| Non-Small Cell Lung Carcinoma
Lorbrena vs Zirabev
Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.Deep comparison between: Lorbrena vs Zirabev 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 signalsZirabev has a higher rate of injection site reactions vs Lorbrena based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zirabev but not Lorbrena, including UnitedHealthcare
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Category
Lorbrena
Zirabev
At A Glance
Oral
Daily
ALK inhibitor
IV infusion
Every 2-3 weeks
VEGF inhibitor
Indications
- Non-Small Cell Lung Carcinoma
- 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
Dosing
Non-Small Cell Lung Carcinoma 100 mg orally once daily, with or without food, until disease progression or unacceptable toxicity.
Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL; 10 mg/kg IV every 2 weeks with FOLFOX4; 5 mg/kg IV every 2 weeks or 7.5 mg/kg IV every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy after progression on a first-line bevacizumab product-containing regimen.
Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel.
Glioblastoma 10 mg/kg IV every 2 weeks.
Renal Cell Carcinoma 10 mg/kg IV every 2 weeks in combination with interferon alfa.
Cervix carcinoma 15 mg/kg IV every 3 weeks in combination 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, followed by 15 mg/kg every 3 weeks as a single agent for up to 22 cycles. Platinum-resistant recurrent: 10 mg/kg IV every 2 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or 15 mg/kg IV every 3 weeks with topotecan (every 3 weeks). Platinum-sensitive recurrent: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, followed by 15 mg/kg every 3 weeks as a single agent.
Contraindications
- Concomitant use of strong CYP3A inducers, due to the potential for serious hepatotoxicity
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Adverse Reactions
Most common (>=20%) Edema, peripheral neuropathy, weight gain, cognitive effects, fatigue, dyspnea, arthralgia, diarrhea, mood effects, cough
Serious Pneumonia, dyspnea, respiratory failure, cognitive effects, pyrexia
Most common (>10%) Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.
Serious Gastrointestinal perforations and fistulae, surgery and 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/rupture.
Pharmacology
Lorlatinib is a kinase inhibitor with activity against ALK and ROS1, as well as multiple mutant forms of ALK including resistance mutations detected at progression on prior ALK inhibitors; antitumor activity is dose-dependent and correlates with inhibition of ALK phosphorylation.
Bevacizumab-bvzr binds VEGF and prevents its interaction with receptors Flt-1 and KDR on the surface of endothelial cells, inhibiting endothelial cell proliferation, new blood vessel formation, and metastatic disease progression.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Lorbrena
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Zirabev
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (0/12)
UnitedHealthcare
Lorbrena
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (4/8) · Qty limit (4/8)
Zirabev
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Lorbrena
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Zirabev
- 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 availableAssistance Fund: Non-Small Cell Lung Cancer (NSCLC)
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0/fillfill
Zirabev Co-Pay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.