UpToDate Lexidrug Compendia Transparency Document

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Monograph	Off-Label Use Proposed	Date	Participating Panel Member(s)	Strength of Recommendation	Level of Evidence	Off-Label Use Vote Record	Panel Member Conflict of Interest Statement
Goserelin	Breast cancer, early stage, premenopausal ovarian preservation during chemotherapy	2015.03 (updated 2022.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the Off-Label Use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cisplatin	Breast cancer (triple-negative)	2015.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the Off-Label Use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cisplatin	Penile cancer	2015.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Nick Link, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	B	For the Off-Label Use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Topotecan	Primary CNS lymphoma, relapsed/refractory	2015.06	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the Off-Label Use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Melanoma, unresectable or metastatic (without BRAF mutation), first-line, single-agent therapy	2015.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Palbociclib	Breast cancer, advanced (second-line endocrine-based therapy)	2015.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link. PharmD, BCOP	Strong	A	For the Off-Label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fulvestrant	Breast cancer, advanced (second-line endocrine-based combination therapy)	2015.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link. PharmD, BCOP	Strong	A	For the Off-Label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cabozantinib	Renal cell cancer, clear cell (advanced)	2015.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the Off-Label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Renal cell cancer, clear cell (advanced)	2015.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest Conflict of Interest No Conflict of Interest No Conflict of Interest
Goserelin	Breast cancer, advanced with endocrine-based combination therapy	2015.11 (updated 2022.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link. PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ipilimumab	Melanoma, unresectable or metastatic, first-line combination therapy	2015.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link. PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trabectedin	Ovarian cancer, refractory (platinum-sensitive)	2016.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Prostate cancer, metastatic, hormone-sensitive	2016.03 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vemurafenib	Erdheim-Chester disease, refractory (with BRAF V600E mutation)	2016.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vemurafenib	Non-small cell lung cancer, relapsed/refractory, with BRAF V600 mutation	2016.05 (updated 2025.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Angela German, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Head and neck cancer, squamous cell (recurrent or metastatic)	2016.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Axitinib	Thyroid cancer (advanced, differentiated)	2016.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Mark Holdsworth, PharmD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carfilzomib	Waldenström macroglobulinemia	2016.07 (updated 2022.07)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Regorafenib	Hepatocellular cancer (intermediate or advanced)	2016.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Mark Holdsworth, PharmD Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Merkel cell carcinoma (advanced)	2016.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Dabrafenib	Non-small cell lung cancer, metastatic, relapsed or refractory (with BRAF V660E mutation)	2016.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trametinib	Non-small cell lung cancer, metastatic, relapsed or refractory (with BRAF V660E mutation)	2016.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Small cell lung cancer (progressive)	2016.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mitomycin	Vulvar cancer, advanced	2016.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Anal cancer	2016.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Gastric cancer	2016.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Thyroid carcinoma, anaplastic	2016.12 (updated 2025.02)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Wilms Tumor	2016.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Mark Holdsworth, PharmD Heidi Trinkman, PharmD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil	Vulvar cancer, advanced	2016.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bevacizumab	Malignant pleural mesothelioma (unresectable)	2016.12 (updated 2020.11)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bevacizumab	Hereditary hemorrhagic telangiectasia	2016.12 (updated 2020.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Heidi Trinkman, PharmD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Temsirolimus	Endometrial cancer (locally advanced, recurrent and/or metastatic)	2017.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Urothelial carcinoma (advanced)	2017.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sargramostim	Neuroblastoma, high-risk, relapsed or refractory	2017.03 (updated 2021.01)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ipilimumab	Small cell lung cancer (progressive)	2017.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Tocilizumab	Cytokine release syndrome (due to BiTE therapy), severe or life-threatening	2017.04 (modified 2017.09)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, PharmD Omer Koc, MD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Pancreatic cancer (adjuvant therapy)	2017.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Gemcitabine	Pancreatic cancer (adjuvant therapy)	2017.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Anal carcinoma	2017.04 (updated 2025.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Antithymocyte globulin (rabbit;Thymoglobulin)	Chronic graft-versus-host disease (prevention)	2017.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Breast cancer, metastatic, HER2-negative, BRCA-mutated	2017.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Abiraterone	Prostate cancer, metastatic or high-risk locally advanced, castration-sensitive	2017.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Myasthenia gravis (refractory)	2017.07 (updated 2021.10)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Heidi Trinkman, PharmD	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Neuromyelitis optica (relapse prevention)	2017.07 (updated 2021.10)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Pemphigus vulgaris (newly diagnosed)	2017.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Heidi Trinkman, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Breast cancer (adjuvant therapy)	2017.07 (updated 2019.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Hepatobiliary cancer (adjuvant therapy)	2017.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lenvatinib	Hepatocellular carcinoma (advanced)	2017.11 (updated; see 2018.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Durvalumab	Non-small cell lung cancer (unresectable, locally advanced)	2017.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil	Glaucoma surgery (adjunctive therapy)	2017.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Alemtuzumab	Aplastic anemia, relapsed or refractory	2017.11 (updated 2025.05)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Mark Holdsworth, PharmD Heidi Trinkman, PharmD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Alemtuzumab	Hemophagocytic lymphohistiocytosis, refractory	2017.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Mark Holdsworth, PharmD Heidi Trinkman, PharmD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Irinotecan (conventional)	Small cell lung cancer (limited stage)	2017.11 (updated 2025.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Corey Carter, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bevacizumab	Diabetic macular edema	2017.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Irinotecan (conventional)	Unknown primary adenocarcinoma	2017.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Tamoxifen	Mastalgia, severe	2017.