| Non-Small Cell Lung Carcinoma

Avastin vs Tagrisso

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

Deep comparison between: Avastin vs Tagrisso with Prescriber.AI

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Safety signalsTagrisso has a higher rate of injection site reactions vs Avastin based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Tagrisso but not Avastin, including UnitedHealthcare

Category

Avastin

Tagrisso

At A Glance

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

RouteOral

FrequencyDaily

ClassEGFR kinase 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
Liver carcinoma

Non-Small Cell Lung Carcinoma

Dosing

Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL, or 10 mg/kg IV every 2 weeks with FOLFOX4; for 2nd-line after a bevacizumab product-containing regimen: 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy.

Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel.

Glioblastoma 10 mg/kg IV every 2 weeks.

Renal Cell Carcinoma 10 mg/kg IV every 2 weeks with interferon alfa.

Cervix carcinoma 15 mg/kg IV every 3 weeks 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, then 15 mg/kg every 3 weeks as single agent for up to 22 total cycles. Platinum-resistant recurrent: 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan. Platinum-sensitive recurrent: 15 mg/kg every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, then 15 mg/kg every 3 weeks as single agent.

Liver carcinoma 15 mg/kg IV every 3 weeks administered after atezolizumab 1,200 mg IV on the same day.

Adjuvant Non-Small Cell Lung Carcinoma 80 mg orally once daily until disease recurrence, unacceptable toxicity, or for up to 3 years.

Locally advanced, unresectable (Stage III) Non-Small Cell Lung Carcinoma Following platinum-based chemoradiation therapy, 80 mg orally once daily until disease progression or unacceptable toxicity.

First-line metastatic Non-Small Cell Lung Carcinoma (monotherapy) 80 mg orally once daily until disease progression or unacceptable toxicity.

First-line locally advanced or metastatic Non-Small Cell Lung Carcinoma (combination) 80 mg orally once daily in combination with pemetrexed and platinum-based chemotherapy until disease progression or unacceptable toxicity.

Previously treated EGFR T790M mutation-positive metastatic Non-Small Cell Lung Carcinoma 80 mg orally once daily until disease progression or unacceptable toxicity.

Contraindications

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Drug Interactions

231View drug interactions

1081View drug interactions

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, 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, and rupture.

Most common (>=20%) Diarrhea, rash, musculoskeletal pain, nail toxicity, dry skin, stomatitis, fatigue.

Serious ILD/pneumonitis, QTc interval prolongation, cardiomyopathy, keratitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, cutaneous vasculitis, aplastic anemia.

Postmarketing Erythema multiforme major, Stevens-Johnson syndrome, toxic epidermal necrolysis, cutaneous vasculitis, erythema dyschromicum perstans, aplastic anemia.

Pharmacology

Bevacizumab is a VEGF inhibitor that binds VEGF and prevents its interaction with receptors Flt-1 and KDR on endothelial cells, inhibiting endothelial cell proliferation and new blood vessel formation, thereby reducing tumor microvascular growth and metastatic disease progression.

Osimertinib is a kinase inhibitor that irreversibly binds to mutant EGFR forms (T790M, L858R, and exon 19 deletions) at approximately 9-fold lower concentrations than wild-type EGFR, inhibiting tumor cell proliferation in EGFR mutation-positive NSCLC; it also inhibits HER2, HER3, HER4, ACK1, and BLK at clinically relevant concentrations.

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Anthem BCBS

Avastin