectable Gastrointestinalpalliative therapy for metastatic or locally advanced gastric or esophagogastric cancer using epirubicin, oxaliplatin and infusional fluorouracil

GIGAVEOF I

oxaliplatin injectable Gastrointestinalperioperative treatment of resectable adenocarcinoma of the stomach, gastroesophageal junction or lower 1/3 esophagus using docetaxel, oxaliplatin, infusional fluorouracil, and leucovorin

UGIGFLODOC R

oxaliplatin (cont'd) injectable Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal carcinomatosis from limited advanced colorectal and appendiceal carcinomas using oxaliplatin and fluorouracil

GIHIPEC I

oxaliplatin injectable Gastrointestinaladjuvant combination chemotherapy for stage III rectal cancer with capecitabine

GIRAJCOX I

oxaliplatin injectable Gastrointestinaladjuvant combination chemotherapy for stage III rectal cancer with fluorouracil and folinic acid

GIRAJFFOX I

paclitaxel injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel

BRAJACT I

paclitaxel injectable Breastsequential combination in combination with doxorubicin and cyclophosphamide as adjuvant therapy for breast cancer using dose dense therapy

BRAJACTG I

paclitaxel injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTT I

paclitaxel (cont'd) injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTTG I

paclitaxel injectable Breastadjuvant therapy for early breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRAJACTW I

paclitaxel injectable Breastadjuvant therapy for breast cancer using weekly paclitaxel and trastuzumab (HERCEPTIN) BRAJTTW I

paclitaxel injectable Breast treatment of metastatic breast cancer using gemcitabine and paclitaxel BRAVGEMT I

paclitaxel (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN), and paclitaxel as first-line treatment for advanced breast cancer

BRAVPTRAT I

paclitaxel (cont'd) injectable Breast palliative therapy for metastatic breast cancer using paclitaxel BRAVTAX I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

paclitaxel (cont'd) injectable Breastcombination with paclitaxel and carboplatin as palliative therapy for metastatic breast cancer as first-line treatment for recurrent breast cancer refractory to anthracycline chemotherapy

BRAVTPCARB I

paclitaxel (cont'd) injectable Breastwith paclitaxel as first-line treatment for advanced breast cancer refractory to anthracycline adjuvant chemotherapy

BRAVTRAP I

paclitaxel injectable Breastpalliative therapy for metastatic breast cancer using weekly paclitaxel (given weekly for 3 weeks out of 4 weeks) (replaces BRAVT7)

BRAVTW I

paclitaxel (cont'd) injectable Breastneoadjuvant therapy for breast cancer using dose dense therapy: paclitaxel followed by doxorubicin and cyclophosphamide

BRLATACG I

paclitaxel injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by weekly paclitaxel

BRLATWAC I

paclitaxel (cont'd) injectable Gastrointestinalneoadjuvant treatment of esophageal and gastroesophageal carcinomas using carboplatin, paclitaxel and radiation therapy

GIENACTRT I

paclitaxel (cont'd) injectable Gastrointestinalsecond-line therapy for metastatic or locally advanced gastric or gastroesophageal junction cancer using weekly paclitaxel and ramucirumab

UGIGAVRAMT R

paclitaxel (cont'd) injectable Gastrointestinalhyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal mesothelioma using doxorubicin, cisplatin and paclitaxel

GIPMHIPEC I

paclitaxel (cont'd) injectable Gynecologyalternative treatment of gynecological malignancies using cisplatin and paclitaxel

GOCISP I

paclitaxel (cont'd) injectable Gynecologyprimary adjuvant treatment of adenocarcinoma/adenosquamous cancer of the cervix with carboplatin and paclitaxel preceding or following irradiation with or without cisplatin

GOCXAJCAT I

paclitaxel (cont'd) injectable Gynecologycombination with carboplatin as primary treatment of advanced/recurrent non-small cell cancer of the cervix in ambulatory care settings

GOCXCAT I

paclitaxel (cont'd) injectable Gynecology primarily advanced or recurrent endometrial cancer GOENDCAT I

paclitaxel (cont'd) injectable Gynecologyprimary treatment of invasive epithelial ovarian, fallopian tube and primary peritoneal cancer, with no visible residual tumour (moderate-high risk)

GOOVCATM I

paclitaxel (cont'd) injectable Gynecologyovarian cancer relapsing after complete remission of at least 4 months’ duration in response to primary treatment with carboplatin and paclitaxel

GOOVCATR I

paclitaxel (cont'd) injectable Gynecologyprimary treatment of visible residual (extreme risk) invasive epithelial ovarian cancer

