| Gastro-enteropancreatic neuroendocrine tumor
Afinitor vs Lutathera
Side-by-side clinical, coverage, and cost comparison for gastro-enteropancreatic neuroendocrine tumor.Deep comparison between: Afinitor vs Lutathera 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 signalsLutathera has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lutathera but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Lutathera
At A Glance
Oral
Daily
mTOR inhibitor
IV infusion
Every 8 weeks
Radiolabeled somatostatin analog
Indications
- Hormone receptor positive breast cancer
- Neuroendocrine tumor of pancreas
- Gastro-enteropancreatic neuroendocrine tumor
- Renal Cell Carcinoma
- Angiomyolipoma of kidney
- Subependymal Giant Cell Astrocytoma
- Seizures, Focal
- Gastro-enteropancreatic neuroendocrine tumor
Dosing
Hormone receptor positive breast cancer 10 mg orally once daily in combination with exemestane until disease progression or unacceptable toxicity.
Neuroendocrine tumor of pancreas, Gastro-enteropancreatic neuroendocrine tumor 10 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma 10 mg orally once daily until disease progression or unacceptable toxicity.
Angiomyolipoma of kidney 10 mg orally once daily until disease progression or unacceptable toxicity.
Subependymal Giant Cell Astrocytoma Starting dose 4.5 mg/m2 orally once daily (AFINITOR or AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Starting dose 5 mg/m2 orally once daily (AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Gastro-enteropancreatic neuroendocrine tumor 7.4 GBq (200 mCi) IV every 8 weeks (+/- 1 week) for a total of 4 doses in adults and pediatric patients 12 years and older.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
—
Adverse Reactions
Most common (>=30%) Stomatitis, infections, rash, fatigue, diarrhea, decreased appetite.
Serious Non-infectious pneumonitis, infections, severe hypersensitivity reactions, angioedema, stomatitis, renal failure, impaired wound healing, metabolic disorders (hyperglycemia, dyslipidemia), myelosuppression, radiation sensitization and recall.
Postmarketing Thrombotic microangiopathy, cardiac failure (including with pulmonary hypertension), acute pancreatitis, cholecystitis, cholelithiasis, sepsis, reflex sympathetic dystrophy, arterial thrombotic events, lymphedema, radiation sensitization and recall.
Most common Nausea, vomiting, lymphopenia, anemia, fatigue, creatinine increased, hyperglycemia, GGT increased, leukopenia, thrombocytopenia
Serious Myelodysplastic syndrome, acute leukemia, renal failure, cardiac failure, myocardial infarction, neuroendocrine hormonal crisis
Postmarketing Hypersensitivity reactions including angioedema
Pharmacology
Everolimus is an mTOR inhibitor that binds the intracellular protein FKBP-12 to form an inhibitory complex with mTORC1, suppressing downstream effectors (S6K1, 4E-BP1) involved in protein synthesis, cell proliferation, and angiogenesis, and reducing HIF-1 and VEGF expression; mTOR pathway dysregulation occurs in several human cancers and in tuberous sclerosis complex.
Lutetium Lu 177 dotatate is a radiolabeled somatostatin analog that binds somatostatin receptors with highest affinity for SSTR2; upon internalization into receptor-positive tumor cells, beta-minus emission from lutetium-177 induces cellular damage via free radical formation in target and neighboring cells.
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Most Common Insurance
Anthem BCBS
Afinitor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Lutathera
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Lutathera
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Lutathera
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
Cost estimate not availableAssistance Fund: Neuroendocrine Tumors: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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AfinitorView full Afinitor profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.