| Metastasis from malignant neoplasm of colon and/or rectum

Cyramza vs Zirabev

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

Deep comparison between: Cyramza vs Zirabev 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 signalsZirabev has a higher rate of injection site reactions vs Cyramza based on FDA-approved prescribing information

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

Category

Cyramza

Zirabev

At A Glance

RouteIV infusion

FrequencyEvery 2 weeks

ClassVEGFR2 antagonist

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

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

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

Dosing

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.

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

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

Glioblastoma 10 mg/kg IV every 2 weeks.

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

Cervix carcinoma 15 mg/kg IV every 3 weeks in combination 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, followed by 15 mg/kg every 3 weeks as a single agent for up to 22 cycles. Platinum-resistant recurrent: 10 mg/kg IV every 2 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or 15 mg/kg IV every 3 weeks with topotecan (every 3 weeks). Platinum-sensitive recurrent: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, followed by 15 mg/kg every 3 weeks as a single agent.

Contraindications

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Drug Interactions

194View drug interactions

232View drug interactions

Adverse Reactions

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.

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

Serious Gastrointestinal perforations and fistulae, surgery and 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/rupture.

Pharmacology

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.

Bevacizumab-bvzr binds VEGF and prevents its interaction with receptors Flt-1 and KDR on the surface of endothelial cells, inhibiting endothelial cell proliferation, new blood vessel formation, and metastatic disease progression.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Cyramza