GOOVCATX I

paclitaxel (cont'd) injectable Gynecologyprimary treatment of metastatic/recurrent cancer of the cervix with bevacizumab, carboplatin and paclitaxel

GOCXCATB I

paclitaxel (cont'd) injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and paclitaxel UGOOVBEVP R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

paclitaxel (cont'd) injectable Gynecologyprimary treatment of advanced epithelial ovarian, primary peritoneal, or fallopian tube carcinoma using carboplatin and weekly paclitaxel

GOOVDDCAT I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

paclitaxel (cont'd) injectable Gynecologyprimary treatment of stage III less than or equal to 1 cm visible residual invasive epithelial ovarian cancer using intravenous and intraperitoneal paclitaxel and intraperitoneal carboplatin

GOOVIPPC I

paclitaxel (cont'd) injectable Gynecologyprogressive, platinum-refractory ovarian carcinoma, primary peritoneal carcinoma or fallopian tube carcinoma

GOOVTAX3 I

paclitaxel (cont'd) injectable Gynecologyprimary management of any gynecologic small cell cancer as part of a combined modality regimen

GOSMCCRT I

paclitaxel (cont'd) injectable Genitourinarycombination palliative therapy with gemcitabine in patients with relapsed, cisplatin-refractory germ cell cancers not amenable to cure with surgery or chemotherapy (patients relapsed after BMT are potentially eligible

UGUTAXGEM R

paclitaxel (cont'd) injectable Genitourinarytherapy for relapsed testicular germ cell cancer using paclitaxel, lfosfamide and cisplatin

UGUTIP R

paclitaxel (cont'd) injectable Head and Necktreatment for unresectable, locoregionally recurrent or metastatic squamous cell carcinoma of the head and neck using paclitaxel and cisplatin or carboplatin

HNAVPC I

paclitaxel (cont'd) injectable Head and Necktreatment of recurrent or metastatic nasopharyngeal carcinoma with carboplatin and paclitaxel

HNNAVPC I

paclitaxel (cont'd) injectable Lungadjuvant carboplatin and paclitaxel following resection of stage I, II and IIIA non-small cell lung cancer

LUAJPC I

paclitaxel (cont'd) injectable Lungcombination with carboplatin as first line treatment of advanced non-small cell lung cancer

LUAVPC I

paclitaxel (cont'd) injectable Lungtreatment of locally advanced non-small cell lung cancer using carboplatin and paclitaxel with radiation therapy

LULACATRT I

paclitaxel (cont'd) injectable Primary Unknownprimary treatment of cancer of unknown primary origin using carboplatin and paclitaxel

PUCAT I

paclitaxel (cont'd) injectable Pediatrictreatment of recurrent or resistant pediatric malignant germ cell tumors with paclitaxel, ifosfamide and carboplatin (COG protocol AGCT0521)

I

paclitaxel-nab (ABRAXANE®)

injectable Breast palliative therapy for metastatic breast cancer BRAVABR I

paclitaxel-nab (ABRAXANE®) (cont'd)

injectable Gastrointestinalfirst line treatment of locally advanced and metastatic pancreatic cancer with paclitaxel-nab (ABRAXANE®) and gemcitabine

GIPGEMABR I

palbociclib capsule Breasttherapy of advanced breast cancer using palbociclib with aromatase inhibitor

UBRAVPALAI R

pamidronate injectable Breast adjuvant treatment of post-menopausal women using pamidronate UBRAJPAM R

pamidronate injectable Breastbony metastases associated with breast cancer for patients who do not tolerate oral clodronate

BRAVCLOD I

pamidronate injectable Breast acute bone pain secondary to metastatic breast cancer BRAVPAM Ipamidronate injectable Myeloma multiple myeloma MYPAM I

Not reimbursed for hypercalcemia

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

panitumumab injectable Gastrointestinalpalliative third-line treatment of metastatic colorectal cancer using panitumumab with wild type KRAS

GIAVPANI I

panitumumab injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using irinotecan, fluorouracil, leucovorin, and panitumumab

UGIFFIRPAN* R

panitumumab injectable Gastrointestinalpalliative combination chemotherapy for metastatic colorectal cancer using oxaliplatin, fluorouracil, leucovorin, and panitumumab

UGIFFOXPAN R

pazopanib tablet Genitourinary palliative therapy for renal cell carcinoma using pazopanib UGUPAZO Rpegaspargase (ONCASPAR®)

injectable Pediatric pediatric patients with leukemia or lymphoma I

peginterferon alfa-2a injectable Leukemia therapy of chronic myeloid neoplasms and hypereosinophilic syndrome LKPEGIFN I

pembrolizumab injectable Lungsecond-line treatment of advanced non-small cell lung cancer using pembrolizumab

