| Metastasis from malignant neoplasm of colon and/or rectum
Lonsurf vs Zaltrap
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Lonsurf 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 Lonsurf based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zaltrap but not Lonsurf, including UnitedHealthcare
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Category
Lonsurf
Zaltrap
At A Glance
Oral
Twice daily, Days 1-5 and Days 8-12 of 28-day cycle
Nucleoside metabolic inhibitor
IV infusion
Every 2 weeks
VEGF inhibitor
Indications
- Metastasis from malignant neoplasm of colon and/or rectum
- Gastric Adenocarcinoma
- Adenocarcinoma of the gastroesophageal junction
- Metastasis from malignant neoplasm of colon and/or rectum
Dosing
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.
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 (>=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)
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
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.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Lonsurf
- 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
Lonsurf
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Zaltrap
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (0/8)
Humana
Lonsurf
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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: Gastric 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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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.