netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:
Please also refer to the Cancer Drugs Fund list
 Details...
08.02.03  Expand sub section  Anti-lymphocyte monoclonal antibodies
Alemtuzumab injection

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Formulary
Red
Blueteq prior approval required

Link  NICE TA312: Alemtuzumab for treating relapsing‑remitting multiple sclerosis    
Blinatumomab injection

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Formulary
Red
Approved for previously treated Philadelphia-chromosome-negative ALL as per NICE TA450

Link  NICE TA450: Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia    
Obinutuzumab injection

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Formulary
High Cost Medicine
Cancer Drugs Fund
Red
Approved for use as per NICE technology appraisal guidance

Link  NICE TA343: Obinutuzumab in combination with chlorambucil for untreated chronic lymphocytic leukaemia
Link  NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab    
Ofatumumab injection

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High Cost Medicine
Red

Link  NICE TA344: Ofatumumab in combination with chlorambucil or bendamustine for untreated chronic lymphocytic leukaemia    
Rituximab injection (haematological malignancies)

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Formulary
High Cost Medicine
Red
Use approved as per NICE TA guidance links below

Biosimilar products available, to be prescribed by brand name. Contact pharmacy department for advice on brand for routine prescribing if unsure

Link  NICE TA137: Rituximab for the treatment of relapsed or refractory stage III or IV follicular non-Hodgkin’s lymphoma
Link  NICE TA174: Rituximab for the first-line treatment of chronic lymphocytic leukaemia
Link  NICE TA193: Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia
Link  NICE TA226: Rituximab for the first-line maintenance treatment of follicular non-Hodgkin’s lymphoma
Link  NICE TA243: Rituximab for the first-line treatment of stage III-IV follicular lymphoma    
Rituximab injection (TTP)

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Restricted Drug Restricted
High Cost Medicine
Red
Approved off-label indication (haematology only):
Thrombotic thrombocytopenic purpura (TTP) with neurological, cardiac or renal pathology
Dose = 375 mg/m2 every 7 days for 4 doses

Biosimilar products available, to be prescribed by brand name. Contact pharmacy department for advice on brand for routine prescribing if unsure
   
Rituximab subcutaneous injection (haematological malignancies)

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Formulary
High Cost Medicine
Red
Maintenance single agent treatment (as per NHSE circular) for:
  • Follicular Lymphoma
  • Mantle cell lymphoma
  • Marginal zone lymphoma
  • Lymphoplasmacytic lymphoma

    Biosimilar products available, to be prescribed by brand name. Contact pharmacy department for advice on brand for routine prescribing if unsure
  •    
    Atezolizumab injection

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    Formulary
    High Cost Medicine
    Cancer Drugs Fund
    Red
    Approved for use as per NICE technology appraisal guidance below

    Link  NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable    
    Rituximab injection (renal transplant)

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    Restricted Drug Restricted
    High Cost Medicine
    Red
    Approved off-label indications:
  • Management of antibody mediated rejection in adult renal transplant patients
  • For ABO blood group and HLA antibody incompatible renal transplantation
    Use in accordance with local guidelines at GSTFT

    Biosimilar products available, to be prescribed by brand name. Contact pharmacy department for advice on brand for routine prescribing if unsure
  •    
    Alemtuzumab injection

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    Restricted Drug Unlicensed
    Red
    Induction immunosuppression:
  • For human leukocyte antigen antibody incompatible renal transplantation
  • In high risk recipients who have previously exhibited significant donor specific antibody but are presently negative by flow cytometry crossmatch
    Use in accordance with local guideline at GSTFT
  •    
     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Link to adult BNF
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    Display tracking information
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    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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