ADO-TRASTUZUMAB EMTANSINE

Guidelines for Use

GUIDELINES FOR USE

Our guideline named ADO-TRASTUZUMAB EMTANSINE (Kadcyla) requires the following rule(s) be met for approval:

1. You have ONE of the following:
   1. Metastatic breast cancer (cancer that has spread to other parts of the body)
   2. Early breast cancer (cancer has not spread to other parts of the body)
2. If you have metastatic breast cancer, approval also requires:
   1. Your cancer is human epidermal growth factor receptor 2 (HER2: a type of protein)- positive
   2. You have previously received trastuzumab and a taxane (types of cancer treatment)
   3. You meet ONE of the following:
      1. You have received prior therapy for metastatic disease
      2. You developed disease recurrence (disease has returned) during or within 6 months of completing adjuvant (add-on) therapy
3. If you have early breast cancer, approval also requires:
   1. Your cancer is human epidermal growth factor receptor 2 (HER2: a type of protein)- positive
   2. You have residual (remaining) invasive disease after neoadjuvant (given before main treatment) taxane and trastuzumab-based treatment (types of cancer treatment)