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cladribine	T-cell large granular lymphocytic leukemia (refractory)	2017.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Alemtuzumab	Mycosis fungoides/Sezary syndrome (advanced)	2018.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Alemtuzumab	T-cell large granular lymphocytic leukemia	2018.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nilotinib	Acute lymphoblastic leukemia, Ph+	2018.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Heidi Trinkman, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Streptozocin	Gastrointestinal neuroendocrine tumors	2018.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trastuzumab	Breast cancer, metastatic, HER2-positive, hormone receptor-positive (in combination with an aromatase inhibitor)	2018.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lenvatinib	Hepatocellular carcinoma (advanced)	2018.03 (updated from 2017.11)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the updated LOE /Strength of Recommendation: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ruxolitinib	Graft versus host disease (acute or chronic; treatment)	2018.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Heidi Trinkman, PharmD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Filgrastim	Alcoholic hepatitis (severe)	2018.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Prednisone	Multiple myeloma (previously untreated; transplant ineligible)	2018.06 (updated 2021.10)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Everolimus	Hodgkin lymphoma (relapsed or refractory)	2018.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Everolimus	Thymoma or thymic carcinoma, advanced or metastatic, relapsed or refractory	2018.06 (updated 2024.12)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cetuximab	Penile cancer (squamous cell, advanced or metastatic)	2018.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Methylprednisolone	Prostate cancer (metastatic, castration-resistant)	2018.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Dolasetron	Chemotherapy-associated nausea and vomiting (high emetic potential) (adults)	2018.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Strong	G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Dolasetron	Chemotherapy-associated nausea and vomiting (low emetic potential) (adults)	2018.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Strong	G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ondansetron	Carcinoid syndrome-associated diarrhea (severe, refractory; alternative agent)	2018.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Melanoma, metastatic with brain metastases	2018.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ipilimumab	Melanoma, metastatic with brain metastases	2018.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Paclitaxel (protein bound)	Bladder cancer, metastatic, platinum-resistant	2018.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Paclitaxel (protein bound)	Cervical cancer, advanced, recurrent or persistent	2018.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Atezolizumab	SCLC (extensive stage; first-line therapy)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Brigatinib	Non-small cell lung cancer, advanced, (initial ALK-inhibitor therapy)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ramucirumab	Hepatocellular carcinoma (advanced, relapsed/refractory)	2018.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Melanoma, stage III (adjuvant treatment)	2018.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Procarbazine	CNS tumors, low grade gliomas (in children)	2018.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Heidi Trinkman, PharmD Jennifer Thackray, PharmD, BCPPS, BCPS Mark Holdsworth, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vincristine	Hepatoblastoma	2018.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Heidi Trinkman, PharmD Jennifer Thackray, PharmD, BCPPS, BCPS Mark Holdsworth, PharmD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cabozantinib	Hepatocellular carcinoma (advanced)	2018.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carfilzomib	Multiple myeloma (newly diagnosed)	2019.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trastuzumab	Endometrial cancer (uterine serous), advanced or recurrent, HER2-positive	2019.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ado-trastuzumab emtansine	Breast cancer, early, HER2-positive (adjuvant therapy for residual disease)	2019.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Zoledronic acid	Breast cancer, early stage, adjuvant therapy in postmenopausal females	2019.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B,G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Oxaliplatin	Pancreatic cancer, potentially curable (adjuvant therapy)	2019.05 (updated 2019.07)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Leucovorin calcium	Pancreatic cancer, potentially curable (adjuvant therapy)	2019.05 (updated 2019.07)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Irinotecan	Pancreatic cancer, potentially curable (adjuvant therapy)	2019.05 (updated 2019.07)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ibandronate	Prostate cancer, metastatic, bone pain (alternative agent)	2019.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vincristine	Merkel cell carcinoma	2019.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Venetoclax	Mantle cell lymphoma, relapsed/refractory	2019.06 (updated 2023.07)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Head and neck cancer, squamous cell (recurrent or metastatic; palliative treatment)	2019.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mitomycin	Hepatocellular carcinoma (chemoembolization)	2019.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Pancreatic cancer, metastatic, BRCA-mutated (maintenance therapy)	2019.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vinblastine	Kaposi sarcoma, oral lesions (intralesional)	2019.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Mark Holdsworth, PharmD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Encorafenib	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2019.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Binimetinib	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2019.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cetuximab	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2019.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ziv-aflibercept	Ascites (malignant; due to malignant ovarian cancer)	2019.08	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Elizabeth Connor, MD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Chlorambucil	Necrobiotic xanthogranuloma	2019.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Chlorambucil	Idiopathic membranous nephropathy	2019.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	B,G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pentostatin	T-cell large granular lymphocytic leukemia	2019.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mesna	Prevention of cyclophosphamide-induced hemorrhagic cystitis in patients with rheumatic or autoimmune disorders	2019.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Etoposide	Hemophagocytic lymphohistiocytosis	2019.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Jordan Lundberg, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pazopanib	Desmoid tumors, progressive	2019.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Luspatercept	Anemia due to lower-risk myelodysplastic syndromes with ring sideroblasts	2020.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lenalidomide	Smoldering multiple myeloma (high-risk)	2020.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Regorafenib	Osteosarcoma, metastatic, progressive (recurrent, relapsed, or refractory)	2020.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Breast cancer (triple negative, early stage)	2020.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Mycosis fungoides, Sézary syndrome (relapsed or refractory)	2020.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP Angela German, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Interferon alfa-2b	Essential thrombocythemia (advanced)	2020.05 (updated 2022.01)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Interferon alfa-2b	Myelofibrosis (early)	2020.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Interferon alfa-2b	Polycythemia vera (advanced)	2020.05 (updated 2022.01)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Daratumumab	Systemic light chain amyloidosis (relapsed)	2020.