Stivarga (regorafenib) — United Healthcare

Initial criteria

• Diagnosis of gastrointestinal stromal tumor (GIST)
• Disease is one of the following: Gross residual (R2 resection) OR Unresectable primary OR Tumor rupture OR Recurrent/metastatic
• One of the following: SDH-deficient GIST OR History of disease progression on BOTH of the following: Imatinib mesylate (Gleevec) AND one of the following: Sutent (sunitinib malate) OR Qinlock (ripretinib)

Reauthorization criteria

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

Approval duration

12 months