| Carcinoma breast stage IV
Ixempra vs Phesgo
Side-by-side clinical, coverage, and cost comparison for carcinoma breast stage iv.Deep comparison between: Ixempra vs Phesgo with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsPhesgo has a higher rate of injection site reactions vs Ixempra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Phesgo but not Ixempra, including UnitedHealthcare
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Category
Ixempra
Phesgo
At A Glance
IV infusion
Every 3 weeks
Microtubule inhibitor (epothilone analog)
SC injection
Every 3 weeks
HER2/neu receptor antagonist
Indications
- Carcinoma breast stage IV
- Locally advanced breast cancer
- HER2-positive carcinoma of breast
- Inflammatory Breast Carcinoma
- Locally advanced breast cancer
- Carcinoma breast stage IV
Dosing
Carcinoma breast stage IV, Locally advanced breast cancer (with capecitabine) 40 mg/m2 IV over 3 hours every 3 weeks; capecitabine 1000 mg/m2 twice daily for 2 weeks per cycle.
Carcinoma breast stage IV, Locally advanced breast cancer (single agent) 40 mg/m2 IV over 3 hours every 3 weeks.
HER2-positive carcinoma of breast, Inflammatory Breast Carcinoma, Locally advanced breast cancer Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with chemotherapy; neoadjuvant: 3-6 preoperative cycles then continue to complete 18 total cycles; adjuvant: up to 18 cycles (1 year) starting Day 1 of first taxane-containing cycle.
Carcinoma breast stage IV Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with docetaxel until disease progression or unmanageable toxicity.
Contraindications
- Neutrophil count <1500 cells/mm3 or platelet count <100,000 cells/mm3
- History of severe hypersensitivity to agents containing Cremophor EL or its derivatives (e.g., polyoxyethylated castor oil)
- Combination with capecitabine in patients with AST or ALT >2.5 x ULN or bilirubin >1 x ULN
- Known hypersensitivity to pertuzumab, trastuzumab, hyaluronidase, or any excipient of PHESGO
Adverse Reactions
Most common (>=20%) Peripheral sensory neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, vomiting, stomatitis/mucositis, diarrhea, musculoskeletal pain; in combination therapy also: palmar-plantar erythrodysesthesia, anorexia, abdominal pain, nail disorder, constipation.
Most common hematologic (>40%) Neutropenia, leukopenia, anemia, thrombocytopenia.
Serious Peripheral neuropathy, myelosuppression, hypersensitivity reactions, cardiac adverse reactions (myocardial infarction, arrhythmia, left ventricular dysfunction), sepsis, pneumonia, respiratory failure, acute hepatic failure.
Postmarketing Radiation recall.
Most common (>=5%) Alopecia, nausea, diarrhea, anemia, asthenia, fatigue, stomatitis, myalgia, arthralgia, neutropenia, vomiting, constipation, headache, dysgeusia, decreased appetite, peripheral sensory neuropathy, mucosal inflammation, injection site reaction, radiation skin injury, insomnia, cough
Serious Febrile neutropenia, neutropenic sepsis, neutrophil count decreased, cardiomyopathy, pulmonary toxicity
Postmarketing Glomerulopathy, immune thrombocytopenia, tumor lysis syndrome
Pharmacology
Ixabepilone is a semi-synthetic analog of epothilone B that binds directly to beta-tubulin subunits on microtubules, suppressing microtubule dynamic instability and blocking cells in the mitotic phase of the cell division cycle, leading to cell death.
Pertuzumab blocks HER2 heterodimerization at subdomain II to inhibit MAP kinase and PI3K signaling, trastuzumab binds subdomain IV to inhibit HER2-mediated cell proliferation, and together they augment antibody-dependent cell-mediated cytotoxicity against HER2-overexpressing tumor cells; hyaluronidase transiently depolymerizes hyaluronan to increase subcutaneous tissue permeability and enable systemic absorption.
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Most Common Insurance
Anthem BCBS
Ixempra
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Phesgo
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Ixempra
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Phesgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ixempra
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Phesgo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.