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Regimen Name Cancer Type Pathway Pathologies Pathway Stages Pathway BioMarkers Pathway Line of Treatment Consensus Group(s) Zytiga (Abiraterone Acetate) and Prednisone (Castration Sensitive; Metastatic/Recurrent; First Line or Greater) Prostate Adenocarcinoma IVB; Recurrent Castration-resistant - No First Line + FDA; NCCN Category 1 Zytiga (Abiraterone Acetate) (1000 mg); Prednisone and Zoladex (Goserelin) (Castration Sensitive/Naïve; High Risk; Stage IVB/Recurrent) Prostate Adenocarcinoma IVB; Recurrent Castration-resistant - No First Line + FDA; NCCN Category 1 Zytiga (Abiraterone Acetate); Prednisone and Lupron (Leuprolide Acetate) (Castration Sensitive/Naïve; High Risk; Stage IVB/Recurrent) Prostate Adenocarcinoma IVB; Recurrent Castration-resistant - No First Line + FDA; NCCN Category 1 Zytiga (Abiraterone Acetate); Prednisone and Trelstar (Triptorelin Pamoate) (Castration Sensitive/Naïve; High Risk; Stage IVB/Recurrent) Prostate Adenocarcinoma IVB; Recurrent Castration-resistant - No First Line + FDA; NCCN Category 1

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Page 1: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Regimen Name Cancer TypePathway

PathologiesPathway Stages

Pathway

BioMarkers

Pathway Line of

TreatmentConsensus Group(s)

Zytiga (Abiraterone

Acetate) and Prednisone

(Castration Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line +

FDA; NCCN Category

1

Zytiga (Abiraterone

Acetate) (1000 mg);

Prednisone and Zoladex

(Goserelin) (Castration

Sensitive/Naïve; High

Risk; Stage

IVB/Recurrent)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line +

FDA; NCCN Category

1

Zytiga (Abiraterone

Acetate); Prednisone and

Lupron (Leuprolide

Acetate) (Castration

Sensitive/Naïve; High

Risk; Stage

IVB/Recurrent)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line +

FDA; NCCN Category

1

Zytiga (Abiraterone

Acetate); Prednisone and

Trelstar (Triptorelin

Pamoate) (Castration

Sensitive/Naïve; High

Risk; Stage

IVB/Recurrent)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line +

FDA; NCCN Category

1

Page 2: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Zytiga (Abiraterone

Acetate) and Prednisone

(Castration Resistant;

Metastatic; First Line)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

YesFirst Line

FDA; NCCN Category

1; NCCN Category

2A

Zytiga (Abiraterone)

(1000mg) and Prednisone

(Metastatic; Second Line

or Greater)

Prostate Adenocarcinoma IVB; Recurrent Second Line +

FDA; NCCN Category

1; NCCN Category

2A; NCCN Category

2B

Zytiga (Abiraterone

Acetate) with Zoladex

(Goserelin Acetate)

(Castration-Resistant;

Metastatic/Recurrent; 1st

Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

YesFirst Line +

Zytiga (Abiraterone

Acetate) with Lupron

(Leuprolide Acetate)

(Castration-Resistant;

Metastatic/Recurrent; 1st

Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

YesFirst Line +

Page 3: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Zytiga (Abiraterone

Acetate) with Trelstar

(Triptorelin Pamoate)

(Castration-Resistant;

Metastatic/Recurrent; 1st

Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

YesFirst Line +

Arimidex (Anastrozole)

(Palliative; Stage IV or

Recurrent)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Post-menopausal;

Estrogen Receptor -

Positive

First Line +NCCN Category 2A;

NCI-PDQ

Page 4: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Arimidex (Anastrozole)

With Monthly Zoladex

(Goserelin)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Page 5: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Arimidex (Anastrozole)

with Monthly Leuprolide

(3.75 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Page 6: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Arimidex (Anastrozole)

with Monthly Leuprolide

(7.5 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Erleada (Apalutamide)

(Castration Sensitive;

Metastatic/Recurrent

First Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Erleada (Apalutamide)

and Zoladex (Goserelin

Acetate ) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Page 7: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Erleada (Apalutamide)

and Lupron (Leuprolide

Acetate) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Erleada (Apalutamide)

and Trelstar (Triptorelin

Pamoate) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Clarithromycin and

Amoxicillin (Gastric

MALT; H-Pylori Positive;

