Vitrakvi (larotrectinib) — United Healthcare
solid tumors that are metastatic or unresectable
Initial criteria
- For patients less than 19 years of age: patient is less than 19 years of age
- For solid tumors: Presence of a solid tumor AND disease is positive for neurotrophic receptor tyrosine kinase (NTRK) gene fusion (e.g., ETV6-NTRK3, TPM3-NTRK1, LMNA-NTRK1, etc.) AND disease is without a known acquired resistance mutation (e.g., TRKA G595R, G623R, G696A, F617L) AND disease is one of the following: metastatic OR unresectable
- For NCCN recommended regimens: recognized treatment regimen in the NCCN Drugs and Biologics Compendium with a Category of Evidence and Consensus of 1, 2A, or 2B
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Vitrakvi therapy
Approval duration
12 months