The NHS is free at the point of use, but a licensed cancer drug is only routinely available once NICE (England, Wales, Northern Ireland) or the SMC (Scotland) has said its benefit is worth its price. Of 486 approved products in OnCo, 288 have a UK coverage record here (59%): 158 are NICE recommended or funded through the Cancer Drugs Fund, 13 were not recommended, 97 were never appraised (generics funded routinely, or products with no UK licence), and 0 are still to be researched. Below: how the system works, then every product.
NHS cancer care and funding
17 cards · plain English first, detail second
How you get into cancer care: GP, urgent referral, and the waiting-time standards
Almost everyone starts with their GP. If the GP suspects cancer they make an urgent referral and you should hear within two weeks and be told whether you have cancer within 28 days. If you do, treatment should start within 62 days of the referral.
More detail
NICE guideline NG12 sets the symptom thresholds at which a GP must refer on the urgent suspected cancer pathway (roughly a 3% risk of cancer). In England the old 'two-week wait' target was replaced in October 2023 by three standards: the 28-day Faster Diagnosis Standard (told you have or do not have cancer within 28 days of referral or screening; target 75%, rising to 80% by March 2026), the 31-day standard (treatment within a month of the decision to treat; 96%), and the 62-day standard (first treatment within 62 days of urgent referral, screening or consultant upgrade; 85%). Performance is published monthly and many trusts miss the 62-day target, so ask your cancer nurse specialist where you are on the pathway. Scotland, Wales and Northern Ireland publish their own 31- and 62-day figures. Emergency presentations (via A&E) account for roughly a fifth of diagnoses and have worse outcomes.
Who decides your treatment: the multidisciplinary team, cancer alliances and specialist centres
Your case is discussed by a team of specialists (the MDT) who agree a recommended plan before it is put to you. Common cancers are treated locally; rare cancers, complex surgery and cell therapy are concentrated in a small number of specialist centres.
More detail
Every NHS cancer patient should have their diagnosis and plan reviewed at a weekly multidisciplinary team meeting (surgeon, oncologist, radiologist, pathologist, clinical nurse specialist and others) and be assigned a named key worker, usually a clinical nurse specialist. England's Cancer Alliances (around 20) coordinate services across regions and run rapid diagnostic centres and the lung screening programme. Care is tiered: local trusts deliver most chemotherapy and radiotherapy; tertiary centres such as The Royal Marsden, The Christie, UCLH, Guy's, Leeds, Birmingham, Glasgow's Beatson, Cardiff's Velindre and Belfast City deliver specialised surgery, sarcoma, neuro-oncology, teenage and young adult and paediatric oncology. Ask your MDT whether your cancer type has a nationally designated centre; you can be referred anywhere in the NHS.
NICE technology appraisals: how a drug gets funded, and the cost-per-QALY threshold
A new cancer drug is only routinely available on the NHS in England, Wales and Northern Ireland once NICE has appraised it and judged that its benefit is worth its price. If NICE says yes, the NHS must fund it within three months. Almost all recent yes decisions depend on a confidential discount.
More detail
NICE runs a single technology appraisal (TA) for each new medicine and indication, usually in parallel with licensing so guidance lands within a few months of MHRA approval. The company submits a cost-effectiveness model; an independent evidence review group critiques it; a committee decides. NICE normally accepts treatments below £25,000 per quality-adjusted life year (QALY) and needs an increasingly strong case between £25,000 and £35,000, a range raised from £20,000 to £30,000 by a government direction; the updated manual was published on 31 March 2026 and the change took effect on 2 April 2026. Until 2022 an 'end-of-life' rule let drugs for people with under 24 months to live and a gain of 3+ months be accepted up to about £50,000 per QALY. The 2022 methods update replaced it with a severity modifier that weights QALYs by 1.2 or 1.7 for conditions with large absolute and proportional health loss; this catches most advanced cancers but not all, which is why some drugs for earlier-stage or HER2-low disease have been rejected. Outcomes are: recommended; recommended with optimisation (a narrower population, a stopping rule, or a Patient Access Scheme discount); recommended for the Cancer Drugs Fund; or not recommended. NHS England must fund positive TAs within 90 days. Wales and Northern Ireland adopt NICE TAs; Scotland uses the SMC instead.
