How Medicare, Medicaid and commercial insurance pay for cancer treatment, in plain English first and detail second, then a coverage record for 269 of the 486 approved products in OnCo: which part of Medicare pays, what commercial plans usually require, published list prices where they exist, and where to find assistance.
Read this first
Not medical or financial advice. Coverage rules, formularies, prices and assistance funds change often and differ between plans; verify with your plan, your oncology practice's financial navigator, or a State Health Insurance Assistance Program counsellor before making decisions. List prices are shown only where a published figure with a source and year exists (4 products); net prices after rebates are usually lower, and what you pay depends on your plan.
How the system works
Fifteen short explainers. The first paragraph is for anyone; the second is for people who want the mechanics.
Medicare Parts A and B (Original Medicare)
Medicare is the federal programme for people 65 and over and some younger people with disabilities. Part A pays for hospital stays. Part B pays for doctors, outpatient care and the cancer drugs a clinician gives you by infusion or injection. You pay 20% of the Part B bill, and there is no ceiling on that 20% unless you buy a Medigap policy.
Part A covers inpatient admissions (including inpatient chemotherapy, stem-cell transplant and CAR-T stays, paid by diagnosis-related group) after a per-benefit-period deductible. Part B covers physician services, hospital outpatient care, radiation therapy, imaging, laboratory tests (no coinsurance), durable medical equipment and drugs that are not usually self-administered, which in oncology means most infused and injected products. Part B pays physicians average sales price plus 6% (about 4.3% after sequestration) for drugs; hospital outpatient departments are paid under the outpatient prospective payment system, or at a reduced rate for 340B hospitals in some years. The beneficiary owes an annual deductible then 20% coinsurance with no out-of-pocket maximum. Medigap plans G and N, employer retiree coverage or Medicaid (for dual eligibles) cover that 20%; roughly one in five Original Medicare beneficiaries has none of these and is fully exposed.
Part D is separate drug insurance you buy from a private plan. It covers the cancer pills and self-injections you take at home. Since 2025 there is a hard limit on what you pay each year for Part D drugs: $2,000 in 2025, $2,100 in 2026. Before that, people on oral cancer drugs could pay $10,000 or more a year.
Part D plans (stand-alone or inside Medicare Advantage) must cover substantially all drugs in six protected classes, one of which is antineoplastics, so every oral cancer drug is on every formulary, although plans can apply prior authorisation and quantity limits. Oral oncology drugs sit on the specialty tier, typically 25 to 33% coinsurance. The Inflation Reduction Act removed the 5% catastrophic coinsurance in 2024 and capped out-of-pocket spending at $2,000 in 2025 (indexed: $2,100 in 2026). The Medicare Prescription Payment Plan lets beneficiaries spread the cap in monthly instalments rather than paying it in January. Manufacturers pay 20% of the cost of brand drugs in the catastrophic phase, which has led some plans to push utilisation management harder. Manufacturer co-pay coupons cannot be used by Medicare beneficiaries under the anti-kickback statute; Extra Help (the low-income subsidy) and independent charity funds are the routes to lower cost sharing.
Part B or Part D? Why the route of administration decides your bill
The same cancer can be treated with an infusion (Part B, 20% of a large bill with no cap) or a pill (Part D, capped at about $2,000 a year). Two drugs for the same disease can therefore cost a patient very different amounts. A handful of oral chemotherapy drugs that also come as injections (capecitabine, temozolomide, cyclophosphamide, methotrexate, etoposide, topotecan, melphalan) are covered by Part B too.
Part B pays for drugs 'not usually self-administered' that are furnished incident to a physician's service, plus specific statutory categories: oral anticancer drugs with an injectable equivalent used for the same indication, oral anti-emetics used within 48 hours of chemotherapy as a full replacement for IV anti-emetics, immunosuppressants after a Medicare-covered transplant, and drugs infused through durable medical equipment such as an ambulatory pump (home 5-FU). Everything else self-administered falls to Part D. Local Medicare contractors publish self-administered drug exclusion lists. Since 2019 Medicare Advantage plans may apply step therapy to Part B drugs, and most do for biosimilars and checkpoint inhibitors. A subcutaneous formulation given by a nurse (Darzalex Faspro, Phesgo, Opdivo Qvantig, Keytruda Qlex) stays in Part B; an oral drug that replaces an infusion (relugolix replacing leuprolide) moves the patient into Part D.
About half of people on Medicare choose a private Medicare Advantage plan instead of Original Medicare. These plans cap your yearly spending on medical care, which Original Medicare does not, but they use networks, prior authorisation and step therapy. Check that your cancer centre is in network before you enrol, because switching back to Original Medicare later can leave you unable to buy a Medigap policy.
