| Metastasis from malignant neoplasm of colon and/or rectum
Erbitux vs Lonsurf
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Erbitux vs Lonsurf 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 signalsLonsurf has a higher rate of injection site reactions vs Erbitux based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lonsurf but not Erbitux, including UnitedHealthcare
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Category
Erbitux
Lonsurf
At A Glance
IV infusion
Weekly or every 2 weeks
EGFR antagonist
Oral
Twice daily, Days 1-5 and Days 8-12 of 28-day cycle
Nucleoside metabolic inhibitor
Indications
- Squamous cell carcinoma of the head and neck
- Metastasis from malignant neoplasm of colon and/or rectum
- Metastasis from malignant neoplasm of colon and/or rectum
- Gastric Adenocarcinoma
- Adenocarcinoma of the gastroesophageal junction
Dosing
Squamous cell carcinoma of the head and neck In combination with radiation therapy: initial 400 mg/m2 IV (120-min) one week prior to radiation, then 250 mg/m2 weekly (60-min) for 6-7 weeks, completing infusion 1 hour prior to radiation; as single-agent or with platinum-based therapy and fluorouracil: weekly (400 mg/m2 initial, 250 mg/m2 subsequent) or biweekly (500 mg/m2 every 2 weeks), completing infusion 1 hour prior to chemotherapy.
Metastasis from malignant neoplasm of colon and/or rectum As single-agent or in combination with irinotecan or FOLFIRI: weekly (400 mg/m2 initial, 250 mg/m2 subsequent) or biweekly (500 mg/m2 every 2 weeks), completing infusion 1 hour prior to irinotecan or FOLFIRI; in combination with encorafenib (BRAF V600E mutation-positive): initial 400 mg/m2 IV (120-min), then 250 mg/m2 weekly (60-min).
Metastasis from malignant neoplasm of colon and/or rectum, Gastric Adenocarcinoma, Adenocarcinoma of the gastroesophageal junction 35 mg/m2 (max 80 mg per dose) orally twice daily with food on Days 1-5 and Days 8-12 of each 28-day cycle, as single agent or in combination with bevacizumab, until disease progression or unacceptable toxicity.
Severe Renal Impairment (CLcr 15-29 mL/min) 20 mg/m2 orally twice daily with food on Days 1-5 and Days 8-12 of each 28-day cycle; reduce to 15 mg/m2 twice daily if 20 mg/m2 is not tolerated; permanently discontinue if 15 mg/m2 is not tolerated.
Contraindications
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Adverse Reactions
Most common (>=25%) Cutaneous adverse reactions (rash, pruritus, nail changes), headache, diarrhea, infection; with encorafenib: fatigue, nausea, diarrhea, dermatitis acneiform, abdominal pain, decreased appetite, arthralgia, rash.
Serious Infusion reactions, cardiopulmonary arrest, pulmonary toxicity, dermatologic toxicity (acneiform rash), hypomagnesemia and electrolyte abnormalities, pulmonary embolism.
Postmarketing Aseptic meningitis, mucosal inflammation, Stevens-Johnson syndrome, toxic epidermal necrolysis, life-threatening and fatal bullous mucocutaneous disease.
Most common (>=10%) Neutropenia, anemia, thrombocytopenia, fatigue, nausea, decreased appetite, diarrhea, vomiting, abdominal pain, pyrexia
Serious Severe myelosuppression (including febrile neutropenia), pulmonary emboli, interstitial lung disease (including fatal cases)
Pharmacology
EGFR antagonist; cetuximab is a recombinant human/mouse chimeric IgG1 monoclonal antibody that binds specifically to the extracellular domain of EGFR, competitively inhibiting EGF and other ligand binding, blocking receptor-associated kinase phosphorylation, inhibiting cell growth, inducing apoptosis, decreasing matrix metalloproteinase and VEGF production, and mediating antibody-dependent cellular cytotoxicity (ADCC) against certain human tumor types.
LONSURF combines trifluridine, a thymidine-based nucleoside analog that is incorporated into DNA to interfere with DNA synthesis and inhibit cell proliferation, and tipiracil, a thymidine phosphorylase inhibitor that increases trifluridine systemic exposure by blocking its primary metabolic pathway.
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Most Common Insurance
Anthem BCBS
Erbitux
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Lonsurf
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Erbitux
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (0/8)
Lonsurf
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Erbitux
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Lonsurf
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Head and Neck Cancer: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Gastric Cancer: Waitlist
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.