When NICE thinks a cancer drug is promising but the evidence is not yet good enough to say yes, it can be funded from the Cancer Drugs Fund for about two years while more data are collected, then re-decided. Patients get it straight away; the company carries the financial risk.
More detail
The original CDF (2010-2016) paid for drugs NICE had rejected and overspent badly. Since July 2016 it has been a managed access fund run jointly by NICE and NHS England with a fixed budget (£340 million a year). A drug enters the CDF when NICE judges it has plausible potential to be cost-effective but material uncertainty; a managed access agreement sets the data to be collected (often from SACT, the national chemotherapy dataset, plus the ongoing trial) and a confidential price. Interim funding from the CDF starts from the point of positive draft guidance, so CDF drugs are often available in England before anywhere else in Europe. At the end of the period NICE reappraises and either moves the drug to routine commissioning or, occasionally, withdraws it for new patients (existing patients continue). Well over a hundred drug-indication pairs have passed through, including CAR-T therapies, osimertinib, durvalumab and pembrolizumab combinations. The live CDF list is published by NHS England and updated monthly.
The Innovative Medicines Fund does for non-cancer medicines what the Cancer Drugs Fund does for cancer: it pays for promising treatments while evidence is collected. Some supportive treatments and rare-disease therapies relevant to cancer patients come through it.
More detail
Launched in June 2022 with £340 million a year, matching the CDF, the IMF is explicitly for non-cancer medicines: NHS England's founding principles state that it should operate as a managed access fund for non-cancer medicines so that any patient, whatever their condition, has an equal potential opportunity to benefit. Cancer medicines stay with the CDF. It matters to cancer patients through gene therapies and treatments for complications such as graft-versus-host disease, and it is barely used: NICE has made three Innovative Medicines Fund recommendations in its history against 61 for the Cancer Drugs Fund. Together the two funds give NHS England a £680 million managed access envelope. The IMF uses the same interim funding mechanism from positive draft guidance and the same data-collection agreements. Patient charities have pressed for the two funds to be merged and for the managed access period to be more flexible.
The most complex treatments are paid for and planned nationally rather than locally, and delivered at a handful of accredited hospitals. If you need CAR-T, protons or radiosurgery you may travel, but the NHS funds it.
More detail
NHS England directly commissions around 150 specialised services. CAR-T cell therapy is delivered at JACIE-accredited centres (roughly 15 adult and 3 paediatric, including UCLH, King's, The Christie, Manchester Royal Infirmary, Birmingham, Bristol, Leeds, Newcastle, Glasgow, Cardiff and Great Ormond Street) after a national CAR-T clinical panel confirms eligibility; the drug cost sits with NICE-approved TAs and the CDF. High-energy proton beam therapy opened at The Christie (Manchester, 2018) and UCLH (London, 2021); indications are mainly paediatric and young adult tumours, base-of-skull chordoma and selected head and neck and spinal tumours, decided by a national proton panel, with overseas referral no longer routine. Stereotactic radiosurgery and stereotactic ablative radiotherapy (SABR) are commissioned at designated centres for brain metastases, vestibular schwannoma, early lung cancer and oligometastatic disease under national clinical commissioning policies. Blood and marrow transplantation, sarcoma surgery, hepatobiliary and oesophago-gastric surgery, teenage and young adult cancer and paediatric oncology are also nationally commissioned.
Scotland: the SMC, the New Medicines Fund and PACS
Scotland does not use NICE for new medicines. The Scottish Medicines Consortium decides, usually within months of licensing, and a New Medicines Fund covers the cost of end-of-life and rare-disease drugs. If a drug has been turned down, your consultant can still ask for it for you through PACS Tier 2.
