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Lynparza (olaparib)United Healthcare

Metastatic breast cancer

Initial criteria

  • Diagnosis of metastatic or recurrent breast cancer
  • Presence of deleterious or suspected deleterious germline BRCA-mutations (gBRCAm)
  • One of the following: (Disease is HER2-negative AND (Disease is HR-negative OR (Disease is HR-positive AND (Disease has progressed on previous endocrine therapy OR provider attests endocrine therapy is inappropriate))) ) OR Disease is HER2-positive

Reauthorization criteria

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

Approval duration

12 months