Calquence®
Drug - Calquence® (acalabrutinib) [AstraZeneca Pharmaceuticals]
July 2018
Therapeutic area - Oral Oncology
Initial approval criteria
- Patient must be at least 18 years of age AND
- Patient must have a diagnosis of advanced mantle cell lymphoma AND
- Patient must be using acalabrutinib as single agent AND
- Patient must have received at least 1 prior therapy for mantle cell lymphoma AND
- NOT have received any prior treatment with a BTK inhibitor (acalabrutinib or ibrutinib)
- Initial approval will be for 6 months
Renewal criteria
- Patient must continue to meet the above criteria AND
- Patient must have documented efficacy with stabilization of disease or decrease in size of tumor or tumor spread AND
- Patient must NOT have unacceptable adverse effects (e.g., anemia, thrombocytopenia, headache, neutropenia, diarrhea, fatigue, myalgia, and bruising)
- Renewal approval will be for 6 months
Quantity limits
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411
