Tukysa (tucatinib) — United Healthcare
CNS cancers with brain metastases from HER2 positive breast cancer
Initial criteria
- Diagnosis of brain metastases with HER2 positive breast cancer
- Patient has been previously treated with an anti-HER2-based regimen in the metastatic setting (e.g., trastuzumab [Kanjinti, Ogivri, Trazimera], pertuzumab [Perjeta], ado-trastuzumab emtansine [Kadcyla])
- Used in combination with trastuzumab (e.g., Kanjinti, Ogivri, Trazimera) AND capecitabine (Xeloda)
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Tukysa therapy
Approval duration
12 months