| Non-Small Cell Lung Carcinoma
Alecensa vs Rybrevant
Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.Deep comparison between: Alecensa vs Rybrevant 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 signalsRybrevant has a higher rate of injection site reactions vs Alecensa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rybrevant but not Alecensa, including UnitedHealthcare
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Category
Alecensa
Rybrevant
At A Glance
Oral
Twice daily
ALK/RET tyrosine kinase inhibitor
Intravenous
Weekly x 4-5 weeks, then every 2-3 weeks
Bispecific EGFR/MET antibody
Indications
- Non-Small Cell Lung Carcinoma
- Non-Small Cell Lung Carcinoma
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).
Non-Small Cell Lung Carcinoma (EGFR Exon 19 Del or L858R, first-line with lazertinib) 1,050 mg (<80 kg) or 1,400 mg (>=80 kg) IV weekly for 5 weeks (Week 1 split over Day 1 and Day 2), then every 2 weeks starting Week 7.
Non-Small Cell Lung Carcinoma (EGFR Exon 19 Del or L858R, post-TKI with chemotherapy) 1,400 mg (<80 kg) or 1,750 mg (>=80 kg) IV weekly for 4 weeks (Week 1 split over Day 1 and Day 2), then 1,750 mg (<80 kg) or 2,100 mg (>=80 kg) every 3 weeks starting Week 7, in combination with carboplatin AUC 5 every 3 weeks for up to 12 weeks and pemetrexed 500 mg/m2 every 3 weeks.
Non-Small Cell Lung Carcinoma (EGFR Exon 20 insertion, first-line with chemotherapy) 1,400 mg (<80 kg) or 1,750 mg (>=80 kg) IV weekly for 4 weeks (Week 1 split over Day 1 and Day 2), then 1,750 mg (<80 kg) or 2,100 mg (>=80 kg) every 3 weeks starting Week 7, in combination with carboplatin AUC 5 every 3 weeks for up to 12 weeks and pemetrexed 500 mg/m2 every 3 weeks.
Non-Small Cell Lung Carcinoma (EGFR Exon 20 insertion, post-platinum as single agent) 1,050 mg (<80 kg) or 1,400 mg (>=80 kg) IV weekly for 5 weeks (Week 1 split over Day 1 and Day 2), then every 2 weeks starting Week 7.
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%) Rash (72-90%), nail toxicity (45-71%), infusion-related reaction (42-64%), fatigue (32-51%), musculoskeletal pain (30-47%), stomatitis (26-43%), edema (27-43%), nausea (21-45%), constipation (23-39%), decreased appetite (24-36%), diarrhea (15-31%), vomiting (12-25%), VTE (36% in combination with lazertinib), paresthesia (35% in combination with lazertinib), hemorrhage (25% in combination with lazertinib), dry skin (25% in combination with lazertinib), pruritus (24% in combination with lazertinib), COVID-19 (21-26%), dyspnea (37% as single agent), cough (17-25%), paronychia (50% as single agent).
Serious Infusion-related reactions including anaphylaxis, interstitial lung disease/pneumonitis, venous thromboembolic events (11% in combination with lazertinib), dermatologic reactions including toxic epidermal necrolysis, ocular toxicity.
Postmarketing Anaphylaxis/anaphylactic 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.
Amivantamab-vmjw is a bispecific antibody that binds EGFR and MET extracellular domains, disrupting ligand binding and receptor degradation, and targeting tumor cells for immune-mediated destruction via ADCC and trogocytosis.
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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)
Rybrevant
- Covered on 5 commercial plans
- PA (10/12) · 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)
Rybrevant
- 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)
Rybrevant
- 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
Cost estimate not availableAssistance Fund: Non-Small Cell Lung Cancer (NSCLC)
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.