More detail
The Scottish Medicines Consortium (SMC) appraises every new medicine for NHS Scotland; its decisions are 'accepted', 'accepted for restricted use' or 'not recommended', and health boards must make accepted medicines available. Since 2014 the Patient and Clinician Engagement (PACE) process gives extra weight to end-of-life and orphan medicines, and an ultra-orphan pathway allows three years of data collection. The New Medicines Fund (funded from pharmaceutical rebates) reimburses health boards for these medicines. Where SMC has not accepted a medicine, a clinician can apply under the Peer Approved Clinical System: PACS Tier 1 for ultra-orphan drugs and PACS Tier 2 (which replaced Individual Patient Treatment Requests in 2018) for any drug the SMC has rejected or not appraised. Scottish cancer waiting times use a 31-day and 62-day standard; the three regional cancer networks are NCA, SCAN and WoSCAN.
Wales and Northern Ireland: AWTTC, One Wales and the New Treatment Fund; NI adoption of NICE
Wales and Northern Ireland follow NICE decisions, with their own rules on top. Wales has a fund that guarantees access within two months of a yes, and a One Wales route for medicines NICE has not looked at. Northern Ireland adopts NICE guidance a little later and runs its own individual funding requests.
More detail
In Wales, NICE TAs apply and the New Treatment Fund (since 2017) requires health boards to make newly recommended medicines available within 60 days. The All Wales Therapeutics and Toxicology Centre (AWTTC) supports the All Wales Medicines Strategy Group (AWMSG), which appraises medicines NICE does not intend to cover and runs the One Wales process for a consistent national position on unlicensed or non-appraised medicines, replacing seven different individual patient funding request policies. Velindre Cancer Centre (Cardiff) and the South West Wales and North Wales cancer centres deliver care, with Welsh patients travelling to English centres for CAR-T and protons. In Northern Ireland the Department of Health endorses NICE TAs (usually within weeks) and the Health and Social Care system funds them; regional cancer services are centred on Belfast City Hospital's Cancer Centre and the North West Cancer Centre at Altnagelvin, and an Individual Funding Request process covers non-approved treatments. NI cancer waiting-time performance has been the weakest in the UK.
Screening programmes: breast, bowel, cervical and lung
The NHS invites healthy people for four cancer screens: mammograms for women 50 to 71, a stool test for bowel cancer from 50, cervical screening for women 25 to 64, and low-dose CT lung checks for current and former smokers aged 55 to 74. You do not need a GP referral; invitations are automatic if you are registered with a GP.
More detail
Breast screening: three-yearly mammography for women 50-70 (invited up to 71; older women can self-refer); AI-assisted reading is being trialled (EDITH). Bowel screening: the faecal immunochemical test (FIT) every two years, extended in England from 60-74 down to 50-74 by 2025; a positive FIT leads to colonoscopy. Scotland has offered FIT from 50 since 2017; Wales offers it from 50; Northern Ireland still starts at 60 and is considering lowering it. Cervical screening: primary HPV testing, every three years at 25-49 and every five years at 50-64; England moved to five-yearly for HPV-negative women in July 2025 (Scotland and Wales already had), and HPV self-sampling is being introduced for under-screened women. Lung: the Targeted Lung Health Check programme (low-dose CT for people aged 55-74 who smoke or used to, identified via GP records) is being rolled out across England as the national NHS Lung Cancer Screening Programme, with full national coverage planned by March 2030; it has raised the share of lung cancers found at stage I-II to roughly three-quarters in screened areas. There is no national prostate screening; the UK National Screening Committee is reviewing PSA-based and risk-stratified screening (TRANSFORM trial) and has recommended a targeted programme for men with BRCA variants.
Genomic testing: the NHS Genomic Medicine Service and the National Genomic Test Directory
If your cancer is one where a gene test changes treatment, the NHS tests for it as standard through seven regional genomic laboratories. The list of what is tested for which cancer is public, so you can check whether your tumour should have been profiled.
