Guidance on the Substitution of Systemic Therapy Agents

Guideline Objective

This document is meant to describe those situations in which one chemotherapy drug is used for another of a similar class and mechanism of action. The two most common reasons for drug substitution include convenience for the patient (i.e., oral versus intravenous administration) and avoidance of toxicities that would aggravate a pre-existing condition (e.g., substitution of a less neurotoxic drug in a patient with diabetic neuropathy). The decision to substitute one chemotherapy drug for another should always be undertaken in the best interests of the patient and not compromise treatment outcomes.

Intended Guideline Users

This guidance document is intended to be used by clinicians (physicians, pharmacists, nurses).