TAYSIDE PRESCRIBER
Tayside DTC Supplement No 108 – August 2011
Produced by NHS Tayside Drug and Therapeutics Committee Medicines Advisory Group (MAG)
SPECIAL FOCUS ON ONCOLOGY & HAEMATOLOGY
SMC ADVICE
Introduction
This Tayside Prescriber DTC supplement includes local recommendations for outstanding Oncology and Haematology SMC advice which has
been agreed by the Oncology & Haematology Medicines Management Group (OHMMG). Links to relevant disease protocols (see below)
have been added in the comments and useful links section.
Oncology & Haematology Protocols
A programme of development of local Oncology and Haematology protocols was introduced in 2009-10. Approved protocols are now
available through the Tayside Area Formulary (TAF).
From the home page of TAF click on Specialist Formulary Lists and Formulary Development link. This is from the index on the left
hand side of the formulary, before the Palliative Care Guidelines and BNF sections and just above the Adverse Drug Reaction reporting link.
From the list of specialist formularies, click on Oncology & Haematology protocols link. There are a few protocols that are still under
development and will appear on the site once they have been finalised / approved by OHMMG.
Updates from previous SMC Advice (Oncology/Haematology 2004 - 2011)
Medicine Indication Local recommendation Comments and
category useful links
Bortezomib 3.5mg vial of powder for Treatment of patients with multiple Hospital only (Haematology) SMC advice
solution for IV injection (Velcade®) myeloma who have received at least two
prior therapies, have demonstrated disease Multiple Myeloma Protocol
(126/04) - Full submission
progression on the last therapy and who
are refractory to alternative licensed treat-
ments for this stage of the disease.
Bortezomib 3.5mg vial of powder for Mono-therapy for the treatment of Hospital only (Haematology) SMC advice
solution for IV injection (Velcade®) progressive multiple myeloma in patients Multiple Myeloma Protocol
(302/06) - 2nd Re-submission who have received at least one prior
therapy and who have already undergone Supplied via Patient Access
or are unsuitable for bone marrow Scheme (PAS)
transplantation.
Carmustine 7.7mg implant (Gliadel®) Treatment of newly diagnosed high-grade Hospital only (Neurosurgery) SMC advice
(215/05) - Full submission malignant glioma patients as an adjunct to
surgery and radiation. Primary Glioma Protocol
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Updates from previous SMC Advice (Oncology/Haematology 2004 - 2011) continued….
Medicine Indication Local recommendation Comments and
category useful links
Degarelix (Firmagon®) (560/09) Gonadotropin-releasing hormone (GnRH) GPs may prescribe under the SMC advice
antagonist indicated for the treatment of direction of the urology/ SPC link 80mg inj
- Re-submission adult male patients with advanced oncology clinic
SPC link 120mg inj
hormone-dependent prostate cancer.
Supplied via a Patient Access
Note that short-term treatment
Scheme (PAS) (simple discount). with anti-androgen is not
required.
Restricted to hormone naïve
metastatic prostate cancer
A general practice minor
patients with PSA>50 who have
surgery fee is available for the
severe bone pain, spinal cord
compression, or other serious administration of degarelix.
complications of metastatic
disease and who need rapid
reduction of testosterone
levels.
Docetaxel concentrate and solvent for In combination with prednisolone for the Hospital only (Oncology) NICE MTA
solution for infusion (Taxotere®) (209/05) treatment of patients with metastatic
hormone refractory prostate cancer Prostate Cancer Protocol
- Full submission
(mHRPC).
Docetaxel 20mg, 80mg concentrate and In combination with doxorubicin and Hospital only (Oncology) SMC advice
solvent for solution for infusion cyclophosphamide for the adjuvant
(Taxotere®) (201/05) treatment of operable, node-positive Breast Cancer Protocol
- Full submission breast cancer.
Erlotinib 100mg and 150mg tablets Treatment of patients with locally advanced Hospital only (Oncology) SMC advice
(Tarceva®) (220/05) or metastatic non-small cell lung cancer Non-Small Cell Lung Cancer
- Re-submission after failure of at least one prior Protocol
chemotherapy regimen.
