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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.