Lumakras (sotorasib) — Highmark

Initial criteria

• age ≥ 18 years
• diagnosis of metastatic CRC (ICD-10: C18, C19, C20, C21)
• disease is KRAS G12C-mutated as determined by an FDA-approved test
• Lumakras is used in combination with panitumumab
• member has received prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy

Reauthorization criteria

• prescriber attests that the member is tolerating therapy and has experienced a therapeutic response defined as disease improvement OR delayed disease progression

Approval duration

12 months