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The Royal Marsden NHS Foundation Trust Drug & Therapeutic Committee minutes 29th January 2020

Present: Consultant Breast and AOS (chair) Drug Resource Manager (secretary) Consultant Palliative Medicine Consultant Pharmacist Chief Pharmacist MI and palliative care specialist pharmacist Nurse Consultant Consultant Medical Oncology – GI & AOS Consultant Microbiologist Pharmacy Administrator (minute taking) In attendance:

1. Minutes of the December meeting a. Minutes – approved.

2. Conflict of Interest No conflicts raised.

3. NICE Guidance update 1. TA621: Osimertinib for untreated EGFR+ve NSCLC 2. TA620: Olaparib for maintenance treatment of relapsed platinum sensitive ovarian, fallopian & peritoneal ca. 3. TA619: & fulvestrant in HR+ve, HER2-ve Breast ca. Relevant clinical leads made aware of the guidance.

4. One off drug use requests 1. Nivolumab (via CUP) in mismatch repair deficient oesophageal adenocarcinoma. 2. (via CUP) in unresectable liposarcoma following standard treatment. 3. CAPOC regimen in recurrent carcinoma. 4. in metastatic Breast ca. post palbociclib. 5. Olaparib (via CUP) in relapsed platinum sensitive ovarian ca. with BRCA mutation. 6. Lorlatanib as per MA – full proposal to come to next meeting. All requests approved.

5. Brincidofovir (via compassionate supply). Presented by the Haemato- oncology unit. Proposed for use Treatment of Adenovirus in adults and paediatric patients with renal impairment where Cidofovir is considered contraindicated or who have progressive adenoviraemia despite adequate treatment with Cidofovir in line with the criteria of the compassionate use program. Action: Approved.

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6. Ameluz (5- hydrochloride) in actinic keratosis. Presented by Skin & Melanoma unit Proposed for use in treatment of actinic keratosis of mild to moderate severity on the face and scalp (Olsen grade 1 to 2) and of field cancerization in adults for superficial and/or nodular basal cell carcinoma unsuitable for surgical treatment. Action: Approved.

7. IVIg annual report. Presented by the Pharmacy. The report showed that the internal and external approval processes were being adhered to at the trust. Patient numbers where similar to the previous year however expenditure has gone down slightly, this is hopefully an indication of the more stringent review processes in view of the development of the Sub Regional Immunoglobulin Assessment Panel. Action: n/a.

8. PGD: Lorazepam (SL) in cold related dysthaesia. Presented by Nursing. Developed in follow up to an action from the December meeting. Action: Approved.

9. Osteo Necrosis of the Jaw trust guidance review. Presented by IV therapies Nursing. New guidance has been published by a working party on behalf of UK Chemotherapy Board. Action: To be taken to Quality Assurance & Chemotherapy for further review and implementation at the trust.

10. AOB Date of the Next Meeting: Thursday 20th of February (pm), 15:00 – 17:00

Minutes Approved DTC chair: Tuesday 28th April 2020

Date of next meeting 20th February 2020.

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