GILOTRIF (afatini)

GILOTRIF (afatinib)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization:

• Treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor (EGFR) exon 19 deletions or exon 21 substitution mutation

Patients must meet the following criteria for the indication(s) above:

• All patients must undergo genetic testing to confirm EGFR status
• Gene mutations must be documented by FDA approved genetic testing

The Following Conditions Do Not Meet the Criteria for Use as Established by the WHA P & T Committee:

• All uses not listed in the approved indications

Recommended Dosing

• 40 mg orally once daily until disease progression or intolerable side effects
• Drug should be taken 1 hour before or 2 hours after meals.

Approval:

Six months