ULUAVPMB R

pembrolizumab injectable Lungfirst-line treatment of advanced non-small cell lung cancer using pembrolizumab

ULUAVPMBF R

pembrolizumab injectable Skin & Melanoma treatment of unresectable or metastatic melanoma using pembrolizumab USMAVPEM R

pemetrexed injectable Lung second-line treatment of advanced non-small cell lung cancer LUAVPEM I

pemetrexed injectable Lungmaintenance therapy of advanced non-small cell lung cancer after first-line chemotherapy

ULUAVPMTN R

pemetrexed injectable Lungfirst-line treatment of advanced non-small cell lung cancer with platinum and pemetrexed

LUAVPP I

pemetrexed (cont'd) injectable Lung treatment of malignant mesothelioma with platinum and pemetrexed LUMMPP I

pertuzumab injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN) and docetaxel as first-line treatment for advanced breast cancer

BRAVPTRAD I

pertuzumab (cont'd) injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN), and paclitaxel as first-line treatment for advanced breast cancer

BRAVPTRAT I

plerixafor injectable hematopoietic stem cell mobilization PLERIXAFOR I

pomalidomide capsule Myeloma therapy of multiple myeloma using pomalidomide with dexamethasone UMYPOMDEX R

ponatinib tablet Leukemiatreatment of chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia using ponatinib

ULKCMLP R

porfimer (PHOTOFRIN®) injectable Gastrointestinalphotodynamic therapy in patients with high-grade dysplasia associated with Barrett's esophagus, and who are not candidates for surgery

UGI0 R

prednisolone suspension Pediatric pediatric patients I

prednisone tablet Genitourinarypalliative therapy for metastatic castration resistant prostate cancer sing cabazitaxel and predniSONE

UGUPCABA R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

prednisone (cont'd) tablet Genitourinarypalliative therapy for metastatic castration resistant prostate cancer using abiraterone and prednisone after failure of docetaxel therapy

UGUPABI R

prednisone tablet Genitourinary palliative therapy for metastatic hormone refractory prostate cancer GUPDOC I

prednisone (cont'd) tablet Genitourinarypalliative therapy for hormone-refractory prostate cancer using mitoxantrone and prednisone

GUPMX I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

prednisone (cont'd) tablet Lymphomatreatment of Hodgkin's disease using cyclophosphamide, vincristine and prednisone

LYCCOP I

prednisone tablet Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine and prednisone

LYCHOP I

prednisone (cont'd) tablet Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab

LYCHOPR I

prednisone tablet Lymphomacentral nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

prednisone tablet Lymphomaadvanced indolent lymphoma using cyclophosphamide, vincristine and prednisone

LYCVP I

prednisone tablet Lymphomatreatment of advanced indolent lymphoma using cyclophosphamide, vincristine, prednisone and rituximab

LYCVPR I

prednisone tablet Lymphomatherapy of lymphoma, Hodgkin's disease, chronic lymphocytic leukemia or multiple myeloma using cyclophosphamide

LYCYCLO I

prednisone (cont'd) tablet Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I

prednisone (cont'd) tablet Lymphoma lymphoma palliative chemotherapy LYPALL I

prednisone (cont'd) tablet Myelomatreatment of multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide as induction pre-stem cell transplant

MYBORPRE I

prednisone (cont'd) tablet Myelomatreatment of relapsed multiple myeloma using bortezomib, dexamethasone with or without cyclophosphamide

MYBORREL I

prednisone (cont'd) tablet Myeloma treatment of multiple myeloma using melphalan and prednisone MYMP I

prednisone (cont'd) tablet Myelomatreatment of multiple myeloma using melphalan, prednisone and weekly bortezomib with the option of substituting cyclophosphamide for melphalan

MYMPBOR I

prednisone (cont'd) tabletNot Otherwise Specified


I

procarbazine capsule Neuro-Oncologymodified PCV chemotherapy of brain tumours using procarbazine, lomustine and vincristine

CNMODPCV I

procarbazine capsule Neuro-Oncology standard procarbazine for second-line treatment of recurrent brain tumor CNPROC I

procarbazine (cont'd) capsule Lymphomatreatment of Hodgkin's Disease with cyclophosphamide, vinblastine, procarbazine and prednisone

LYCVPPABO I

procarbazine capsule Lymphoma lymphoma palliative chemotherapy LYPALL I

procarbazine (cont'd) capsuleNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. CNNOS)

