821 Antibody responsive malignancy - Milton Keynes Formulary

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8.2.1 Antibody responsive malignancy

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First line drugs

Second line drugs

Specialist drugs

Secondary care drugs

Traffic light status (TLS) explained:

• Green: Routine prescribing within licensed indication
• Amber 1: specialist recommendation followed by GP initiation and continuation
• Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
• Amber 3: specialist initiation and stabilisation followed by GP continuation
• Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
• Red: Hospital or specialist prescribing only

 

Monoclonal Antibodies (Antineoplastic drugs)

 

Atezolizumab

• Tecentriq^® 1,200mg concentrate for solution for infusion in vials

Notes:

• Use as per NICETA584: Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer (June 2019)

 

• Use as per NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy (June 2018)

 

• Use as per NICE TA520: Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy (May 2018)

 

• Use as per NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable (December 2017) 

 

Avelumab

• Bavencio^® 20mg/mL concentrate for solution for infusion vials

Note:

• Use as per NICE TA517: Avelumab for treating metastatic Merkel cell carcinoma (April 2018)

 

 

Bevacizumab

• Bevacizumab is recommended for use in wet AMD
• Avastin^® Concentrate for IV infusion, 25mg in 1mL  (100mg/4mL, 400mg/16mL vials) 

Notes: 

• Use as per NICE TA285: Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer (May 2013)

 

• Use as per NICE TA284: Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer (May 2013)

 

• Use as per NICE TA263: Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer (August 2012) 

 

• Use as per NICE TA242: Cetuximab, bevacizumab and panitumumab for the treatment of metastatic colorectal cancer after first-line chemotherapy: Cetuximab (monotherapy or combination chemotherapy), bevacizumab (in combination with non-oxaliplatin chemotherapy) and panitumumab (monotherapy) for the treatment of metastatic colorectal cancer after first-line chemotherapy (January 2012)

 

• Use as per NICE TA214: Bevacizumab in combination with a taxane for the first-line treatment of metastatic breast cancer (February 2011)  

 

• Use as per NICE TA212: Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer (December 2010)

 

• Use as per NICE TA178: Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma (August 2009)

 

• Use as per NICE TA118: Bevacizumab and cetuximab for the treatment of metastatic colorectal cancer (January 2007) 

 

 

• MHRA/CHM advice: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw (January 2011)

 

 

  

Blinatumomab

• Blincyto^®  Powder for concentrate and solution for infusion, 38.5 mcg in vial

Note: 

• Use as per NICE TA450: Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia (June 2017) 

 

 

Brentuximab vedotin

• Adcetris^® Injection, 50mg powder for concentrate for solution for infusion in vial

Notes: 

• Use as per NICE TA577: Brentuximab vedotin for treating CD30-positive cutaneous T-cell lymphoma (April 2019)

 

• Use as per NICE TA524: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma (June 2018)

 

• Use as per NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma (October 2017)

 

• Use as per NICE TA446: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma (June 2017)  

 

 

Cetuximab

• Erbitux^® Intravenous Infusion, 5mg/mL in vial

Notes: 

• Use as per NICE TA473: Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck (August 2017)

 

• Use as per NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer (March 2017)

 

• Use as per NICE TA242: Cetuximab, bevacizumab and panitumumab for the treatment of metastatic colorectal cancer after first-line chemotherapy: Cetuximab (monotherapy or combination chemotherapy), bevacizumab (in combination with non-oxaliplatin chemotherapy) and panitumumab (monotherapy) for the treatment of metastatic colorectal cancer after first-line chemotherapy (January 2012)

 

• Use as per NICE TA145: Cetuximab for the treatment of head and neck cancer (June 2008)

 

• Drug Safety Update: Cetuximab: importance of establishing wild type RAS (KRAS and NRAS) status before treatment of metastatic colorectal cancer (Drug Safety Update volume 7 issue 7, February 2014: A1)

 

• MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

 

 

Daratumumab

• Darzalex^® 20mg/mL concentrate for solution for infusion

Note:

• Use as perTA573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma (April2019)

 

• Use as per NICE TA510: Daratumumab monotherapy for treating relapsed and refractory multiple myeloma (14 March 2018)

 

 

Dinutuximab beta

• Qarziba^® 20mg/4.5mL concentrate for solution for infusion

Note:

 

• Use as per NICE TA538: Dinutuximab beta for treating neuroblastoma ( 22 August 2018) 

 

Durvalumab

• Imfinzi® 50 mg/mL concentrate for solution for infusion
•  
• Note:
• Use as per NICE TA578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation (May 2019)

 

Gemtuzumab ozogamicin

• Mylotarg^® 5mg powder for concentrate for solution for infusion vials

Note:

• Use as per NICE TA545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia (November 2018)

 

 

Inotuzumab ozogamicin 

• Besponsa^®  1mg Powder for solution for infusion 
• Note:
• Use as per NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia (September 2018)

 

 

Ipilimumab

• Yervoy^® Concentrate for Intravenous Infusion 5mg/mL: 10mL, 40mL vial

Notes: 

• MHRA Drug Safety Update (January 2019) Ipilimumab (Yervoy): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation

 

• Use as per NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma (July 2016)

 

• Use as per NICE TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma (July 2014)

 

• Use as per NICE TA268 Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma (December 2012)

 

 

 

Nivolumab

• Opdivo^® 10mg/mL concentrate for solution for infusion in vial

Notes:

