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Eligibility Data Proforma List for ECNMMB
UPDATED October 2012
Date
Approved
18.04.08
18.04.08
18.04.08
18.07.08
18.07.08
18.07.08
Audit No
Consultant
Name of audit
2008/001
2008/002
2008/003
2008/004
2008/005
2008/006
Date
Finished
17.07.09
17.07.09
17.07.09
17.07.09
17.07.09
17.07.09
Pluta
Tahir
Tahir
Cambell
Tahir
Robinson
18.07.08
2008/007
17.07.09
Robinson
18.07.08
18.07.08
18.07.08
18.07.08
18.07.08
postponsed
2008/008
2008/009
2008/010
2008/011
2008/012
2008/013
17.07.09
17.07.09
17.07.09
17.07.09
17.07.09
NA
Hamblin
Hamblin
Hamblin
Davidson
Cambell
NA
postponsed
2008/014
NA
NA
24.10.08
2008/015
02.10.09
Sarwar
24.10.08
06.02.09
06.02.09
2008/016
2009/001
2009/002
02.10.09
22.01.10
22.01.10
Trask
Skaria
Robinson
06.02.09
2009/003
NICE
Robinson
06.02.09
2009/004
22.01.10
Tahir
06.02.09
2009/005
22.01.10
Tahir
06.02.09
06.02.09
01.04.07
24.04.09
2009/006
2009/007
2009/008
2009/009
22.01.10
22.01.10
23.04.10
NICE
Sarwar
Sarwar
Cervi
Cervi
Temozolomide and rituximab in NHL brain
Topotecan & cisplatin for metastatic cervical cancer
Cisplatin, docetaxel & 5FU for Head & Neck cancer
Rituximab and chlorambucil (R-Clb) for first line treatment of follicular lymphoma
EOX regimen for untreated advanced esophgogastric cancer
Lapatinib for patients with advanced or metastatic breast cancer whose tumours over-express ErbB2
(HER2).
TC chemotherapy in adjuvant node +ve or node –ve breast cancer treatment of weakly hormone positive
patients with risk factors and hormone negative high risk elderly patients
FCR in previously treated patients with CLL
Use of Fludarabine/Cycloposphamide (F/C) as first line therapy in CLL
Alemtuzumab in Fludarabine-refractory Chronic Lymphocytic Leukaemia
Ixabepilone on compassionate use
Nilotinib use in chronic phase Chronic Myeloid Leukaemia
Bevacizumab in combination with interferon alfa-2a is indicated for first line treatment of patients with
advanced and/or metastatic renal cell cancer.
Pemetrexed used as second line agent for relapsed NSCLC for those who received Docetaxel as a first
line treatment.
Mitoxantrone for hormone refractory prostate cancer (HRPC) patients who have relapsed on Docetaxel
Chemotherapy
The use, toxicity and outcome data of Topotecan in the treatment of relapsed SCLC
The use, toxicity and outcome data of Erlotinib in the second line treatment of NSCLC
Myocet® in place of conventional Doxorubicin where patient has metastatic Breast Cancer and ejection
fraction < 50% or is at high risk
The use of Lapatinib for patients with advanced or metastatic breast cancer whose tumours over-express
ErbB2 (HER2)
Bevacizumab first line for patients with metastatic colorectal cancer with metastasis confined to liver, unresectable, good PS who carries KRAS mutant type.
