Crizotinib [CRI3]
1st or subsequent line systemic therapy for ROS1-positive inoperable locally advanced/metastatic non squamous non- small cell lung cancer where the following criteria have been met:
- I confirm that this application is made by and the first cycle of systemic anti-cancer therapy with crizotinib will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy
- The patient has histological or cytological evidence of NSCLC that carries a ROS1 gene rearrangement based on a validated test OR there is documented agreement by the lung MDT that the radiological appearances are in keeping with locally advanced or metastatic NSCLC AND there is an informative circulating free DNA test result confirming the presence of a ROS1 gene rearrangement. Please mark below on which basis the diagnosis of ROS1 positive NSCLC has been made in this patient:
- Histological or cytological evidence.
- Documented agreement by the lung MDT that the radiological appearances are in keeping with locally advanced or metastatic NSCLC and there is an informative circulating free DNA test result confirming the presence of a ROS1 gene rearrangement
- I confirm that this non squamous NSCLC carries a confirmed ROS1 gene rearrangement as demonstrated by an accurate and validated assay
- I confirm that the patient has received no previous ROS1-targeted therapy
- I confirm that EITHER the patient has received no previous cytotoxic chemotherapy for locally advanced or metastatic non-small cell lung cancer OR has been previously treated with cytotoxic chemotherapy for locally advanced or metastatic disease Note: NHS England has a strong preference for ROS1-positive patients to be treated with crizotinib as 1st line therapy for locally advanced/metastatic NSCLC though recognises that some patients have had to be treated with chemotherapy for urgent clinical reasons before the ROS1 result was known
- I confirm that crizotinib will be used only as single-agent therapy
- I confirm that the patient has an ECOG performance status of 0 or 1 or 2
- I confirm that the patient either has no brain metastases or, if the patient has brain metastases, the patient is symptomatically stable prior to starting crizotinib
- I confirm that the patient will be treated until loss of clinical benefit or excessive toxicity or patient choice to discontinue treatment, whichever is the sooner
- I confirm that treatment breaks of up to 6 weeks are allowed but solely to allow toxicities to settle
- I confirm that crizotinib will be otherwise used as set out in its Summary of Product Characteristics (SPC)
NHS funded From: 03 January 2025
Additional information
Current Form Version
Note
The data on this page was produced using version 1.341 of the CDF list, downloaded from an archive of NHS England’s website on 11 January 2025 at 21:05.
If NHS England has published a new version of the CDF List but this site has not yet accessed that, this form may be out of date. Additionally, if any update has occurred without NHS England noting it as a change, this page will be out of date.