| Gastric Adenocarcinoma
Lonsurf vs Enhertu
Side-by-side clinical, coverage, and cost comparison for gastric adenocarcinoma.Deep comparison between: Lonsurf vs Enhertu 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 signalsEnhertu has a higher rate of injection site reactions vs Lonsurf based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Enhertu but not Lonsurf, including UnitedHealthcare
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Category
Lonsurf
Enhertu
At A Glance
Oral
Twice daily, Days 1-5 and Days 8-12 of 28-day cycle
Nucleoside metabolic inhibitor
IV infusion
Every 3 weeks
HER2-directed antibody-drug conjugate with topoisomerase I inhibitor
Indications
- Metastasis from malignant neoplasm of colon and/or rectum
- Gastric Adenocarcinoma
- Adenocarcinoma of the gastroesophageal junction
- Breast Carcinoma
- Non-Small Cell Lung Carcinoma
- Gastric Adenocarcinoma
Dosing
Metastasis from malignant neoplasm of colon and/or rectum, Gastric Adenocarcinoma, Adenocarcinoma of the gastroesophageal junction 35 mg/m2 (max 80 mg per dose) orally twice daily with food on Days 1-5 and Days 8-12 of each 28-day cycle, as single agent or in combination with bevacizumab, until disease progression or unacceptable toxicity.
Severe Renal Impairment (CLcr 15-29 mL/min) 20 mg/m2 orally twice daily with food on Days 1-5 and Days 8-12 of each 28-day cycle; reduce to 15 mg/m2 twice daily if 20 mg/m2 is not tolerated; permanently discontinue if 15 mg/m2 is not tolerated.
Breast Carcinoma (HER2-positive, HER2-low, or HER2-ultralow) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Breast Carcinoma (HER2-positive, first-line with pertuzumab) Cycle 1 Day 1: 5.4 mg/kg IV followed by pertuzumab 840 mg; subsequent cycles: 5.4 mg/kg IV followed by pertuzumab 420 mg every 3 weeks
Non-Small Cell Lung Carcinoma (HER2-mutant) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Gastric Adenocarcinoma (HER2-positive) 6.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Contraindications
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Adverse Reactions
Most common (>=10%) Neutropenia, anemia, thrombocytopenia, fatigue, nausea, decreased appetite, diarrhea, vomiting, abdominal pain, pyrexia
Serious Severe myelosuppression (including febrile neutropenia), pulmonary emboli, interstitial lung disease (including fatal cases)
Most common (>=20%) Decreased white blood cell count, nausea, decreased hemoglobin, decreased neutrophil count, decreased lymphocyte count, fatigue, decreased platelet count, increased aspartate aminotransferase, increased alanine aminotransferase, increased blood alkaline phosphatase, vomiting, alopecia, decreased blood potassium, constipation, musculoskeletal pain, diarrhea, decreased appetite
Serious Interstitial lung disease, pneumonitis, pneumonia, febrile neutropenia, vomiting, nausea, hypokalemia, pulmonary embolism, sepsis
Pharmacology
LONSURF combines trifluridine, a thymidine-based nucleoside analog that is incorporated into DNA to interfere with DNA synthesis and inhibit cell proliferation, and tipiracil, a thymidine phosphorylase inhibitor that increases trifluridine systemic exposure by blocking its primary metabolic pathway.
Fam-trastuzumab deruxtecan-nxki is a HER2-directed antibody-drug conjugate consisting of a humanized anti-HER2 IgG1 antibody linked to a topoisomerase I inhibitor (DXd). After binding to HER2 on tumor cells, the drug undergoes internalization and lysosomal cleavage, releasing the membrane-permeable DXd that causes DNA damage and apoptotic cell death.
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Most Common Insurance
Anthem BCBS
Lonsurf
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Enhertu
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Lonsurf
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Enhertu
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Lonsurf
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Enhertu
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Gastric Cancer: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Enhertu.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.