Cetuximab (Erbitux)

Aetna covers cetuximab (Erbitux) for unresectable/advanced/metastatic colorectal cancer (no prior clinical failure on panitumumab) only for RAS (KRAS/NRAS) wild‑type tumors — with BRAF V600E tumors allowed only when given with encorafenib and limited to left‑sided colon primaries — or for KRAS G12C‑mutant disease only when combined with sotorasib or adagrasib after prior chemotherapy; it also covers cetuximab for locally/regional advanced, unresectable, recurrent, persistent, or metastatic squamous cell carcinoma of the head and neck (including patients unfit for surgery or when used with radiation) and as a single agent for occult primary head and neck cancer with chemoradiation. Precertification is required; Erbitux is not indicated for RAS‑mutant or unknown RAS colorectal tumors, is contraindicated in patients with hypersensitivity to cetuximab, has unestablished pediatric safety, and pregnancy/breastfeeding risks must be discussed.

"Locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) — radiotherapy +/- cetuximab referenced (Bonner et al."