| Metastasis from malignant neoplasm of colon and/or rectum
Erbitux vs Zaltrap
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Erbitux vs Zaltrap 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 signalsZaltrap has a higher rate of injection site reactions vs Erbitux based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zaltrap but not Erbitux, including UnitedHealthcare
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Category
Erbitux
Zaltrap
At A Glance
IV infusion
Weekly or every 2 weeks
EGFR antagonist
IV infusion
Every 2 weeks
VEGF 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
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 4 mg per kg IV infusion over 1 hour every 2 weeks in combination with FOLFIRI until disease progression or unacceptable toxicity; administer ZALTRAP prior to any component of the FOLFIRI regimen on the day of treatment.
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 (>=20%) leukopenia, diarrhea, neutropenia, proteinuria, AST increased, stomatitis, fatigue, thrombocytopenia, ALT increased, hypertension, weight decreased, decreased appetite, epistaxis, abdominal pain, dysphonia, serum creatinine increased, headache
Serious neutropenia, diarrhea, hypertension, leukopenia, stomatitis, fatigue, proteinuria, asthenia (all Grade 3-4, >=5%); also hemorrhage, gastrointestinal perforation, impaired wound healing, fistula formation, arterial thromboembolic events, reversible posterior leukoencephalopathy syndrome
Postmarketing osteonecrosis of the jaw, cardiac failure, ejection fraction decreased, arterial aneurysms/dissections/rupture
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.
Ziv-aflibercept is a recombinant fusion protein that acts as a soluble decoy receptor binding VEGF-A, VEGF-B, and PlGF, thereby inhibiting their cognate receptor activation and resulting in decreased neovascularization and vascular permeability.
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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)
Zaltrap
- Covered on 5 commercial plans
- PA (9/12) · 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)
Zaltrap
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (0/8)
Humana
Erbitux
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Zaltrap
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
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 availableCancerCare: Metastatic Colorectal Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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ErbituxView full Erbitux profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.