| Metastasis from malignant neoplasm of colon and/or rectum

Avastin vs Cyramza

Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.

Deep comparison between: Avastin vs Cyramza with Prescriber.AI

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

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

Category

Avastin

Cyramza

At A Glance

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

RouteIV infusion

FrequencyEvery 2 weeks

ClassVEGFR2 antagonist

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

Gastric Adenocarcinoma
Non-Small Cell Lung Carcinoma
Metastasis from malignant neoplasm of colon and/or rectum
Liver carcinoma

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.

Gastric Adenocarcinoma 8 mg/kg every 2 weeks by IV infusion as a single agent or in combination with weekly paclitaxel.

Non-Small Cell Lung Carcinoma (EGFR exon 19/21, first-line) 10 mg/kg every 2 weeks by IV infusion in combination with erlotinib.

Non-Small Cell Lung Carcinoma (post-platinum progression) 10 mg/kg by IV infusion on Day 1 of a 21-day cycle in combination with docetaxel.

Metastasis from malignant neoplasm of colon and/or rectum 8 mg/kg every 2 weeks by IV infusion prior to FOLFIRI.

Liver carcinoma 8 mg/kg every 2 weeks by IV infusion as a single agent.

Contraindications

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Drug Interactions

232View drug interactions

194View 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 (>=10%) Hypertension, fatigue/asthenia, neutropenia, diarrhea, epistaxis, peripheral edema, stomatitis, proteinuria, thrombocytopenia, decreased appetite, nausea.

Serious Febrile neutropenia, pneumonia, hemorrhage, gastrointestinal perforation, arterial thromboembolic events, impaired wound healing, posterior reversible encephalopathy syndrome, proteinuria including nephrotic syndrome, infusion-related reactions, sepsis.

Postmarketing Thrombotic microangiopathy, hemangioma, dysphonia, arterial aneurysms/dissections/rupture, heart failure.

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.

Ramucirumab is a VEGFR2 antagonist that specifically binds VEGFR2 and blocks binding of VEGFR ligands VEGF-A, VEGF-C, and VEGF-D, inhibiting ligand-stimulated activation of VEGFR2 and thereby inhibiting endothelial cell proliferation, migration, and angiogenesis.

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Most Common Insurance

Anthem BCBS

Avastin