Stivarga (regorafenib) — CareFirst (Caremark)
Soft tissue sarcomas including angiosarcoma, rhabdomyosarcoma, and non-adipocytic sarcomas (extremity/body wall, head/neck, retroperitoneal/intra-abdominal)
Initial criteria
- Requested for treatment of angiosarcoma, rhabdomyosarcoma, or non-adipocytic sarcoma as a single agent
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on current regimen
Approval duration
12 months