More detail
The NHS Genomic Medicine Service (launched 2018, the first national system of its kind) delivers tumour and germline testing through seven Genomic Laboratory Hubs in England, with equivalent services in Scotland, Wales (All Wales Medical Genomics Service) and Northern Ireland. The National Genomic Test Directory, updated annually, lists every funded test by cancer type: small and large panels for solid tumours; fusion panels for lung and sarcoma; whole genome sequencing for sarcoma, paediatric cancers, acute leukaemias and some CNS tumours; germline BRCA and Lynch testing with eligibility criteria; and pharmacogenomic tests such as DPYD before fluoropyrimidines. Turnaround targets are 14 to 21 days for panels. Liquid biopsy (ctDNA) for lung cancer mutations was added in 2024-25 after a national pilot. Ask your team which tests were requested and whether your tumour meets the criteria for a large panel or WGS; a companion diagnostic named in a NICE TA (e.g. HER2, PD-L1, FRα, CLDN18.2) must be available where the drug is.
Clinical trials: NIHR, Be Part of Research, and how to ask
Around one in eight NHS cancer patients joins a clinical trial. You can search for trials yourself and ask your oncologist to refer you to the trial site, which may be a different hospital. Trials give free access to drugs the NHS does not yet fund.
More detail
The National Institute for Health and Care Research (NIHR) funds the research infrastructure in every NHS trust in England, with parallel bodies in Scotland (NHS Research Scotland), Wales (Health and Care Research Wales) and Northern Ireland. The NIHR Be Part of Research service and Cancer Research UK's trial finder both list open UK cancer trials by cancer type and location. Experimental Cancer Medicine Centres (ECMCs, 17 adult and a paediatric network) run early-phase trials of new drugs. Your oncologist can refer you to any UK trial site; travel costs may be reimbursed by the trial. Ask specifically whether a trial is open for your cancer at your line of treatment, and whether a molecular profiling study (e.g. DETERMINE for rare cancers, or TARGET National) could open drug-matched options. Compassionate access outside trials is via the MHRA's Early Access to Medicines Scheme (EAMS) or company-funded named-patient programmes.
Private and self-funded treatment, and how it fits with NHS care
You can pay privately for a drug the NHS will not fund and still receive the rest of your care on the NHS. The private drug must be given separately, but you cannot be removed from NHS care for paying for something extra. Many private hospitals host NHS consultants and can run trials too.
More detail
Since the 2009 Richards review, NHS patients in England may pay for additional private drugs ('top-ups') without losing NHS entitlement, provided the private element is delivered separately (different appointment or setting) so that NHS resources do not subsidise it. Private medical insurance typically covers licensed cancer drugs regardless of NICE status, subject to policy limits, and a growing share of new drugs are first used in the UK in the private sector. Self-funding costs are high: a year of a modern immunotherapy or ADC at list price is often £50,000 to £150,000, though some companies offer patient access schemes. Private hospital groups offer proton therapy, tumour treating fields and drugs NICE has rejected. A private consultation for a second opinion or a specific test can be followed by an NHS referral back; NHS consultants will accept privately obtained scans and genomics. Discuss any private element with your NHS team so records stay complete and drug interactions are managed.
If you have cancer in England you can get all your NHS prescriptions free, not only cancer drugs, with a medical exemption certificate your GP or oncologist signs. Prescriptions are already free for everyone in Scotland, Wales and Northern Ireland. Hospital-administered cancer drugs are always free.
More detail
Since April 2009 people undergoing treatment for cancer, the effects of cancer, or the effects of cancer treatment are entitled to a five-year medical exemption certificate (form FP92A, signed by a GP or hospital doctor) that covers all NHS prescriptions in England. The certificate can be renewed while any of those conditions applies. Wigs and fabric supports are free on the NHS in Wales and Scotland and on low income in England; dental treatment and sight tests may be free on income grounds. Hospital car parking must be free for frequent outpatient attenders including cancer patients in England (since 2020), and is free in Wales and Scotland. Travel to hospital may be reimbursed under the Healthcare Travel Costs Scheme if you receive qualifying benefits, and some Cancer Alliances and charities run transport services.
