Systemic Anti-Cancer Protocols and Information

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Systemic Anti-Cancer Therapy Protocol Information

The following Systemic Anti-Cancer Therapy (SACT) clinical protocols and guidance have been developed by local clinicians, with support from the Somerset, Wiltshire, Avon and Gloucestershire (SWAG) provider Trusts, and Cancer Alliance. The information provided is for guidance only, and has no legal or official standing. The guidance does not override the responsibility of Healthcare Professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer. Availability of treatments may change, subject to NHS funding agreements. The protocols must be used in conjunction with local and national commissioning guidance.

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Funding

NATIONAL SACT DOSING GUIDANCE

BOPA Guideline for 6-mercaptopurine dosing in adult acute lymphoblastic leukaemia based on TPMT and NUDT15 genotypes

https://ukclinicalpharmacy.org/wp-content/uploads/2024/02/Guideline-for-6-mercaptopurine-dosing-in-adult-acute-lymphoblastic-leukaemia-based-on-TPMT-and-NUDT15-g.pdf

DPD (dihydropyridimine dehydrogesase) Guidance

https://www.theacp.org.uk/userfiles/file/resources/dpd-testing-ukcb-july-2020-final.pdf

The protocols are frequently updated, and more will be added to the website as they are completed. If you have any queries or suggestions, or would like to be involved in the development of these protocols, please contact: SSGMeetings@uhbw.nhs.uk

3-weekly Cisplatin & Radiotherapy (Endometrial)

Abemaciclib

Abiraterone

ABVD

Acalabrutinib

Adjuvant Bleomycin, Etoposide and Cisplatin (BEP) 500

Adjuvant Capecitabine (Hepatobiliary)

Adjuvant Carboplatin

Adjuvant Gemcitabine (Pancreas)

Temozolomide monotherapy

Afatinib

Alectinib

Alpelisib and Fulvestrant

Apalutamide

Arsenic Trioxide

Asciminib

Atezolizumab (NSCLC)

Atezolizumab (Urothelial)

Atezolizumab and Bevacizumab

Atezolizumab, Bevacizumab, Carboplatin and Paclitaxel

Atezolizumab, Carboplatin and Etoposide

Atezolizumab and Nab-paclitaxel

ATRA (Tretinoin)

Avelumab

Avelumab (Urothelial)

Axitinib

Azacitidine

BEACOPP 14 / Escalated BEACOPP

BEACOPPDac 14 / Escalated BEACOPDac

BEAM (Auto)

Belantamab, Bortezomib and Dexamethasone (BVd)

Bendamustine 120 (NHL)

Bevacizumab

Bevacizumab and Lonsurf

Bevacizumab and Olaparib

Bleomycin, Etoposide and Cisplatin (BEP) 360

Bleomycin, Etoposide and Cisplatin (BEP) 500

Blinatumomab

Bone Protection Lymphoma

Bone Protection Myeloma

Bortezomib, Cyclophosphamide and Dexamethasone (VCD)

Bortezomib, Melphalan and Prednisolone (VMP)

Bortezomib, Thalidomide and Dexamethasone (VTD) – 21 day

Bortezomib, Thalidomide and Dexamethasone (VTD) – 28 day

Bosutinib

Brigatinib

Busulphan

Cabazitaxel

Cabozantinib

Cabozantinib

Capecitabine (Metastatic Breast)

Capecitabine (Colorectal)

Capecitabine and Oxaliplatin (XELOX)

Capecitabine and Radiotherapy (Colorectal)

Capecitabine and Radiotherapy (Pancreas)

Capecitabine and Temozolomide (CAPTEM – Neuroendocrine Tumours)

Capivasertib

CapOx – Oxaliplatin and Capecitabine

Carboplatin (Metastatic Breast)

Carboplatin (Ovary)

Carboplatin and Etoposide (Ovary)

Carboplatin and Etoposide (SCLC)

Carboplatin and Etoposide (Sarcoma)

Carboplatin and Etoposide (SCLC) (for CUP as per Lung Cancer Protocol)

Carboplatin and Fluorouracil

Carboplatin and Gemcitabine (Gynae)

Carboplatin and Gemcitabine (Bladder)

Carboplatin and Paclitaxel (Breast)

Carboplatin and Paclitaxel (Gynae)

Carboplatin and Paclitaxel (Anal)

Carboplatin and Paclitaxel (for CUP as per Gynae Cancer Protocol)

Carboplatin, Paclitaxel and Radiotherapy (Oesophagus)

Carboplatin and Pegylated Liposomal Doxorubicin Hydrochloride (Caelyx)

