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The Royal Marsden NHS Foundation Trust
Drug & Therapeutic Committee minutes
24th November 2016
Present: Consultant Haemato-oncologist (chair)
Consultant GI/Lung
Consultant Breast / Acute Oncology Service
Associate Chief Pharmacist
Nurse Consultant
Consultant Lung / Acute Oncology Service
Nurse Consultant intravenous therapy
Consultant GI/Lymphoma
Consultant Neuro-oncology
Consultant Microbiologist
1.
Minutes of the September meeting
a. Minutes – approved.
2.
Conflict of Interest
Provided and agreed
3.
NICE Guidance update
1. TA406 Crizotinib for untreated anaplastic lymphoma kinase advanced NSCLC. Lung
unit confirmed awareness
2. TA408 Pegasparagase for treating acute lymphoblastic leukaemia (untreated/newly
diagnosed). Haemato-oncology unit confirmed awareness.
3. TA410 TVEC (talimogene) unresectable metastatic melanoma (where
immunotherapies are not suitable). Melanoma unit confirmed awareness.
4. TA411 Necitimumab for untreated advanced or metastatic squamous NSCLC (in
combination with gemcitabine & cisplatin). Lung unit confirmed awareness.
5. TA412 Radium-223 for treating hormone relapsed prostate ca. (with no known
visceral mets). Urology unit confirmed awareness
6. TA414 Cobimetinib in combination with vemurafenib for treating unresectable or
metastatic BRAF V600 mutation-positive melanoma (-ve). Melanoma unit confirmed
awareness
7. TA416 Osimertinib for treating locally advanced or metastatic EGFR T790M
mutation-positive non-small-cell lung cancer (via CDF) (+ve). Lung unit confirmed
awareness
4.
One off drug use requests
1.
2.
3.
4.
5.
6.
7.
8.
Rivaroxaban treatment of DVT/PE (x2)
Cinacelet in denosumab refractory hypercalcaemia
Temsirolimus (in combination) desmoplastic small round cell tumour
Treastuzumab and Pertuzumab – HER2 +ve gastric cancer
Pegfilgrastim in needle phobic patient
Venetoclax (via compassionate supply) in TP53 deleted CLL intolerant to ibrutinib
Vedolizumab for nivolumab induced colitis
Lorlatinib (via compassionate supply)for advanced/metastatic ALK re-arranged
NSCLC following progression on other ALK inhibitors
9. C1-esterase inhibitor for ACEi angioedema.
5.
Aprepitant in treatment of pruritis. Presented by the Dermatology unit
Approved for use when standard lines of treatment have failed. Usage and outcomes to be
reviewed.
Action:
Approved
6.
Cabozantinib in Renal Cell Cancer (via compassionate supply program).
Presented by the Renal unit
Proposed for use in advanced renal cell carcinoma in adults. Drug to be obtained via a
compassionate supply programme for patients who are registered and meet the entry criteria.
Action:
Approved.
7.
Neratinib in Breast cancer (via compassionate supply program). Presented by
the Breast unit
Proposed for use after alternative HER2 directed treatment available for patients with HER2
positive metastatic breast cancer are no longer suitable due to progression or ineligible for
treatment. Drug to be obtained via a compassionate supply programme for patients who are
registered and meet the entry criteria..
Action:
Approved.
8.
Avelumab in Metastatic Merkel cell ca. (via compassionate supply program).
9.
Olanzapine as an anti-emetic. Presented by Lung unit for trust wide use
Presented by Skin & Melanoma unit.
Proposed for use as 2nd line treatment as currently there is no standard second line treatment
for metastatic Merkel cell carcinoma. Drug to be obtained via a compassionate supply
programme for patients who are registered and meet the entry criteria
Action:
Approved.
Proposed for use as a treatment option to treat patients who have nausea and vomiting
despite optimal prophylaxis.
Action:
Approved.
10.
Non Medical Prescribing Policy. Presented by Nursing
Updates to current version reviewed.
Action:
Approved.
14.
Guidelines for the treatment of immunotherapy induced arthritis and
nephritis.
Action:
Approved.
11.
Parenteral Nutrition prescription chart for paediatric patients. Presented
by Pharmacy
Action:
Approved.
12.
Surgical discharge prescription chart. Presented by Pharmacy
Action:
Approved.
15.
AOB
Date of the Next Meeting:
Tuesday 20th of December (pm), 15:00 – 17:00
Minutes Approved
DTC chair : 20th December 2016
Date of next meeting 20th December 2016.