Alberta Regulation 155/2002

Cancer Programs Act

CANCER PROGRAMS AMENDMENT REGULATION

Filed: July 18, 2002

Made by the Minister of Health and Wellness (M.O. 65/2002) on July 16, 2002

pursuant to sections 16 and 22 of the Cancer Programs Act.

1 The Cancer Programs Regulation (AR 242/98) is amended by this

Regulation.

2 The

Schedule is repealed and the following is substituted:

SCHEDULE

Drug

Group

Dosage Form

Criteria

13 Cis-RETINOIC ACID

capsules

Pediatrics

restricted to the treatment of advanced stage neuroblastoma following

POG/CCG Protocols

prescribing limited to written authorization by physicians recommended by

the pediatric tumour program

ALL-TRANS RETINOIC ACID

capsules

restricted to treatment of acute promyelocytic leukemia

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumour program or the pediatric tumour program

AMSACRINE

injectable

ANAGRELIDE

capsules

for thrombocytosis due to myeloproliferative disorder

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumour program

ANASTROZOLE

tablets

alternative first line hormonal therapy for post menopausal women with

hormone positive, metastatic breast cancer

ASPARAGINASE

injectable

BCG

injectable

bladder carcinoma

BICALUTAMIDE

tablets

restricted to patients who are intolerant to Nilutamide or Flutamide.

approved dosage is 50 mg daily.

BLEOMYCIN

injectable

pump

BUSERELIN

injectable

prostate cancer

Restricted to:

Stage II (T2a-T2c): Neoadjuvant use pre RT (2 months pre and during RT).

Neoadjuvant use pre radical prostatectomy (4 months pre).

Stage III (T3a-T4b): Neoadjuvant use pre RT (2 months pre and during RT).

Adjuvant use (3 years post RT).

Stage IV (N1-N3) (M1-M1c): As monotherpy in medical castration.

In total androgen blockade (medical castration and nonsteriodal

antiandrogen).

Guidelines for LHRH use in the above stated stages include: LHRH agonists

are indicated for use in patients at risk of thromboembolic disease,

strokes (CVA), myocardial infarction and also for consideration in patients

with dyslipidemia, hypertension, diabetes mellitus or where a patient is

considered intolerant to cyproterone acetate or megestrol acetate.

BUSULFAN

tablets

CAPECITABINE

oral

oral

for use in anthracycline pretreated metastatic or advanced breast cancer

patients who may or may not have been previously treated with taxanes.

prescribing limited to written authorization by physicians recommended by

the breast tumour program

option in first line treatment of advanced or metastatic colorectal cancer

prescribing limited to written authorization by named physicians as

recommended by the GI tumour program

CARBOPLATIN

injectable

CARMUSTINE

injectable

CHLORAMBUCIL

tablets

CISPLATIN

injectable

CLADRIBINE

injectable

restricted to treatment of hairy cell leukemia

Waldenstrom's macroglobulinemia

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumour program

injectable

POG Protocol 9720

prescribing limited to written authorization by physicians recommended by

the pediatric tumour program

CLODRONATE

oral

treatment of osteolytic bone lesions in metastatic breast cancer

CYCLOPHOSPHAMIDE

injectable, tablets

CYPROTERONE

tablets

CYTARABINE

injectable

CYTARABINE LIPOSOMAL

injectable

for intrathecal management of neoplastic meningitis due to solid tumours

or lymphoma

DACARBAZINE

injectable

DACTINOMYCIN

injectable

DAUNORUBICIN

injectable

DEXAMETHASONE

injectable, tablets

antiemetic use NOT covered

DOCETAXEL

injectable

treatment of metastatic breast cancer after failure of any previous

chemotherapy regimen.

