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LumakrasCareFirst (Caremark)

KRAS G12C-mutated recurrent, advanced or metastatic non-small cell lung cancer (NSCLC)

Initial criteria

  • Treatment of KRAS G12C‑mutated recurrent, advanced or metastatic NSCLC
  • Member has received at least one prior systemic therapy
  • Requested medication will be used as a single agent

Reauthorization criteria

  • No evidence of unacceptable toxicity
  • No disease progression while on current regimen

Approval duration

12 months