| Non-Small Cell Lung Carcinoma

Alecensa vs Imfinzi

Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.

Deep comparison between: Alecensa vs Imfinzi 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 signalsImfinzi has a higher rate of injection site reactions vs Alecensa based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Imfinzi but not Alecensa, including UnitedHealthcare

Category

Alecensa

Imfinzi

At A Glance

RouteOral

FrequencyTwice daily

ClassALK/RET tyrosine kinase inhibitor

RouteIV infusion

FrequencyEvery 2 to 4 weeks

ClassPD-L1 antagonist

Indications

Non-Small Cell Lung Carcinoma

Non-Small Cell Lung Carcinoma
Small cell carcinoma of lung
Biliary Tract Cancer
Liver carcinoma
Endometrial Carcinoma
Carcinoma of bladder
Stomach Carcinoma
Gastroesophageal junction cancer

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).

Resectable NSCLC Neoadjuvant: 1,500 mg IV every 3 weeks in combination with chemotherapy for up to 4 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks as a single agent for up to 12 cycles after surgery (or 20 mg/kg if weight <30 kg).

Unresectable Stage III NSCLC 1,500 mg IV every 4 weeks or 10 mg/kg every 2 weeks as a single agent until disease progression or unacceptable toxicity (maximum 12 months) (or 10 mg/kg every 2 weeks if weight <30 kg).

Metastatic NSCLC 1,500 mg IV in combination with tremelimumab-actl 75 mg and platinum-based chemotherapy every 3 weeks for 4 cycles, then 1,500 mg every 4 weeks as a single agent with pemetrexed maintenance for non-squamous (or 20 mg/kg and 1 mg/kg tremelimumab-actl if weight <30 kg).

Limited Stage SCLC 1,500 mg IV every 4 weeks as a single agent until disease progression or unacceptable toxicity (maximum 24 months) (or 20 mg/kg if weight <30 kg).

Extensive Stage SCLC 1,500 mg IV every 3 weeks in combination with etoposide and carboplatin or cisplatin for 4 cycles, then 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg if weight <30 kg).

Biliary Tract Cancer 1,500 mg IV every 3 weeks in combination with gemcitabine and cisplatin for up to 8 cycles, then 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg if weight <30 kg).

Unresectable Hepatocellular Carcinoma 1,500 mg IV in combination with a single dose of tremelimumab-actl 300 mg at Cycle 1/Day 1, followed by 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg and 4 mg/kg tremelimumab-actl if weight <30 kg).

dMMR Endometrial Carcinoma 1,120 mg IV in combination with carboplatin and paclitaxel every 3 weeks for 6 cycles, followed by 1,500 mg every 4 weeks as a single agent until disease progression (or 15 mg/kg followed by 20 mg/kg if weight <30 kg).

Muscle Invasive Bladder Cancer Neoadjuvant: 1,500 mg IV in combination with gemcitabine and cisplatin every 3 weeks for 4 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks as a single agent for up to 8 cycles after surgery (or 20 mg/kg if weight <30 kg).

Resectable Gastric/Gastroesophageal Junction Adenocarcinoma Neoadjuvant: 1,500 mg IV every 4 weeks with FLOT for up to 2 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks with FLOT for up to 2 cycles, followed by 1,500 mg as a single agent every 4 weeks for up to 10 cycles (or 20 mg/kg if weight <30 kg).

Contraindications

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Drug Interactions

998View drug interactions

203View drug interactions

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 (>=10%) Nausea, fatigue, cough, pneumonitis, rash, diarrhea, decreased appetite, musculoskeletal pain, constipation, dyspnea, upper respiratory tract infections, pyrexia, pruritus, headache, vomiting, abdominal pain, hypothyroidism, peripheral neuropathy, alopecia, insomnia

Serious Pneumonitis, pneumonia, hepatitis, colitis, myocarditis, nephritis, endocrinopathies, infusion-related reactions, exfoliative dermatologic conditions

Postmarketing Not specified in label

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.

Durvalumab is a human IgG1 kappa monoclonal antibody that binds to PD-L1 and blocks the interaction of PD-L1 with PD-1 and CD80, releasing the inhibition of immune responses without inducing antibody-dependent cell-mediated cytotoxicity.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Alecensa