I

quinagolide tablet Neuro-Oncology therapy for pituitary adenaomas using quinagolide CNQUIN I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

radium-223radio-

pharmaceuticalGenitourinary

therapy for metastatic castration resistant prostate cancer using radium-223

UGUPRAD R

raltitrexed injectable Gastrointestinalunresectable or metastatic colorectal adenocarcinoma for patients with previous fluorouracil toxicity

GIRALT I

raltitrexed (cont'd) injectable Gastrointestinaladjuvant combination chemotherapy for node-positive colon cancer using oxaliplatin and raltitrexed in patients intolerant to fluorouracil or capecitabine

UGIAJRALOX R

ramucirumab injectable Gastrointestinalsecond-line therapy for metastatic or locally advanced gastric or gastroesophageal junction cancer using weekly paclitaxel and ramucirumab

UGIGAVRAMT R

regorafenib tablet Sarcomathird line treatment of advanced gastrointestinal stromal cell tumours (GIST's) using regorafenib

USAAVGR R

rituximab IV injectable BMTpre-emptive rituximab therapy of Epstein-Barr virus related post-transplant lymphoproliferative disease

BMTLPDRIT IIV formulation only; Rituximab®

SC not funded

rituximabIV / SC

injectableLymphoma treatment of Non-Hodgkin Lymphoma with bendamustine and rituximab ULYBENDR R

rituximabIV / SC

injectableLymphoma

treatment of indolent B-cell lymphoma and chronic lymphocytic leukemia with chlorambucil and rituximab

LYCHLRR I

rituximab (cont'd)IV / SC

injectableLymphoma

in combination with CHOP (cyclophosphamide, doxorubicin, prednisone, vincristine), in all stages of newly diagnosed diffuse large B-cell lymphoma and mantle cell lymphoma, advanced stage at diagnosis

LYCHOPR I

rituximabIV / SC

injectableLymphoma

central nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

IV injectabletreatment of previously untreated chronic lymphocytic leukemia (CLL) with bendamustine and rituximab

ULYCLLFBR RIV formulation only; Rituximab®

SC not funded

rituximabIV / SC

injectableLymphoma

treatment of Burkitt’s lymphoma and leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I


injectableLymphoma

combination with CVP for advanced stage indolent lymphoma at diagnosis

LYCVPR I

rituximab (cont'd) IV injectable Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR IIV formulation only; Rituximab®

SC not funded


injectableLymphoma

treatment of chronic lymphocytic leukemia (CLL) or prolymphocytic leukemia with fludarabine, cyclophosphamide and rituximab

LYFCR I

rituximabIV / SC

injectableLymphoma

in combination with fludarabine for treatment of chronic lymphocytic leukemia or prolymphocytic leukemia and relapsed indolent lymphoma

LYFLUDR I


injectableLymphoma

in combination with gemcitabine, dexamethasone and cisplatin for lymphoma

LYGDPR I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

rituximabIV / SC

injectableLymphoma

treatment of primary intracerebral lymphoma with high dose methotrexate and rituximab

LYHDMRP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

rituximab (cont'd) IV injectable Lymphomatreatment of relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma using idelalisib and rituximab

ULYIDELAR RIV formulation only; Rituximab®

SC not funded


injectableLymphoma

treatment of Burkitt’s lymphoma and leukemia with ifosfamide, mesna, etoposide, cytarabine and rituximab

LYIVACR I


injectableLymphoma

treatment of advanced stage large B-cell non-Hodgkin’s lymphoma with ifosfamide, carboplatin, etoposide and rituximab

ULYRICE R


injectableLymphoma

follicular lymphoma progressive despite alkylating agents and purine analogues (fludarabine or cladribine), post-transplant lymphoproliferative disease, or newly diagnosed (within 6 months) asymptomatic advanced follicular lymphoma

LYRITUX I

rituximab (cont'd) IV injectable Lymphomapalliative therapy for lymphoma using radioimmunotherapy: rituximab-priming for ibritumomab 90Y (ZEVALIN®) ULYRITZ R

IV formulation only; Rituximab® SC not funded


injectableLymphoma maintenance treatment of indolent lymphoma LYRMTN I

rituximab (cont'd) IV injectable Pediatric

pediatric patients treated on the COG protocols ANHL0221 for CD20 positive post-transplant lymphoproliferative disease following solid organ transplantation and ANHL01P1 for newly diagnosed advanced B-cell leukemia/lymphoma

IIV formulation only; Rituximab®

SC not funded

romidepsin injectable Lymphomatreatment of relapsed or refractory Peripheral T-Cell lymphoma (PTCL) with romidepsin

