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MIDOSTAURIN CAP,ORAL

Clinical Criteria Summary

Exclusion Criteria

  • Hypersensitivity to midostaurin or any of the excipients
  • Inability to swallow whole capsules
  • Pregnancy (known pregnancy or positive pregnancy test)
  • Lactating

Inclusion Criteria

  • Newly diagnosed FLT3 mutation positive Acute Myeloid Leukemia (AML) and eligible for standard induction and consolidation chemotherapy regimens
  • Diagnosis of Aggressive Systemic Mastocytosis (ASM), Indolent Systemic Mastocytosis (ISM), Systemic Mastocytosis with Associated Hematologic Neoplasm (SM-AHN) or Mast Cell Leukemia (MCL)

Additional Inclusion Criteria

  • Care for the condition provided by VA or VA Community Care hematology/oncology provider
  • Goals of care and role of Palliative Care consult have been discussed and documented
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 - 3

Pregnancy & Contraception Counseling Requirements

  • For patients who can become pregnant and patients with partners who can become pregnant: Counseling provided on potential risk vs. benefit of taking midostaurin if they were to become pregnant
  • For patients who can become pregnant and patients with partners who can become pregnant: Counsel on effective contraception use during treatment and for 4 months following the last dose

Source Documents