Carboplatin and Radiotherapy

Carboplatin and Vinorelbine

Carboplatin, Gemcitabine and Bevacizumab

Carboplatin, Paclitaxel and Bevacizumab

Carboplatin, Paclitaxel and Pembrolizumab

Carboplatin, Paclitaxel and Radiotherapy

Carboplatin, Paclitaxel, Bevacizumab and Pembrolizumab (Gynae)

Carboplatin, Pemetrexed and Pembrolizumab

Carfilzomib and Dexamethasone (Kd)

CBOP-BEP

Cemiplimab

Ceritinib

Cetuximab

Cetuximab and Encorafenib

Cetuximab and Radiotherapy

Cetuximab, Carboplatin and Fluorouracil

Cetuximab, Cisplatin and Fluorouracil

ChIVPP

Chlorambucil

Cisplatin and Capecitabine

Cisplatin and Etoposide (Thymic)

Cisplatin and Etoposide (SCLC)

Cisplatin and Fluorouracil

Cisplatin and Gemcitabine (Biliary)

Cisplatin and Gemcitabine (NSCLC)

Cisplatin and Gemcitabine (Bladder)

Cisplatin and Gemcitabine (Nasopharynx)

Cisplatin and Pemetrexed

Cisplatin and Radiotherapy (Gynae)

Cisplatin and Vinorelbine

Cisplatin, Vinorelbine and Radiotherapy

Cisplatin, Etoposide and Radiotherapy

Cladribine

Clofarabine and Cytarabine

Crizotinib

Cyclophosphamide and Prednisolone

Cyclophosphamide, Doxorubicin and Vincristine (CAV)

Cyclophosphamide priming

Cyclophosphamide, Thalidomide and Dexamethasone (CTD and CTDa)

Dabrafenib

Dabrafenib and Trametinib

Dabrafenib and Trametinib (NSCLC)

Dabrafenib and Trametinib (Thyroid)

Dacarbazine

Dacarbazine (Sarcoma)

Daratumumab, Bortezomib, Thalidomide and Dexamethasone (D-VTD)

Daratumumab Monotherapy

Daratumumab, Bortezomib and Dexamethasone (DVd)

Daratumumab, Lenalidomide and Dexamethasone (DRd)

Darolutamide

Dasatinib

Daunorubicin & Cytarabine – DA (AML Induction)

Denosumab

Dexamethasone, Rituximab and Cyclophosphamide (DRC)

Docetaxel (Metastatic Breast)

Docetaxel (NSCLC)

Docetaxel (Prostate)

Docetaxel and Carboplatin

Docetaxel and Cyclophosphamide

Docetaxel and Darolutamide

Docetaxel, Carboplatin, Trastuzumab and Pertuzumab (TCPH)

Docetaxel, Cisplatin and Fluorouracil (TPF)

Docetaxel, Doxorubicin, and Cyclophosphamide (TAC)

Docetaxel (Head and Neck)

Docetaxel, Trastuzumab and Pertuzumab (TPH)

Docetaxel (UGI)

Dose Adjusted (DA)-EPOCH-R

Dostarlimab, Carboplatin and Paclitaxel

Dostarlimab (Endometrial)

Doxorubicin and Cisplatin (AP)

Doxorubicin and Ifosfamide

Doxorubicin single agent

Durvalumab and Tremelimumab (HCC)

Durvalumab, Cisplatin and Gemcitabine

Durvalumab

EC (Epirubicin & Cyclophosphamide) / Carboplatin + Weekly Paclitaxel (Breast)

EC-Paclitaxel

EC-T (Epirubicin and Cyclophosphamide and Docetaxel) (Breast)

EC-TPH (Epirubicin and Cyclophosphamide then Docetaxel, Pertuzumab and Trastuzumab)

Elranatamab

Encorafenib and Binimetinib

Enfortumab, Vedotin and Pembrolizumab

Enhertu (Trastuzumab Deruxtecan)

Entrectinib (NSCLC / NTRK Gene Fusion Solid Tumours)

Enzalutamide

Epirubicin

Epirubicin and Cyclophosphamide

Epirubicin, Cisplatin and Capecitabine (ECX)

Epirubicin, Cisplatin and Capecitabine (ECX – oesophagus) (for CUP as per Upper GI protocol)

Dose Dense EC-Paclitaxel

Epirubicin, Oxaliplatin and Capecitabine (EOX)

Epirubicin, Oxaliplatin and Capecitabine (EOX – oesophagus) (for CUP as per Upper GI protocol)

Eribulin

Erlotinib

Etoposide and Cisplatin (EP) 500

Etoposide, Ifosfamide and Cisplatin (VIP)