First Line) (W)

Lymphoma/

Lymphoprolife

rative Diseases

MALT - Gastric IA-E, IB-E, IIA-E, IIB-E First Line

Clarithromycin and

Metronidazole (Gastric

MALT; H-Pylori Positive;

First Line)

Lymphoma/

Lymphoprolife

rative Diseases

MALT - Gastric IA-E, IB-E, IIA-E, IIB-E First Line

Xtandi (Enzalutamide)

(Castration Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB; RecurrentCastration-resistant -

NoFirst Line +

FDA; NCCN Category

1

Page 8: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Xtandi (Enzalutamide)

(Metastatic; 1st Line)Prostate Adenocarcinoma IVB; Recurrent

Castration-resistant -

YesFirst Line

ASCO; FDA; NCCN

Category 1; NCI-PDQ

Xtandi (Enzalutamide)

and Zoladex (Goserelin

Acetate) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Xtandi (Enzalutamide)

and Lupron (Leuprolide

Acetate) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Xtandi (Enzalutamide)

and Trelstar (Triptorelin

Pamoate) (Castration

Sensitive;

Metastatic/Recurrent;

First Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line + NCCN Category 1

Page 9: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Aromasin (Exemestane)

(Stage IV or Recurrent;

Palliative)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Post-menopausal;

Estrogen Receptor -

Positive

Second Line +NCCN Category 2A;

NCI-PDQ

Page 10: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Aromasin (Exemestane)

With Monthly GoserelinBreast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

Second Line,

Third Line, Third

Line +

NCCN Category 2A;

NCI-PDQ

Page 11: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Aromasin (Exemestane)

With Monthly Leuprolide

(3.75 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

Second Line,

Third Line, Third

Line +

NCCN Category 2A;

NCI-PDQ

Page 12: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Aromasin (Exemestane)

With Monthly Leuprolide

(7.5 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

Second Line,

Third Line, Third

Line +

NCCN Category 2A;

NCI-PDQ

Page 13: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

500 mgBreast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 14: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

(No Prior Endocrine

Therapy)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Post-menopausal;

Estrogen Receptor -

Positive

First Line +FDA; NCCN Category

1

Page 15: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

250 mg reduced dose for

Patients with Liver

Impairment With

Goserelin

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 16: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

250 mg reduced dose for

Patients with Liver

Impairment with Monthly

Lupron (Leuprolide) (3.75

mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 17: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

250 mg reduced dose for

Patients with Liver

Impairment with Monthly

Lupron (Leuprolide) (7.5

mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 18: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

250 mg reduced dose for

Patients with Liver

Impairment

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 19: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

with Monthly GoserelinBreast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 20: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

with Monthly Leuprolide

(3.75 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Page 21: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Faslodex (Fulvestrant)

with Monthly Leuprolide

(7.5 mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +NCCN Category 1;

NCCN Category 2A

Zoladex (Goserelin

Acetate) (For 1-3 Years)

(Stages IIC-IVA)

(High/Very High/Regional

Risk; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line

NCCN Category 1;

NCCN Category 2A;

NCI-PDQ

Zoladex (Goserelin

Acetate) for 1-3 years

with Bicalutamide or

Flutamide (Stages IIC-IVA)

(High/Very High/Regional

Risk; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line

NCCN Category 1;

NCCN Category 2A;

NCI-PDQ

Page 22: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Zoladex (Goserelin

Acetate) For 4-6 Months

(Stage II; Unfavorable

Intermediate Risk of

Recurrence; 1st Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First LineAUA; NCCN

Category 2A

Zoladex (Goserelin

Acetate) For 4-6 Months

With Bicalutamide or

Flutamide (Stage II;

Unfavorable Intermediate

Risk of Recurrence; 1st

Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First LineAUA; NCCN

Category 2A

Zoladex (Goserelin

Acetate) For 6 months

(Stages IIC-IVA)

(High/Very High/Regional

Risk; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line NCI-PDQ

Zoladex (Goserelin

Acetate) For 6 months

with Bicalutamide or

Flutamide (Stages IIC-IVA)

(High/Very High/Regional

Risk; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line NCI-PDQ

Zoladex (Goserelin

Acetate) (IVA-

IVB/Recurrent; Palliative;

