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Systemic Anti Cancer Therapy Protocols

Our Cancer Protocols are now hosted at https://www.swagcanceralliance.nhs.uk/protocols/.
As of 30th July 2021 the access to these Protocols on this site will no longer be active. Please use the new website for the most up-to-date information.

These clinical protocols have been developed by local clinicians, with the support of the South West Clinical Network (SWCN). The information is provided as 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. These protocols must be used in conjunction with local and national commissioning guidance.

The protocols are still being updated and more will be added to this 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 us

NEWSFLASH! WE HAVE A NEW WEBSITE. THE PROTOCOL SECTION CAN BE FOUND HERE: https://www.swagcanceralliance.nhs.uk/protocols/

Please familiarise yourself with this website, as the SWCN website will be deactivated on Wednesday 31st March 2021.

The protocols are listed alphabetically and can be filtered by cancer site, for example, by selecting Haematology, Leukaemia, Acute Lymphocytic Leukaemia, to access the relevant list.

A button named ‘Reset’ needs to be pressed to search for a different list of protocols.

Oncology

ALERT: INTERIM TREATMENT CHANGE OPTIONS DURING THE COVID-19 PANDEMIC

https://www.nice.org.uk/guidance/ng161

https://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic

CLINICAL_PRIORITISATION_CANCER_TREATMENT_COVID-19_PANDEMIC_FINAL

Breast

Early and locally advanced disease

Atezolizumab and Abraxane
Carboplatin and Paclitaxel
Docetaxel and Carboplatin
Docetaxel, Carboplatin, Trastuzumab and Pertuzumab (TCHP)
Docetaxel and Cyclophosphamide
Dose Dense EC-Paclitaxel
Fluorouracil, Epirubicin (75) and Cyclophosphamide (FEC 75)
Fluorouracil, Epirubicin (100) and Cyclophosphamide (FEC 100)
Fluorouracil, Epirubicin and Cyclophosphamide - Docetaxel (FEC-T)
Fluorouracil, Epirubicin and Cyclophosphamide and Docetaxel + Carboplatin (FEC-T + Carboplatin)
Fluorouracil, Epirubicin and Cyclophosphamide - Docetaxel, Pertuzumab and Trastuzumab (FEC-TPH)
Adjuvant FEC-TPH
Neoadjuvant, FEC-TPH
Neratinib
Paclitaxel albumin (Abraxane)
Trastuzumab
Trastuzumab Emtansine (Kadcyla)

Metastatic

Abemaciclib
Atezolizumab and Abraxane
Capecitabine
Carboplatin
Carboplatin and Paclitaxel
Docetaxel and Carboplatin
Docetaxel
Docetaxel, Trastuzumab and Pertuzumab
Enhertu
Epirubicin and Cyclophosphamide
Epirubicin
Eribulin
Everolimus and Exemestane
Gemcitabine and Carboplatin
Paclitaxel Albumin (Abraxane)
Paclitaxel 3 weekly
Paclitaxel weekly
Palbociclib and Fulvestrant
Palbociclib and Letrozole
Trastuzumab
Trastuzumab Emtansine (Kadcyla)
Vinorelbine

Cancer of Unknown Primary

The site specific chemotherapy protocols on the SWCN website can be used for CUP patients, as agreed by the CUP MDT.

The most frequently used protocols are listed below:
Carboplatin and Etoposide (SCLC) (as per Lung Cancer Protocol)
Carboplatin and Paclitaxel (as per Gynae Cancer protocol)
Gemcitabine and Capecitabine (pancreas) (as per Upper GI protocol)
Gemcitabine and Carboplatin (as per Lung Cancer protocol)
Epirubicin, Cisplatin and Capecitabine (ECX - oesophagus) (as per Upper GI protocol)
Epirubicin, Oxaliplatin and Capecitabine (EOX - oesophagus) (as per Upper GI protocol)
Paclitaxel weekly (as per Gynae protocol)

Central Nervous System

Temozolomide
Procarbazine, Lomustine and Vincristine (PCV)
Temozolomide and Radiotherapy

Germ Cell cancer (including Testicular)

