TURALIO (pexidartinib)


SELF ADMINISTRATION-ORAL

 
Indications for Prior Authorization:
  • Treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery

Patients must meet the following criteria for the indication(s) above:
  • Patient is 18 years of age and older, AND

  • Diagnosis of symptomatic tenosynovial giant cell tumor (TGCT), AND

  • Prescribed by or in consultation with an oncologist, AND

  • Patient has symptomatic disease with a score by worst pain or worst stiffness numeric rating scale (NRS) of 4 or greater, AND

  • Measurable disease with a minimum tumor size of 2 cm, AND

  •  Evaluation showing surgical resection would have been associated with potential worsening, functional limitation, or severe morbidity


Dosing:
  • 400 mg twice daily until disease progression or unacceptable toxicity


Approval:
  •  6 months

 

Last review date: October 15, 2019

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