8: Malignant disease & immunosupression
Approved: 4 Oct 2017. Last amended: 4 Oct 2017.
8.1 Cytotoxic drugs
Not currently included in Joint Formulary
8.2 Drugs affecting the immune response
Not currently included in Joint Formulary
8.3 Sex hormones and hormone antagonists in malignant disease
8.3.1 Oestrogens
Not currently included in Joint Formulary
8.3.2 Progrestogens
Not currently included in Joint Formulary
8.3.3 Androgens
Not currently included in Joint Formulary
8.3.4 Hormone antagonists
8.3.4.1 Breast Cancer
Not currently included in Joint Formulary
8.3.4.2 Gonadorelin analogues
Recommended
Triptorelin (Decapeptyl® SR)
3mg, 11.25mg, 22.5mg (22.5mg IM 6 monthly injection preferred in Primary Care)
Alternative
Leuprorelin (Prostap®)
3.75mg, 11.25mg
Goserelin (Zoladex®)
3.6mg, 10.8mg
8.3.4.3 Anti-androgens
Recommended
Bicalutamide
Alternative
Cyproterone
Specific Indication
Abiraterone
castration-resistant metastatic prostate cancer, as per NICE TA259
8.3.4.4 Gonadotrophin-releasing hormone antagonists
Degarelix
Advanced hormone-dependent prostate cancer in people with spinal metastases, as per NICE TA404
8.3.4.5 Somatostatin analogues
Not currently included in Joint Formulary