| Metastasis from malignant neoplasm of colon and/or rectum
Zirabev vs Zaltrap
Side-by-side clinical, coverage, and cost comparison for metastasis from malignant neoplasm of colon and/or rectum.Deep comparison between: Zirabev 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 Zirabev based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zaltrap but not Zirabev, including UnitedHealthcare
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Category
Zirabev
Zaltrap
At A Glance
IV infusion
Every 2-3 weeks
VEGF inhibitor
IV infusion
Every 2 weeks
VEGF inhibitor
Indications
- 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
- Metastasis from malignant neoplasm of colon and/or rectum
Dosing
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.
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%) 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.
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
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.
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
Zirabev
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (0/12)
Zaltrap
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Zirabev
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Zaltrap
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (0/8)
Humana
Zirabev
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
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
$0/fillfill
Zirabev Co-Pay Savings ProgramCommercial 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.