| Hormone receptor positive breast cancer
Afinitor vs Faslodex
Side-by-side clinical, coverage, and cost comparison for hormone receptor positive breast cancer.Deep comparison between: Afinitor vs Faslodex 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 signalsFaslodex has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Faslodex but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Faslodex
At A Glance
Oral
Daily
mTOR inhibitor
IM injection
Once monthly
Estrogen receptor antagonist
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
- Hormone receptor positive breast cancer
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.
Hormone receptor positive breast cancer - Monotherapy 500 mg IM as two 5 mL injections into the gluteal area on Days 1, 15, 29, and once monthly thereafter; reduce to 250 mg as one 5 mL injection for moderate hepatic impairment (Child-Pugh class B) on the same schedule.
Hormone receptor positive breast cancer - Combination with palbociclib, abemaciclib, or ribociclib 500 mg IM as two 5 mL injections into the gluteal area on Days 1, 15, 29, and once monthly thereafter.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
- Known hypersensitivity to fulvestrant or any of its components
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 (>=10%) Arthralgia, hot flash, fatigue, nausea, injection site pain, bone pain
Serious Hepatic enzyme elevations (Grade 3-4), injection site reactions including sciatica and neuropathic pain
Postmarketing Vaginal bleeding, elevated bilirubin, elevated gamma GT, hepatitis, liver failure
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.
Fulvestrant is an estrogen receptor (ER) antagonist that competitively binds to the ER with affinity comparable to estradiol, downregulates ER protein in human breast cancer cells, and inhibits growth of both estrogen-sensitive and tamoxifen-resistant cell lines with no agonist effects.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Afinitor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Faslodex
- Covered on 5 commercial plans
- PA (10/12) · 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)
Faslodex
- 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)
Faslodex
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
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.