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Rozlytrek (entrectinib capsules and oral pellets – Genentech)Cigna

Pediatric Diffuse High-Grade Gliomas with NTRK gene fusion

Initial criteria

  • Patient age < 18 years
  • Tumor is positive for neurotrophic receptor tyrosine kinase (NTRK) gene fusion
  • EITHER medication is used as adjuvant therapy OR medication is used for recurrent or progressive disease

Approval duration

1 year