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Commissioning - PCT Clinical Exceptions - OncologyA collection of clinical exceptions reviews on cancers.

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177 Lutetium octreotate for ileal carcinoid and liver metastases
Trastuzumab with paclitaxel for HER2-positive metastatic gastric cancer
Yttrium90 radioembolisation for stage III intrahepatic cholangiocarcinoma
Adjuvant imatinib for gastrointestinal stromal tumour (GIST)
Arsenic and interferon for adult T-cell lymphoma (ATLL)
Bendamustine plus rituximab for relapsed chronic lymphocytic leukaemia (CLL)
Bevacizumab for Gliomatosis Cerebri (multiple Glioblastoma Multiforme)
Bevacizumab in combination with capecitabine for the treatment of relapsed metastatic breast cancer
Bortezomib in combination with cyclophosphamide and dexamethasone for the treatment of lymphoplasmacytic lymphoma (Waldenstroms macroglubulinemia)
Brentuximab vedotin for multiple relapsed Hodgkin’s lymphoma
First-line Erlotinib for disseminated adenocarcinoma of the lung
Folfirinox chemotherapy for pancreatic cancer
Irinotecan plus temozolomide for relapsed Ewing’s sarcoma
Lenalidomide for progressive diffuse large B cell lymphoma (DLBCL)
Lenalidomide for the treatment of peripheral T cell lymphoma
Lutetium octreotate for liver dominant neuroendocrine tumour metastases in MEN1 syndrome
Paclitaxel for stage IV transitional cell carcinoma
Pemetrexed for fifth-line treatment of metastatic lung adenocarcinoma
Raltitrexed plus temozolamide for metastatic neuroendocrine tumour of unknown primary
Raltitrexed plus temozolamide for metastatic neuroendocrine tumour of unknown primary
Rituximab for a patient with high Epstein Barr virus DNA titres to prevent post-transplant lymphoproliferative disease (PTLD)
Rituximab for Epstein Barr virus reactivation post-allogeneic transplant for acute myeloid leukaemia
Sunitinib for untreated retroperitoneal paraganglioma
Temozolomide combination with Irinotecan for refractory neuroblastoma
The use of docetaxel in conjunction with carboplatin in patient with high grade papillary adenocarcinoma allergic to paclitaxel
Topotecan in combination with cyclophosphamide for the treatment of metastatic Ewing's sarcoma
Bendamustine therapy in a patient with advanced and relapsed multiple myeloma (MM)
Bevacizumab for haemangioblastoma of the craniospinal axis complicated by immune thrombocytopenic purpura
Bevacizumab plus FOLFOX followed by bevacizumab monotherapy in relapsed metastatic colorectal cancer
Cetuximab in combination with irinotecan and 5-FU (FOLFIRI) for the second-line treatment of metastatic adenocarcinoma of the sigmoid colon
Gemcitabine and oxaliplatin (GEMOX) chemotherapy for female patient who has relapsed following 1st line chemotherapy with gemcitabine followed by chemoradiotherapy + 5 fluorouracil, for pancreatic adenocarcinoma with liver metastases
Pematrexted for a 71 year old patient with right sided epithelioid mesothelioma and adrenal metastases who has slow progressive disease becoming increasingly symptomatic?
