Regimen Reference Orders (RROs)

These standardized, approved support documents are created at CCMB by teams of pharmacists, nurses, and guideline developers as part of the formal Manitoba Oncology Drug Review Process. Content is reviewed and approved by medical oncologists.

An RRO provides: planned course of the drug or drug regimen, indication for use, whether a central venous access devise is required or recommended, blood work parameters to proceed with treatment, pre-treatment requirements, sequence of medication administration, dosing and drug administration instructions, monitoring parameters, discharge instructions and any notable information regarding the particular drug or drug regimen.

RROs are intended as Evidence-informed Practice Tools to assist healthcare professionals in Manitoba who provide drug treatments to cancer patients. Please see the Legal Disclosure at the bottom of this page for more information.

RROs by Disease Site Group, and for Supportive Care are listed below.

Regimen Reference Order Disease Site Group(s) Sub Group(s) Keyword(s) SortCol(s) Last Updated

Cancer Management Guidelines

CCMB Cancer Management Guidelines are created to generate, disseminate, implement and evaluate evidence-based guidelines for the consistent management of common clinical scenarios encountered by oncology patients in Manitoba. These guidelines are a type of knowledge translation tool, and offer information for clinicians based on scientific research, highest quality of evidence, and/or best-practice consensus recommendations from cancer care experts.

Guidelines can be applied in various healthcare settings by administrators, clinicians and patients so the best course of action can be determined when decisions about treatment options or care delivery must be made. The ultimate aim of these guidelines is to keep patients and their families at the centre of care.

CancerCare Manitoba welcomes the input of healthcare professionals. If you’re interested in further learning or participating in the development or review of guidelines, or you have a question about guideline development or the after-care process, please contact: [email protected]

Clinical Practice Guidelines Process Maps

Please click on the following to view process maps from the Clinical Practice Guidelines Initiative.

Phase One – Preliminary

Phase Two – Development

Phase Three – Review and Implementation

Phase Four – Evaluation

Cancer Management Guidelines

CancerCare Manitoba Practice Guidelines are scheduled for regular content review and update in order to improve recommendations and to remain current.
Please view guidelines for treatment (Systemic Therapy, Radiation Therapy, Surgery) and Supportive Care below.

Acute Leukemia and Bone Marrow Transplant Practice Guidelines

Coming Soon...

Breast Practice Guidelines

Central Nervous System Practice Guidelines

Coming Soon...

Cutaneous Practice Guidelines


Disease & Symptom Management


Endocrine Practice Guidelines

Coming Soon...

Gastro-Intestinal Practice Guidelines


Disease & Symptom Management

Gastric Cancer

Disease Management

Genitourinary Practice Guidelines

Coming Soon...

Gynecologic Oncology Practice Guidelines

Coming Soon...

Head and Neck Practice Guidelines

Hematology Practice Guidelines

Immune Thrombocytopenia (ITP)

Disease & Symptom Management

Lymphoproliferative Disorders Practice Guidelines

Sarcoma Practice Guidelines

Coming Soon...

Practice Guidelines for Smoking Cessation

Despite a diagnosis of cancer, some patients continue to smoke. Healthcare providers can use this document as a guide to facilitate an evidence-based, shared approach to the clinical support of smoking cessation within oncology care.

For this purpose, it may be used by qualified and licensed healthcare practitioners involved with the care of oncology patients, which may include (but is not limited to): physicians, surgeons, nurses, radiation therapists, pharmacists, psychosocial oncology caregivers and dietitians.

To view this practice guideline, click Supportive Care Smoking Cessation in Oncology Care.

Practice Guidelines for Filgrastim Use in Adults by Disease Site

Neutropenia and its complications such as febrile neutropenia and infection are major toxicities associated with myelosuppressive chemotherapy.

Adverse consequences of febrile neutropenia include hospitalization, use of antibiotics and delays in chemotherapy administration

This document is intended as a guide to facilitate an evidence-informed, shared approach to the appropriate use of filgrastim in adults.

For this purpose, it may be used by qualified and licensed healthcare practitioners involved with the care of oncology patients, which may include (but is not limited to): physicians, surgeons, nurses, radiation therapists, pharmacists, psychosocial oncology caregivers and dietitians

The recommendations are stratified by each Disease Site Group in order to help clarify the indications in which filgrastim should be used.

To view these practice guidelines, click Recommendations for Filgrastim Use in Adults by Disease Site.

Febrile Neutropenia

Disconnecting your Elastomeric Infusor from your PORT or PICC

Thoracic (Lung) Practice Guidelines


Carcinoma of Unknown Primary Practice Guidelines

Coming Soon...

Legal Disclosure for CCMB Practice Guidelines and related Evidence-informed Practice Tools

CCMB Practice Guidelines and related Evidence-informed Practice Tools represent the consensus of CCMB professionals regarding their views of currently accepted approaches to treatment. These materials have been published so that qualified and licensed healthcare practitioners can consider this information in determining appropriate care or treatment for their patients. The publication of these materials by CCMB and the consequent knowledge of them by practitioners must not preclude use of a practitioner's independent clinical judgement, nor must such publication and consequent knowledge replace the need for a practitioner to consult with the appropriate oncology care provider if warranted in a particular patient’s circumstances.

CCMB may update these materials at any time or from time to time, as it sees fit in its sole discretion. As a result, it is recommended that practitioners frequently consult this website to ensure that they are aware of the most recent Practice Guidelines and Evidence-informed Practice Tools published by CCMB.


Drug Education Communication Team (DECT)

DECT is a multidisciplinary team (pharmacists, nursing educators, nursing leadership, and ARIA Information Education Specialists) working together to ensure appropriate anticancer and supportive therapy information and education is available provincially.  The team works to provide both patient and health care professionals with standardized appropriate education, information tools and be informative by the way of funding announcements, new indications for current medications, as well as any changes or amendments to current systemic therapy processes.

DECT is responsible for the identification, review, adaptation and/or development, approval, maintenance, and dissemination of appropriate drug information resources, tools for education/monitoring of anticancer systemic therapies administered throughout the provincial Oncology programs.  DECT oversees a framework for the re-evaluation, amendment, communication, and dissemination of any modifications to any education tools/resources/communication maintained by the TEAM.  All resources are reviewed and re-evaluated annually or sooner as deemed necessary by staff/patient feedback.