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Malignant pleural mesothelioma, relapsed or refractory, with PD-L1 expression	2020.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Omer Koc, MD	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Porfimer	Cholangiocarcinoma (unresectable)	2020.06	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fam-trastuzumab deruxtecan	Gastric cancer, advanced, previously treated (HER2-positive)	2020.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Paclitaxel (conventional)	Anal cancer (advanced)	2020.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Avelumab	Gestational trophoblastic neoplasia, resistant	2020.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Doxorubicin (liposomal)	Castleman disease, multicentric (human herpes virus-8-associated)	2020.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Doxorubicin (liposomal)	Diffuse large B-cell lymphoma	2020.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Paclitaxel (protein bound)	Biliary tract cancer (advanced)	2020.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil (topical)	Penile carcinoma (in situ)	2020.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil (topical)	Squamous cell carcinoma (in situ; Bowen disease)	2020.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Osimertinib	Non-small cell lung cancer (adenocarcinoma), with leptomeningeal metastases (EGFR mutation-positive)	2020.12 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Castleman disease, idiopathic, multicentric	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Graft-versus-host disease (acute and chronic), prophylaxis	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Merkel cell carcinoma	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Osteosarcoma (relapsed/refractory)	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Primary CNS lymphoma	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Angela German, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Systemic light chain amyloidosis	2020.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Thymoma or thymic carcinoma	2020.12 (updated 2024.12)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Omer Koc, MD Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Methotrexate	Large granular lymphocyte leukemia (symptomatic)	2021.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Methotrexate	Primary cutaneous anaplastic large cell lymphoma	2021.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Eribulin	Uterine leiomyosarcoma, refractory	2021.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Prostate cancer, castration-resistant, metastatic	2021.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Mark Holdsworth, PharmD Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Thyroid carcinoma, anaplastic	2021.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Mark Holdsworth, PharmD Jordan Lundberg, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Bladder cancer, non-muscle invasive, refractory (intravesical)	2021.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Uterine sarcoma (advanced or high-grade)	2021.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carboplatin	Gestational trophoblastic neoplasia, high-risk, refractory	2021.04 (updated 2022.02)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Anal carcinoma (squamous cell), advanced	2021.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Melphalan	Regional perfusion in solid tumors (melanoma and soft tissue sarcoma)	2021.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Mark Holdsworth, PharmD Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Melphalan	Hematopoietic stem cell transplant (allogeneic), reduced intensity conditioning regimen (hematologic malignancies)	2021.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Erlotinib	Renal cell carcinoma, papillary (advanced)	2021.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Elizabeth Connor, MD Mark Holdsworth, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Zanubrutinib	Waldenström macroglobulinemia	2021.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ofatumumab	Waldenström macroglobulinemia, relapsed or refractory	2021.06	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Klodiana Neme, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fam-trastuzumab deruxtecan	Colorectal cancer, metastatic, HER2-expressing	2021.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Triptorelin	Breast cancer, premenopausal ovarian suppression during adjuvant endocrine therapy	2021.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Craig Vargo, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Triptorelin	Breast cancer, premenopausal ovarian preservation during chemotherapy	2021.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Acalabrutinib	Waldenström macroglobulinemia	2021.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Lymphodepleting therapy prior to autologous T-cell immunotherapy	2021.08 (updated 2024.08)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fludarabine	Lymphodepleting therapy prior to autologous T-cell immunotherapy	2021.08 (updated 2024.08)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Breast cancer, early, high risk, HER2-negative, germline BRCA-mutated, adjuvant therapy	2021.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Omer Koc, MD Craig Vargo, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Romidepsin	Peripheral T-cell lymphoma, relapsed/refractory	2021.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Venetoclax	Multiple myeloma, relapsed/refractory, t(11;14)	2021.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Oxaliplatin	Small bowel adenocarcinoma (advanced or metastatic)	2021.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fam-trastuzumab deruxtecan	Non-small cell lung cancer, metastatic, relapsed/refractory, nonsquamous, HER2-mutant	2021.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Nick Link, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ifosfamide	Extra nodal NK/T-cell lymphoma, nasal type	2021.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ifosfamide	Gestational trophoblastic neoplasia, high-risk, refractory	2021.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ifosfamide	Penile cancer, metastatic, squamous cell	2021.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ifosfamide	Uterine carcinosarcoma	2021.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Exemestane	Breast cancer, high-risk, hormone receptor-positive, adjuvant endocrine therapy (in combination with ovarian function suppression) in premenopausal patients	2021.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rucaparib	Pancreatic cancer, locally advanced or metastatic, germline BRCA2-mutated, maintenance therapy	2021.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Elizabeth Connor, MD Klodiana Neme, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Peginterferon alfa-2a	Essential thrombocythemia, advanced	2022.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Peginterferon alfa-2a	Polycythemia vera, advanced	2022.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Jordan Lundberg, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Epirubicin	Bladder cancer, non-muscle invasive	2022.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bleomycin	Gestational trophoblastic neoplasia, high-risk, refractory	2022.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Paclitaxel (conventional)	Gestational trophoblastic neoplasia, high-risk, refractory	2022.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Polatuzumab vedotin	Diffuse large B-cell lymphoma, intermediate or high-risk, previously untreated	2022.02	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Filgrastim	Fanconi anemia (neutropenia)	2022.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trametinib	Ovarian carcinoma, serous, low-grade, recurrent	2022.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Angela German, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Doxorubicin (conventional)	Adult T-cell leukemia/lymphoma	2022.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Klodiana Neme, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Doxorubicin (conventional)	Neuroendocrine tumors, pancreatic	2022.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Doxorubicin (conventional)	Adrenocorticol carcinoma, advanced	2022.