Tukysa (tucatinib) — Highmark
advanced unresectable or metastatic HER2-positive breast cancer
Initial criteria
- age ≥ 18 years
- EITHER advanced unresectable or metastatic HER2-positive breast cancer (ICD-10: C50) AND use in combination with trastuzumab and capecitabine AND received ≥1 prior anti-HER2 based regimen in metastatic setting OR colorectal cancer (ICD-10: C19) AND RAS-wild type, HER2-positive, unresectable or metastatic AND use in combination with trastuzumab AND disease progressed after fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy
Reauthorization criteria
- prescriber attests that the member is tolerating therapy
- member has experienced a therapeutic response defined as disease improvement OR delayed disease progression
Approval duration
12 months