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Alternative methods of feeding your baby - patient information

Description
This factsheet explains alternative ways to feed your baby until breastfeeding is established.
Url
/Media/UHS-website-2019/Patientinformation/Pregnancyandbirth/Alternative-methods-of-feeding-your-baby-3008-PIL.pdf

After your eyelid surgery - patient information

Description
This factsheet explains what to expect after having eyelid surgery.
Url
/Media/UHS-website-2019/Patientinformation/Eyes/After-your-eyelid-surgery-2090-PIL.pdf

Dupuytren's contracture: post-operative advice - patient information

Description
This factsheet contains post-operative exercises and advice after having an operation for Dupuytren's contracture.
Url
/Media/UHS-website-2019/Patientinformation/Medicinestherapiesandanaesthetics/Dupuytren's-contracture-post-operative-advice-1829-PIL.pdf

Finger exercises - patient information

Description
This factsheet contains some finger exercises to help improve the range of movement in the joints of your fingers.
Url
/Media/UHS-website-2019/Patientinformation/Medicinestherapiesandanaesthetics/Finger-exercises-3460-PIL.pdf

Talimogene laherparepvec (T-VEC)

Description
Chemotherapy Protocol SKIN CANCER Talimogene laherparepvec (T-VEC) Regimen • Skin – Talimogene laherparepvec (T-VEC) Indication • Talimogene laherparepvec (T-VEC) is recommended, in adults, as an option for treating unresectable, regionally or distantly metastatic (Stage IIIB, IIIC or IVM1a) melanoma that has not spread to bone, brain, lung or other internal organs, only if;  treatment with systemically administered immunotherapies is not suitable and  the company provides talimogene laherparepvec with the discount agreed in the patient access scheme. • WHO Performance Status 0 or 1 Toxicity Drug Talimogene laherparepvec (T-VEC) Adverse Effect Herpetic infections (including cold sores and herpes keratitis), immune-mediated events, influenza like illness, injection site reactions, myalgia, arthralgia, gastrointestinal disturbances, cough, headache, dehydration, ear pain, peripheral oedema, anaemia The adverse effects listed are not exhaustive. Please refer to the relevant Summary of Product Characteristics for full details. Monitoring Regimen • FBC, LFTs and U&Es prior to each dose Dose Modifications Haematological Talimogene laherparepvec is contraindicated in patients who are severely immunocompromised Hepatic Impairment No adjustment in dosage is required in patients with hepatic impairment. Version 1 (Jan 2024) Page 1 of 6 Skin – Talimogene laherparepvec (T-VEC) Renal Impairment No adjustment in dosage is required in patients with renal impairment. Other Talimogene laherparepvec treatment may need to be temporarily held in the event of cellulitis. Careful wound care and infection precautions are recommended, particularly if tissue necrosis results in open wounds. Regimen 28 day cycle continued for at least 6 cycles or as long as there is clinical benefit (24 cycles will be set in ARIA) Cycle 1 Drug Talimogene laherparepvec Talimogene laherparepvec Dose Day Up to 4ml 106 (1 million) 1 PFU/mL Up to 4ml 108 (100 million) 22 PFU/mL Route Intra-lesional Intra-lesional Cycle 2 onwards Drug Talimogene laherparepvec Dose Up to 4ml 108 (100 million) PFU/mL Day 8 and 22 Route Intra-lesional Talimogene laherparepvec (T-VEC) is an attenuated herpes simplex virus type-1 (HSV-1) given by intra-lesional injection according to the schedule below. Version 1 (Jan 2024) Page 2 of 6 Skin – Talimogene laherparepvec (T-VEC) Treatment visit Initial Second All subsequent treatment visits (including re-initiation) Treatment interval N/A 3 weeks after initial treatment 2 weeks after previous treatment Maximum total injection volume Up to 4 mL Up to 4 mL Up to 4 mL Dose concentration 106 (1 million) PFU/mL 108 (100 million) PFU/mL 108 (100 million) PFU/mL Prioritisation of lesions to be injected Inject largest lesion(s) first. Prioritise injection of remaining lesions based on lesion size until maximum injection volume is reached. First inject any new lesions (lesions that may have developed since initial treatment). Prioritise injection of remaining lesions based on lesion size until maximum injection volume is reached. First inject any new lesions (lesions that may have developed since previous treatment). Prioritise injection of remaining lesions based on lesion size until maximum injection volume is reached. The volume of talimogene laherparepvec to be injected into each lesion is dependent on the size of the lesion and should be determined according to the table below. The total injection volume for each treatment session should be up to a maximum of 4 mL Lesion size (longest dimension) > 5 cm > 2.5 cm to 5 cm > 1.5 cm to 2.5 cm > 0.5 cm to 1.5 cm ≤ 0.5 cm Talimogene laherparepvec injection volume up to 4 mL up to 2 mL up to 1 mL up to 0.5 mL up to 0.1 mL Patients may experience increase in size of existing lesion(s) or the appearance of a new lesion prior to achieving a response. As long as there are injectable lesion(s) remaining, talimogene laherparepvec should be continued for at least 6 months unless the physician considers that the patient is not benefitting from talimogene laherparepvec treatment or that other treatment is required. Talimogene laherparepvec treatment may be reinitiated if new lesions appear following a complete response and the physician considers that the patient will benefit from treatment. Dose Information • Talimogene laherparepvec is available as a solution for injection