everolimus — CareFirst (Caremark)
Residual, unresectable, recurrent, metastatic, or tumor rupture gastrointestinal stromal tumor (GIST)
Initial criteria
- Used in combination with either imatinib, sunitinib, or regorafenib for members who have failed at least four FDA-approved therapies (e.g., imatinib, sunitinib, regorafenib, ripretinib)
Reauthorization criteria
- Continuation may be approved when no unacceptable toxicity or disease progression
Approval duration
12 months