Medicare Advantage plans must cover everything Parts A and B cover and usually bundle Part D. In 2025 the maximum in-network out-of-pocket limit for medical (not drug) spending was $9,350, with many plans lower. In exchange, plans manage utilisation: prior authorisation is nearly universal for Part B oncology drugs, step therapy on Part B drugs has been permitted since 2019, and networks may exclude NCI-designated centres. Prior authorisation denials in Medicare Advantage are overturned on appeal most of the time, and CMS rules from 2024 require plans to follow Medicare coverage criteria and to honour approved authorisations for at least 90 days after a plan switch. Disenrolling back to Original Medicare is possible each autumn, but Medigap insurers in most states may underwrite or refuse applicants with a cancer history after the first year of Medicare eligibility.
Medicaid is the state-run programme for people with low incomes; CHIP covers children. Rules differ by state, and ten states have not expanded Medicaid to all low-income adults, so a working-age adult with cancer and no children may have no route to coverage there. Where you qualify, Medicaid covers cancer drugs with little or no copay.
Medicaid covers all FDA-approved drugs from manufacturers in the federal rebate programme, so every approved cancer drug is coverable, subject to prior authorisation and state preferred drug lists. Copays are nominal and capped as a share of income. Eligibility in expansion states is 138% of the federal poverty level; in the ten non-expansion states (in 2025: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming), childless adults generally qualify only through disability. The Breast and Cervical Cancer Prevention and Treatment Act gives a Medicaid pathway to people diagnosed through the CDC screening programme. Dual eligibles (Medicare plus Medicaid) have their Part B coinsurance and Part D cost sharing covered. The 2025 federal budget law introduced work requirements and more frequent eligibility checks for expansion adults from 2027, which cancer advocacy groups expect to cause coverage churn during treatment; medically frail exemptions apply but must be documented.
Most Americans under 65 are insured through work. Employer and marketplace plans cover approved cancer drugs, but nearly every branded cancer drug needs prior authorisation: your oncologist's office must show the plan that the drug matches your diagnosis, biomarker results and previous treatments. Infusions go through the medical benefit; pills go through a specialty pharmacy under the pharmacy benefit, often with a coinsurance of 20 to 40% until you hit your plan's out-of-pocket maximum.
Commercial plans split drugs between the medical benefit (physician-administered, billed by the clinic, often with site-of-care steering away from hospital outpatient departments) and the pharmacy benefit run by a PBM (oral and self-injected, dispensed by the PBM's specialty pharmacy). Coverage criteria track the FDA label and NCCN compendia (most states require insurers to cover compendia-listed off-label uses). The ACA caps annual in-network out-of-pocket spending ($9,200 individual in 2025) but high-deductible plans front-load that cost into the first weeks of treatment. Co-pay accumulator and maximiser programmes may stop manufacturer co-pay cards from counting towards the deductible; several states have banned this. Employer self-funded plans (ERISA) are exempt from state mandates, including step-therapy and accumulator bans. Oncology pathway programmes and clinical-pathway vendors increasingly attach preferred regimens to authorisation.
The Affordable Care Act and pre-existing conditions
Since 2014, insurers cannot refuse to cover you, charge you more or cap your lifetime benefits because you have or had cancer. Marketplace plans must cover prescription drugs and cancer screening, and you can buy one even mid-treatment during open enrolment or after losing job coverage.
The ACA bans pre-existing condition exclusions, medical underwriting and annual or lifetime dollar limits on essential health benefits, which include prescription drugs, hospitalisation, laboratory services and preventive care (USPSTF A/B screening such as mammography, colonoscopy, lung CT and cervical screening at $0). Marketplace subsidies are income-based; the enhanced subsidies enacted in 2021 expired at the end of 2025, raising premiums for many enrollees in 2026. Losing employer coverage triggers a special enrolment period; COBRA continuation is an alternative but costs the full premium. Short-term and some association plans are not ACA-compliant and may still exclude cancer. Section 2709 of the Public Health Service Act requires non-grandfathered plans to cover routine patient costs in approved clinical trials.
The Inflation Reduction Act: the $2,000 cap and Medicare price negotiation
A 2022 law made three changes that matter for cancer. Medicare drug-plan spending is now capped ($2,000 in 2025, $2,100 in 2026). Medicare now negotiates prices for its most expensive drugs, and the first list included the leukaemia and lymphoma pill Imbruvica, whose Medicare price fell 38% from January 2026. And drug makers must pay rebates if they raise prices faster than inflation.