Money: PIP, Universal Credit, sick pay, Macmillan grants and the special rules for terminal illness
Cancer usually costs money: lost income, travel, heating. You may be able to claim Personal Independence Payment (or Attendance Allowance over state pension age), get faster and higher payments under the special rules if a clinician says you may have less than 12 months, and receive one-off grants from Macmillan and other charities.
More detail
Personal Independence Payment (PIP; Adult Disability Payment in Scotland) is not means-tested and pays roughly £70 to £190 a week depending on how cancer or its treatment affects daily living and mobility. If a clinician completes an SR1 form stating you may have 12 months or less to live, claims for PIP, Universal Credit, Employment and Support Allowance and Attendance Allowance are fast-tracked, paid at the highest rate and not subject to a face-to-face assessment. Employees are entitled to Statutory Sick Pay for up to 28 weeks, and cancer counts as a disability under the Equality Act from diagnosis, giving rights to reasonable adjustments and protection from dismissal. Macmillan grants (typically a few hundred pounds) help with heating, clothing and travel; Macmillan's welfare rights advisers and Citizens Advice can complete benefit forms with you. Carers may claim Carer's Allowance. Young people have specific support through Teenage Cancer Trust and Young Lives vs Cancer, which pays a registration grant.
Palliative care is symptom control and support at any stage of cancer, not only at the end of life, and you can have it alongside active treatment. Hospice care is free, mostly charity-run with part NHS funding, and includes home visits, day services and inpatient stays.
More detail
Every NHS cancer centre has a specialist palliative care team (consultants in palliative medicine, nurses, sometimes pharmacists and social workers) who can be involved from diagnosis for pain, breathlessness, nausea and psychological distress; early palliative care improves quality of life and in some trials survival. Community palliative care is delivered by district nurses, GPs, Marie Curie nurses and hospice-at-home teams. The UK's 200-plus hospices are mostly charities receiving roughly a third of their funding from the NHS; care is free to patients. Advance care planning (ReSPECT forms, lasting power of attorney, preferred place of care) is offered and recorded on shared records. Fast-track NHS Continuing Healthcare funding covers a package of care at home or in a care home when someone is rapidly deteriorating. Children's palliative care is coordinated through Together for Short Lives.
You can ask for a second opinion within the NHS and you can ask to be treated at a different hospital, including a specialist centre. There is no legal right to a second opinion, but it is rarely refused, and your own consultant or GP can arrange it.
More detail
Under the NHS Constitution you have a right to choose the provider for your first outpatient appointment after GP referral, and once in cancer care your MDT can refer you to any NHS specialist centre for an opinion or treatment. A second opinion is usually arranged by your consultant or GP with a copy of your notes and imaging; specialist centres such as The Royal Marsden and The Christie receive many. For rare cancers, ask whether your case has been discussed at a national or supra-regional MDT (e.g. sarcoma, neuro-oncology, ocular melanoma, thymic tumours). Patients sometimes seek a private second opinion for speed and then continue on the NHS. If you feel you have been refused reasonable care, the Patient Advice and Liaison Service (PALS) at each trust and Macmillan's support line can help you make the request.
Where to get help now: Macmillan, Cancer Research UK nurses, Maggie's
Three free services answer questions and support anyone affected by cancer in the UK: Macmillan's support line (0808 808 00 00, 8am to 8pm every day), Cancer Research UK's nurse helpline (0808 800 4040, weekdays), and Maggie's centres next to major cancer hospitals where you can walk in without an appointment.
More detail
Macmillan Cancer Support runs the largest network: a support line staffed by nurses, welfare rights advisers, financial guides and work-support specialists; an online community; Macmillan nurses and information centres in most cancer hospitals; and grants. Cancer Research UK's nurse helpline answers questions about diagnosis, treatment, trials and evidence, and its Cancer Chat forum is moderated by nurses. Maggie's has more than 20 walk-in centres at major UK cancer hospitals offering psychological support, benefits advice, exercise and relaxation classes and a kitchen table, plus online support. Cancer-specific charities (Breast Cancer Now, Prostate Cancer UK, Bowel Cancer UK, Roy Castle Lung Cancer Foundation, Blood Cancer UK, Myeloma UK, Pancreatic Cancer UK, The Brain Tumour Charity, Sarcoma UK, Teenage Cancer Trust and many others) run helplines with specialist nurses. Mental health support is available via NHS Talking Therapies and, in many centres, clinical psychology within the cancer service.
