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Dasatinib [DAS6]

Dasatinib for the treatment of untreated chronic phase chronic myeloid leukaemia

  1. I confirm that an application has been made by 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 that the patient has chronic phase myeloid leukaemia
  3. I confirm that the patient has received no prior treatment unless it was dasatinib received as part of the SPIRIT 2 trial for this indication and the patient meets all other criteria listed here* *In March 2018 patients previously entered into the Spirit 2 trial and receiving free-of-charge supplies of dasatinib can transition to NHS commercial supply.
  4. . I confirm that imatinib is not appropriate for this patient and that this has been discussed and supported by the relevant MDT involved in CML decision making unless they are already receiving dasatinib as part of the SPIRIT 2 trial for this indication and the patient meets all other criteria listed here
  5. I confirm that dasatinib will be used as outlined in the Summary of Product Characteristics (SPC).

[NHS funded]{.badge .rounded-pill .bg-success} From: 21 March 2017

Additional information

Form version:

CDF Managed Access: NA

NICE Technology Appraisal: TA426 (21 December 2016)

Current Form Version

Important

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