in 1ml vials containing:  106 (1 million) PFU/mL - for initial dose only  108 (100 million) PFU/mL - for all subsequent doses Version 1 (Jan 2024) Page 3 of 6 Skin – Talimogene laherparepvec (T-VEC) • Vials must be stored in the freezer. Allow to thaw at room temperature until talimogene laherparepvec solution is liquid (approximately 30 minutes). Gently swirl. Do NOT shake. Administration Information • Treatment should only be administered by clinicians/nurses with specialist training. • In order to improve the traceability of biological medicinal products, the tradename and the batch number of the administered product should be clearly recorded (or stated) in the patient file. Extravasation • N/A Additional Information • Patients must be issued with a patient alert card • No interaction studies have been conducted with talimogene laherparepvec. Aciclovir and other anti-viral agents may interfere with the effectiveness of talimogene laherparepvec if administered systemically or topically directly to the injection site. Consider the risks and benefits of talimogene laherparepvec treatment before administering aciclovir or other anti-viral agents indicated for management of herpetic infection. • In order to improve the traceability of biological medicinal products, the tradename and the batch number of the administered product should be clearly recorded (or stated) in the patient file. Coding • Procurement – X70.8 • Delivery – X72.9 References 1. Talimogene laherparepvec for treating unresectable metastatic melanoma. NICE TA410 28/09/2016 2. Andtbacka RHI, Collichio F, Harrington J, et al. (2019) Final analyses of OPTiM: a randomized phase III trial of talimogene laherparepvec versus granulocyte-macrophage colony-stimulating factor in unresectable stage III–IV melanoma. Journal for ImmunoTherapy of Cancer, 7, 145. Version 1 (Jan 2024) Page 4 of 6 Skin – Talimogene laherparepvec (T-VEC) REGIMEN SUMMARY Talimogene laherparepvec (T-VEC) Cycle 1 Day 1 1. Warning – Prescribe total volume required for this treatment. Prescribe the total volume (max 4ml) of talimogene laherparepvec required for this treatment according the size of the lesions to be injected. Lesion size (longest dimension) Injection volume > 5 cm up to 4 mL > 2.5 cm to 5 cm up to 2 mL > 1.5 cm to 2.5 cm up to 1 mL > 0.5 cm to 1.5 cm up to 0.5 mL ≤ 0.5 cm up to 0.1 mL Each vial contains 1ml of talimogene laherparepvec. 2. Talimogene laherparepvec 106 PFU/ml intra-lesional injection 0.001gram Please ensure the total volume (max 4ml) of talimogene laherparepvec required for this treatment has been prescribed. Thaw vials at room temperature until the solution is liquid (approximately 30 minutes). Gently swirl. Do NOT shake. After administration please record the actual volume of talimogene laherparepvec administered. Cycle 1 Day 22 3. Warning – Prescribe total volume required for this treatment. Prescribe the total volume (max 4ml) of talimogene laherparepvec required for this treatment according the size of the lesions to be injected. Lesion size (longest dimension) Injection volume > 5 cm up to 4 mL > 2.5 cm to 5 cm up to 2 mL > 1.5 cm to 2.5 cm up to 1 mL > 0.5 cm to 1.5 cm up to 0.5 mL ≤ 0.5 cm up to 0.1 mL Each vial contains 1ml of talimogene laherparepvec. 4. Talimogene laherparepvec 108 PFU/ml intra-lesional injection 0.001gram Please ensure the total volume (max 4ml) of talimogene laherparepvec required for this treatment has been prescribed. Thaw vials at room temperature until the solution is liquid (approximately 30 minutes). Gently swirl. Do NOT shake. After administration please record the actual volume of talimogene laherparepvec administered. Cycle 2 onwards Days 8 and 22 5. Warning – Prescribe total volume required for this treatment. Prescribe the total volume (max 4ml) of talimogene laherparepvec required for this treatment according the size of the lesions to be injected. Lesion size (longest dimension) Injection volume > 5 cm up to 4 mL > 2.5 cm to 5 cm up to 2 mL > 1.5 cm to 2.5 cm up to 1 mL > 0.5 cm to 1.5 cm up to 0.5 mL ≤ 0.5 cm up to 0.1 mL Each vial contains 1ml of talimogene laherparepvec. 6. Talimogene laherparepvec 108 PFU/ml intra-lesional injection 0.001gram Administration instructions Please prescribe the total volume of talimogene laherparepvec to be administered. Thaw vials at room temperature until the solution is liquid (approximately 30 minutes). Gently swirl. Do NOT shake. After administration please record the actual volume of talimogene laherparepvec administered. Version 1 (Jan 2024) Page 5 of 6 Skin – Talimogene laherparepvec (T-VEC) DOCUMENT CONTROL Version Date Amendment Written By Approved By 1 Jan 2024 None Rebecca Wills Pharmacist Dr Mathew Wheater Consultant Medical Oncologist This chemotherapy protocol has been developed as part of the chemotherapy electronic prescribing project. This was and remains a collaborative project that originated from the former CSCCN. These documents have been approved on behalf of the following Trusts; Hampshire Hospitals NHS Foundation Trust NHS Isle of Wight Portsmouth Hospitals NHS Trust Salisbury NHS Foundation Trust University Hospital Southampton NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust All actions have been taken to ensure these protocols are correct. However, no responsibility can be taken for errors that occur as a result of following these guidelines. Version 1 (Jan 2024) Page 6 of 6 Skin – Talimogene laherparepvec (T-VEC)
Url
/Media/UHS-website-2019/Docs/Chemotherapy-SOPs1/Skincancer/Talimogene-laherparepvec-T-VEC.pdf