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Elizabeth Connor, MD Mark Holdsworth, PharmD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclosporine (systemic)	Aplastic anemia	2022.03 (updated 2022.11)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Strong	A, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclosporine (systemic)	T-cell large granular lymphocytic leukemia, symptomatic	2022.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Goserelin	Breast cancer, premenopausal ovarian suppression during adjuvant endocrine therapy	2022.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Omer Koc, MD Craig Vargo, PharmD, BCOP	Strong	G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cemiplimab	Cervical carcinoma, recurrent or metastatic	2022.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Acute lymphoblastic leukemia, B-cell precursor, CD20-positive	2022.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Klodiana Neme, PharmD, BCOP Mark Holdsworth, PharmD	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Enasidenib	Acute myeloid leukemia, newly diagnosed, IDH2 mutated	2022.05 (updated 2025.02)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Enasidenib	Myelodysplastic syndromes, high-risk, relapsed/refractory, IDH2 mutated	2022.05 (updated 2025.02)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Angela German, PharmD, BCOP Omer Koc, MD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Filgrastim	Hematopoietic cell mobilization in healthy donors for peripheral blood stem cells for allogeneic transplantation	2022.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Durvalumab	Biliary tract cancer, advanced	2022.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lapatinib	Colon cancer, metastatic, HER2 overexpressing, with progression on conventional chemotherapy	2022.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Angela German, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trastuzumab	Colon cancer, metastatic, HER2 positive (previously treated)	2022.06 (updated 2025.06)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Angela German, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fludarabine	T-cell large granular lymphocytic leukemia, relapsed/refractory	2022.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil (systemic)	Small bowel adenocarcinoma, advanced or metastatic	2022.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP Mark Holdsworth, PharmD Elizabeth Connor, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Idarubicin	Acute lymphoblastic leukemia, recurrent or refractory, salvage therapy	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sacituzumab govotecan	Breast cancer, metastatic, hormone receptor-positive, HER2-negative, salvage therapy	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Elizabeth Conner, MD Angela German, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Busulfan	Myeloablative conditioning prior to betibeglogene autotemcel in beta thalassemia	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Plerixafor	Hematopoietic cell mobilization prior to betibeglogene autotemcel in beta thalassemia	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Filgrastim	Hematopoietic cell mobilization prior to betibeglogene autotemcel in beta thalassemia	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Irinotecan (liposomal)	Biliary tract cancer, metastatic, progressive	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP Matt Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Renal cell carcinoma, advanced, first-line single-agent therapy	2022.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Matt Arango, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Renal cell carcinoma, advanced, first-line single-agent therapy	2022.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Matt Arango, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Toxicities associated with immune checkpoint inhibitor therapy, treatment	2022.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matt Arango, PharmD, BCOP Mark Holdsworth, PharmD Lauren Ice, PharmD, BCPS, BCOP	Equivocal	G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Letrozole	Breast cancer, high-risk, hormone-receptor positive, adjuvant endocrine therapy in premenopausal patients (in combination with ovarian function suppression)	2022.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Panitumumab	Cutaneous squamous cell carcinoma, unresectable	2022.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Mark Holdsworth, PharmD Omer Koc, MD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	Pneumonitis, immune checkpoint inhibitor-induced, grade 3 or 4, steroid-refractory	2022.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matt Arango, PharmD, BCOP Mark Holdsworth, PharmD Lauren Ice, PharmD, BCPS, BCOP	Equivocal	C, G	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Anastrozole	Breast cancer, high-risk, hormone receptor-positive, adjuvant endocrine therapy in premenopausal patients (in combination with ovarian function suppression)	2022.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Irinotecan (conventional)	Small bowel adenocarcinoma, advanced unresectable or metastatic	2022.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP Mark Holdsworth, PharmD Elizabeth Connor, MD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Zanubrutinib	Chronic lymphocytic leukemia, relapsed or refractory	2023.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Strong	A	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vemurafenib	Hairy cell leukemia, relapsed or refractory	2023.02	Stephanie Minich, PharmD, BCOP, BCPS Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ipilimumab	Merkel cell carcinoma, unresectable, recurrent, or stage IV	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Merkel cell carcinoma, unresectable, recurrent, or stage IV	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Head and neck cancer: nasopharyngeal cancer, locally advanced	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Klodiana Neme, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Neuroendocrine tumors: GI/carcinoid, refractory	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP	Equivocal	C	For the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Small bowel adenocarcinoma, advanced unresectable or metastatic	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Omer Koc, MD Craig Vargo, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Thymoma or thymic carcinoma, advanced or metastatic, relapsed or refractory	2023.02 (updated 2024.12)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Craig Vargo, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vemurafenib	Langerhans cell histiocytosis, with BRAF V600 mutation	2023.02	Stephanie Minich, PharmD, BCOP, BCPS Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vemurafenib	Thyroid cancer, papillary, recurrent or metastatic, BRAF V600E-mutated	2023.02	Stephanie Minich, PharmD, BCOP, BCPS Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Gastric cancer, adjuvant treatment	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Angela German, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Hairy cell leukemia	2023.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Melanoma, advanced, high-risk, resectable, neoadjuvant regimen	2023.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Imiquimod	Cutaneous squamous cell carcinoma in situ (Bowen disease), low-risk	2023.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Imiquimod	Melanoma in situ, lentigo maligna type	2023.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Mark Holdsworth, PharmD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Imiquimod	Mycosis fungoides, early stage, refractory	2023.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Imiquimod	Penile cancer, superficial/noninvasive disease	2023.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mitoxantrone	T-cell prolymphocytic leukemia	2023.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fludarabine	T-cell prolymphocytic leukemia	2023.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cyclophosphamide	T-cell prolymphocytic leukemia	2023.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Anastrozole	Breast cancer in male patients, hormone receptor-positive	2023.