| Metastasis from malignant neoplasm of colon and/or rectum
Stivarga vs Avastin
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Stivarga vs Avastin 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 signalsAvastin has a higher rate of injection site reactions vs Stivarga based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Avastin but not Stivarga, including UnitedHealthcare
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Category
Stivarga
Avastin
At A Glance
Oral
Once daily (21 of 28 days)
Multikinase inhibitor
IV infusion
Every 2-3 weeks
VEGF inhibitor
Indications
- Metastasis from malignant neoplasm of colon and/or rectum
- Gastrointestinal Stromal Tumors
- 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
- Liver carcinoma
Dosing
Metastasis from malignant neoplasm of colon and/or rectum, Gastrointestinal Stromal Tumors, Liver carcinoma 160 mg orally once daily for the first 21 days of each 28-day cycle, taken after a low-fat meal; continue until disease progression or unacceptable toxicity.
Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL, or 10 mg/kg IV every 2 weeks with FOLFOX4; for 2nd-line after a bevacizumab product-containing regimen: 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy.
Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel.
Glioblastoma 10 mg/kg IV every 2 weeks.
Renal Cell Carcinoma 10 mg/kg IV every 2 weeks with interferon alfa.
Cervix carcinoma 15 mg/kg IV every 3 weeks 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, then 15 mg/kg every 3 weeks as single agent for up to 22 total cycles. Platinum-resistant recurrent: 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan. Platinum-sensitive recurrent: 15 mg/kg every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, then 15 mg/kg every 3 weeks as single agent.
Liver carcinoma 15 mg/kg IV every 3 weeks administered after atezolizumab 1,200 mg IV on the same day.
Contraindications
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Adverse Reactions
Most common (>=20%) pain, HFSR/PPES, asthenia/fatigue, diarrhea, decreased appetite/food intake, hypertension, infection, dysphonia, hyperbilirubinemia, fever, mucositis, weight loss, rash, nausea
Serious hepatotoxicity, infections, hemorrhage, gastrointestinal perforation or fistula, dermatological toxicity, hypertension, cardiac ischemia and infarction, reversible posterior leukoencephalopathy syndrome
Postmarketing hypersensitivity reaction, nephrotic syndrome, cardiac failure, arterial aneurysms/dissections/rupture
Most common (>10%) Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.
Serious Gastrointestinal perforations and fistulae, 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, and rupture.
Pharmacology
Regorafenib is a small molecule inhibitor of multiple membrane-bound and intracellular kinases involved in oncogenesis, tumor angiogenesis, metastasis, and tumor immunity, including VEGFR1-3, KIT, PDGFR-alpha/beta, FGFR1/2, RAF-1, BRAF, and CSF1R.
Bevacizumab is a VEGF inhibitor that binds VEGF and prevents its interaction with receptors Flt-1 and KDR on endothelial cells, inhibiting endothelial cell proliferation and new blood vessel formation, thereby reducing tumor microvascular growth and metastatic disease progression.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Stivarga
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Avastin
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Stivarga
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Avastin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Stivarga
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Avastin
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Stivarga.
No savings programs available for Avastin.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.