Belinostat (Beleodaq) (CPB 0887, reviewed 2026-09-10)
Summary
Aetna considers belinostat (Beleodaq) medically necessary for commercial medical plans as a single agent for relapsed or refractory peripheral T-cell lymphoma or for palliative intent, for hepatosplenic T-cell lymphoma after two or more previous lines of chemotherapy, and for relapsed or refractory extranodal NK/T-cell lymphoma with an inadequate response or contraindication to asparaginase-based therapy. It is also considered medically necessary for subsequent therapy in adult T-cell leukemia/lymphoma and breast implant-associated anaplastic large cell lymphoma. Reauthorization is considered medically necessary for a listed indication when there is no evidence of unacceptable toxicity or disease progression on the current regimen, and all other indications, including concomitant use with Folotyn, Istodax, Ninlaro or Zolinza, are considered experimental, investigational, or unproven.
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