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	Prevention of early menopause during chemotherapy for early stage hormone receptor negative breast cancer	2015.03	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
Idarubicin	AML (Pediatric), newly diagnosed	2015.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Heidi Trinkman, PharmD Polly Kintzel, PharmD, BCOP, BCPS	Strong (for off-label use)	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
Idarubicin	AML (Pediatric), relapsed/refractory	2015.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Mark Holdsworth, PharmD Heidi Trinkman, 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
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 (second-line endocrine-based combination therapy [with palbociclib and fulvestrant] in pre- or peri-menopausal women)	2015.11	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	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
Defibrotide	Hepatic sinusoidal obstruction syndrome, prevention (pediatrics)	2016.04	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, PharmD 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
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, refractory (with BRAF V600 mutation)	2016.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD 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
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	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
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 Cancer	2016.12	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 (pediatrics)	2017.03	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, 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
Isotretinoin	Neuroblastoma, high-risk (pediatrics)	2017.04	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly KIntzel, PharmD, BCOP, BCPS Heidi Trinkman, 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
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	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
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
Bevacizumab	Gliomas (recurrent or progressive (pediatrics)	2017.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD 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
Bevacizumab	Medulloblastoma (relapsed or refractory)	2017.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP 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
Bevacizumab	Solid tumors, refractory (pediatrics)	2017.10	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Corey Carter, 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
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, 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
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	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Omer Koc, MD Corey Carter, MD Nick Link, PharmD, BCOP	Equivocal	B, 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
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, Pharm D, 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
Oxaliplatin	Neuroblastoma, high-risk, relapsed/refractory (pediatrics)	2017.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Nick Link, PharmD, BCOP 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
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 and thymic carcinomas (advanced, refractory)	2018.06	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
Temozolomide	Pediatric CNS tumors (anaplastic astrocytoma, brain stem glioma or medulloblastoma), relapsed or refractory	2018.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS Heidi Trinkman, PharmD Mark Holdsworth, 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
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
Doxorubicin (conventional)	Hepatoblastoma (pediatrics)	2018.12	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Jennifer Thackray, PharmD, BCPPS, BCPS Heidi Trinkman, PharmD 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, Pharm D 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	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Omer Koc, MD 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
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, Pharm D, 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 myeloma (high-risk)	2020.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Angela German, Pharm D, 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/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	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
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	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
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/refractory, PD-L1 positive	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 brain or leptomeningeal metastases (EGFR mutation-positive)	2020.12	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
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	Thymomas (advanced or metastatic)	2020.12	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	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD 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
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	For the off-label 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 chimeric antigen receptor (CAR) T-cell immunotherapy	2021.08	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 chimeric antigen receptor (CAR) T-cell immunotherapy	2021.08	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

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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
Ixabepilone	Endometrial cancer (second-line treatment)	2014.11	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Nick Link, PharmD, BCOP Mark Holdsworth, PharmD	Against off-label use: Evidence suggests a lack of support for this off-label use; additional studies are needed to further define the role of ixabepilone in the management of this condition	Remove the Off-Label Use: 4 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
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	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Cater, MD Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS	Against Off-Label Use	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
Decitabine	Sickle Cell Anemia	2015.05	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Heidi Trinkman, PharmD	Against off-label use: Evidence suggests a lack of support for this off-label use; evidence-based guidelines do not mention decitabine as a therapeutic option for management of sickle cell anemia. Additional studies are needed to further define the role of decitabine in the management of this condition.	Remove the Off-Label Use: 4 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
Topotecan	Merkel cell carcinoma	2015.06	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD Omer Koc, MD Nick Link, PharmD, BCOP	Against off-label use: Limited evidence exists for the use of topotecan in the management of merkel cell carcinoma; additional trials are needed to further define the role of topotecan in the treatment of this condition.	Remove the Off-Label Use: 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
Octreotide	Meningioma	2015.09	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Add to Use: Unsupported: While results from a small study of octreotide LAR for recurrent meningioma demonstrated partial response or stable disease in some patients, subsequent studies in recurrent/progressive meningioma have not demonstrated a benefit. Given the unknown natural history of meningioma, the role of somatostatin analogues in meningioma is unclear.	For the Use: 3 of 6 (Off-label use not added [no consensus]); Add to Use: Unsupported	No Conflict of Interest 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
Docetaxel	Cervical Cancer (recurrent)	2016.02	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Corey Carter, MD Omer Koc, MD Polly Kintzel, PharmD, BCOP, BCPS	Against off-label use: Evidence suggests a lack of support for this off-label use; additional studies are needed to further define the role of docetaxel in the management of this condition.	Remove the off-label use: 3 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
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	Head and neck cancer	2016.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD 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 ifosfamide for the treatment of head and neck 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
Ifosfamide	Small cell lung cancer	2016.09	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Corey Carter, MD 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 ifosfamide for the treatment 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	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, 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	While 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 to men 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	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Nick Link, PharmD, BCOP	American Society of Clinical Oncology (ASCO) guidelines for Systemic Therapy for Stage IV Non-Small Cell Lung Cancer do not recommend cetuximab in the treatment of advanced NSCLC (ASCO [Masters 2015]). Cetuximab does not currently have an established role in the treatment of NSCLC either as a component of initial therapy or as second-line therapy.	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	Stephanie Minich, PharmD, BCOP Diedra Bragalone, PharmD, BCOP, BCPS Elizabeth Connor, MD Omer Koc, MD Nick Link, PharmD, BCOP	Although included in the manufacturer's labeling as a use, 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	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 contemporary 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)	2019.09	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)	2019.09	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	2020.01	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Mark Holdsworth, PharmD Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD	Although interferon alfa-2b 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 cancers (RCC). The 2019 Society for Immunotherapy of Cancer (SITC) consensus statement on immunotherapy in the treatment of advanced renal cell carcinoma does not discuss interferons in the management of this condition (SITC [Rini 2019]).	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	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 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	Diedra Bragalone, PharmD, BCOP, BCPS Stephanie Minich, PharmD, BCOP Polly Kintzel, PharmD, BCOP, BCPS Omer Koc, MD Nick Link, PharmD, BCOP	While 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 2019, 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	2021.06	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. Hodgkin lymphoma guidelines do not include lomustine as a treatment component for Hodgkin lymphoma management (ESMO [Eichenauer 2018]).	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

Last update January 3, 2022

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