ULYROMI R

ruxolitinib tablet Leukemia treatment of symptomatic myelofibrosis with ruxolitinib ULKMFRUX Rruxolitinib tablet Leukemia treatment of polycythemia vera with ruxolitinib ULKPCVRUX R

sargramostim injectable Pediatricpediatric patients with neuroblastoma treated on the COG ANBL0032 protocol

I

sargramostim injectable Pediatricpediatric patients with relapsed neuroblastoma treated on the COG ANBL1021 protocol

I

siltuximab injectable Lymphomatreatment of Multicentric Castleman’s Disease (MCD) negative for Human Immunodeficiency Virus (HIV) and Human Herpes Virus-8 (HHV-8) Using siltuximab

ULYSILTUX R

sorafenib tablet Gastrointestinal sorafenib therapy for advanced hepatocellular carcinoma UGISORAF R

sorafenib tablet Genitourinary palliative therapy for renal cell carcinoma in patients after cytokine failure UGUSORAF R

sorafenib tablet Leukemia therapy of acute myeloid leukemia using azacitidine and sorafenib ULKAMLAS R

streptozocin injectable Gastrointestinalpalliative therapy for pancreatic endocrine tumours using streptozocin and doxorubicin

GIENDO2 I

streptozocin injectableNot Otherwise Specified

Other tumour site code followed by ‘NOS’ (e.g. GINOS)

I

Approval from Health Canada Special Access Programme is

required for each patient

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

sunitinib capsule Gastrointestinal as palliative treatment of advance pancreatic neuroendocrine tumours UGIPNSUNI R

sunitinib capsule Genitourinarypalliative therapy for renal cell carcinoma in patients who are not suitable candidates for interferon

UGUSUNI R

sunitinib (cont'd) capsule Sarcomasecond line treatment of advanced c-kit positive gastrointestinal stromal cell tumours (GIST's) after imatinib

SAAVGS I

tamoxifen tablet Breastneoadjuvant or adjuvant therapy for breast cancer using a LHRH agonist and tamoxifen

BRAJLHRHT I

tamoxifen tablet Breast neoadjuvant or adjuvant therapy for breast cancer using tamoxifen BRAJTAM I

tamoxifen (cont'd) tablet Breast palliative therapy for breast cancer using a LHRH agonist and tamoxifen BRAVLHRHT I

tamoxifen tablet Breast palliative therapy for breast cancer BRAVTAM I

tamoxifen tablet Gynecologyendometrial cancernon-aromatase inhibitor hormonal treatment of endometrial cancer

GOENDH I

tamoxifen tablet Gynecology therapy for advanced ovarian cancer using tamoxifen GOOVTAM Itamoxifen (cont'd) tablet Head and Neck treatment of recurrent/metastatic salivary gland cancers HNSAVTAM Itamoxifen tablet Sarcoma recurrent desmoid tumors/aggressive fibromatosis SATAM Itamoxifen tablet Skin & Melanoma recurrent or metastatic melanoma SMTAM I

temozolomide capsule Neuro-Oncologyconcomitant (dual modality) and 12 cycles of adjuvant temozolomide for newly diagnosed astrocytomas and oligodendrogliomas with radiation

CNAJ12TZRT I

temozolomide capsule Neuro-Oncologyconcomitant and adjuvant temozolomide for newly diagnosed malignant gliomas with radiation

CNAJTZRT I

temozolomide capsule Neuro-Oncologytreatment of elderly newly diagnosed glioma patient with concurrent and adjuvant temozolomide and radiation therapy

CNELTZRT I

temozolomide capsule Neuro-Oncologytherapy for newly diagnosed malignant brain tumours with MGMT methylation in elderly patients using temozolomide

CNTEM60 I

temozolomide capsule Neuro-Oncology therapy for malignant brain tumours CNTEMOZ I

temozolomide capsule Neuro-Oncologytherapy for malignant brain tumours using metronomic dosing of temozolomide

CNTEMOZMD I

temozolomide capsule Neuro-Oncologytherapy for recurrent malignant brain tumours using temozolomide and etoposide

CNTMZETO I

temozolomide (cont'd) capsule Gastrointestinalpalliative therapy of metastatic neuroendocrine cancer using temozolomide and capecitabine

GIAVTZCAP I

temozolomide capsule Pediatric pediatric patients with brain tumours I

temozolomide capsule Pediatricpediatric patients treated on the COG protocol ANBL0421 for recurrent neuroblastoma

I

temozolomide (cont'd) capsule Pediatricpediatric patients with rhabdomyosarcoma treated on the COG ARST08P1 protocol

