| Liver carcinoma

Avastin vs Cabometyx

Side-by-side clinical, coverage, and cost comparison for liver carcinoma.

Deep comparison between: Avastin vs Cabometyx with Prescriber.AI

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Safety signalsCabometyx has a higher rate of injection site reactions vs Avastin based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Cabometyx but not Avastin, including UnitedHealthcare

Category

Avastin

Cabometyx

At A Glance

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

RouteOral

FrequencyOnce daily

ClassTyrosine kinase inhibitor

Indications

Metastasis from malignant neoplasm of colon and/or rectum
Non-Small Cell Lung Carcinoma
Glioblastoma
Renal Cell Carcinoma
Cervix carcinoma
Malignant neoplasm of ovary
Fallopian Tube Carcinoma
Primary Peritoneal Cancer
Liver carcinoma

Renal Cell Carcinoma
Liver carcinoma
Well Differentiated Pancreatic Endocrine Neoplasm
Neuroendocrine Tumors

Dosing

Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL, or 10 mg/kg IV every 2 weeks with FOLFOX4; for 2nd-line after a bevacizumab product-containing regimen: 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy.

Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel.

Glioblastoma 10 mg/kg IV every 2 weeks.

Renal Cell Carcinoma 10 mg/kg IV every 2 weeks with interferon alfa.

Cervix carcinoma 15 mg/kg IV every 3 weeks with paclitaxel and cisplatin, or paclitaxel and topotecan.

Malignant neoplasm of ovary, Fallopian Tube Carcinoma, Primary Peritoneal Cancer Stage III/IV following initial surgical resection: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel for up to 6 cycles, then 15 mg/kg every 3 weeks as single agent for up to 22 total cycles. Platinum-resistant recurrent: 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan. Platinum-sensitive recurrent: 15 mg/kg every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, then 15 mg/kg every 3 weeks as single agent.

Liver carcinoma 15 mg/kg IV every 3 weeks administered after atezolizumab 1,200 mg IV on the same day.

Renal Cell Carcinoma (single agent) 60 mg orally once daily until disease progression or unacceptable toxicity.

Renal Cell Carcinoma (+ nivolumab) 40 mg orally once daily in combination with nivolumab (240 mg every 2 weeks or 480 mg every 4 weeks, or subcutaneous formulations) until disease progression or unacceptable toxicity.

Liver carcinoma 60 mg orally once daily until disease progression or unacceptable toxicity.

Differentiated Thyroid Cancer, Well Differentiated Pancreatic Endocrine Neoplasm, Neuroendocrine Tumors 60 mg orally once daily for adults and pediatric patients >=40 kg; 40 mg orally once daily for pediatric patients 12 years and older with bodyweight <40 kg, until disease progression or unacceptable toxicity.

Contraindications

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Drug Interactions

232View drug interactions

970View drug interactions

Adverse Reactions

Most common (>10%) Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.

Serious Gastrointestinal perforations and fistulae, wound healing complications, hemorrhage, arterial thromboembolic events, venous thromboembolic events, hypertension, posterior reversible encephalopathy syndrome, renal injury and proteinuria, infusion-related reactions, ovarian failure, congestive heart failure.

Postmarketing Polyserositis, pulmonary hypertension, mesenteric venous occlusion, gastrointestinal ulcer, intestinal necrosis, anastomotic ulceration, pancytopenia, gallbladder perforation, osteonecrosis of the jaw, renal thrombotic microangiopathy, nasal septum perforation, arterial aneurysms, dissections, and rupture.

Most common (>=25%) Diarrhea, fatigue, palmar-plantar erythrodysesthesia, hypertension, decreased appetite, nausea, vomiting, weight decreased, constipation, stomatitis, rash, hypothyroidism, musculoskeletal pain.

Serious Hemorrhage, perforations and fistulas, thromboembolic events, hypertensive crisis, cardiac failure, hepatotoxicity, adrenal insufficiency, proteinuria, osteonecrosis of the jaw, reversible posterior leukoencephalopathy syndrome, thyroid dysfunction, hypocalcemia.

Postmarketing Arterial (including aortic) aneurysms, dissections, and rupture.

Pharmacology

Bevacizumab is a VEGF inhibitor that binds VEGF and prevents its interaction with receptors Flt-1 and KDR on endothelial cells, inhibiting endothelial cell proliferation and new blood vessel formation, thereby reducing tumor microvascular growth and metastatic disease progression.

Cabozantinib is a tyrosine kinase inhibitor that inhibits MET, VEGFR-1/-2/-3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2 - receptor tyrosine kinases involved in oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.

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Most Common Insurance

Anthem BCBS

Avastin