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The Royal Marsden NHS Foundation Trust
Drug & Therapeutic Committee minutes
19th July 2016
Present: Consultant Medical Oncologist (chair)
Consultant Paediatrics
Drug Resource Manager
Consultant Microbiologist
Consultant Lung
Chief Pharmacist
Nurse Consultant intravenous therapy
Specialist Pharmacist Palliative Care and Community Services
Consultant GI/Lymphoma
Consultant Neuro-oncology
1.
Minutes of the June meeting
a. Minutes – approved.
2. Conflict of Interest
Provided and agreed
3.
NICE Guidance update
1. TA395: Ceritinib – in previously treated anaplastic lymphoma kinase +ve NSCLC (who
have previously had crizotinib). +ve recommendation Lung team aware.
2. TA396: Trametanib & dabrafenib – unresectable or metastatic melanoma that has
BRAF V600 mutation. +ve recommendation Skin & Melanoma team aware.
4.
One off drug use requests.
1. Ceftazadime & Avibactam (combination) (named patient medicine) for pan resistant
infection.
2. Diazoxide (named patient) for insulinoma
3. Paclitaxel (weekly regimen) for recurrent intracranial germinoma
5.
MHRA safety update
1. Not since last meeting.
6. Terms of Reference.
Amendments made in follow up to last meeting, draft document to be circulated to the
committee for comment (TM)
7.
e-chemo implementation paper for NHSE. Presented by Pharmacy.
A report regarding timelines for the echemo project implementation requirements in view of
the project contractual requirement for full implementaion of SACT e-prescribing including
clinical trials required by 31st March 2017 for adults and 30th September 2017 for children.
Action:
Implemetation schedule approved
8.
Palliative Medicines Symptom Control update. Presented by Pharmacy
Four chapters from the Guidelines which have been updated and peer reviewed by the
palliative care team; Itch, Sweating, Bone Pain and bisphosphonates, Lymphoedema.
Action:
Approved
9. Daratumumab in myeloma. Presented by Haemato-oncology department.
Proposed for use as monotherapy for the treatment of adult patients with relapsed and
refractory multiple myeloma, whose prior therapy included a proteasome inhibitor(PI) and an
immunomodulatory agent (IMiD), and who have demonstrated disease progression on the
last therapy.
Action:
Approved.
10.
Guideline for use of SC Furosemide in community for patients with HF
Presented by Pharmacy
Guidelines in development in collaboration with local specialist palliative care (St Raphael’s
Hospice) to allow community nursing to effectively manage patients at home with end stage
Congestive Heart Failure
Action:
Approved.
11.
Netupitant/palonosetron Presented by GI unit (for trust wide use)
Proposed for use of prevention of acute and delayed nausea and vomiting associated with
highly emetogenic cancer chemotherapy in patients with poor compliance to standard anti
sickness regimens.
Action:
Use at the trust not supported in view of no significant clinical efficacy was seen over the
trusts current treatment options for of prevention of acute and delayed nausea and vomiting
associated with highly emetogenic cancer chemotherapy i.e. 5HT3 & NK1 combination.
12.
Idelalasib in lymphoma Presented by Haemato-oncology department.
Proposed for use as monotherapy for the treatment of adult patients with follicular lymphoma
(FL) that is refractory to two prior lines of treatment.
Action:
Approved.
13. PGD’s (x11): Ametop gel, Glucose 5% IV flush, Hyaluronidase & Hydrocortisone, IV
hydrocortisone, Heparin sodium flushing solution 10iu/ml, Heparin sodium flushing solution
100iu/ml, Chlorphenamine 10mg IV, Lidocaine for BMA, Lidocaine removal skin tunnelled
catheter, Sodium Chloride & Desmprssin.
Action:
Approved.
13.
AOB
Date of the Next Meeting:
Thursday 22nd of September (pm), 15:00 – 17:00
Minutes Approved
DTC chair : 22nd September 2016
Date of next meeting 22nd September 2016.