Systemic Anti-Cancer Therapy Regimen Library
Background and purpose
The phrase ‘systemic anti-cancer therapy’ (SACT) refers to a group of medicine-based cancer treatments comprising cytotoxic chemotherapy agents alongside targeted therapies, immunotherapy, hormones and key supportive care medicines to reduce side-effects. SACT may be used either alone or in combination with other cancer treatments such as surgery and radiation therapy. People with blood cancers, for example, rely on access to drug treatments, such as cytotoxic chemotherapy, antibody therapy, targeted agents and immunotherapy.
The Anti-Cancer Therapy – Nationally Organised Workstreams (“ACT-NOW”) programme, launched in late 2018, will develop a detailed database of information on patients receiving SACT across New Zealand and work with the medical oncology, haematology, pharmacist and nursing community to identify and reduce variation, enhance equity of access and support resource planning. Phase 1 of this programme requires the development of national regimen definitions to create a solid foundation for the subsequent capture of nationally comparable data. The system for the development, maintenance and publication of regimen definitions is known as the SACT Regimen Library system, or SRL.
SRL is an online library of SACT regimens developed via a multi-disciplinary approach with the clinical community. These regimens detail the combinations, doses and frequencies of medicines that are used in New Zealand. The goal of the SRL is to support consistency in how regimens are named, reported and administered. The SRL is a component of the ACT-NOW programme of work, sponsored and led by Te Aho o Te Kahu Cancer Control Agency. ACT-NOW has the objective of developing a national collection of SACT data to inform quality improvement, equity and resource planning initiatives. SRL serves as a mechanism to support the nationally consistent capture of treatment data within electronic systems, which is critical for subsequent extraction and meaningful analysis across providers.
SRL also provides a mechanism for regimen curation and a repository of commonly used regimens within New Zealand. The intent is that New Zealand SACT providers align their local regimens with those in the SRL. SRL regimens are intended for use in conjunction with professional judgement and expertise and taking account of individual patient factors to inform clinically appropriate use.
ACT-NOW is a key deliverable under the New Zealand Cancer Action Plan 2019-2029 from Te Aho o Te Kahu Cancer Control Agency. This plan is guided by four overarching principles:
- Equity-led
- Knowledge-driven
- Outcomes-focused
- Person and whānau-centred
The intent of the SRL is to provide coverage of all commonly used regimens across all cancer groups within adult medical oncology and malignant haematology. An initial focus has been placed on developing regimens within the high-volume cancer streams where significant inequities are known to exist. Equity will remain a key criterion on which regimens are prioritised.
Our stakeholders
In late 2018, the Medical Oncology Working Group (MOWG) requested that the Ministry of Health (the Ministry) develop a sustainable option for the collection and analysis of detailed SACT data. This request was echoed by the Haematology Working Group (HWG) and Radiation Oncology Work Group (who prescribe some SACT treatments). These working groups and other clinical groups (including the broader medical oncology, haematology, radiation oncology, nurse, nurse practitioner and pharmacist communities) are key to the development and maintenance of the SRL regimens.
The New Zealand Formulary (NZF) is an independent resource funded by the Ministry to provide healthcare professionals with clinically validated and standardised medicines information, enabling healthcare professionals to select safe and effective medicines for individual patients. NZF is considered the single source of truth for codified medicines data within New Zealand. As a trusted development partner, NZF works with the ACT-NOW programme team to co-design, build, publish and support SRL.
Funding of SRL
SRL is funded by the New Zealand Government and governed by Te Aho o Te Kahu Cancer Control Agency. The SRL does not receive sponsorship from any commercial or pharmaceutical industry, nor does it use advertising from any source. The SRL maintains editorial independence across all processes.