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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
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08.01.05  Expand sub section  Other antineoplastic drugs
08.01.05  Expand sub section  Amsacrine
08.01.05  Expand sub section  CDK inhibitors
08.01.05  Expand sub section  Arsenic trioxide
08.01.05  Expand sub section  Bevacizumab to top
08.01.05  Expand sub section  Bexarotene
08.01.05  Expand sub section  Bortezomib
08.01.05  Expand sub section  Brentuximab vedotin
08.01.05  Expand sub section  Cetuximab
Cetuximab
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Formulary
Red
  • Approved for the first-line treatment of metastatic colorectal cancer in combination with FOLFOX in line with NICE (monotherapy or combination chemotherapy is not recommended for the treatment of people with metastatic colorectal cancer that has progressed after first-line chemotherapy -  as per NICE). 
  • NECDAG approved for K-RAS wild type metastatic colorectal cancer; second line use in combination with chemotherapy in patients that have progressed on previous chemotherapy; third line use as a single agent in patients who have failed oxaliplatin- and irinotecan based therapy and who are intolerant to irinotecan. 
  • Approved for locally advanced squamous cell carcinoma of the head and neck in line with NICE. 
  • Approved for previously untreated metastatic colorectal cancer in line with NICE.
  • Approved for the treatment of metastatic and/or recurrent squamous cell carcinoma of the head and neck (oral cavity only) in line with NICE and NHS England Commissioning Policy
  • Note: cetuximab is not approved in combination with platinum-based chemotherapy for recurrent and/or metastatic squamous cell cancer of the head and neck as per NICE.
 
Link  NICE TA145: Cetuximab for the treatment of locally advanced squamous cell cancer of the head and neck
Link  NICE TA242: Cetuximab for the treatment of metastatic colorectal cancer after first-line chemotherapy: monotherapy or combination chemotherapy
Link  NICE TA439 Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
Link  NICE TA473 Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck (oral cavity)
Link  MHRA Drug Safety Update (Feb 2014): Cetuximab: new safety information available
Link  MHRA Drug Safety Update (May 2012): Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis
 
08.01.05  Expand sub section  Dacarbazine and Temozolomide to top
08.01.05  Expand sub section  Erlotinib
08.01.05  Expand sub section  Hydroxycarbamide
08.01.05  Expand sub section  Imatinab
08.01.05  Expand sub section  Ipilimumab
08.01.05  Expand sub section  Mitotane to top
08.01.05  Expand sub section  Panitumumab
08.01.05  Expand sub section  Pentostatin
08.01.05  Expand sub section  Platinum compounds
08.01.05  Expand sub section  Porfimer sodium and temoporfin
08.01.05  Expand sub section  Procarbazine to top
08.01.05  Expand sub section  Protein kinase inhibitors
08.01.05  Expand sub section  Taxanes
08.01.05  Expand sub section  Topoisomerase I inhibitors
08.01.05  Expand sub section  Trabectedin
08.01.05  Expand sub section  Trastuzumab to top
08.01.05  Expand sub section  Tretinoin
08.01.05  Expand sub section  Vismodegib
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances. For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing.  

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs.  

Green

Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care.  

Black

NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria.   

Brown

UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.  

Not Recomended

NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status.  

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