I

temozolomide (cont'd) capsule Sarcomatherapy for advanced solitary fibrous tumours and hemangiopericytoma using temozolomide and bevacizumab

USATEMBEV R

temozolomide (cont'd) capsule Skin & Melanoma palliative therapy for malignant melanoma with brain metastases SMAVTMZ Itemsirolimus injectable Genitourinary therapy for advanced renal cancer using temsirolimus UGUTEM R

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

teniposide injectableNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. GUNOS)

I

testosterone injectable Breast palliative therapy for metastatic breast cancer BRAVTEST INot reimbursed for symptom

management or appetite stimulation

thioguanine tabletNot Otherwise Specified

Tumour site code followed by ‘NOS’ (e.g. LYNOS)

I

thiotepa injectable Miscellaneous Originstherapy for solid tumours using intrathecal methotrexate and/or thiotepa and/or cytarabine

MOIT I

thiotepa (cont'd) injectableNot Otherwise Specified


I

thyrotropin alfa injectable Head and Neck radioiodine imaging in patients with thyroid cancer and treatment HNOTTSH I

topotecan injectable Gynecologytreatment of relapsed/progressive epithelial ovarian, fallopian tube or primary peritoneal cancer using topotecan

GOOVTOP I

topotecan injectable Lung second line treatment of recurrent small cell lung cancer LUSCTOP Itopotecan (cont'd) injectable Pediatric pediatric sarcoma I

topotecan injectable Pediatricintermediate-risk (COG ANBL0532) and high risk (COG ANBL0531) pediatric neuroblastoma

I

topotecan injectable Sarcomasummary for treatment of recurrent/refractory neuroblastoma, ewing’s sarcoma, osteogenic sarcoma or rhabdomyosarcoma with topotecan/cyclophosphamide

SAAVTC I

trametinib tablet Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using dabrafenib and trametinib

USMAVDT R

trametinib tablet Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using trametinib

USMAVTRA R

trastuzumab (HERCEPTIN) injectable Breastadjuvant therapy for breast cancer using doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTT I

trastuzumab (HERCEPTIN) Injectable Breastadjuvant treatment of HER-2 positive breast cancer using carboplatin, docetaxel and trastuzumab (HERCEPTIN)

BRAJDCARBT I

trastuzumab (HERCEPTIN) Injectable Breastcombination with docetaxel after FEC regimen as adjuvant therapy for breast cancer

BRAJFECDT I

trastuzumab (HERCEPTIN) cont'd

Injectable Breastdocetaxel, cyclophosphamide and concurrent trastuzumab (HERCEPTIN) as adjuvant treatment of HER-2 postive breast cancer

BRAJTDC I

trastuzumab (HERCEPTIN) Injectable Breastadjuvant therapy for breast cancer using trastuzumab (HERCEPTIN) following the completion of chemotherapy (sequential)

BRAJTR I

Approval from Health Canada Special Access Programme is

required for each patient

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

trastuzumab (HERCEPTIN) (cont'd)

injectable Breast adjuvant therapy for breast cancer using weekly paclitaxel and trastuzumab (HERCEPTIN)

BRAJTTW I


injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN) and docetaxel as first-line treatment for advanced breast cancer

BRAVPTRAD I


injectable Breastpalliative therapy for metastatic breast cancer using pertuzumab, trastuzumab (HERCEPTIN), and paclitaxel as first-line treatment for advanced breast cancer

BRAVPTRAT I


injectable Breastcombination with capecitabine as second-line treatment of HER-2 positive metastatic breast cancer after prior treatment with trastuzumab (HERCEPTIN)

UBRAVTCAP R


injectable Breastcombination with paclitaxel and carboplatin as palliative therapy for metastatic breast cancer as first-line treatment for recurrent breast cancer refractory to anthracycline chemotherapy

BRAVTPCARB I


injectable Breast

single agent therapy for metastatic breast cancer progressing after 1 prior regimens (e.g., taxane) and responding to trastuzumab (HERCEPTIN) in combination with paclitaxel, with paclitaxel and carboplatin, or with vinorelbine

BRAVTR I


Injectable Breastwith docetaxel as first-line treatment for advanced breast cancer refractory to anthracycline adjuvant chemotherapy

BRAVTRAD I


Injectable Breastwith paclitaxel as first-line treatment for advanced breast cancer refractory to anthracycline adjuvant chemotherapy

BRAVTRAP I


Injectable Breastcombination with 3-weekly vinorelbine as palliative therapy for metastatic breast cancer