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Nick Link, PharmD, BCOP Craig Vargo, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Exemestane	Breast cancer in male patients, hormone receptor-positive	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Letrozole	Breast cancer in male patients, hormone receptor-positive	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fulvestrant	Breast cancer in male patients, advanced or metastatic, hormone receptor-positive, HER2-negative	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Omer Koc, MD	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Goserelin	Breast cancer in male patients, hormone receptor-positive	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Leuprolide	Breast cancer in male patients, hormone receptor-positive	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Triptorelin	Breast cancer in male patients, hormone receptor-positive	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Leucovorin calcium	Small bowel adenocarcinoma, advanced or metastatic	2023.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Obinutuzumab	Diffuse large B cell lymphoma, relapsed or refractory; glofitamab pretreatment	2023.07	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pirtobrutinib	Chronic lymphocytic leukemia/small lymphocytic lymphoma, relapsed or refractory	2023.08	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Lauren Ice, PharmD, BCPS, BCOP Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Binimetinib	Melanoma, unresectable or metastatic, with NRAS mutation	2023.09	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Hydroxyurea	Chronic myelomonocytic leukemia, advanced, proliferative	2023.09	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Hydroxyurea	Differentiation syndrome, cytoreduction	2023.09	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Hydroxyurea	Myelofibrosis, primary, symptomatic (alternative agent)	2023.09	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Nick Link, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Floxuridine	Cholangiocarcinoma, intrahepatic metastases, unresectable	2023.10	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matt Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Streptozocin	Thyroid carcinoma, medullary, advanced or metastatic	2023.11	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mogamulizumab	Adult T cell leukemia/lymphoma, relapsed or refractory	2023.11	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pegfilgrastim	Hematopoietic support/recovery following autologous transplantation	2023.12	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Omer Koc, MD Klodiana Neme, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bicalutamide	Prostate cancer, reduction of lower urinary tract symptoms associated with tumor flare	2024.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bicalutamide	Salivary gland tumors, advanced, nonadenoid cystic, androgen receptor-positive	2024.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Elizabeth Connor, MD Nick Link, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Atezolizumab	Cervical cancer, persistent, recurrent, or metastatic	2024.02	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Durvalumab	Hepatocellular carcinoma, unresectable, single-agent therapy	2024.02	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matt Arango, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Omer Koc, MD	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Plerixafor	Hematopoietic cell mobilization prior to lovotibeglogene autotemcel in sickle cell anemia	2024.03	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Busulfan	Myeloablative conditioning prior to lovotibeglogene autotemcel in sickle cell anemia	2024.03	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Thiotepa	Primary CNS lymphoma, newly diagnosed, induction therapy	2024.03	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Docetaxel	Cervical cancer, advanced or recurrent	2024.04	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bevacizumab	Meningioma, recurrent or refractory	2024.04	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Leucovorin calcium	Anal carcinoma, advanced	2024.04	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Epirubicin	Peripheral T cell lymphoma, enteropathy-associated	2024.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fostamatinib	Warm autoimmune hemolytic anemia, refractory or intolerant	2024.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Lauren Ice, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bendamustine	Lymphodepleting therapy prior to chimeric antigen receptor (CAR) T-cell immunotherapy	2024.05	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Jordan Lundberg, PharmD, BCOP Jen Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Bendamustine	Peripheral T-cell lymphoma, relapsed or refractory	2024.05	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Temozolomide	Small-cell lung cancer, relapsed/refractory	2024.05	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pemetrexed	Primary CNS lymphoma, relapsed or refractory	2024.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Lauren Ice, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Tucatinib	Biliary tract cancer, HER2-positive, metastatic	2024.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trastuzumab and Hyaluronidase	Breast cancer, early, HER2-positive, neoadjuvant treatment	2024.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Jen Thackray, PharmD, BCPPS, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Trastuzumab	Biliary tract cancer, HER2-positive, metastatic	2024.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich. PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cetuximab	Colorectal cancer, locally advanced or metastatic, KRAS G12C mutated	2024.08	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lorlatinib	Non–small cell lung cancer, metastatic, ROS1-positive	2024.08	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Amivantamab	Non–small cell lung cancer, locally advanced or metastatic, refractory, with EGFR exon 19 deletion or exon 21 L858R substitution mutation	2024.08	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Klodiana Neme, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cladribine	Systemic mastocytosis	2024.09	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD Lauren Ice, PharmD, BCOP Nick Link, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cladribine	Erdheim-Chester disease	2024.10	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	C, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cladribine	Langerhans cell histiocytosis	2024.10	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCOP Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sotorasib	Colorectal cancer, metastatic, relapsed or refractory, KRAS G12C-mutated	2024.11	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Lauren Ice, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sotorasib	Pancreatic cancer, locally advanced or metastatic, relapsed or refractory, KRAS G12C-mutated	2024.11	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Lenvatinib	Thymic carcinoma, advanced or metastatic, relapsed or refractory	2024.12	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Michael B Smith, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sunitinib	Thymic carcinoma, advanced or metastatic, relapsed or refractory	2024.12	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Michael B Smith, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Thymic carcinoma, advanced or metastatic, relapsed or refractory	2024.12	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Michael B Smith, PharmD, BCOP	Equivocal	C	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vinorelbine	Kaposi sarcoma, AIDS-related, relapsed or refractory	2025.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD Lauren Ice, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fulvestrant	Endometrial carcinoma, recurrent or metastatic	2025.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ibrutinib	Mantle cell lymphoma, relapsed or refractory	2025.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Mark Holdsworth, PharmD Omer Koc, MD Jordan Lundberg, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Vulvar cancer, squamous cell, unresectable or metastatic	2025.03	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Elizabeth Connor, MD Mark Holdsworth, PharmD Klodiana Neme, PharmD, BCOP	Equivocal	B, G	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pertuzumab	Biliary tract cancer, metastatic, HER2-positive (previously treated)	2025.04	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pertuzumab	Colorectal cancer, metastatic, HER2 positive (previously treated)	2025.04	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Matthew Arango, PharmD, BCOP Lauren Ice, PharmD, BCOP, BCPS Omer Koc, MD	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Palbociclib	Liposarcoma, unresectable or metastatic (retroperitoneal)	2025.05	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Liz Connor, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Equivocal	B	For the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest

