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LORLATINIB TAB,ORAL

Clinical Criteria Summary

Exclusion Criteria

  • Concurrent use of strong CYP3A inducers
  • History of interstitial fibrosis or interstitial lung disease
  • Severe renal impairment (i.e. CrCl < 15 ml/min using Cockroft-Gault or ESRD requiring dialysis)
  • Baseline moderate to severe hepatic impairment [i.e. total bilirubin ≥ 1.5 x ULN with any AST OR AST/ALT > 2.5 x ULN (>5 x ULN in patients with liver metastases)]
  • Inadequate bone marrow function (i.e. ANC < 1,500/mm3, PLT < 100,000/mm3, Hgb < 9 g/dL)
  • Pregnancy (i.e. known pregnancy or positive pregnancy test)
  • Breastfeeding

Inclusion Criteria

  • Care provided by a VA/VA Community Care oncology provider
  • Goals of care and role of Palliative Care consult discussed and documented
  • ECOG Performance Status 0-2

Additional Inclusion Criteria (Clinical Indications)

  • Metastatic non-small cell lung cancer (NSCLC) with a confirmed ALK mutation AND progressive disease or intolerance to at least one prior ALK TKI (e.g. crizotinib, alectinib, brigatinib, ceritinib)
  • Metastatic NSCLC with a confirmed ROS1 rearrangement AND progressive disease or intolerance to entrectinib or crizotinib

Source Documents