Individual patient treatment requests: process and evaluation of the use of third-line single-agent cetuximab
Hazel Steel Macmillan colorectal cancer clinical nurse specialist, NHS Ayrshire and Arran, Kilmarnock, Scotland
Jeff White Consultant medical oncologist, Beatson West of Scotland Cancer Centre, Glasgow, Scotland
Aileen Roy MacMillan colorectal cancer nurse specialist, NHS Ayrshire and Arran, Kilmarnock, Scotland
Nicholas MacLeod Consultant clinical oncologist, Beatson West of Scotland Cancer Centre, Glasgow, Scotland
Ethel McLean Lead cancer audit facilitator, NHS Ayrshire and Arran, Kilmarnock, Scotland
Nabanita Bose Specialty doctor, NHS Ayrshire and Arran, Kilmarnock, Scotland
Amy Kerr MacMillan colorectal cancer, CNS, NHS Ayrshire and Arran, Kilmarnock, Scotland
Diane Woodburn Clinical oncology pharmacist, NHS Ayrshire and Arran, Kilmarnock, Scotland
Alec McDonald Consultant clinical oncologist, Beatson West of Scotland Cancer Centre, Glasgow, Scotland
Aim
Single agent cetuximab can be used as palliative treatment for chemo-refractory colorectal cancer (CRC). Although randomised trial data suggest its use is associated with enhanced progression-free and overall survival, access to the drug in Scotland was until recently limited. The aim of the study was to retrospectively review the authors' experience of gaining access to cetuximab, and the efficacy of the treatment for this patient group.
Method
Patients with CRC were identified retrospectively from an electronic prescribing database. The authors reviewed the case sheets in relation to ease of access to the drug, toxicities and efficacy.
Results
Treatment was actively sought for 18 patients between 2010 and 2014, of whom nine were initially denied access to the drug, however ultimately 13 received the treatment. This group had a median survival of 15 months.
Conclusion
There were challenges associated with accessing cetuximab through the system in place at the time of review. The drug has demonstrated considerable efficacy and only modest toxicity in this small retrospective series.
Cancer Nursing Practice.
16, 6, 27-31.
doi: 10.7748/cnp.2017.e1389
Correspondence
Hazel.steel@nhs.net
Peer review
This article has been subject to external double-blind peer review and checked for plagiarism using automated software
Conflict of interest
None declared
Received: 16 December 2016
Accepted: 09 May 2017
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