Stivarga (regorafenib) — CareFirst (Caremark)

Initial criteria

• Member has progressed on previous treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy (with or without bevacizumab)
• If RAS mutation status is negative (wild-type), member has received an anti-epidermal growth factor receptor (EGFR) therapy such as Erbitux (cetuximab) or Vectibix (panitumumab) for rectal cancer, appendiceal adenocarcinoma, anal adenocarcinoma, or left-sided colon cancer

Reauthorization criteria

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

Approval duration

12 months