Lorbrena (lorlatinib tablets) — Cigna
Pediatric Diffuse High-Grade Gliomas
Initial criteria
- Patient age < 18 years
- The tumor is positive for anaplastic lymphoma kinase (ALK)-positive disease
- Patient meets ONE of the following: (i) The medication is used as adjuvant therapy; OR (ii) The medication is used for recurrent or progressive disease
Approval duration
1 year