Alberta Regulation 6/2000

Cancer Programs Act

CANCER PROGRAMS AMENDMENT REGULATION

Filed: January 21, 2000

Made by the Minister of Health (M.O. 5/2000) on January 18, 2000 pursuant

section 17 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Schedule is repealed and the following is substituted: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 tumor 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 tumor program or the pediatric tumor program

ALTRETAMINE

capsules

restricted to treatment of 2nd line ovarian cancer

prescribing limited to written authorization by physicians recommended by

the gynecology tumor program

AMSACRINE

injectable

ANASTROZOLE

tablets

2nd line hormonal therapy for postmenopausal metastatic breast cancer

may be given first line in those patients who are at risk of a

thromboembolic event

ANAGRELIDE

capsules

for thrombocytosis due to myeloproliferative disorder

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumor program

ASPARAGINASE

injectable

BCG

injectable

bladder carcinoma

BICALUTAMIDE

tablets

restricted to patients who are intolerant to Nilutamide and Flutamide

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

advanced or metastatic breast cancer after failure of standard therapy

including an anthracycline and taxane

prescribing limited to written authorization by physicians recommended by

the breast tumor 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 tumor program

injectable

POG Protocol 9720

prescribing limited to written authorization by physicians recommended by

the pediatric tumor program

CLODRONATE

oral

treatment of osteolytic bone lesions in metastatic breast cancer

CORTISONE ACETATE

tablets

use with Mitotane only

CYCLOPHOSPHAMIDE

injectable, tablets

CYPROTERONE

tablets

CYTARABINE

injectable

DACARBAZINE

injectable

DACTINOMYCIN

injectable

DAUNORUBICIN

injectable

DEXAMETHASONE

injectable, tablets

antiemetic use NOT covered

DIETHYLSTILBESTROL

tablets

DIETHYLSTILBESTROL DIPHOSPHATE

injectable, tablets

DOCETAXEL

injectable

restricted to the treatment of metastatic breast cancer after failure of

any previous chemotherapy regimen.

only one taxane is to be administered to any one patient

prescribing limited to written authorization by physicians recommended by

the breast tumor program

DOXORUBICIN

injectable

DOXORUBICIN LIPOSOMAL

injectable

Kaposi's sarcoma

EPIRUBICIN

injectable

Premenopausal node positive breast cancer patients who either:

a) are not eligible for a study and want high intensity treatment (FEC),

b) have mild underlying heart disease but would benefit from an

anthracycline and who do not want high intensity treatment (EC)

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 tumor program

or the hematology/ lymphoma program

ESTRAMUSTINE

capsules

ETOPOSIDE

injectable, capsules

FLUDARABINE

injectable

previously treated chronic lymphocytic leukemia

low grade lymphoma

Waldenstrom's macroglobulinemia

prescribing limited to written authorization by physicians recommended by

the hematology/lymphoma tumor program

FLUOROURACIL

injectable, cream

pump

FLUOXYMESTERONE

tablets

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 tumor program

injectable

Bladder Cancer

progressive local or metastatic transitional cell carcinoma of the

urothelium who have failed on cisplatin or are intolerant to cisplatin

based chemotherapy due to age, performance status, renal function in

concomitant medical illness.

prescribing limited to written authorization by physicians recommended by

the GU tumor program

injectable

Pancreas

locally advanced or metastatic adenocarcinoma of the pancreas.

prescribing limited to written authorization by physicians recommended by

the GI tumor 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 ER positive pre-perimenopausal patients after tamoxifen failure.

prescribing limited to written authorization by physicians recommended by

the breast tumor 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 tumor program

IFOSFAMIDE

injectable

pump

INTERFERON

- alpha 2a or 2b

- alpha 2b in new patients "98-99"

injectable

cladribine-resistant hairy cell leukemia

Kaposi's sarcoma

chronic myelogenous leukemia

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 tumor program

metastatic renal cell carcinoma

INTERFERON

alpha 2b ONLY

injectable

basal cell carcinoma

adjuvant treatment of high risk melanoma

2nd line therapy of superficial bladder cancer

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