Rozlytrek (entrectinib) — United Healthcare
Solid tumors with NTRK gene fusion
Initial criteria
- Presence of solid tumors (e.g., sarcoma, NSCLC, salivary, breast, thyroid, colorectal, neuroendocrine, pancreatic, gynecological, cholangiocarcinoma, etc.)
- Disease is positive for neurotrophic receptor tyrosine kinase (NTRK) gene fusion (e.g., ETV6-NTRK3, TPM3-NTRK1, LMNA-NTRK1, etc.)
- Disease is without a known acquired resistance mutation [e.g., TRKA G595R substitution, TRKA G667C substitution, or other recurrent kinase domain (solvent front and xDFG) mutations]
- Disease is one of the following: Metastatic OR Unresectable
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Rozlytrek therapy
Approval duration
12 months