• Use as per NICE TA581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma (May 2019)
•  
• Use as per NICE TA558: Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease (Jan 2019)

  

• Use as per NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy (July 2018)

 

• Use as per NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer (November 2017)

 

• Use as per NICE TA483: Nivolumab for previously treated squamous non-small-cell lung cancer (November 2017)

 

• Use as per NICE TA462: Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma (July 2017)

 

• Use as per NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma (November 2016) 

 

• Use as per NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma (July 2016) 

 

• Use as per NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma (February 2016) 

 

• Drug Safety Update: MHRA: Nivolumab (Opdivo), pembrolizumab (Keytruda): reports of organ transplant rejection. (July 2017)

 

 

 

Obinutuzumab

• Gazyvaro^® Concentrate for intravenous infusion, 25mg/mL (40mL vial)

Notes: 

• Use as per NICE TA513: Obinutuzumab for untreated advanced follicular lymphoma (March 2018).
•  
• NHSE Position Statement.

 

• Use as per NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab (August 2017)

 

• Use as per NICE TA343: Obinutuzumab in combination with chlorambucil for untreated chronic lymphocytic leukaemia (June 2015)

 

 

Ofatumumab

• Arzerra^® Concentrate for intravenous infusion, 100mg in 5ml, 1000mg in 50ml vials

Note: 

• Use as per NICE TA344: Ofatumumab in combination with chlorambucil or bendamustine for untreated chronic lymphocytic leukaemia (June 2015)

 

Olaratumab

• Lartruvo^® 10mg/mL concentrate for solution for infusion in vial

Note:

• Use as per NICE TA465: Olaratumab in combination with doxorubicin for treating advanced soft tissue sarcoma (August 2017)

 

Panitumumab 

• Vectibix^® Concentrate for solution for infusion 100mg/5mL, 400mg/20mL vials

Notes: 

• Use as per NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer (March 2017)

 

• MHRA/CHM advice: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis (May 2012)

 

• NICE does not recommend panitumumab on its own for people with metastatic colorectal cancer that has progressed after first-line chemotherapy. Not recommended as per NICE TA242 Colorectal cancer (metastatic) 2nd line - cetuximab, bevacizumab and panitumumab (review) (January 2012)

 

 

Pembrolizumab 

• Keytruda^® 25mg/mL concentrate for solution for infusion vial
• Keytruda^® 50mg powder for concentrate for solution for infusion in vial 

Notes:

• Use as per NICE TA 557 Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer (January 2019)

 

• Use as per NICE TA553 Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence (December 2018)

 

• Use as per NICE TA540: Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma (September 2018)

 

• Use as per NICE TA531:Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer (July 2018)

 

• Use as per NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable (July 2018)

 

• Use as per NICE TA519: Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy (April 2018)

 

• Use as per NICE TA447: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer (June 2017)

 

• Use as per NICE TA428: Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy (January 2017) 

 

• Use as per NICE TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab (Last updated: September 2017 

 

• Use as per NICE TA357: Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab (Last updated: September 2017) 

 

• Drug Safety Update: MHRA: Nivolumab (Opdivo?), pembrolizumab (Keytruda?): reports of organ transplant rejection. (July 2017)

 

 

Pertuzumab 

• Perjeta^®  Injection, 420mg/14mL concentrate for solution for infusion in vial

Note: 

• Use as per NICE TA569: Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer (March 2019)
•  
• Use as per NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer (March 2018)

 

• Use as per NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer (December 2016)

 

 

 

Rituximab

• MabThera^® Concentrate for IV infusion 100mg in 10mL, 500mg in 50mL      

Notes: 

• Use as per NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia (Feb 2019)

 

• Use as per NICE TA137: Rituximab for the treatment of relapsed or refractory stage III or IV follicular non-Hodgkin’s lymphoma (February 2008)

 

• Use as per NICETA174: Rituximab for the first-line treatment of chronic lymphocytic leukaemia (July 2009)

 

• Use as per NICE TA193: Rituximab for the treatment of relapsed chronic lymphocytic leukaemia (July 2010)

 

• Use as per NICE TA226: Rituximab for the first-line maintenance treatment of follicular non-Hodgkin's lymphoma (June 2011)

 

• Use as per NICE TA243: Rituximab for the first-line treatment of stage III-IV follicular lymphoma (June 2011)                                      

 

Trastuzumab

• Herceptin^® Intravenous Infusion 150mg vial

Notes: 

• Use as per NICE TA257: Lapatinib or trastuzumab in combination with an aromatase inhibitor for the first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2 (June 2012)

 

• Use as per NICE TA208: Breast cancer (early) - trastuzumab (November 2010)

 

• Use as per NICE TA107: Breast cancer (early) - trastuzumab (August 2007)

 

• Use as per NICE TA34: The clinical effectiveness and cost effectiveness of trastuzumab for breast cancer (March 2002)

  

Trastuzumab emtansine

• Kadcyla^® Injection 100mg, 160mg Powder for concentrate for solution for infusion vial

Note: 

• Use as per NICE TA458: Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane (July 2017)  

 

 

 

 

 

 

Traffic light status (TLS) explained:

• Green: Routine prescribing within licensed indication
• Amber 1: specialist recommendation followed by GP initiation and continuation
• Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
• Amber 3: specialist initiation and stabilisation followed by GP continuation
• Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
• Red: Hospital or specialist prescribing only

 

Return to Chapter: 8. Immune System and Malignant Disease

Last updated by: Sheila Wood on 06-08-2019 11:59