Negotiation: CMS selected ten Part D drugs in 2023 (prices effective 1 January 2026), including ibrutinib (Imbruvica: list $14,934 per 30 days in 2023, maximum fair price $9,319). Fifteen more were selected in January 2025 for 2027, including palbociclib (Ibrance), enzalutamide (Xtandi), pomalidomide (Pomalyst) and acalabrutinib (Calquence). The third cycle, selected in January 2026 for 2028, adds Part B (physician-administered) drugs for the first time. Negotiated prices apply to Medicare only, though they anchor commercial negotiations. Other provisions: Part B coinsurance on biosimilars is calculated against the reference product's price; manufacturers owe inflation rebates on Part B and Part D drugs whose prices rise faster than CPI-U; the coverage gap and the 5% catastrophic coinsurance were eliminated; Part D vaccines are free; Extra Help was expanded to 150% of poverty. Litigation by manufacturers against the negotiation programme has so far failed in the courts.
Hospitals that serve many low-income patients can buy outpatient drugs at steep discounts from manufacturers. The discount goes to the hospital, not automatically to you; whether it lowers your bill depends on the hospital's charity policy.
Section 340B of the Public Health Service Act requires manufacturers participating in Medicaid to sell covered outpatient drugs to eligible hospitals and clinics (disproportionate share hospitals, children's hospitals, cancer hospitals, federally qualified health centres) at a ceiling price, roughly 25 to 50% below list. Insurers, including Medicare, still pay the hospital the normal rate, so the spread funds the hospital. Oncology drugs account for a large share of 340B purchases and have driven the shift of infusion from physician offices to hospital outpatient departments. Disputes over contract pharmacies, manufacturer restrictions and Medicare's 2018 to 2022 payment cut (struck down by the Supreme Court in 2022, with remedy payments made in 2024) continue. Patients can ask whether a 340B hospital passes discounts on through its financial assistance policy.
Payment reform: from the Oncology Care Model to the Enhancing Oncology Model
Medicare has been testing ways to pay oncology practices for keeping patients well and out of hospital rather than for the volume of drugs they give. If your practice takes part, you should get 24/7 access to a clinician, a written care plan and help navigating costs, at no extra charge.
The Oncology Care Model (2016 to 2022) paid about 200 practices a monthly enhanced-services fee per patient on chemotherapy and offered performance payments for reducing total episode cost; evaluations found modest savings concentrated in high-risk episodes and improved processes but no reduction in overall Medicare spending after the fees. The Enhancing Oncology Model began in July 2023 for seven cancer types, added a mandatory downside risk, a lower monthly fee, requirements for health-related social needs screening and electronic patient-reported outcomes, and new participants in 2025. Commercial payers run parallel episode and pathway programmes. Payment models influence which regimens are offered when cost is a tie-breaker, and they fund the navigation and financial counselling services described below.
Cancer is one of the most common causes of medical debt and bankruptcy in the United States, even for insured people. Ask your cancer centre for a financial navigator or oncology social worker early: they can find assistance programmes, appeal denials, set up payment plans and apply for hospital charity care on your behalf.
Around 40% of US cancer patients report material financial hardship; those who file for bankruptcy after diagnosis have a measurably higher mortality. Drivers include cost sharing on drugs, lost income, travel and caregiving, and denials or delays. The NCI, ASCO and NCCN now treat financial toxicity as an adverse event to be screened for (the COST measure). Financial navigation programmes at cancer centres, funded partly through the Enhancing Oncology Model and philanthropy, secure manufacturer free drug, charity co-pay grants, Medicaid or Marketplace enrolment, disability benefits and charity care. Non-profit hospitals must publish a financial assistance policy under IRS section 501(r) and offer discounts before pursuing collections; many states set income thresholds for free care. Medical debt under $500 or less than a year old no longer appears on major credit reports.
Joining a clinical trial should not cost you more than standard care. Medicare, Medicaid (since 2022) and ACA-compliant private plans must pay for the routine care you would have had anyway, such as visits, scans and standard drugs, while the trial sponsor pays for the experimental treatment and research-only tests.
Medicare NCD 310.1 (2000, revised 2007) covers routine costs in qualifying clinical trials, including items and services needed to administer the investigational agent and to manage complications; the investigational drug itself and research-only procedures are excluded, and sponsors usually supply the drug free. The CLINICAL TREATMENT Act, enacted in the Consolidated Appropriations Act 2021 and effective 1 January 2022, extends the same requirement to all state Medicaid programmes for serious or life-threatening conditions. Section 2709 of the Public Health Service Act (added by the ACA) requires non-grandfathered private plans to cover routine costs in approved trials and bars them from denying participation, although plans may require in-network providers where an equivalent trial exists. Out-of-network trial sites, travel and lodging remain common gaps; some sponsors and charities (Lazarex Cancer Foundation, NCI Community Oncology Research Program sites) help with travel.
