IMDELLTRA ( tarlatamab-dlle)

IMDELLTRA (tarlatamab-dlle)

Office-Administration - intravenous ( IV ) infusion

Comparator Agents:

• Zepzelca (lurbinectedin)
• Hycamtin (topotecan)

Diagnosis considered for coverage:

• Small cell lung cancer (SCLC): Indicated for the treatment of adult patients with extensive stage small cell lung cancer (ES-SCLC) with disease progression on or after platinum-based chemotherapy.
  • This indication is approved under accelerated approval based on response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).

Coverage Criteria:

For diagnosis of small cell lung cancer (SCLC):

• Diagnosis of extensive stage small cell lung cancer (ES-SCLC), AND
• Disease has progressed on or after platinum-based chemotherapy (e.g., cisplatin, carboplatin), AND
• Patient has an Eastern Cooperative Oncology Group (ECOG) Score of 0 or 1

Reauthorization Criteria:

For diagnosis of small cell lung cancer (SCLC):

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

Coverage Duration: 

• Initial: 6 months
• Reauthorization: 12 months

Dosing: 

• Cycle 1 step-up dosing schedule: 1 mg on day 1, 10 mg on day 8 and 15 
• Cycle 2 and beyond: 10 mg on day 1 and 15

Authorization is not covered for the following:

The use of this drug for indications not listed in this policy does not meet the coverage criteria established by the Western Health Advantage (WHA) Pharmacy and Therapeutics (P&T) Committee.

Policy Updates:

• 10/01/2024 – New policy approved by WHA P&T Committee. (P&T, 11/20/2024)   

References:

1. Imdelltra Prescribing Information. Amgen Inc. Thousand Oaks, CA. May 2024.