Truqap (capivasertib) — Highmark
locally advanced or metastatic breast cancer
Initial criteria
- age ≥ 18 years
- diagnosis of locally advanced or metastatic breast cancer (ICD-10: C50)
- Truqap is used in combination with fulvestrant
- tumor status is HR-positive, HER2-negative
- presence of one of the following alterations detected by an FDA-approved test: PIK3CA OR AKT1 OR PTEN
- disease has progressed on at least one endocrine-based regimen in the metastatic setting OR recurrence occurred on or within 12 months of completing adjuvant therapy
Reauthorization criteria
- prescriber attests that member is tolerating therapy
- therapeutic response is observed as disease improvement OR delayed disease progression
Approval duration
12 months