Lumakras (sotorasib) — United Healthcare

Initial criteria

• Diagnosis of ampullary adenocarcinoma
• Disease is progressive
• Tumor is KRAS G12C-mutation positive
• Patient has received at least one prior systemic therapy (e.g., immune checkpoint inhibitor, platinum-based chemotherapy)

Reauthorization criteria

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

Approval duration

12 months