Fruzaqla (fruquintinib) — Cigna

Rectal Cancer

Initial criteria

Patient age ≥ 18 years; AND
Patient has advanced or metastatic disease; AND
Patient meets ONE of the following (i or ii):
i. Patient has proficient mismatch repair/microsatellite-stable (pMMR/MSS) disease; OR
ii. Patient is ineligible for or progressed on checkpoint inhibitor therapy AND meets ONE of the following (a or b):
a) Patient has deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H) disease; OR
b) Patient is polymerase epsilon/delta (POLE/POLD1) mutation positive; AND
Patient has previously been treated with ALL of the following (i, ii, and iii):
i. Fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy; AND
ii. An anti-vascular endothelial growth factor (VEGF) agent; AND
iii. If tumor is RAS wild-type (KRAS wild-type and NRAS wild-type), patient meets ONE of the following (a or b):
a) According to prescriber, anti-epidermal growth factor receptor (EGFR) therapy is NOT medically appropriate; OR
b) Patient has received an anti-EGFR therapy.

1 year