Everolimus

Everolimus and Exemestane

Everolimus and Lenvatinib

Fedratinib

FLAG-IDA

Fluorouracil, Epirubicin (100) and Cyclophosphamide (FEC 100)

Fluorouracil, Epirubicin (75) and Cyclophosphamide (FEC 75)

Fluorouracil, Epirubicin and Cyclophosphamide – Docetaxel (FEC-T)

Fluorouracil, Epirubicin and Cyclophosphamide – Docetaxel, Pertuzumab and Trastuzumab (FEC-TPH)

Fluorouracil, Oxaliplatin and Docetaxel (FLOT)

Fludarabine, Cyclophosphamide and Rituximab (FCR)

Fluorouracil, Epirubicin and Cyclophosphamide and Docetaxel + Carboplatin (FEC-T + Carboplatin)

FOLFIRINOX

Fruquintinib

Gefitinib

Gemcitabine

Gemcitabine and Capecitabine (Pancreas)

Gemcitabine and Capecitabine (for CUP as per Upper GI protocol for pancreas)

Gemcitabine and Carboplatin (Metastatic Breast)

Gemcitabine and Carboplatin (NSCLC)

Gemcitabine and Carboplatin (for CUP as per Lung Cancer Protocol)

Gemcitabine and Dacarbazine

Gemcitabine and Docetaxel (Sarcoma)

Gemcitabine and Paclitaxel Albumin (Abraxane)

Gemcitabine and Radiotherapy (Pancreas)

Gemcitabine and Radiotherapy (Bladder)

Gemtuzumab Ozogamicin

Gilteritinib

Glofitamab

High Dose Carboplatin and Etoposide (Auto)

High Dose Melphalan (Auto)

High Dose Methotrexate and Cytarabine

High Dose Methotrexate for CNS Prophylaxis

Hydroxycarbamide

Ibrutinib

Ifosfamide

Ifosfamide and Etoposide

Ifosfamide (Ewing Sarcoma)

Imatinib (GIST)

Imatinib (Leukaemia)

Inotuzumab Ozogamicin

Ipilimumab

Ipilimumab and Nivolumab

Ipilimumab and Nivolumab (Mesothelioma)

Irinotecan

Irinotecan and Modified de Gramont Fluorouracil (FOLFIRI)

Irinotecan and Temozolomide

Isatuximab, Pomalidomide and Dexamethasone (IsaPd)

IVADo

Ivosidenib

Ixazomib, Lenalidomide and Dexamethasone (IRd)

JAKACKI – Part 1 – Carboplatin and Vincristine

LACE (Auto)

Lapatinib and Capecitabine

Lenalidomide and Dexamethasone – first line

Lenalidomide and Dexamethasone – second and subsequent line

Lenalidomide and Rituximab

Lenalidomide Maintenance

Lenvatinib

Lenvatinib and Pembrolizumab (Renal)

Lomustine

Loncastuximab Tesirine (Zynlonta)

Lorlatinib

Low dose induction Etoposide and Cisplatin (EP)

MATRIX (Methotrexate, Cytarabine, Thiotepa and Rituximab)

Melphalan and Prednisolone (MP)

Melphalan, Prednisolone and Thalidomide (MPT)

Methotrexate, Doxorubicin and Cisplatin (MAP)

Midostaurin

Mifamurtide

Mitomycin C and Fluorouracil and Radiotherapy

Mitomycin C and Fluorouracil

Mobocertinib (NSCLC)

Modified de Gramont

Modified FOLFIRINOX (Pancreas)

Momelotinib

Nelarabine

Neoadjuvant Cisplatin and Fluorouracil

Neratinib

Nilotinib

Nintedanib and Docetaxel

Niraparib

Nivolumab (Head and Neck)

Nivolumab (NSCLC)

Nivolumab (Melanoma)

Nivolumab (Renal)

Nivolumab and Cabozantinib (RCC)

Nivolumab and Ipilimumab

Nivolumab and Ipilimumab (Colorectal)

Nivolumab and Relatlimab (Melanoma)

Nivolumab, Carboplatin and Paclitaxel

Nivolumab (Hodgkin Lymphoma)

Nivolumab Monotherapy (Colorectal – COVID-19)

Nivolumab Monotherapy (Urothelial)

Nivolumab, Pemetrexed and Platinum (NSCLC)

Nivolumab (UGI)

NORDIC

(O) CHOP

(O) CVP

Obinutuzumab and Bendamustine

Obinutuzumab and Venetoclax

Olaparib tablets

Olaparib tablets (Breast)

Olaparib tablets (Prostate)

Oral Azacitidine (Onureg)

Oral Etoposide

Osimertinib

Oxaliplatin and Gemcitabine

Oxaliplatin and Modified de Gramont Fluorouracil (FOLFOX)