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Monograph	Off-Label Use Removed	Date	Participating Panel Member(s)	Strength of Recommendation	Off-Label Use Removal Vote Record	Conflict of Interest Statement
Bevacizumab	Ovarian cancer, advanced, recurrent (platinum sensitive)	2014.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA-approved (no panel vote needed - removed from off-label uses due to approval by FDA)	N/A	N/A
Alemtuzumab	Multiple sclerosis	2014.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA-approved (no panel vote needed - removed from off-label uses due to approval by FDA)	N/A	N/A
Medroxyprogesterone injection	Renal Carcinoma (labeled use, add to Use: Unsupported)	2015.02 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Cater, MD Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS	Although included in the medroxyprogesterone (400 mg/mL injection) manufacturer’s labeling as adjunctive therapy and palliative treatment of inoperable, recurrent, and metastatic renal carcinoma, there is insufficient evidence to recommend medroxyprogesterone for the management of renal carcinoma when compared to other generally accepted treatments.	Add to Use: Unsupported: 5 of 5 (add to unsupported use)	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pegfilgrastim	Prevention of chemotherapy-induced neutropenia in children	2015.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to pediatric dosing addition to FDA labeling).	n/a	n/a
Nivolumab	Renal cell cancer, clear cell (advanced)	2015.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Nivolumab	Melanoma, unresectable or metastatic (without BRAF mutation), first-line, single-agent therapy	2015.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Uridine Triacetate	Fluorouracil overdose/overexposure	2015.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Palbociclib	Breast cancer, advanced (second-line endocrine-based therapy)	2016.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Fulvestrant	Breast cancer, advanced (second-line endocrine-based therapy)	2016.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Cabozantinib	Renal cell carcinoma, advanced	2016.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Ifosfamide	Small cell lung cancer	2016.09 (updated 2024.03)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Against off-label use: Although ifosfamide had previously been used off-label for the treatment of small cell lung cancer, available literature suggest a lack of improvement in clinical outcomes and increased toxicity with the addition of ifosfamide to standard therapy. Other contemporary therapies have replaced the use of ifosfamide for management of small cell lung cancer.	Remove the off-label use: 5 of 5 (Add to Use: Unsupported)	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Head and neck cancer, squamous cell (recurrent or metastatic)	2016.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Mitomycin	Non-small cell lung cancer	2016.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Against off-label use: Evidence suggests a lack of support for this off-label use; other contemporary therapies have replaced the use of mitomycin for the treatment of non-small cell lung cancer.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fluorouracil	Thymic cancers	2017.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD. BCOP	Against off-label use: A lack of evidence suggests a lack of support for this off-label use.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Antithymocyte globulin (rabbit;Thymoglobulin)	Myelodysplastic syndrome (low risk; non-sideroblastic)	2017.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD. BCOP	Against off-label use: A lack of evidence for antithymocyte globulin (rabbit; Thymoglobulin) suggests a lack of support for this off-label use.	Remove the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Regorafenib	Hepatocellular carcinoma (intermediate or advanced)	2017.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Pembrolizumab	Urothelial carcinoma (advanced)	2017.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Dabrafenib	Non-small cell lung cancer, metastatic, relapsed or refractory (with BRAF V600E mutation)	2017.07	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Trametinib	Non-small cell lung cancer, metastatic, relapsed or refractory (with BRAF V600E mutation)	2017.07	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Tocilizumab	Cytokine release syndrome (due to CAR-T cell therapy)	2017.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Vemurafenib	Erdheim-Chester disease, refractory (with BRAF V600E mutation)	2017.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed - removed from off-label uses due to approval by FDA).	n/a	n/a
Busulfan (oral)	Chronic myeloid leukemia (palliative treatment)	2017.12 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Heidi Trinkman, PharmD	Against the use: Although palliative treatment of chromic myeloid leukemia (CML) is as an approved use in the manufacturer’s labeling for busulfan tablets, other contemporary therapies have replaced the use of oral busulfan for management of CML. According to the European LeukemiaNet Recommendations for Management of CML, recommended treatments include tyrosine kinase inhibitors, omacetaxine, or allogeneic transplant, however, oral busulfan (unless part of a transplant conditioning regimen) is not recommended (Baccarani 2013).	Remove the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cladribine	Chronic myeloid leukemia (palliative treatment)	2017.12	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Against off-label use: Evidence suggests a lack of support for this off-label use; other contemporary therapies have replaced the use of cladribine for the treatment of chronic lymphocytic leukemia.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Breast cancer, metastatic, HER2-negative, BRCA-mutated	2018.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Abiraterone	Prostate cancer, metastatic or high-risk locally advanced, castration-sensitive	2018.02	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Durvalumab	Non-small cell lung cancer (unresectable, locally advanced)	2018.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Sargramostim	Hematopoietic radiation injury syndrome, acute	2018.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Estramustine	Prostate cancer (metastatic castration-resistant)	2018.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Although estramustine is approved for palliative treatment of progressive or metastatic prostate cancer, guidelines from the American Society of Clinical Oncology/ Cancer Care Ontario (for systemic therapy in men w/metastatic castration-resistant prostate cancer) recommend against offering estramustine in patients with metastatic castration-resistant prostate cancer due to a lack of benefit in survival or quality of life and an increased risk of toxicity (ASCO [Basch 2014]).	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Rituximab	Pemphigus vulgaris (newly diagnosed)	2018.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved; (no panel vote needed – removed from off-label uses due to FDA approval)	n/a	n/a
Cetuximab	NSCLC, EGFR-expressing, advanced	2018.07 (updated 2024.03)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Nick Link, PharmD, BCOP	Although cetuximab had previously been an off-label option for the treatment of stage IV non-small cell lung cancer, the 2015 update of the American Society of Clinical Oncology guidelines for Systemic Therapy for Stage IV Non-Small Cell Lung Cancer removed the recommendation to consider cetuximab as a treatment option (ASCO [Masters 2015]).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Vinblastine	Breast cancer	2018.07 (updated 2024.04)	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Nick Link, PharmD, BCOP	Although included as a use in the manufacturer’s prescribing information, other contemporary therapies have replaced the use of vinblastine for the treatment of refractory breast cancer.	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Nivolumab	Small cell lung cancer (progressive)	2018.08	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to FDA approval)	n/a	n/a
