Lumakras — CareFirst (Caremark)
Advanced or metastatic colorectal cancer, including appendiceal adenocarcinoma and anal adenocarcinoma
Initial criteria
- Tumor or plasma specimen is positive for the KRAS G12C mutation
- Requested medication will be used as a single agent OR in combination with cetuximab (Erbitux) or panitumumab (Vectibix)
- Member previously received treatment with chemotherapy
Reauthorization criteria
- No evidence of unacceptable toxicity
- No disease progression while on current regimen
Approval duration
12 months