Cetuximab for first line treatment for patients with liver (only) metastasis, un-resectable disease, good PS
with KRAS wild type discussed in MDT
Sunitinib for treatment of palliative second-line clear-cell renal cell cancer
Sunitinib: first-line palliative treatment for renal-cell cancer
Dasatinib for use in Chronic Myeloid Leukaemia
Azacitidine in Myelodysplastic Syndrome (MDS) patients
Date
Approved
24.04.09
24.04.09
24.04.09
Not approved
Audit No
Date
Finished
23.04.10
23.04.10
23.04.10
NA
Consultant
2009/010
2009/011
2009/012
2009/013
24.04.09
2009/014
Cervi
2009/015
2009/017
NOT USED
YET
NA
NA
Not approved
Not approved
17.07.09
2009/016
17.07.10
NA
17.07.09
2009/018
17.07.10
Campbell
02.10.09
02.10.09
2009/019
2009/020
02.10.10
02.10.10
Davidson
Cervi
Not approved
2009/021
NA
Cervi
02.10.09
2009/022
02.10.10
Cervi
02.10.09
22.01.10
Not approved
02.03.10
02.03.10
02.03.10
23.04.10
2009/023
2010/001
02.10.10
NA
Sawar
Sarwar
2010/002
2010/003
2010/004
2010/005
23.04.10
23.04.10
23.04.10
NA
Cervi
Cervi
Cervi
Tahir
23.04.10
23.04.10
23.04.10
23.07.10
23.07.10
23.07.10
2010/006
2010/007
2010/008
2010/009
2010/010
Not
approved
20.05.11
20.05.11
NA
15.07.11
15.07.11
NA
Tahir
Tahir
Campbell
Tahir
Tahir
Sarwar
Cervi
Cervi
Cervi
NA
NA
NA
Name of audit
Liposomal Cytarabine (Depocyte) in patients with Lymphomatous meningitis
GEMP as salvage regimen in patients with Relapsed/Resistant HD or NHL
Alemtuzumab for the 1st line treatment of patients with 17p deletion (P53 mutation) CLL
Ibritumomab tiuxetan (Zevalin) for consolidation therapy after remission induction in previously untreated
patients with follicular lymphoma
Ibritumomab tiuxetan (Zevalin) and rituximab for relapsed or refractory CD20+ follicular B-cell nonHodgkin's lymphoma (NHL)
Adjuvant Imatinib after resection of High Risk GIST
Trabectedine for advanced soft tissue sarcoma
Sunitinib for the treatment of unresectable and/or metastatic malignant GIST after failure of Imatinib
treatment due to resistance or intolerance
Rituximab as combination therapy in the treatment of lymphoplasmacytic lymphoma (LPL) (AKA
Waldenstrom’s macroglobulinaemia) and splenic marginal zone lymphoma (SMZL)
Abraxane monotherapy for the 2nd line treatment of metastatic breast cancer in patients
Maintenance rituximab for first or second remission in patients with relapsed/refractory follicular lymphoma
responding to induction therapy with chemotherapy with or without rituximab
Plerixafor (with G-CSF) to enhance mobilisation of haematopoietic stem cells in patients with lymphoma
and multiple myeloma whose cells mobilise poorly
Thalidomide single agent in selected lymphoma patients when all other treatment options have been
exhausted
Carboplatin and Liposomal Doxorubicin (Caylex) for Relapsed Platinum Sensitive Ovarian Cancer
Everolimus as a second line option for patients who progress on or after treatment with VEGF-targeted
therapy
Bendamustine in MM
Bendamustine in NHL
Bendamustine in CLL
Trastuzumab with cisplatin and capecitabine as first line treatment for patients with HER2 positive
metastatic adenocarcinoma of the stomach or gastro-esophageal junction
Oxaliplatin and Capecitabine for adjuvant treatment of Stage 3 Colorectal Adenocarcinoma
Cisplatin/Gemcitabine for advanced biliary tract carcinoma
RCD for the treatment of multiple myeloma (lenalidomide to be given as per NICE guidance)
Mitomycin/Capecitabine with RT for anal Squamous cell carcinoma
Adjuvant Gemcitabine for resected pancreatic adenocarcinoma
Degarelix is a gonadotrophin releasing hormone (GnRH) antagonist indicated for treatment of patients with
advanced hormone-dependent prostate cancer
Date
Approved
22.10.10
Audit No
2010/011
Date
Finished
07.10.11
Consultant
Lamont
NICE
NICE
NICE
NICE
Sarwar
Cervi
Cervi
Tahir
21.01.11
21.01.11
2010/012
2010/013
2010/014
NICE
TA 208
2011/001
2011/002
20.01.12
20.01.12
Kancherla
Chowdhury
21.01.11
2011/003
20.01.12
Chowdhury
21.01.11
20.05.11
20.05.11
15.07.11
15.07.11
15.07.11
15.07.11
15.07.11
15.07.11
2011/004
2011/005
2011/007
2011/008
2011/009
2011/010
2011/011
2011/012
2011/013
20.01.12
20.04.12
CDF
20.07.12
20.07.12
No audit form
20.07.12
20.07.12
Campbell
Campbell
Wood
Robinson
Kancherla
Kancherla
Kancherla
Tahir
Skaria
20.01.12
20.01.12
20.04.12
20.07.12
20.07.12
20.07.12
2012/001
2012/002
2012/003
2012/004
2012/005
2012/006
No audit form
20.01.13
20.04.13
20.07.13
20.07.13
No audit form