1st Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line +

ASCO; FDA; NCCN

Category 2A; NCI-

PDQ

Page 23: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Zoladex (Goserelin

Acetate) Post

Prostatectomy with

Positive Nodes

Prostate Adenocarcinoma IVAAdjuvant/ Post-

operativeNCCN Category 1

Zoladex (Goserelin

Acetate) and Casodex

(Bicalutamide) (IVA-

IVB/Recurrent; Palliative;

1st Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

YesFirst Line +

ASCO; FDA; NCCN

Category 2A; NCI-

PDQ

Zoladex (Goserelin

Acetate) with

Bicalutamide or

Flutamide (Up to 60 Days

for Flare)

(Advamced/Metastatic/R

ecurrent; 1st Line or

Greater)

Prostate Adenocarcinoma IVB, Recurrent First Line +ASCO; FDA; NCCN

Category 2A

Page 24: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Femara (Letrozole) (Stage

IV or Recurrent;

Palliative)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Post-menopausal;

Estrogen Receptor -

Positive

First Line +FDA; NCCN Category

2A

Page 25: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Femara (Letrozole) with

Monthly GoserelinBreast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Page 26: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Femara (Letrozole) with

Monthly Leuprolide (3.75

mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Page 27: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Femara (Letrozole) With

Monthly Leuprolide (7.5

mg)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line + NCCN Category 2A

Eligard (Leuprolide) 1-3

Years with Bicalutamide

or Flutamide (Stages IIC-

IVA; High/Very

High/Regional Risk of

Recurrence; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First LineNCCN Category 1;

NCCN Category 2A

Lupron (Leuprolide) For 1-

3 Years (Stages IIC-IVA;

High/Very High/Regional

Risk of Recurrence; 1st

Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First LineNCCN Category 1;

NCCN Category 2A

Page 28: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Lupron (Leuprolide) For 1-

3 Years with Bicalutamide

or Flutamide (Stages IIC-

IVA; High/Very

High/Regional Risk of

Recurrence; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line

NCCN Category 1;

NCCN Category 2A;

NCI-PDQ

Lupron (Leuprolide) For 4-

6 Months (Stages IIC-IVA;

High/Very High/Regional

Risk of Recurrence; 1st

Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line NCI-PDQ

Lupron (Leuprolide) For 4-

6 Months (Stage II;

Unfavorable Intermediate

Risk of Recurrence; 1st

Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First Line NCCN Category 2A

Lupron (Leuprolide) For 4-

6 Months with

Bicalutamide or

Flutamide (Stages IIC-IVA;

High/Very High/Regional

Risk of Recurrence; 1st

Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line NCI-PDQ

Page 29: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Lupron (Leuprolide) For 4-

6 Months With

Bicalutamide or

Flutamide (Stage II;

Unfavorable Intermediate

Risk of Recurrence; 1st

Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First Line NCCN Category 2A

Lupron (Leuprolide) (IVA-

IVB/Recurrent; Palliative;

1st Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line +

ASCO; FDA; NCCN

Category 2A; NCI-

PDQ

Lupron (Leuprolide

Acetate) Post

Prostatectomy with

Positive Nodes

Prostate Adenocarcinoma IVAAdjuvant/ Post-

operativeNCCN Category 1

Lupron (Leuprolide) and

Casodex (Bicalutamide)

(IVA-IVB/Recurrent;

Palliative; 1st Line or

Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

YesFirst Line +

ASCO; FDA; NCCN

Category 2A

Lupron (Leuprolide

Acetate) with

Bicalutamide or

Flutamide (Up to 60 Days

For Flare)

(Advanced/Metastatic/Re

current; 1st Line or

Greater)

Prostate Adenocarcinoma IVB, Recurrent First Line +ASCO; FDA; NCCN

Category 2A

Page 30: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Tamoxifen (Stage IV or

Recurrent; 1st Line or

Greater)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; RecurrentMenopausal Status -

Pre-menopausalFirst Line +

FDA; NCCN Category

2A; NCI-PDQ

Tamoxifen (Recurrent;

First Line or Greater)Ovarian

Adenocarcinoma;

Cystadenocarcinom

a; Endometroid

Carcinoma;

Epithelial Cancer;

