| Metastasis from malignant neoplasm of colon and/or rectum

Zaltrap vs Zirabev

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

Deep comparison between: Zaltrap vs Zirabev with Prescriber.AI

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

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

Category

Zaltrap

Zirabev

At A Glance

RouteIV infusion

FrequencyEvery 2 weeks

ClassVEGF inhibitor

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

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

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.

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

5View drug interactions

232View drug interactions

Adverse Reactions

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

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

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.

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.

View Full FDA Information

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Most Common Insurance

Anthem BCBS

Zaltrap