Low dose induction Etoposide and Cisplatin (EP)

Non-Seminoma/Combined

Adjuvant Bleomycin, Etoposide and Cisplatin (BEP) 500
Bleomycin, Etoposide and Cisplatin (BEP) 360
Bleomycin, Etoposide and Cisplatin (BEP) 500
CBOP-BEP
Etoposide and Cisplatin (EP) 500
Etoposide, Ifosfamide and Cisplatin (VIP)
High Dose Carboplatin and Etoposide
Oxaliplatin and Gemcitabine
Paclitaxel, Ifosfamide and Cisplatin (TIP)

Seminoma

Adjuvant Carboplatin
Bleomycin, Etoposide and Cisplatin (BEP) 500
Etoposide and Cisplatin (EP) 500
Etoposide, Ifosfamide and Cisplatin (VIP)
High Dose Carboplatin and Etoposide
Oxaliplatin and Gemcitabine
Paclitaxel, Ifosfamide and Cisplatin (TIP)

Head and Neck

Carboplatin and Fluorouracil
Carboplatin and Radiotherapy
Cetuximab, Carboplatin and Fluorouracil
Cetuximab, Cisplatin and Fluorouracil
Cetuximab and Radiotherapy
Cisplatin and Radiotherapy
Docetaxel, Cisplatin and Fluorouracil (TPF)
Neo adjuvant Cisplatin and Fluorouracil
Nivolumab
Palliative Cisplatin and Fluorouracil
Three Weekly Cisplatin and Radiotherapy
Weekly Cisplatin and Radiotherapy

Medullary Thyroid Cancer

Thoracic

Non small cell

Afatinib
Alectinib
Atezolizumab
Atezolizumab, Bevacizumab, Carboplatin and Paclitaxel
Brigatinib
Carboplatin, Paclitaxel and Pembrolizumab
Carboplatin, Paclitaxel and Radiotherapy
Carboplatin, Pemetrexed and Pembrolizumab
Carboplatin and Vinorelbine
Ceritinib
Cisplatin, Etoposide and Radiotherapy
Cisplatin and Gemcitabine
Cisplatin and Pemetrexed
Cisplatin and Vinorelbine
Cisplatin, Vinorelbine and Radiotherapy
Crizotinib
Docetaxel
Durvalumab
Erlotinib
Gefitinib
Gemcitabine
Gemcitabine and Carboplatin
Lorlatinib
Nintedanib and Docetaxel
Nivolumab
Osimertinib
Pembrolizumab
Pemetrexed maintenance
Vinorelbine

Small cell

Carboplatin and Etoposide
Cisplatin and Etoposide
Cyclophosphamide, Doxorubicin and Vincristine (CAV)
Topotecan

Mesothelioma

Cisplatin and Pemetrexed
Vinorelbine

Thymoma

Cisplatin and Etoposide

Sarcoma

Sarcoma

Doxorubicin single agent
Doxorubicin and Olaratumumab
Gemcitabine and Dacarbazine
Trabectedin

Skin

Melanoma

Dabrafenib
Dabrafenib and Trametinib
Dacarbazine
Encorafenib and Binimetinib
Ipilimumab
Ipilimumab and Nivolumab
Nivolumab
Pembrolizumab
Vemurafenib
Vinblastine

Merkel cell

Other skin cancers

Urology

Bladder

Atezolizumab
Cisplatin and Gemcitabine
Gemcitabine and Radiotherapy
Mitomycin C and Fluorouracil
Pembrolizumab

Kidney

Axitinib
Cabozantinib
Everolimus
Everolimus and Lenvatinib
Nivolumab
Nivolumab and Ipilimumab
Pazopanib
Sunitinib
Tivozanib