Pemetrexed monotherapy or combination with platinum for a patient with stage 4 lung adenocarcinoma at third relapse (fourth-line treatment)
Rituximab in combination with Fludarabine and Cyclophosphamide (FCR) for a patient with relapsed chronic lymphocytic leukaemia (CLL), and who was previously been treated with FCR in 2004
Rituximab plus CHOP for relapsed diffuse large B-cell lymphoma (DLBCL)
Second line Vinorelbine monotherapy to treat a relapsed patient with epithelioid mesothelioma
Sorafenib for a man with advanced hepatocellular cancer (HCC) with macroscopic vascular invasion (portal vein), with BCLC stage C and Child-Pugh status
Sorafenib for an Islington patient suffering from advanced hepatocellular cancer (HCC), occurring on a background of hepatitis C cirrhosis, and with a WHO performance status 0, BCLC stage C, Child-Pugh A
Sorafenib for metastatic follicular thyroid cancer
Sorafenib for metastatic thyroid cancer (Hurthle cell carcinoma)
Sunitinib as 2nd line therapy for a patient with metastatic renal cell carcinoma, who has had previous treatment with Temsirolimus
Sunitinib for a patient with metastatic renal cell carcinoma, who has had previous treatment with Sorafenib, Interferon Alfa and Temsirolimus, and for whom there are no other alternative treatment options
Targeted radionuclide treatment (MIBG) for a patient, in addition to his current treatment with somatostatin analogues, for metastatic midgut Neuroendocrine tumour (NET) who has multiple bilobar liver metastases and a mesenteric mass
Topotecan, vinorelbine, thiotepa, dexamethasone and gemcitabine (TVTG) chemotherapy for refractory T-cell acute lymphoblastic leukaemia
Trabectedin as a 3rd line therapy for a patient with lapsed myxoid metastatic liposarcoma
Bevacizumab with capecitabine and oxaliplatin (CAPOX or XELOX) for first line treatment of metastatic colorectal cancer
Cetuximab in combination to standard second-line (Irinotecan + 5FU), adjuvant therapy for a 49 year old with metastatic rectal cancer and currently inoperable liver metastases, and whose tumour is K_RAS wild type
Cetuximab in combination with Irinotecan for a 37 year old male with metastatic colorectal cancer, who has failed to respond to previous treatment containing Irinotecan, and for whom all other treatment options have been exhausted? The patient is K-RAS wild type
Cetuximab monotherapy for relapsed metastatic colorectal cancer
Cetuximab with irinotecan, 4th line therapy, for a 73 year old with adenocarcinoma of the rectum for whom all other treatment options have been exhausted
Cetuximab, in combination with Irinotecan and 5FU, as second line therapy for a 29 year old male with metastatic adenocarcinoma of the caecum, who has never been treated with a chemotherapy regime containing Irinotecan before, and whose tumor is K-RAS wild type
Dasatinib (Sprycel) treatment, for a 54 year old with chronic myeloid leukaemia who has had a stem cell transplant but is in early-stage relapse, and who is intolerant to Imatinib, to control the CML until donor lymphocyte infusion can be effective
Dasatinib for chronic-phase chronic myeloid leukaemia (CP-CML) refractory to imatinib.
Docetaxel monotherapy for recurrent metastatic adenocarcinoma of the gastro-oesophageal junction
Erlotinib (tarceva) for non small cell lung cancer
Intensity modulated radiotherapy versus conventional conformal external beam radiotherapy for poorly differentiated squamous cell carcinoma
Lenalidomide for follicular lymphoma
Lenalidomide for patient with multiple myeloma previously responding to bortezomib but patient experiencing peripheral neuropathy with bortezomib
Lenalidomide for relapsed multiple myeloma
Lenalidomide, 2nd line therapy, for a patient with aggressive epidermotropic CD8+ peripheral cutaneous T cell Non Hodgkin’s Lymphoma, post allogeneic stem cell transplant to stabilise disease prior to donor lymphocyte infusion
Paclitaxel for cervical carcinoma
Radionucleide therapy with yttrium-90 DOTA octreotate for a 47 year old patient with a metastatic pancreatic neuroendocrine tumor, who is not responding to the alternative therapies
Rituximab for gastric mucosa associated lymphoid tissue (MALT) lymphoma
Rituximab for pure red cell aplasia
Rituximab monotherapy for heavily pretreated patient with chronic lymphocytic leukaemia
Sorafenib for hepatocellular carcinoma
Sorafenib, 2nd line therapy, for a 69 year old with metastatic renal cell carcinoma (brain, pulmonary, and adrenal metastases), who is intolerant to standard 1st line treatment with interferon-alfa
Sunitinib 4th line therapy for a 62 year old patient with metastatic renal cell carcinoma, who has been previously treated with Sorafenib, Interferon Alfa and Temsirolimus, and for whom there are no other alternative treatment options
Temozolomide for metastatic low-grade endobronchial neuroendocrine tumour
Temozolomide in malignant melanoma with brain metastases
Topotecan for a patient with metastatic alveolar rhabdomyosarcoma
Trabectedin for synovial sarcoma with recurrent pulmonary metastases
Vinorelbine for maintenance/consolidation therapy for child with metastatic embryonal rhabdomyosarcoma
Nilotinib for chronic-phase chronic myeloid leukaemia refractory to Imatinib.
Pemetrexed and cisplatin for the treatment of metastatic malignant mesothelioma
Sorafenib for metastatic hepatocellular carcinoma
Sorafenib for metastatic renal cell cancer
Pemetrexed for malignant pleural mesothelioma
Paclitaxel as adjuvant chemotherapy for early breast cancer
Trabectedin for myxoid liposarcoma
Pegylated-liposomal doxorubicin (Caelyx) for treatment of recurrent angiosarcoma of the scalp

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