Abiraterone is a pill that shuts down testosterone production everywhere, including inside the tumour. Discovered at the Institute of Cancer Research, now generic and used from the first metastatic diagnosis.
Acalabrutinib is a cleaner BTK blocker with fewer heart and bleeding problems than ibrutinib. In February 2026 it became half of the first all-oral, fixed-duration CLL regimen.
Afatinib (Gilotrif) is a second-generation pill that binds EGFR, HER2 and HER4 irreversibly, approved in 2013 for EGFR-mutant lung cancer. Its lasting value is activity against the uncommon EGFR mutations G719X, L861Q and S768I, approved in 2018, because osimertinib has displaced it for common mutations and its wild-type EGFR binding causes more rash and diarrhoea.
Alectinib is a well-tolerated ALK pill, standard first line for years and, since 2024, the first targeted therapy given after surgery for ALK-positive lung cancer.
Alpelisib was the first PI3K drug for PIK3CA-mutant breast cancer (2019). It is effective, but high blood sugar and rash limited its use, and newer drugs are displacing it.
With androgen deprivation therapy for high-risk hormone-relapsed non-metastatic prostate cancer, high risk being a PSA that has doubled in 10 months or less
Asciminib is a BCR::ABL1 blocker that binds a different pocket from every other TKI, approved for all newly diagnosed chronic myeloid leukaemia in 2024 and now being tested in Ph-positive ALL.
An enzyme that starves leukaemia cells of an amino acid they cannot make; a mainstay of childhood ALL therapy for 50 years, with new versions solving allergy and supply problems.
A PD-L1 blocker used in lung, liver, and bladder cancer. In 2026 it became the first drug approved based on a blood test showing leftover cancer after bladder surgery.
Avapritinib is the first drug for GIST driven by the PDGFRA D842V mutation, which resists every other kinase inhibitor; it is also approved for systemic mastocytosis.
A gentle chemotherapy that switches silenced genes back on. With venetoclax it became the standard for older people with AML who cannot take intensive treatment.
Belumosudil is a pill for chronic graft-versus-host disease, the long-term immune complication of donor stem-cell transplants used to cure blood cancers.
An East German chemotherapy rediscovered in the 2000s that became the backbone partner for rituximab in follicular, mantle cell and Waldenström lymphomas.
Binimetinib is the MEK inhibitor partnered with encorafenib; blocking the next step in the same relay stops the tumour rerouting around the BRAF block.
Blinatumomab was the first T-cell engager (2014), and is now given to children and adults with leukaemia even when in remission, because it improves survival.
With fulvestrant for HR-positive HER2-negative advanced breast cancer with PIK3CA, AKT1 or PTEN alterations after a CDK4/6 inhibitor plus an aromatase inhibitor
Cetuximab is a chimeric antibody that blocks the EGFR growth receptor. It is used with FOLFIRI or FOLFOX in RAS wild-type, left-sided bowel cancer, with encorafenib in BRAF V600E disease, with KRAS G12C inhibitors, and with radiation or chemotherapy in head and neck cancer; RAS-mutant tumours gain nothing and may be harmed, so RAS testing comes first.
The two old chemotherapy drugs packed together into tiny fat bubbles at a fixed ratio, which doubled five-year survival in older adults with high-risk AML.
Crizotinib was the first ALK inhibitor, approved four years after ALK fusions were found in lung cancer; it was also the first drug for ROS1 lung cancer and for ALK-positive lymphoma and inflammatory myofibroblastic tumour in children.
