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CRIZOTINIB CAP,ORAL

Clinical Criteria Summary

Exclusion Criteria

  • History of interstitial fibrosis or interstitial lung disease
  • History of congenital long QT syndrome
  • Unmanageable drug-drug interactions
  • Inadequate bone marrow function (Absolute Neutrophil Count < 1000/mm3, platelets < 50,000/mm3, hemoglobin < 8g/dL), unless due to marrow involvement
  • Pregnancy
  • Lactating

Inclusion Criteria

  • Care provided by a VA/VA Community Care hematology or oncology provider
  • Goals of care and role of Palliative Care consult discussed and documented
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
  • Relapsed or refractory systemic Anaplastic Lymphoma Kinase (ALK)-positive anaplastic large cell lymphoma (ALCL)
  • Unresectable, recurrent or refractory ALK-positive inflammatory myofibroblastic tumor (IMT)

Reproductive Health & Pregnancy Management

  • Pregnancy must be excluded prior to receiving crizotinib for patients who can become pregnant
  • Counseling on potential risks vs benefits of treatment and use of effective contraception during therapy and for 45 days after stopping treatment for patients who can become pregnant
  • Counseling on potential risks vs benefits of treatment and use of effective contraception during therapy and for 90 days after stopping treatment for patients with partners who can become pregnant

Source Documents