| Non-Small Cell Lung Carcinoma
Alecensa vs Enhertu
Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.Deep comparison between: Alecensa vs Enhertu 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 signalsEnhertu has a higher rate of injection site reactions vs Alecensa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Enhertu but not Alecensa, including UnitedHealthcare
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Category
Alecensa
Enhertu
At A Glance
Oral
Twice daily
ALK/RET tyrosine kinase inhibitor
IV infusion
Every 3 weeks
HER2-directed antibody-drug conjugate with topoisomerase I inhibitor
Indications
- Non-Small Cell Lung Carcinoma
- Breast Carcinoma
- Non-Small Cell Lung Carcinoma
- Gastric Adenocarcinoma
Dosing
Non-Small Cell Lung Carcinoma (adjuvant) 600 mg orally twice daily with food for a total of 2 years or until disease recurrence or unacceptable toxicity following tumor resection of ALK-positive NSCLC (tumors >= 4 cm or node positive).
Non-Small Cell Lung Carcinoma (metastatic) 600 mg orally twice daily with food until disease progression or unacceptable toxicity; reduce to 450 mg orally twice daily for severe hepatic impairment (Child-Pugh C).
Breast Carcinoma (HER2-positive, HER2-low, or HER2-ultralow) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Breast Carcinoma (HER2-positive, first-line with pertuzumab) Cycle 1 Day 1: 5.4 mg/kg IV followed by pertuzumab 840 mg; subsequent cycles: 5.4 mg/kg IV followed by pertuzumab 420 mg every 3 weeks
Non-Small Cell Lung Carcinoma (HER2-mutant) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Gastric Adenocarcinoma (HER2-positive) 6.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Contraindications
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Adverse Reactions
Most common (>=20%) Hepatotoxicity, constipation, fatigue, myalgia, edema, rash, cough
Serious Hepatotoxicity, ILD/pneumonitis, renal impairment, bradycardia, severe myalgia and CPK elevation, hemolytic anemia, pneumonia
Most common (>=20%) Decreased white blood cell count, nausea, decreased hemoglobin, decreased neutrophil count, decreased lymphocyte count, fatigue, decreased platelet count, increased aspartate aminotransferase, increased alanine aminotransferase, increased blood alkaline phosphatase, vomiting, alopecia, decreased blood potassium, constipation, musculoskeletal pain, diarrhea, decreased appetite
Serious Interstitial lung disease, pneumonitis, pneumonia, febrile neutropenia, vomiting, nausea, hypokalemia, pulmonary embolism, sepsis
Pharmacology
Alectinib is a tyrosine kinase inhibitor that targets ALK and RET; it inhibits ALK phosphorylation and ALK-mediated activation of downstream signaling proteins STAT3 and AKT, with the major active metabolite M4 showing similar in vitro potency and activity against multiple mutant forms of ALK, including mutations identified in NSCLC tumors that have progressed on crizotinib.
Fam-trastuzumab deruxtecan-nxki is a HER2-directed antibody-drug conjugate consisting of a humanized anti-HER2 IgG1 antibody linked to a topoisomerase I inhibitor (DXd). After binding to HER2 on tumor cells, the drug undergoes internalization and lysosomal cleavage, releasing the membrane-permeable DXd that causes DNA damage and apoptotic cell death.
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Most Common Insurance
Anthem BCBS
Alecensa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Enhertu
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Alecensa
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Enhertu
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Alecensa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Enhertu
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAlecensa Access Solutions Bridge Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Enhertu.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.