Nerlynx — Medical Mutual
Breast Cancer, Early Stage
Initial criteria
- Nerlynx is used as an adjuvant treatment following adjuvant trastuzumab based therapy
- Antidiarrheal prophylaxis was initiated with the first dose of Nerlynx and provider will adjust the dose as necessary to manage the adverse effect
- Patient age ≥ 18 years
- Patient has HER2-positive breast cancer
Reauthorization criteria
- Continuation of therapy may be granted to complete 1 full year of treatment for HER2-overexpressed/amplified Breast Cancer; if one full year has been given, approval cannot be granted
- For other approvable indications, extended approval is 1 year
Approval duration
1 year