as a single agent or in combination, as an option for first line treatment

of metastatic breast cancer

only one taxane is to be administered to any one patient

prescribing limited to written authorization by named physicians as

recommended by the breast tumour program

injectable

2nd line therapy in patients with advanced or metastatic non-small cell

lung cancer having received prior platinum-based chemotherapy, good

performance status

(ECOG 0-2), no brain metastases

prescribing limited to written authorization by named physicians as

recommended by the lung tumour program

DOXORUBICIN

injectable

DOXORUBICIN LIPOSOMAL

injectable

Kaposi's sarcoma

injectable

2nd or 3rd line treatment of ovarian cancer, fallopian tube carcinoma and

primary peritoneal neoplasms

prescribing limited to written authorization by named physicians as

recommended by the gynecology tumour program

EPIRUBICIN

injectable

adjuvant (node positive) and neoadjuvant (stage II and III), treatment of

pre and post menopausal breast cancer patients

prescribing limited to written authorization by named physicians as

recommended by the breast tumour program

ERWINIA ASPARAGINASE

injectable

restricted to use in patients hypersensitive to E. Coli asparaginase for

remission induction in acute lymphoblastic leukemia

prescribing limited to written authorization by physicians recommended by

the pediatric tumour program

or the hematology/ lymphoma program

ESTRAMUSTINE

capsules

ETOPOSIDE

injectable, capsules

EXEMESTANE

oral

for hormonal treatment of advanced breast cancer in postmenopausal women

who have progressed following hormonal therapy

prescribing limited to written authorization by named physicians as

recommended by the breast tumour program

FLUDARABINE

injectable

previously treated or untreated chronic lymphocytic leukemia

low grade lymphoma

Waldenstrom's macroglobulinemia

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumour program

FLUOROURACIL

injectable, cream

pump

FLUTAMIDE

tablets

prostate cancer

GEMCITABINE

injectable

Lung Cancer

patients who have failed treatment with Vinorelbine or Paclitaxel

containing regimens or who are unable to tolerate treatment with these

agents.

prescribing limited to written authorization by physicians recommended by

the lung tumour program

injectable

Bladder Cancer

Gemcitabine/Cisplatin as first line chemotherapy in locally

advanced/metastatic bladder cancer

prescribing limited to written authorization by physicians recommended by

the GU tumour program

injectable

Pancreas

locally advanced or metastatic adenocarcinoma of the pancreas.

prescribing limited to written authorization by physicians recommended by

the GI tumour program

GOSERELIN

injectable

prostate cancer

Restricted to:

Stage II (T2a-T2c): Neoadjuvant use pre RT (2 months pre and during RT).

Neoadjuvant use pre radical prostatectomy (4 months pre).

Stage III (T3a-T4b): Neoadjuvant use pre RT (2 months pre and during RT).

Adjuvant use (3 years post RT).

Stage IV (N1-N3) (M1-M1c): As monotherpy in medical castration.

In total androgen blockade (medical castration and nonsteriodal

antiandrogen).

Guidelines for LHRH use in the above stated stages include: LHRH agonists

are indicated for use in patients at risk of thromboembolic disease,

strokes (CVA), myocardial infarction and also for consideration in patients

with dyslipidemia, hypertension, diabetes mellitus or where a patient is

considered intolerant to cyproterone acetate or megestrol acetate.

injectable

breast cancer. 2nd line hormonal therapy for recurrent or metastatic

disease in estrogen and/or progesterone receptor positive pre and

perimenopausal patients after tamoxifen failure.

prescribing limited to written authorization by physicians recommended by

the breast tumour program

HYDROCORTISONE SODIUM SUCCINATE

injectable

intrathecal use only

HYDROXYUREA

capsules

IDARUBICIN

injectable

POG Protocol 9720

prescribing limited to written authorization by physicians recommended by

the pediatric tumour program

IFOSFAMIDE

injectable

pump

INTERFERON

- alpha 2a or 2b

- alpha 2b in new patients "02-03"

injectable

cladribine-resistant hairy cell leukemia

Kaposi's sarcoma

chronic myelogenous leukemia

metastatic renal cell carcinoma

INTERFERON

alpha 2a ONLY

injectable

mycosis fungoides and sezary syndrome (cutaneous T-cell lymphomas)

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumour program

INTERFERON

alpha 2b ONLY

injectable

injectable

basal cell carcinoma

adjuvant treatment of high risk melanoma

2nd line therapy of superficial bladder cancer

treatment of patients with malignant carcinoid and neuroendocrine

gastroenteropancreatic tumours not amenable to surgical extirpation

prescribing limited to written authorization by physicians recommended by

the GI and endocrine tumour programs

injectable

maintenance therapy in multiple myeloma patients who have achieved

complete remission after high dose chemotherapy and autologous stem cell

transplant.

follicular lymphoma and need for therapy as indicated by any of: mass >7

cm or 3 sites >3 cm, Bsx, splenomegaly @ umbilicus, compression syndromes

(GI, GU, orbit), effusions cytopenias, Age