Prostate

Abiraterone
Cabazitaxel
Docetaxel
Enzalutamide

Penis

Haematology

Lymphomas

Lymphomas

Bendamustine 120 (NHL)
Bortezomib, Dexamethasone and Rituximab
Chlorambucil
Dexamethasone, Rituximab and Cyclophosphamide
Dose Adjusted (DA)-EPOCH-R
Fludarabine, Cyclophosphamide and Rituximab (FCR)
NORDIC
Obinutuzumab and Bendamustine
(O) CHOP
(O) Cyclophosphamide,Vincristine and Prednisolone (O) CVP
Pixantrone
(R) Bendamustine 90 (NHL)
(R) CHOEP
Rituximab and Chlorambucil
(R) CODOX-M (R) IVAC
(R) Cyclophosphamide, Vincristine and Prednisolone (R) CVP
(R) Doxorubicin, Cyclophosphamide, Vincristine and Prednisolone (R) CHOP
Rituximab maintenance
(R) mini CHOP
Temozolomide
VR-CAP

Hodgkin

ABVD
BEACOPP 14 / Escalated BEACOPP
BBEACOPDac 14 / Escalated BEACOPDac
Brentuximab
ChIVPP
VEPEM-B
Pembrolizumab

T-Cell Lymphoma

SMILE

CLL/SLL (specific treatments)

Acalabrutinib
Alemtuzumab
Fludarabine, Cyclophosphamide and Rituximab (FCR)
Ibrutinib
Obinutuzumab and Chlorambucil
Ofatumumab
(R) Bendamustine 70 (CLL)
(R) Bendamustine 90 (CLL)
R Idelalisib
R Venetoclax
Venetoclax

Salvage

(R) DHAP
(R) ESHAP
(R) ICE
(R) Gemcitabine, Dexamethasone and Cisplatin +/- Rituximab
Mini BEAM
(R) Cockle

CNS Directed Therapy

High Dose Methotrexate for CNS Prophylaxis
High Dose Methotrexate and Cytarabine
MATRIX (Methotrexate, Cytarabine, Thiotepa and Rituximab)
R IDARAM

Leukaemia

Acute Myeloid Leukaemia

Arsenic Trioxide
ATRA
Azacitidine
Clofarabine and Cytarabine
FLAG/IDA
Gemtuzumab Ozogamicin
Midostaurin
Venetoclax and Azacitidine (COVID-19 Protocol)
Vyxeos

Acute Lymphocytic Leukaemia

Blinatumomab
Inotuzumab
Nelarabine

Chronic Myeloid Leukaemia

Bosutinib
Dasatinib
Hydroxycarbamide
Imatinib
INF
Nilotinib
Ponatinib

Hairy Cell Leukaemia

Myeloproliferative disorders

ATG
Azacitidine
Busulphan
Hydroxycarbamide
Ruxolitinib

Myeloma

Bendamustine, Thalidomide and Dexamethasone (BTD)
Bone Protection Myeloma 2020
Bortezomib, Cyclophosphamide and Dexamethasone (VCD)
Bortezomib, Melphalan and Prednisolone (VMP)
Bortezomib, Thalidomide and Dexamethasone (VTD) -21 day
Bortezomib, Thalidomide and Dexamethasone (VTD) -28 day
Carfilzomib and Dexamethasone
Cyclophosphamide, Thalidomide and Dexamethasone (CTD and CTDa)
Daratumumab
Daratumumab, Bortezomib and Dexamethasone (DVd)
DTPACE
Isatuximab, Pomalidomide and Dexamethasone (IsaPd)
Ixazomib, Lenalidomide and Dexamethasone (IRd)
Lenalidomide and Dexamethasone - first line
Lenalidomide and Dexamethasone - second and subsequent line
Lenalidomide maintenance
Melphalan and Prednisolone
Melphalan, Prednisolone and Thalidomide (MPT)
Panobinostat, Bortezomib and Dexamethasone
Pomalidomide
Thalidomide and Dexamethasone
VDT PACE

Stem cell mobilisation

BEAM
Cyclophosphamide priming
High dose Melphalan
LACE
Plerixafor

Supportive Therapy

Bone Protection Myeloma 2020
Denosumab
Zoledronic Acid

Guidelines

Bone Protection Myeloma 2020

Archived Protocols

Carboplatin, Gemcitabine and Bevacizumab
Docetaxel, Doxorubicin and Cyclophosphamide (TAC)
Lapatinib and Capecitabine
Topotecan