Bosutinib [BOS1]

Bosutinib for previously treated chronic myeloid leukaemia

1. I confirm that an application has been made and the first cycle of systemic anti-cancer therapy will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.
2. I confirm the patient has chronic, accelerated or blast phase Philadelphia chromosome positive chronic myeloid leukaemia.
3. I confirm the patient has had previous treatment with 1 or more tyrosine kinase inhibitor.
4. I confirm that treatment is not appropriate with either imatinib, nilotinib or dasatinib.
5. I confirm the patient will receive the licensed dose and frequency of bosutinib

[NHS funded]{.badge .rounded-pill .bg-success} From: 22 November 2016

Additional information

Form version:

CDF Managed Access: NA

NICE Technology Appraisal: TA401 (24 August 2016)

Current Form Version

Important

This is an older version of the form. To view the most up to date form follow this link

Older Form Versions

There are previous versions of this form. These may not all be available on this site.