Users of the network regimen lists should note the following limitations:

1. Currently, the commissioners pay for activity and high cost (NICE and formulary) drugs separately. They do not commission chemotherapy according to these regimens or treatment pathways made up of several of these regimens. The HRG codes should therefore not be used to code activity to the West Midlands specialised commissioning group (WMSCG).

2. The list was correct as of November 2009, however there may now be regimens which have been introduced or modified since this list was produced.

3. Whilst specific parts of the list relating to individual specialities were sent to the relevant oncologist for comment and correction, there was very little feedback. This could mean that they were either happy with the list, did not see it or they were unable to comment.

4. No radio-chemo regimens were included on the list.

5. For some tumours, e.g. breast and colorectal, an attempt was made to clarify the regimen for neo-adjuvant, adjuvant, relapsed or metastatic disease. Many of the same regimens are used in either both or all contexts, depending on the clinical condition and stage of the individual patient.

6. Within the list there are regimens with the same drugs, but with different doses or different schedules. These regimens are often used in the same disease, but for patients with different performance statuses. It is not possible to guarantee that all such combinations and variations are recorded.

7. No attempt has been made in the regimen list to describe the sequencing of chemotherapy regimens. For example, in early breast cancer both FEC-docetaxel and docetaxel-FEC are used.

8. Regimens are, or may be used concurrently with each other and no attempts have been made to capture all these possible combinations. This is most common in the case of the monoclonal antibodies such as trastuzumab, but does occur with other oral chemotherapy.

If you have any queries relating to the regimen list please contact Andrew Stanley.