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VEMURAFENIB TAB

Clinical Criteria Summary

Exclusion Criteria

  • Uncorrectable electrolyte abnormalities, QTc ≥500msec, or long QT syndrome
  • Use of concomitant medications known to prolong QT interval
  • Severe baseline hepatic impairment (Child-Pugh Class C) or severe renal impairment (creatinine clearance <30 mL/min)
  • Active or symptomatic brain metastases
  • Pregnancy (known pregnancy or positive pregnancy test)
  • Breastfeeding

Inclusion Criteria

  • Care provided by a VA/VA purchased care oncology provider
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Goals of care and role of Palliative Care consult have been discussed and documented
  • Female patients of child-bearing potential: counseling provided on contraception during treatment and for 2 weeks after completing treatment and risks vs. benefits of treatment

Indications / Additional Inclusion Criteria (One must be met)

  • Unresectable or metastatic melanoma with BRAF V600E mutation
  • In combination with cobimetinib for unresectable or metastatic melanoma with BRAF V600E mutation if patient cannot tolerate dabrafenib plus trametinib
  • Erdheim-Chester Disease (ECD) with BRAF V600 mutation

Treatment Preferences

  • Dabrafenib plus trametinib is the preferred BRAF + MEK inhibitor combination.

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