BRAVTRVIN I


Injectable Breastadjuvant therapy for breast cancer using dose dense therapy: doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab (HERCEPTIN)

BRAJACTTG I


Injectable Breasttreatment of locally advanced breast cancer using doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (HERCEPTIN)

BRLAACDT I


Injectable Gastrointestinalpalliative treatment of metastatic or locally advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma using cisplatin, capecitabine and trastuzumab (HERCEPTIN)

GIGAVCCT I


Injectable Gastrointestinalpalliative treatment of metastatic or inoperable, locally advanced gastric or gastroesophageal junction adenocarcinoma using cisplatin, infusional fluorouracil and trastuzumab (HERCEPTIN)

GIGAVCFT I


injectable Gastrointestinalcontinuation of palliative treatment of metastatic or inoperable, locally advanced gastric or gastroesophageal junction adenocarcinoma using trastuzumab (HERCEPTIN)

GIGAVTR I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

trastuzumab emtansine (KADCYLA)

injectable Breastpalliative therapy for metastatic breast cancer using trastuzumab emtansine (KADCYLA)

UBRAVKAD R

tretinoin (VESANOID®) capsule Leukemia acute promyelocytic leukemia LKNOS I

tretinoin (VESANOID®) (cont'd)

capsule Leukemiafirst-line induction and consolidation therapy of acute promyelocytic leukemia using arsenic trioxide and tretinoin

LKATOATRA I

tretinoin (VESANOID®) capsule Leukemiafirst-line induction and consolidation therapy of acute promyelocytic leukemia using arsenic trioxide, tretinoin and daunorubicin

LKATOP I

vemurafenib tablet Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using vemurafenib

USMAVVEM R

vemurafenib tablet Skin & Melanomatreatment of BRAF V600 mutation-positive unresectable or metastatic melanoma using vemurafenib and cobimetinib

USMAVVC R

vinblastine injectable Genitourinary therapy for transitional cell cancers using carboplatin-vinblastine GUBCV I

vinblastine injectable Genitourinarytherapy for transitional cell cancers of the urothelium using methotrexate, vinblastine, doxorubicin and cisplatin

GUMVAC I

vinblastine injectable Genitourinaryconsolidation/ salvage treatment for germ cell cancer using vinblastine, cisplatin, ifosfamide and mesna

GUVEIP I

vinblastine injectable Kaposi's Sarcoma therapy for Kaposi's Sarcoma using vinblastine-vincristine KSVB I

vinblastine injectable Lymphomatreatment of Hodgkin's disease with doxorubicin, bleomycin, vinblastine and dacarbazine

LYABVD I

vinblastine (cont'd) injectable Lymphoma lymphoma palliative chemotherapy LYPALL I

vinblastine (cont'd) injectable Sarcomapalliative therapy for aggressive fibromatosis using weekly or alternate week methotrexate and vinblastine intravenously

SAMV I

vinblastine injectableNot Otherwise Specified


I

vincristine injectable Neuro-Oncologyadjuvant lomustine, cisplatin and vincristine in adult high-risk medulloblastoma or other primitive neuroectodermal tumour

CNCCV I

vincristine (cont'd) injectable Neuro-Oncologymodified PCV chemotherapy of brain tumours using procarbazine, lomustine and vincristine

CNMODPCV I

vincristine (cont'd) injectable Gynecologytherapy for high-risk Gestational Trophoblastic Neoplasia (GTN) using etoposide, methotrexate, leucovorin (folinic acid), dactinomycin, cyclophosphamide and vincristine

GOTDEMACO I

vincristine (cont'd) injectable Kaposi's sarcoma therapy for Kaposi's Sarcoma using vinblastine-vincristine KSVB I

vincristine (cont'd) injectable Lungtreatment of thymoma/thymic carcinoma with cyclophosphamide, doxorubicin and vincristine

LUOTCAV I

vincristine (cont'd) injectable Lungtreatment of extensive small cell lung cancer with cyclophosphamide, doxorubicin and vincristine

LUSCCAV I

vincristine (cont'd) injectable Lymphomatreatment of Hodgkin's disease using cyclophosphamide, vincristine and prednisone

LYCCOP I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

vincristine (cont'd) injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine and prednisone

LYCHOP I

vincristine (cont'd) injectable Lymphomatreatment of lymphoma with doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab

LYCHOPR I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

vincristine (cont'd) injectable Lymphomacentral nervous system prophylaxis with high dose methotrexate, CHOP and rituximab in diffuse large B-cell lymphoma