Lenvatinib	Hepatocellular carcinoma (advanced)	2018.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to FDA approval)	n/a	n/a
Dactinomycin	Osteosarcoma	2018.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS Mark Holdsworth, PharmD	Limited (older) data exists for the use of chemotherapy regimens containing dactinomycin in the treatment of non-metastatic osteosarcoma; other contemporary chemotherapy regimens have replaced the use of dactinomycin-containing regimens for management of osteosarcoma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Bronchogenic carcinoma (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine in the palliative management of bronchogenic carcinoma.	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Chronic lymphocytic leukemia (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine in the palliative management of chronic lymphocytic leukemia (CLL). CLL guidelines and treatment recommendations do not include mechlorethamine as a treatment option (ESMO [Eichhorst 2015]; iwCLL [Hallek 2018]).	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Chronic myelocytic leukemia (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine injection in the palliative management of chronic myelocytic (myeloid) leukemia (CML). CML guidelines and treatment recommendations do not include mechlorethamine as a treatment option (ELN [Baccarini 2013]; ESMO [Hochhaus 2017]).	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Lymphosarcomas (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine injection in the palliative management of lymphosarcomas.	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Malignant effusion from metastatic carcinomas (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine injection in the palliative management of malignant effusions.	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Mycosis fungoides (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, PharmD	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of IV mechlorethamine in the palliative management of mycosis fungoides. A topical mechlorethamine product is commercially available and approved for treatment of mycosis fungoides-type cutaneous T-cell lymphoma.	Remove the use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mechlorethamine	Polycythemia vera (palliative treatment)	2018.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Although included in the manufacturer's labeling as a use, other contemporary therapies have replaced the use of mechlorethamine injection in the palliative management of polycythemia vera. Chronic myeloproliferative neoplasm guidelines do not include mechlorethamine as a treatment option for polycythemia vera (ESMO [Vannucchi 2015]).	Remove the use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mitoxantrone	Breast cancer (metastatic)	2018.12 (updated 2024.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Elizabeth Connor, MD Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Limited (older) data exists for the use of mitoxantrone in the treatment of metastatic breast cancer; other established therapies have replaced the use of mitoxantrone for the treatment of metastatic breast cancer.	Remove the use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Merkel cell carcinoma (advanced)	2019.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Cabozantinib	Hepatocellular carcinoma (advanced)	2019.01	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Pembrolizumab	Melanoma, stage III (adjuvant treatment)	2019.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Atezolizumab	Small cell lung cancer (extensive-stage)	2019.03	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Ado-trastuzumab emtansine	Breast cancer, early, HER2-positive (adjuvant therapy for residual disease)	2019.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Ramucirumab	Hepatocellular carcinoma (advanced, relapsed/refractory)	2019.05	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Vinblastine	Melanoma, metastatic (component of biochemotherapy)	2019.09 (updated 2024.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Although vinblastine has been previously used off-label as a component of the biochemotherapy regimen, CVD-interleukin-interferon (cisplatin, vinblastine, dacarbazine, aldesleukin, and interferon) for the treatment of metastatic melanoma, other contemporary therapies have replaced the use of this regimen in melanoma treatment. While combination biochemotherapy induced higher response rates and progression-free survival, this regimen did not improve overall survival or result in durable responses (Atkins 2008; Ives 2007).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Cisplatin	Melanoma, metastatic (component of biochemotherapy)	2019.09 (updated 2024.02)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP	Although cisplatin has been previously used off-label as a component of the biochemotherapy regimen, CVD-interleukin-interferon (cisplatin, vinblastine, dacarbazine, aldesleukin, and interferon) for the treatment of metastatic melanoma, other contemporary therapies have replaced the use of this regimen in melanoma treatment. While combination biochemotherapy induced higher response rates and progression-free survival, this regimen did not improve overall survival or result in durable responses (Atkins 2008; Ives 2007).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Pancreatic cancer, metastatic, BRCA-mutated (maintenance therapy)	2020.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Interferon alfa-2b	Renal cell cancer, metastatic	2020.01 (updated 2024.02)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Although interferon alfa-2b has previously been used off-label and is included in combination with bevacizumab as a labeled use for bevacizumab (Avastin), other contemporary therapies have replaced the use of interferon in the management of renal cell cancer. Other therapies for the treatment of metastatic renal cell carcinoma have demonstrated improved response and survival compared to interferon alfas (ASCO [Rathmell 2022]).	Remove the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Interferon alfa-2b	Multiple myeloma	2020.01 (updated 2024.02)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Nick Link, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	Although interferon alfa-2b has been previously used off label as maintenance therapy for multiple myeloma, other contemporary therapies have replaced the use of interferon in the management of multiple myeloma. Interferon alfa-2b is not included in ASCO/CCO guidelines for the treatment of multiple myeloma (ASCO/CCO [Mikhael 2019]).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Luspatercept	Anemia due to lower-risk myelodysplastic syndromes with ring sideroblasts	2020.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Encorafenib	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2020.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Brigatinib	Non-small cell lung cancer, advanced (initial ALK-inhibitor therapy)	2020.06	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Dexamethasone	Multiple myeloma	2020.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	Hemady 20 mg tablet FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Fam-trastuzumab deruxtecan	Gastric cancer, advanced, previously treated (HER2-positive)	2021.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Ipilimumab	Small cell lung cancer (progressive)	2021.03 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	Although an early phase study suggested ipilimumab (in combination with nivolumab) may be of benefit in the treatment of progressive small cell lung cancer (after at least 1 platinum-based chemotherapy regimen), a confirmatory phase 3 trial did not demonstrate an overall survival benefit (Antonia 2016, Owonikoko 2021, Ready 2020).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Ipilimumab	Melanoma, unresectable or metastatic, first-line combination therapy	2021.06	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Lomustine	Hodgkin Lymphoma, progressive	2021.06 (updated 2024.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	Although included as a labeled use in the Gleostine prescribing information, other contemporary therapies have replaced the use of lomustine in the treatment of progressive Hodgkin lymphoma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Pembrolizumab	Breast cancer (triple negative, early stage)	2021.08	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	No Conflict of Interest No Conflict of Interest