Finger flexor tendon injury - patient information

Description
This factsheet explains what finger flexor tendons are and how to care for your fingers after your operation.
Url
/Media/UHS-website-2019/Patientinformation/Medicinestherapiesandanaesthetics/Finger-flexor-tendon-injury-3466-PIL.pdf

Oesophageal manometry test and 24-hour pH and impedance measurement test - Patients off proton pump inhibitors (PPIs) - patient information

Description
This factsheet explains what an oesophageal manometry test and a 24-hour pH and impedance measurement test are and what they involve, so you know what to expect at your appointment.
Url
/Media/UHS-website-2019/Patientinformation/Tests/Oesophageal-manometry-test-and-24-hour-pH-and-impedance-measurement-test-Patients-off-proton-pump-inhibitors-PPIs-3729-PIL.pdf

Oesophageal manometry test and 24-hour pH and impedance measurement test - Patients on proton pump inhibitors (PPIs) - patient information

Description
This factsheet explains what an oesophageal manometry test and a 24-hour pH and impedance measurement test are and what they
Url
/Media/UHS-website-2019/Patientinformation/Tests/Oesophageal-manometry-test-and-24-hour-pH-and-impedance-measurement-test-Patients-on-proton-pump-inhibitors-PPIs-3728-PIL.pdf

Vaginal dilator therapy - patient information

Description
This factsheet explains why your doctor has recommended that you use vaginal dilators regularly once your radiotherapy treatment has finished and
Url
/Media/UHS-website-2019/Patientinformation/Cancercare/Vaginal-dilator-therapy-2173-PIL.pdf

Expressing breast milk for your baby - patient information

Description
A guide to expressing breast milk for your baby.
Url
/Media/UHS-website-2019/Patientinformation/Neonatal/Expressing-breast-milk-for-your-baby-3251-PIL.pdf
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