LYCHOPRMTX I

vincristine (cont'd) injectable Lymphomatreatment of Burkitt’s Lymphoma and Leukemia with cyclophosphamide, vincristine, doxorubicin, methotrexate, leucovorin and rituximab

LYCODOXMR I

vincristine (cont'd) injectable Lymphomaadvanced indolent lymphoma using cyclophosphamide, vincristine and prednisone

LYCVP I

vincristine (cont'd) injectable Lymphomatreatment of Hodgkin's Disease with cyclophosphamide, vinblastine, procarbazine and prednisone

LYCVPPABO I

vincristine (cont'd) injectable Lymphomatreatment of advanced indolent lymphoma using cyclophosphamide, vincristine, prednisone and rituximab

LYCVPR I

vincristine (cont'd) injectable Lymphomatreatment of lymphoma with dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone and rituximab with intrathecal methotrexate

LYEPOCHR I

vincristine (cont'd) injectable Lymphoma lymphoma palliative chemotherapy LYPALL I

vincristine (cont'd) injectable Sarcoma


SAALT2W I

vincristine (cont'd) injectable Sarcoma


SAALT3W I

vincristine (cont'd) injectable Sarcomatreatment of sarcomas with vincristine, doxorubicin and cyclophosphamide

SAVAC I

vincristine (cont'd) injectable Sarcomatreatment of sarcomas with pelvic primaries or chemotherapy induced hematuria using vincristine, doxorubicin, cyclophosphamide and mesna

SAVACM I

vincristine (cont'd) injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin and cyclophosphamide

SAVDC I

vincristine (cont'd) injectable Sarcomaadjuvant therapy for rhabdomyosarcoma using vincristine, dactinomycin, cyclophosphamide and mesna

SAVDCM I

vincristine (cont'd) injectableNot Otherwise Specified


I

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

vinorelbine injectable Breast palliative therapy for metastatic breast cancer BRAVNAV I

vinorelbine injectable Breastcombination with 3-weekly trastuzumab (HERCEPTIN) as palliative therapy for metastatic breast cancer

BRAVTRVIN I

vinorelbine injectable Gynecologytreatment of platinum resistant epithelial ovarian cancer with bevacizumab and vinorelbine

UGOOVBEVV R

vinorelbine injectable Gynecologypalliative chemotherapy for re-treatment of ovarian, tubal, and peritoneal cancer

GOOVVIN I

vinorelbine injectable Head and Neckcombination with cisplatin as treatment of advanced salivary gland cancers with cisplatin and vinorelbine

HNSAVNP I

vinorelbine (cont'd) injectable Lungadjuvant cisplatin and vinorelbine following resection of stage I, II and IIIA non-small cell lung cancer

LUAJNP I

vinorelbine (cont'd) injectable Lungcombination with cisplatin as treatment for advanced non-small cell lung cancer

LUAVNP I

vinorelbine (cont'd) injectable Lung advanced non-small cell lung cancer in elderly patients LUAVVIN Ivinorelbine (cont'd) injectable Lung malignant mesothelioma LUMMVIN I

vinorelbine (cont'd) injectable Pediatricpediatric patients treated on the COG protocol AHOD0521 for refractory/recurrent Hodgkin’s disease

I

vismodegib capsule Skin & Melanoma treatment of metastatic or locally advanced basal cell carcinoma USMAVVIS R

yttrium-90 injectable Gastrointestinaltransarterial radioembolisation of hepatocellular carcinoma with portal venous invasion or T3 tumours, and metastatic neuroendocrine tumours

UGIYTT R

zoledronic acid injectable Breast adjuvant treatment of post-menopausal women using zoledronic acid BRAJZOL5* Iadjuvant treatment breast cancer in post-menopausal women using 3-monthly zoledronic acid BRAJZOL2* I

treatment of acute bone pain secondary to breast cancer metastases using IV zoledronic acid

BRAVZOL I

zoledronic acid injectable Breast treatment of multiple myeloma with zoledronic acid MYZOL* I

BMTBRGIGUGOHNKSLKLULYMOMYCN

Miscellaneous Origin

LeukemiaLung

MyelomaNeuro-Oncology

Lymphoma

Gastrointestinal

Head and NeckKaposi’s sarcoma

Protocol Code DefinitionsBone Marrow Transplantation

GenitourinaryGynecologic

Breast

* denotes change


of 70

DRUGDOSAGE

FORMTUMOUR


PROTOCOL CODES

CLASS NOTES

OCPUSASMSkin & Melanoma

OcularPrimary UnknownSarcoma

* denotes change

benefit drug list 3may2018 - bc cancer and forms...bc cancer benefit drug list may 2018 page 1 of 55...

Documents