pralsetinib — CareFirst (Caremark)
Resectable locoregionally advanced gallbladder cancer with RET gene fusion
Initial criteria
- Documentation of the presence of a rearranged during transfection (RET) gene fusion in tumor specimens or plasma
- For non-small cell lung cancer: treatment of recurrent, advanced, or metastatic disease when tumors have a RET gene fusion and the member has not experienced disease progression on therapy with a RET rearrangement positive-targeted regimen; use as a single agent
- For anaplastic thyroid cancer: stage IV disease with a RET gene fusion; use as a single agent
- For thyroid cancer: member age ≥ 12 years with advanced or metastatic follicular, oncocytic, or papillary thyroid cancer not amenable to radioactive iodine therapy (RAI) whose tumors have a RET gene fusion
- For gallbladder cancer: neoadjuvant treatment of resectable locoregionally advanced disease that is RET gene fusion positive; use as a single agent
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months