Lazcluze (lazertinib) — United Healthcare
Non-small cell lung cancer (NSCLC) with EGFR exon 19 deletions or exon 21 L858R substitution mutations
Initial criteria
- Diagnosis of non-small cell lung cancer (NSCLC)
- Disease is recurrent OR advanced OR metastatic
- Disease is positive for one of the following: EGFR exon 19 deletion OR EGFR exon 21 L858R mutation
- Used in combination with Rybrevant (amivantamab-vmjw)
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Lazcluze therapy
Approval duration
12 months