Exemestane 25mg tablets (Aromasin®) Adjuvant treatment of postmenopausal GPs may prescribe under the SMC advice
(210/05) women with oestrogen receptor positive direction of the Oncology clinic
invasive early breast cancer, following 2–3 Breast Cancer Protocol
- Full submission
years of initial adjuvant tamoxifen therapy.
Imatinib 100mg and 400mg film-coated Adjuvant treatment of adult patients who Hospital only (Oncology) SMC advice
tablets (Glivec®) (584/09) are at significant risk of relapse following Upper GI Protocol
- Re-submission resection of Kit (CD117) - positive
gastro-intestinal stromal tumours (GIST).
Letrozole 2.5mg tablets (Femara®) Adjuvant treatment of postmenopausal GPs may prescribe under the SMC advice
(251/06) women with hormone receptor positive direction of the Oncology clinic
Breast Cancer Protocol
invasive early breast cancer.
- Full submission
Nilotinib 200mg capsules (Tasigna®) Treatment of chronic phase Philadelphia Hospital only (Haematology) SMC advice
(440/08) chromosome positive chronic myelogenous CML Protocol
- Full submission leukaemia (CML) in adult patients resistant
to or intolerant of at least one prior
therapy including imatinib.
Pemetrexed 500mg infusion (Alimta®) In combination with cisplatin is accepted for Hospital only (Oncology) SMC advice
(192/05) restricted use within NHS Scotland for the
Malignant Mesothelioma
- Full submission treatment of chemotherapy-naïve patients
with stage III/IV unresectable malignant Protocol
pleural mesothelioma.
Tayside DTC Supplement No 108 - August 2011 2
Updates from previous SMC Advice (Oncology/Haematology 2004 - 2011) continued….
Medicine Indication Local recommendation Comments and
category useful links
Rituximab 100 & 500mg concentrate First-line treatment of patients with Hospital only (Haematology) SMC advice
for solution for infusion (MabThera®) chronic lymphocytic leukaemia (CLL) CLL Protocol
(540/09) in combination with fludarabine and
- Full submission cyclophosphamide.
Rituximab 100 & 500mg concentrate Treatment of patients with previously Hospital only (Haematology) SMC advice
for solution for infusion (MabThera®) untreated and relapsed/refractory CLL Protocol
(591/09) chronic lymphocytic leukaemia (CLL)
- Full submission in combination with chemotherapy.
Sunitinib 12.5mg, 25mg, 50mg hard Treatment of unresectable and / or Hospital only (Oncology) SMC advice
capsule (Sutent®) (275/06) metastatic malignant gastrointestinal Upper GI Protocol
- Re-submission stromal tumour (GIST) after failure of
imatinib mesilate treatment due to Supplied via a Patient Access Scheme
resistance or intolerance. (PAS)
Thalidomide 50mg hard capsule In combination with melphalan and Hospital only (Haematology) SMC advice
(Thalidomide Pharmion®) (525/08) prednisone as first line treatment of Multiple Myeloma Protocol
- Full submission patients with untreated multiple mye-
loma, aged 65 years or over or ineligi-
ble for high dose chemotherapy,
Topotecan 0.24mg, 1mg hard cap- Treatment of adult patients with Hospital only (Oncology) SMC advice
sules (Hycamtina®) (545/0) relapsed small cell lung cancer (SCLC) Small cell lung cancer
- Full submission for whom re-treatment with the Protocol
first-line regimen is not considered
appropriate.
This bulletin is produced by the Medicines Advisory Group (MAG), which is a sub-group of the NHS Tayside Drug and Therapeutics
Committee. Please direct any queries to either: Karen Harkness, Principal Pharmacist - Clinical Effectiveness, email: kharkness@nhs.net
or Claire James, Senior Pharmacist - Clinical Effectiveness, email: clairejames@nhs.net
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