sotorasib — CareFirst (Caremark)
Recurrent, locally advanced or metastatic pancreatic adenocarcinoma
Initial criteria
- Tumor or plasma specimen is positive for the KRAS G12C mutation
- Member has an ECOG performance status of 0‑2
- 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