lapatinib — CareFirst (Caremark)
Colorectal cancer (including appendiceal adenocarcinoma and anal adenocarcinoma)
Initial criteria
- Disease is HER2-amplified and RAS and BRAF wild-type
- Requested medication will be used in combination with trastuzumab
- Member is not appropriate for intensive therapy OR medication will be used as subsequent therapy for progression of advanced or metastatic disease
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months