Mucinous

Cystadenocarcinom

a; Primary

Peritoneal; Serous

Cystadenocarcinom

a

Recurrent

Platinum

Resistant/Refractory

- Yes

First Line +

NCCN Category 2A;

NCCN Category 2B;

NCI-PDQ

Page 31: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Tamoxifen with Monthly

Goserelin

(Premenopausal; Stage IV

or Recurrent; 1st Line or

Greater)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IV; Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +FDA; NCCN Category

2A; NCI-PDQ

Page 32: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Tamoxifen with Monthly

Leuprolide (7.5 mg)

(Stage IV or Recurrent;

1st Line or Greater) (W)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IA; IB; IIA; IIB; IIIA;

IIIB; IIIC; IV;

Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +FDA; NCCN Category

2A; NCI-PDQ

Page 33: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Tamoxifen with Monthly

Lupron (Leuprolide

Acetate) (3.75) (Stages I-

IV/Recurrent; 1st Line or

Greater)

Breast

Adenocarcinoma;

Adenoid Cystic

Carcinoma;

Inflammatory

Carcinoma; Invasive

Ductal Carcinoma;

Invasive Lobular

Carcinoma; Invasive

Metaplastic

Carcinoma;

Medullary

Carcinoma;

Mucinous (Colloid)

Carcinoma; Papillary

Carcinoma; Spindle

Cell Carcinoma;

Tubular Carcinoma

IA; IB; IIA; IIB; IIIA;

IIIB; IIIC; IV;

Recurrent

Progesterone

Receptor - Positive;

Menopausal Status -

Peri-menopausal;

Menopausal Status -

Pre-menopausal;

Menopausal Status -

Does Not Apply-

Patient is Male;

Estrogen Receptor -

Positive

First Line +FDA; NCCN Category

2A; NCI-PDQ

Trelstar (Triptorelin) Post

Prostatectomy with

Positive Nodes

Prostate Adenocarcinoma IVAAdjuvant/ Post-

operativeNCCN Category 1

Trelstar (Triptorelin

Pamoate) (For 1-3 Years)

(Stages IIC-IVA; High/Very

High/Regional Risk; 1st

Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line

NCCN Category 1;

NCCN Category 2A;

NCI-PDQ

Page 34: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Trelstar (Triptorelin

Pamoate) For 1-3 Years

with Bicalutamide or

Flutamide (Stages IIC-IVA;

High/Very High/Regional

Risk; 1st Line)

Prostate AdenocarcinomaIIC; III; IIIA; IIIB; IIIC;

IVA

Prostate Cancer

Recurrence Risk -

High; Prostate

Cancer Recurrence

Risk - Very High;

Prostate Cancer

Recurrence Risk -

Regional

First Line

NCCN Category 1;

NCCN Category 2A;

NCI-PDQ

Trelstar (Triptorelin

Pamoate) (For 4-6

Months) (Stage II;

Unfavorable Intermediate

Risk of Recurrence; 1st

Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First Line NCCN Category 2A

Trelstar (Triptorelin

Pamoate) (For 4-6

Months) With

Bicalutamide or

Flutamide (Stage II;

Unfavorable Intermediate

Risk of Recurrence; 1st

Line)

Prostate Adenocarcinoma IIA; IIB; IIC

Prostate Cancer

Recurrence Risk -

Unfavorable

Intermediate

First Line NCCN Category 2A

Trelstar (Triptorelin

Pamoate) (IVA-

IVB/Recurrent; Palliative;

1st Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

NoFirst Line +

ASCO; FDA; NCCN

Category 2A; NCI-

PDQ

Page 35: Pathway Pathway Line of Regimen Name Cancer Type Pathway

Trelstar (Triptorelin

Pamoate) with Casodex

(Bicalutamide) (IVA-

IVB/Recurrent; Palliative;

1st Line or Greater)

Prostate Adenocarcinoma IVB, RecurrentCastration-resistant -

YesFirst Line +

ASCO; FDA; NCCN

Category 2A

Trelstar (Triptorelin

Pamoate) with

Bicalutamide or

Flutamide (Up to 60 Days

For Flare)

(Advanced/Metastatic/Re

current; 1st Line or

Greater)

Prostate Adenocarcinoma IVB, Recurrent First Line +ASCO; FDA; NCCN

Category 2A


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