Cancer treatment—systemic therapy agent or protocol, text X[X(149)]

Guide for use:

Systemic therapy agents are drugs that travel through the bloodstream and reach and effect cells all over the body. They are administered orally or intravenously.

Each systemic therapy agent or protocol used during the initial treatment of the cancer should be recorded. The initial course of treatment includes all treatments administered to the patient from diagnosis and before disease progression or recurrence.

The name of each systemic therapy agent or protocol given as initial treatment is recorded regardless of whether the course of treatment is completed as intended, and regardless of the intent or timing of the treatment.

Oral systemic therapy agents normally given on an outpatient basis should also be included.

Systemic therapy agents may be administered as single-agent treatments or as a combination of drugs administered according to a prespecified regimen or protocol. A protocol is a precise and detailed plan for therapy that includes the type, quantity, method and length of time of taking the drugs required for any treatment cycle.

A combination of drugs may be known by acronyms but since details of drugs and acronyms may vary it is recommended that the name of each agent be recorded.

When recording systemic therapy protocol names, eviQ should be used wherever possible. eviQ Cancer Treatments Online is a point of care clinical information resource that provides health professionals with current evidence based, peer maintained, best practice cancer treatment protocols and information. It was developed and is maintained by the Cancer Institute NSW.

If a single agent is being used or a protocol is not included in eviQ, then the full, generic name of any agent should be recorded preferably using the Australian Medicines Terminology (AMT), or if necessary, the Australian Medicines Handbook (AMH) or MIMS. If a generic name is not available because the drug is experimental or under patent protection, record the brand name.

The eviQ protocol identifier number should be recorded separately in the data element Cancer treatment—systemic therapy agent(s) or protocol, eviQ protocol identifier, NNNNNN.

Systemic therapy agents are encompassed in the treatment modalities chemotherapy, immunotherapy and hormone therapy administered for the treatment of cancer.

A patient may receive treatment with a protocol that includes different types of systemic therapy agents, for example, a chemotherapy agent and an immunotherapy agent.

Targeted therapies (treatments that use drugs or other substances to identify and attack specific cancer cells) using a chemotherapy agent are included. Other targeted therapies, such as monoclonal antibody therapy, are recorded in the data element Cancer treatment—other cancer treatment, text [X(150)].

Do not code prednisone as hormone therapy when it is administered for reasons other than chemotherapeutic treatment. Only record prednisone as hormone therapy when administered in combination with chemotherapy such as MOPP (mechlorethamine, vincristine, procarbazine, prednisone) or COPP (cyclophosphamide, vincristine, procarbazine, prednisone).

Tumour involvement or cancer treatment may destroy hormone-producing tissue. Hormone replacement therapy will be given if the hormone is necessary to maintain normal metabolism and body function. Do not code hormone replacement therapy as part of the initial course of treatment.

Note the distinction between the administration of systemic agents or drugs and systemic therapy procedures that affect the hormonal or immunologic balance of the patient.

The collection of specific treatment information is useful to evaluate patterns of care, the effectiveness of different treatment modalities, and treatment by patient outcome.