Dabrafenib plus trametinib is the BRAF-plus-MEK pill combination, approved for BRAF V600E lung cancer and, since 2022, for any solid tumour with that mutation.
Darolutamide is an AR blocker that barely enters the brain, so it causes fewer falls and cognitive side effects; it is approved with and without chemotherapy.
Dasatinib is a second-generation BCR::ABL1 pill that, combined with the immunotherapy blinatumomab, can put Ph-positive ALL into deep remission with no chemotherapy at all.
The antibody that raised cure rates in high-risk childhood neuroblastoma by about 20 points when given after transplant with immune boosters and retinoid.
Enzalutamide is a second-generation androgen-receptor blocker that stops the receptor binding testosterone, entering the nucleus and switching on genes. It is approved at every stage of advanced prostate cancer, from rising PSA after surgery to castration-resistant disease, and fatigue, falls and memory problems are its main drawbacks.
Unresectable or metastatic urothelial cancer with susceptible FGFR3 alterations after at least 1 line of treatment that included a PD-1 or PD-L1 inhibitor
Erlotinib was one of the first EGFR pills for lung cancer; it was approved before anyone knew EGFR mutations predicted who would respond, then redefined by them.
A second JAK inhibitor for myelofibrosis that works after ruxolitinib fails; it carries a boxed warning for a rare brain toxicity (Wernicke encephalopathy) so thiamine is checked.
A versatile chemotherapy used in pancreatic, bladder, lung, ovarian, breast and biliary cancers, in nasopharyngeal cancer, and as a bladder instillation.
Gemtuzumab ozogamicin (Mylotarg) is an anti-CD33 antibody linked to the DNA-cutting payload calicheamicin, the first ADC approved, in 2000 for relapsed acute myeloid leukaemia. An unstable linker and no benefit in a confirmatory trial led to withdrawal in 2010; it returned in 2017 at a lower fractionated dose, with liver toxicity, including veno-occlusive disease, its defining risk.
Glasdegib is a hedgehog-pathway pill that, with low-dose chemotherapy, extends survival in older AML patients who cannot have intensive treatment; it has largely been displaced by venetoclax combinations.
The pill that ended chemotherapy for most CLL. It blocks the survival signal B cells depend on, and it was the first drug to beat chemoimmunotherapy in nearly every CLL setting.
Idelalisib was the first PI3K inhibitor for blood cancers; it is effective in CLL with rituximab but so toxic (colitis, hepatitis, pneumonitis, infections) that the class has largely been abandoned.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
Inotuzumab ozogamicin is an antibody carrying a DNA-cutting toxin to CD22 on leukaemia cells. It gets far more relapsed ALL patients into remission than chemotherapy and bridges them to transplant.
Irinotecan is a topoisomerase-blocking chemotherapy central to bowel and pancreatic cancer regimens (FOLFIRI, FOLFIRINOX, NALIRIFOX) and to salvage therapy in childhood sarcomas; it carries the same warhead as the deruxtecan ADC payloads.
The first drug to block a mutant metabolic enzyme in cancer. With azacitidine it tripled survival in IDH1-mutated AML that could not take intensive chemotherapy.
Lenalidomide is a thalidomide descendant that glues the proteins IKZF1 and IKZF3 to cereblon so the cell destroys them, killing plasma cells and rousing T cells. It is the backbone of myeloma treatment and maintenance, also used in mantle cell and follicular lymphoma, and generic since 2022.
An oral anti-angiogenic pill that matched sorafenib in liver cancer with higher response rates, and partners with pembrolizumab in kidney and endometrial cancer.
Lisocabtagene maraleucel is the only CAR-T approved for chronic lymphocytic leukaemia, for patients whose disease has outrun both BTK and BCL-2 inhibitors.
Large B-cell lymphoma refractory to, or relapsed within 12 months of, first-line chemoimmunotherapy when an autologous stem cell transplant would be suitable
An immune-activating drug approved in Europe for osteosarcoma after a trial suggested it improved survival; the FDA never approved it, and it remains one of oncology's transatlantic disagreements.
