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Tykerb (lapatinib)United Healthcare

Breast Cancer

Initial criteria

  • One of the following:
  • (1) All of the following:
  • Diagnosis of recurrent unresectable (local or regional) or stage IV breast cancer
  • AND Disease is hormone receptor positive and human epidermal growth factor receptor 2-positive (HER2+)
  • AND Used in combination with an aromatase inhibitor [e.g., Aromasin (exemestane), Femara (letrozole), Arimidex (anastrozole)]
  • OR
  • (2) All of the following:
  • Diagnosis of recurrent unresectable or stage IV breast cancer OR breast cancer unresponsive to preoperative systemic therapy
  • AND Disease is HER2+
  • AND Used as fourth line therapy and beyond in combination with Herceptin (trastuzumab) OR Xeloda (capecitabine)

Reauthorization criteria

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

Approval duration

12 months