Cabometyx (cabozantinib) — United Healthcare

Initial criteria

• One of the following soft tissue sarcoma subtypes: alveolar soft part sarcoma (ASPS) OR atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) OR clear cell sarcoma OR extraskeletal myxoid chondrosarcoma
• Used as subsequent line of therapy for advanced/metastatic disease

Reauthorization criteria

• Patient does not show evidence of progressive disease while on Cabometyx therapy

Approval duration

12 months