Zanubrutinib	Waldenström macroglobulinemia	2021.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	No Conflict of Interest No Conflict of Interest
Ruxolitinib	Graft-versus-host disease, treatment (chronic)	2021.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	No Conflict of Interest No Conflict of Interest
Cetuximab	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2021.10	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	No Conflict of Interest No Conflict of Interest
Binimetinib	Colorectal cancer, metastatic, refractory (RAS wild-type, BRAF V600E-mutant)	2021.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Initial data from a phase 3 study suggested that binimetinib (in combination with encorafenib and cetuximab) was effective for the treatment of progressive metastatic RAS wild-type colorectal cancer in patients with BRAF V600E-mutant tumors (Van Cutsem 2019); however, an updated analysis demonstrated similar overall survival between the doublet regimen (cetuximab and encorafenib) and the triplet regimen (cetuximab, encorafenib, and binimetinib), while the triplet regimen was associated with a higher incidence of ≥ grade 3 adverse events (Tabernero 2021).	Remove the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Epirubicin	Esophageal cancer	2022.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Evidence suggests a lack of support for this off-label use; other contemporary therapies have replaced the use of epirubicin for the treatment of esophageal cancer.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Epirubicin	Gastric cancer	2022.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Klodiana Neme, PharmD, BCOP	Evidence suggests a lack of support for this off-label use; other contemporary therapies have replaced the use of epirubicin for the treatment of gastric cancer.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Epirubicin	Osteosarcoma	2022.01 (updated 2024.04)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, Pharm D Nick Link PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS	Evidence suggests a lack of support for this off-label use; other established therapies have replaced the use of epirubicin for the treatment of osteosarcoma.	Remove the off-label use: 4 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Olaparib	Breast cancer, early, high risk, HER2-negative, germline BRCA-mutated, adjuvant therapy	2022.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Fludarabine	Follicular lymphoma (relapsed/refractory)	2022.07 (updated 2024.08)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, Pharm D Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	While fludarabine had been used off-label to treat relapsed or refractory follicular lymphoma, other established therapies and/or targeted therapies have replaced the use of fludarabine in the management of follicular lymphoma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Fam-trastuzumab deruxtecan	Non-small cell lung cancer, metastatic, relapsed/refractory, nonsquamous, HER2-mutant	2022.08	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Durvalumab	Biliary tract cancer, advanced	2022.09	Diedra Bragalone, PharmD, BCOP, BCPS Jennifer Godden, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Carmustine injection	Multiple myeloma, palliative treatment	2022.10 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Mark Holdsworth, PharmD Lauren Ice, PharmD, BCPS, BCOP	Although carmustine (injection) is approved for the palliative treatment of multiple myeloma (in combination with prednisone), other contemporary therapies have replaced IV carmustine for palliative treatment of multiple myeloma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Carmustine injection	Non-Hodgkin lymphoma, relapsed or refractory, palliative treatment	2022.10 (updated 2024.03)	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Jordan Lundberg, PharmD, BCOP	Although carmustine (injection) is approved for the palliative treatment (secondary) of non-Hodgkin lymphoma (in combination with other antineoplastics) that has relapsed with or was refractory to primary therapy, other contemporary therapies have replaced IV carmustine for treatment of relapsed or refractory non-Hodgkin lymphoma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Mitomycin (systemic)	Esophageal cancer, advanced	2022.11	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Angela German, PharmD, BCOP	Evidence suggests a lack of support for this off-label use; other contemporary therapies have replaced the use of mitomycin (systemic) for the treatment of advanced esophageal cancer.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Capecitabine	Esophageal, gastric, and gastroesophageal cancers	2023.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Capecitabine	Pancreatic cancer, potentially curable, adjuvant therapy	2023.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Zanubrutinib	Chronic lymphocytic leukemia, relapsed or refractory	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Sacituzumab govitecan	Breast cancer, metastatic, hormone receptor-positive, HER2-negative, salvage therapy	2023.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Polatuzumab vedotin	Diffuse large B-cell lymphoma, intermediate or high-risk, previously untreated	2023.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Pirtobrutinib	Chronic lymphocytic leukemia/small lymphocytic lymphoma, relapsed or refractory	2023.12	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Fam-trastuzumab deruxtecan	Colorectal cancer, metastatic, HER2-expressing	2024.04	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Matthew Arango, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval [in solid tumors] by FDA).	n/a	n/a
Pentostatin	Chronic lymphocytic leukemia	2024.08	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Klodiana Neme, PharmD, BCOP Jordan Lundberg, PharmD, BCOP	While pentostatin had been used off-label for the treatment of chronic lymphocytic leukemia (CLL), other established therapies and/or targeted therapies have replaced the use of pentostatin for management of CLL.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Amivantamab	Non–small cell lung cancer, locally advanced or metastatic, refractory, with EGFR exon 19 deletion or exon 21 L858R substitution mutation	2024.10	Angela German, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Cladribine	Mantle cell lymphoma	2024.10	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Jordan Lundberg, PharmD, BCOP Klodiana Neme, PharmD, BCOP	While cladribine had been used off-label for the treatment of mantle cell lymphoma, other established therapies and/or targeted therapies have replaced the use of cladribine in the management of mantle cell lymphoma.	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest
Sotorasib	Colorectal cancer, metastatic, relapsed or refractory, KRAS G12C-mutated	2025.01	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP	FDA approved (no panel vote needed – removed from off-label uses due to approval by FDA).	n/a	n/a
Pembrolizumab	Malignant pleural mesothelioma, relapsed or refractory (with PD-L1 expression)	2025.03	Diedra Bragalone, PharmD, BCOP, BCPS Angela German, PharmD, BCOP Lauren Ice, PharmD, BCPS, BCOP Klodiana Neme, PharmD, BCOP Michael B Smith, PharmD, BCOP	While pembrolizumab had been used off-label for the treatment of relapsed or refractory pleural mesothelioma (PM) in previously treated patients with PD-L1 expression, findings from a randomized phase 3 study (in previously treated PM) did not demonstrate an improvement in overall survival with pembrolizumab when compared to single-agent chemotherapy, and there was no association between efficacy and PD-L1 status (Popat 2020).	Remove the off-label use: 5 of 5	No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest No Conflict of Interest

Last update June 30, 2025

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