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