NOTE: In addition to the above criteria, product specific dosage and/or frequency limits may apply in accordance with the U.S. Food and Drug Administration (FDA)-approved product prescribing information, national compendia, Centers for Medicare and Medicaid Services (CMS) and other peer reviewed resources or evidence-based guidelines.
*Note: Bevacizumab (Avastin)-containing regimens should be used with caution and withheld for at least 6 weeks prior to interval debulking surgery due to potential interference with postoperative healing.
**Note: Pemetrexed-based chemotherapy may also be used for malignant peritoneal mesothelioma, pericardial mesothelioma, and tunica vaginalis testis mesothelioma.
Limitation of Use: Bevacizumab-awwb (Mvasi) and bevacizumab-bvzr (Zirabev) are not indicated for adjuvant treatment of colon cancer.
The effectiveness of bevacizumab products in glioblastoma is based on an improvement in objective response rate. There are no data demonstrating an improvement in disease-related symptoms or increased survival with bevacizumab products.
Note: Biologic therapy is only appropriate for continuation of favorable response from conversion therapy.
If there is insufficient tissue to allow testing for all of EGFR, ALK, ROS1, BRAF, MET, and RET, repeat biopsy and/or plasma testing should be done. If these are not feasible, treatment is guided by available results and, if unknown, these individuals are treated as though they do not have driver oncogenes.