Tahir
Hamblin
Tahir
Lamont
Shankari
Lamont
05.10.12
05.10.12
2012/007
2012/008
05.10.13
05.10.13
Kumar
Howard
22.10.10
22.10.10
22.10.10
21.01.11
Name of audit
Sorafenib for locally inoperable and/or metastatic and inoperable radio-iodine resistant Hurthle Cell
Thyroid cancer, with symptomatic progression and for which local Radiotherapy has been given
already or is considered inappropriate on SMDT assessment, in good performance status patients
(ECOG0,1,2)
Pazopanib for renal cell carcinoma
Bendamustine for the first-line treatment of chronic lymphocytic leukaemia
Rituximab for NHL
Trastuzumab for Gastric cancer (approved by NICE on 24th November 2010)
Mitomycin C + 5FU for muscle invasive bladder cancer (MIBC)
Bortezomib + High dose dexamethasone (HDD) for first line treatment in selected older myeloma
patients presenting in renal failure or at high risk of developing renal failure
PAD (bortezomib + doxorubicin + dexamethasone) for first line treatment in selected younger myeloma
patients presenting in renal failure or at high risk of developing renal failure
RCD (Lenalidomide + Dexamethasone + Cyclophosphamide) – Multiple Myeloma
R-maxiCHOP/R-ara-C as induction chemotherapy for mantle cell lymphoma rather than R-CHOP
Dexrazoxane for anthracycline extravasation
Use of eribulin in 3rd or subsequent line metastatic breast cancer
Cisplatin/ Etoposide with RT for NSCLC
Cisplatin / Etoposide with RT for SCLC
Oral vinorelbine instead of IV vinorelbine in combination with cisplatin for NSCLC
Gemcitabine and docetaxel for first or second line treatment in advanced soft tissue sarcoma
Afatinib for progressive adenocarcinoma NSCLC in patients who have previously benefited from erlotinib
or gefitinib
Two weekly cetuximab
R-Chlorambucil for 2nd and subsequent line CLL
FOLFIRINOX in Metastatic/advanced inoperable pancreatic carcinoma
Oral topotecan in Gynae, ovarian and related subtypes.
RGCVP in newly diagnosed DLBCL
Methyl-5-aminolevulinate in basal and squamous cell carcinoma and actinic keratosis (approved in
principal subject to local business case at CHUFT)
S1 (Teysuno) for gastric/gastro-oesophageal cancer
CVD for first line amyloidosis
NICE forms
02.10.09
02.10.09
NICE TA 179
NICE TA 181
02.10.10
02.10.10
Skaria
Sunitinib for the treatment of gastrointestinal stromal tumours
Pemetrexed for the first-line treatment of non-small-cell lung cancer
22.01.10
22.01.10
23.04.10
23.06.10
22.10.10
28.07.10
28.07.10
24.11.10
Feb 2011
23.02.11
23.03.11
NICE TA 183
NICE TA 184
NICE TA 185
NICE TA 190
NICE TA 191
NICE TA 192
NICE TA 193
NICE TA 208
NICE TA 215
NICE TA 216
NICE TA 218
22.01.11
22.01.11
20.05.11
23.06.11
22.10.11
28.07.11
28.07.11
24.11.11
Feb 2012
23.02.12
23.03.12
22.06.11
27.07.11
20.01.12
NICE TA 226
NICE TA 228
NICE TA 235
20.07.12
20.07.12
No audit
form
13.01.12
NICE TA 241
20.07.12
20.07.12
NICE TA 258
NICE Ta 259
20.07.13
20.07.13
Lamont
Skaria
Skaria
Tahir
Skaria
Hamblin
Tahir
Sarwar
Hamblin
Hamblin
Hamblin
Hamblin
Tertiary
only
Campbell
Skaria
Sarwar
Topotecan for the treatment of recurrent and stage IVB cervical cancer
Topotecan for the treatment of relapsed small-cell lung cancer
Trabectedin for the treatment of advanced soft tissue sarcoma
Pemetrexed for the maintenance treatment of non-small-cell lung cancer
Capecitabine for the treatment of advanced gastric cancer
Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer
Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia
Trastuzumab for the treatment of HER2-positive metastatic gastric cancer
Pazopanib for the first-line treatment of advanced renal cell carcinoma
Bendamustine for the first-line treatment of chronic lymphocytic leukaemia
Azacytidine in Intermediate 2 and High-risk MDS; CMML; AML with 20-30% blasts – in which stem cell
transplantation is not indicated
Rituximab for the first-line maintenance treatment of follicular non-Hodgkin’s lymphoma
Bortezomib and thalidomide for the firstline treatment of multiple myeloma
Mifamurtide for the treatment of osteosarcoma
Dasatinib, high-dose imatinib and nilotinib for the treatment of imatinib-resistant CML, and dasatinib
and nilotinib for people with CML for whom treatment with imatinib has failed because of intolerance
Erlotinib - Locallly advanced/metastatic EGFR +ve NSCLC - 1st line
Abiraterone for castration-resistant metastatic prostate cancer previously treated with a docetaxelcontaining regimen