Oxaliplatin, Irinotecan and Fluorouracil (FOLFOXIRI)

Paclitaxel 3 weekly (Metastatic Breast)

Paclitaxel 3 weekly (Ovary)

Paclitaxel Albumin (Abraxane)

Paclitaxel, Ifosfamide and Cisplatin (TIP)

Paclitaxel weekly (Metastatic Breast)

Paclitaxel weekly (Gastric)

Paclitaxel weekly (Gynae)

Paclitaxel weekly (for CUP as per Gynae protocol)

Palbociclib (Breast)

Palliative Cisplatin and Fluorouracil

Palliative Gemcitabine (Pancreas)

Panitumumab

Panobinostat, Bortezomib and Dexamethasone (PanBorDex)

Pazopanib

Pegylated Liposomal Doxorubicin Hydrochloride (Caelyx)

Pegylated Liposomal Doxorubicin Hydrochloride (PLDH)

Pegylated Liposomal Doxorubicin Hydrochloride (PLDH) and Ifosfamide

Pembrolizumab (NSCLC)

Pembrolizumab (Melanoma)

Pembrolizumab (Bladder)

Pembrolizumab (Hodgkin Lymphoma)

Pembrolizumab and Lenvatinib (Gynae)

Pembrolizumab and Paclitaxel/Nab-Paclitaxel (Breast)

Pembrolizumab, Carboplatin and Weekly Paclitaxel-EC

Pembrolizumab (Colorectal)

Pembrolizumab (Head and Neck)

Pembrolizumab (MSI-H and DMMR Cancers)

Pembrolizumab, Oxaliplatin and Capecitabine (Oesophageal or Gastro-Oesophageal)

Pembrolizumab (RCC)

Pemetrexed Maintenance

Pixantrone

Plerixafor

POLA-R-CHP

Polatuzumab vedotin, Bendamustine and Rituximab (PBR)

Pomalidomide and Dexamethasone

Ponatinib

Procarbazine, Lomustine and Vincristine (PCV)

Quizartinib

(R) Bendamustine 70 (CLL)

(R) Bendamustine 90 (CLL)

(R) Bendamustine 90 (NHL)

(R) CHOEP

(R) Cockle

(R) CODOX-M (R) IVAC

(R) CVP

(R) DHAP

(R) CHOP

(R) ICE

(R) Mini BEAM

(R) Mini CHOP

Rituximab and Venetoclax

Raltitrexed

Raltitrexed and Oxaliplatin (TOMOX)

Raltitrexed and Radiotherapy

Regorafenib

Ribociclib

Rituximab and Chlorambucil

Rituximab (B-ALL)

Rituximab Monotherapy and Maintenance

(R) GDP

Ropeginterferon alpha-2b (MPN)

Rucaparib

Ruxolitinib

Selinexor and Dexamethasone (Sd)

Selinexor, Bortezomib and Dexamethasone (SVd)

Selpercatinib (Lung and Thyroid)

Sirolimus (Sarcoma)

Sorafenib

Sorafenib

Sotorasib (Lung)

Sunitinib (GIST)

Sunitinib (Renal)

Sunitinib (PNET)

Talazoparib

Tebentafusp (Uveal Melanoma)

Teclistamab

Temozolomide (CNS Lymphoma)

Temozolomide and Radiotherapy

Tepotinib (Lung)

Thalidomide and Dexamethasone

Three Weekly Cisplatin and Radiotherapy

Tivozanib

Topotecan (SCLC)

Topotecan (Archived Gynae)

Trabectedin

Trametinib

Trastuzumab (Breast)

Trastuzumab Emtansine (Kadcyla)

Trastuzumab (Herceptin)

Treosulfan

Trifluridine and Tipiracil (Lonsurf)

Trodelvy (Sacituzumab Govitecan)

Tucatinib, Capecitabine and Trastuzumab (Breast)

Vandetanib

VDC (Sarcoma)

VDC/IE

VDT PACE

Vemurafenib

Venetoclax

Venetoclax and Azacitidine (COVID-19 Protocol)

Vinblastine

Vinorelbine (Metastatic Breast)

Vinorelbine (Thoracic)

Vinorelbine and Cyclophosphamide Maintenance

Vinorelbine (Fibromatosis)

VIT (Vincristine, Irinotecan and Temozolomide)

VR-CAP

Vyxeos

Weekly Carboplatin and Paclitaxel (Cervix)

Weekly Cisplatin and Radiotherapy

Weekly Fluorouracil (QUASAR)

Weekly Fluorouracil (Roswell Park)

Zanubrutinib

Zoledronic Acid

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