Every large cancer drug maker runs a programme that gives its drug free to uninsured or underinsured patients below an income limit, and a co-pay card that covers most of the out-of-pocket cost for people with commercial insurance. Medicare patients cannot use co-pay cards, but independent charities run disease-specific funds that pay Medicare cost sharing. The funds open and close through the year, so check often.
Manufacturer patient assistance programmes (PAPs) provide free product to patients typically below 400 to 600% of the federal poverty level with no insurance or after a coverage denial; each requires a physician form and proof of income and takes days to weeks. Manufacturer co-pay programmes are lawful only for commercially insured patients; the anti-kickback statute bars them for Medicare and Medicaid. Independent charities (PAN Foundation, HealthWell, CancerCare Co-Payment Assistance Foundation, Patient Advocate Foundation Co-Pay Relief, Leukemia & Lymphoma Society, Good Days) receive manufacturer donations under Office of Inspector General guidance and pay Medicare cost sharing within disease funds that have income caps (usually 400 to 500% FPL). Several manufacturers settled kickback cases over charity steering in 2018 to 2020, making today's funds strictly disease-based rather than drug-based. Hospitals also run replacement programmes that recover free drug from manufacturers on behalf of uninsured patients.
Biosimilars are near-identical copies of biologic drugs such as trastuzumab (Herceptin), bevacizumab (Avastin) and rituximab (Rituxan). They cost 15 to 35% less and work the same way. Most insurers now require a biosimilar before they will pay for the original brand, and in Medicare your coinsurance on a biosimilar is usually lower.
FDA has approved biosimilars for trastuzumab, bevacizumab, rituximab, filgrastim, pegfilgrastim, epoetin and denosumab; oncology biosimilars reached 80%+ share for bevacizumab and trastuzumab within four years of launch, faster than in other therapy areas, because they are buy-and-bill Part B products where practices earn a margin. Medicare pays biosimilars at their own average sales price plus 8% of the reference product's ASP (a permanent incentive under the IRA), and the IRA bases beneficiary coinsurance for biosimilars on the reference price. Commercial plans and Medicare Advantage use step therapy (preferred biosimilar first) and formulary exclusions; step therapy on Part B drugs has been permitted in Medicare Advantage since 2019, applies only to new starts and must have an exception process within 72 hours (24 hours if expedited). Interchangeability designations allow pharmacy-level substitution for pharmacy-benefit biologics but matter little for infused oncology drugs.
You do not have to work this out alone. Free, expert help exists for choosing a plan, appealing a denial, finding co-pay funds and dealing with work and disability questions.
State Health Insurance Assistance Programs (SHIPs) give free, unbiased Medicare counselling in every state. Triage Cancer runs a legal and financial navigation helpline and publishes state-by-state guides on insurance, disability, employment and appeals. CancerCare provides oncology social workers, limited financial grants and the co-payment foundation. The PAN Foundation and HealthWell Foundation pay cost sharing for specific diagnoses. Patient Advocate Foundation offers case management for insurance disputes. The Leukemia & Lymphoma Society runs co-pay and travel assistance for blood cancers. The American Cancer Society's helpline (1-800-227-2345) and Hope Lodge programme cover lodging near treatment. For denials: request the plan's clinical criteria in writing, ask the oncology practice to file a peer-to-peer review, use the internal appeal, then the external (independent) review that ACA plans and Medicare must offer.
Filter by Medicare part or commercial pattern, sort by list price, and click through to the product page for the full record with sources and assistance links. Part B means a clinician gives it (20% coinsurance, uncapped in Original Medicare); Part D means you take it at home (capped at $2,000 in 2025 and $2,100 in 2026).
Data gap: 217 of the 486 approved products in OnCo have no US coverage record yet. Most are newly approved (2025 to 2026) products whose Medicare coding and plan policies are still settling, or products approved outside the US. If you know how one of them is covered, tell us through the issue form with a source, and we will add it after checking.
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.
High-dose interleukin-2 was the first immunotherapy to cure a small fraction of patients with metastatic melanoma and kidney cancer, at the cost of ICU-level toxicity; today it mainly supports TIL therapy.
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.
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.
Avutometinib plus defactinib is the first treatment approved specifically for low-grade serous ovarian cancer, a slow-growing type driven by the RAS pathway.
Vidaza / Onureg (oral) · Subcutaneous or IV (Vidaza); oral (Onureg)
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.
