| Non-Small Cell Lung Carcinoma
Alecensa vs Opdivo
Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.Deep comparison between: Alecensa vs Opdivo 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 signalsOpdivo has a higher rate of injection site reactions vs Alecensa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Opdivo but not Alecensa, including UnitedHealthcare
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Category
Alecensa
Opdivo
At A Glance
Oral
Twice daily
ALK/RET tyrosine kinase inhibitor
IV infusion
Every 2 weeks or Every 4 weeks
PD-1 blocking antibody
Indications
- Non-Small Cell Lung Carcinoma
- melanoma
- Non-Small Cell Lung Carcinoma
- Malignant Pleural Mesothelioma
- Renal Cell Carcinoma
- Hodgkin Disease
- Squamous cell carcinoma of the head and neck
- Urothelial Carcinoma
- Colorectal Carcinoma
- Liver carcinoma
- Squamous cell carcinoma of esophagus
- Stomach Carcinoma
- Gastroesophageal junction cancer
- Adenocarcinoma Of Esophagus
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).
Melanoma Adults and pediatric >=40 kg: 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks
Non-Small Cell Lung Carcinoma Neoadjuvant: 360 mg every 3 weeks with platinum-doublet chemotherapy for 3-4 cycles; Adjuvant after neoadjuvant: 480 mg every 4 weeks; Metastatic: 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks and 2 cycles platinum-doublet chemotherapy; or 240 mg every 2 weeks or 480 mg every 4 weeks
Malignant Pleural Mesothelioma 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks
Renal Cell Carcinoma 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; or 240 mg every 2 weeks or 480 mg every 4 weeks with cabozantinib 40 mg daily orally; or 240 mg every 2 weeks or 480 mg every 4 weeks
Hodgkin Disease Previously untreated: Adults and pediatric >=40 kg: 240 mg with AVD every 2 weeks for 6 cycles; Pediatric <40 kg: 3 mg/kg with AVD every 2 weeks for 6 cycles; Relapsed or refractory: 240 mg every 2 weeks or 480 mg every 4 weeks
Squamous cell carcinoma of the head and neck 240 mg every 2 weeks or 480 mg every 4 weeks
Urothelial Carcinoma Adjuvant: 240 mg every 2 weeks or 480 mg every 4 weeks; First-line: 360 mg every 3 weeks with cisplatin and gemcitabine for up to 6 cycles, then 240 mg every 2 weeks or 480 mg every 4 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks
Colorectal Carcinoma Adults and pediatric >=40 kg: 240 mg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks
Liver carcinoma 1 mg/kg with ipilimumab 3 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks
Squamous cell carcinoma of esophagus Adjuvant resected: 240 mg every 2 weeks or 480 mg every 4 weeks for 1 year; First-line with chemotherapy: 240 mg every 2 weeks or 480 mg every 4 weeks with fluoropyrimidine- and platinum-containing chemotherapy; First-line with ipilimumab: 3 mg/kg every 2 weeks or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks
Stomach Carcinoma 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
Gastroesophageal junction cancer 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
Adenocarcinoma Of Esophagus 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
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%) fatigue, musculoskeletal pain, rash, diarrhea, pruritus, nausea, decreased appetite, cough, dyspnea, constipation, upper respiratory tract infection
Serious pneumonitis, colitis, hepatitis, endocrinopathies, nephritis, dermatologic reactions, myocarditis, neurological toxicities, infusion-related reactions
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.
Nivolumab is a PD-1 blocking antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Alecensa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Opdivo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (0/12)
UnitedHealthcare
Alecensa
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Opdivo
- 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)
Opdivo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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 Opdivo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.