| Metastasis from malignant neoplasm of colon and/or rectum

Erbitux vs Zirabev

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

Deep comparison between: Erbitux vs Zirabev with Prescriber.AI

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

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

Category

Erbitux

Zirabev

At A Glance

RouteIV infusion

FrequencyWeekly or every 2 weeks

ClassEGFR antagonist

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF 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
Non-Small Cell Lung Carcinoma
Glioblastoma
Renal Cell Carcinoma
Cervix carcinoma
Malignant neoplasm of ovary
Fallopian Tube Carcinoma
Primary Peritoneal Cancer

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 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

189View drug interactions

232View drug interactions

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%) 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

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.

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.

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Most Common Insurance

Anthem BCBS

Erbitux