Belinostat is an HDAC inhibitor for relapsed peripheral T-cell lymphoma; about a quarter of patients respond, and it can be used in patients with low platelets.
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.
Bevacizumab is a humanised antibody that soaks up VEGF-A, the signal tumours use to grow new blood vessels. Approved in 2004, it partners chemotherapy in colorectal, ovarian, cervical, lung, kidney and liver cancer and glioblastoma, and adds to trifluridine/tipiracil in late-line bowel cancer; hypertension, protein in the urine and bleeding are its characteristic side effects.
The old antiandrogen pill used to block the testosterone flare from GnRH agonists and in combined androgen blockade; superseded by enzalutamide-class drugs.
Binimetinib is the MEK inhibitor partnered with encorafenib; blocking the next step in the same relay stops the tumour rerouting around the BRAF block.
Bleomycin is the 'B' in BEP for testicular cancer and ABVD for Hodgkin lymphoma; its unique danger is scarring of the lungs, so lung function is monitored and it is often dropped when safe.
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.
Brexucabtagene autoleucel is the CAR-T therapy for mantle cell lymphoma and adult acute lymphoblastic leukaemia, giving long remissions after BTK inhibitors fail.
A Chinese two-armed antibody that blocks PD-1 and CTLA-4 together, approved in China for cervical cancer and extending survival even in PD-L1-negative tumours.
Camrelizumab is Jiangsu Hengrui's humanised PD-1 antibody, approved in China for oesophageal, liver and lung cancer but not in the US, where its liver cancer combination with rivoceranib drew complete response letters in 2024 and 2025 over manufacturing and inspection issues. Its signature side effect is reactive cutaneous capillary endothelial proliferation, a skin reaction seen in most patients.
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.
Akalux · Intravenous infusion, then light at 24 hours
Cetuximab sarotalocan is an EGFR antibody carrying a light-activated dye: after infusion, a red laser is shone on the tumour and the cells burst. It has been approved in Japan since 2020.
Carvykti · Single IV infusion after lymphodepletion
Ciltacabtagene autoleucel is a one-time BCMA CAR-T for myeloma that, in CARTITUDE-4, cut the risk of death by about 45% compared with standard regimens.
Cisplatin is the original platinum chemotherapy, discovered by accident in 1965; it cures testicular cancer and makes radiation work better in cervical and head and neck cancer.
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.
Cyclophosphamide is an alkylating chemotherapy that damages DNA in dividing cells. It is part of CHOP for lymphoma, AC for breast cancer and VAC for childhood sarcomas, clears lymphocytes before CAR-T and prevents graft-versus-host disease after transplant; bladder bleeding, infertility and secondary leukaemia are its harms.
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.
The first antibiotic used as an anticancer drug (1954) and still the core of chemotherapy for Wilms tumour, rhabdomyosarcoma and gestational trophoblastic disease.
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.
Datopotamab deruxtecan (Datroway) is the second TROP2 ADC and shares Enhertu's payload. In 2026 it became a first-line option for triple-negative breast cancer patients who cannot receive immunotherapy.
Oral decitabine-cedazuridine is a pill version of the hypomethylating chemotherapy that, since May 2026, lets older AML patients take their whole venetoclax regimen at home.
The antibody that raised cure rates in high-risk childhood neuroblastoma by about 20 points when given after transplant with immune boosters and retinoid.
The red chemotherapy drug from a soil bacterium that is still the backbone of treatment for sarcoma, lymphoma and breast cancer, limited by cumulative heart damage.
Eflornithine (DFMO) is an old sleeping-sickness drug repurposed as the first oral maintenance therapy for high-risk neuroblastoma, approved in December 2023 to reduce relapse after immunotherapy.
Enasidenib is the IDH2 counterpart of ivosidenib, approved in the US for relapsed disease but never approved in Europe after it failed to extend survival in a confirmatory trial.
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.
Epcoritamab is an under-the-skin injection that pulls T cells onto lymphoma cells; it is approved for relapsed large B-cell and follicular lymphoma, and moving toward first line.
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.
Etoposide is a chemotherapy from the mayapple plant, essential to curing testicular cancer (BEP), treating small-cell lung cancer, lymphomas, childhood sarcomas and leukaemias, and used in transplant conditioning.
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.
Fluciclovine F-18 was the first PET tracer approved for finding recurrent prostate cancer after treatment (2016), and has been largely superseded since 2020 by PSMA PET.
A PET scan that shows which breast cancer deposits still have oestrogen receptors, helping decide whether hormone therapy will work when biopsy is impractical.
The 1957 chemotherapy that remains the backbone of treatment for bowel, stomach, pancreatic, anal, head and neck and breast cancers, and as a cream for skin precancers.