Folate receptor-alpha-positive, platinum-resistant high-grade serous ovarian, fallopian tube or primary peritoneal cancer after 1 to 3 lines of systemic treatment
Nilotinib is a second-generation CML pill that produces deeper responses faster than imatinib, at the cost of cardiovascular and metabolic side effects.
Nivolumab was the second PD-1 blocker and is often combined with ipilimumab. Long-term data show about half of advanced melanoma patients alive at 10 years on the combination.
Obinutuzumab is a glycoengineered CD20 antibody that recruits immune cells and kills B cells more directly than rituximab. Paired with venetoclax for a fixed 12 months in chronic lymphocytic leukaemia, it keeps over half of patients treatment-free six years later, and it is also used in follicular lymphoma; first-dose infusion reactions are common and managed by splitting the dose.
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
Palbociclib was the first CDK4/6 inhibitor (2015), and in 2026 became the first approved as maintenance in HER2-positive, hormone-positive breast cancer.
Panitumumab is a fully human EGFR antibody, the preferred first-line partner for chemotherapy in left-sided, RAS-normal bowel cancer after the PARADIGM trial.
Pemetrexed is the chemotherapy that, with a platinum drug, became the first approved treatment for mesothelioma in 2004, and is still the backbone today.
A second HER2 antibody that binds a different spot from trastuzumab, blocking HER2 from pairing with HER3; together they extended survival by 16 months in CLEOPATRA.
Polatuzumab vedotin is an ADC against CD79b that, swapped into the classic R-CHOP regimen, became the first improvement on frontline lymphoma therapy in twenty years.
The third-generation thalidomide analogue for myeloma that has failed lenalidomide, and since 2020 the first new drug for Kaposi sarcoma in two decades.
Ponatinib is the only BCR::ABL1 inhibitor that covers the T315I resistance mutation. In 2024 it became the preferred pill for newly diagnosed Ph-positive ALL.
Radium-223 was the first alpha-emitting drug ever approved (2013). It homes to bone like calcium and treats prostate cancer that has spread only to bone.
Ribociclib is the CDK4/6 inhibitor with the most consistent survival benefit, approved for a broad population of early breast cancer patients since 2024.
Rituximab was the first antibody ever approved for cancer (1997). It made chemoimmunotherapy the CLL standard for a decade, and biosimilars keep it cheap and everywhere.
Ruxolitinib was the first JAK inhibitor: it shrinks the spleen and relieves symptoms in myelofibrosis and controls blood counts in polycythaemia vera, without eliminating the disease clone.
The first TROP2-targeted ADC. It delivers a strong chemotherapy directly to breast and bladder cancer cells and is now a first-line option in triple-negative breast cancer.
Selinexor is a first-in-class pill that traps tumour-suppressor proteins inside the nucleus; approved in myeloma, it failed its endometrial cancer test in 2026.
288 of 486 approved products (59%) have a record; 288 (59%) have a researched outcome rather than a placeholder. 0 rows are marked “not yet researched”: each links to a NICE search so you can check in one click, and if you know the outcome you can tell us through the issue form with the appraisal link.
Each row records one flagship appraisal; most modern drugs have several TAs, one per indication, named in the note on the product page. SMC status is per medicine, not per indication. Wales (AWMSG) positions are recorded only where they differ from NICE. Corrections are welcome via the repo.
Verify with NICE and your team
This page is a map, not a decision. NICE publishes new and updated technology appraisals every week, Cancer Drugs Fund entries move to routine commissioning or are withdrawn, and whether a drug is available to you depends on the exact indication, line of treatment, biomarker and, sometimes, the hospital. TA numbers here were recorded from memory of the guidance and checked against the linked page where possible; where a number was not verified the row says so and links to a NICE search.
Before acting on any row: open the linked NICE page and read the recommendation section; check the current CDF list; and ask your oncologist or clinical nurse specialist whether the appraised indication matches your situation and whether an individual funding request, a trial or an early access scheme applies. In Scotland check the SMC; in Wales the AWTTC.