| Metastasis from malignant neoplasm of colon and/or rectum
Stivarga vs Lonsurf
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Stivarga 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 Stivarga based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lonsurf but not Stivarga, including UnitedHealthcare
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Category
Stivarga
Lonsurf
At A Glance
Oral
Once daily (21 of 28 days)
Multikinase inhibitor
Oral
Twice daily, Days 1-5 and Days 8-12 of 28-day cycle
Nucleoside metabolic 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
- Gastric Adenocarcinoma
- Adenocarcinoma of the gastroesophageal junction
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, 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 (>=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%) 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
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.
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
Stivarga
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Lonsurf
- Covered on 5 commercial plans
- PA (12/12) · 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)
Lonsurf
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Stivarga
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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
No savings programs available for Stivarga.
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.