| Non-Small Cell Lung Carcinoma
Rybrevant vs Zirabev
Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.Deep comparison between: Rybrevant 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 Rybrevant based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zirabev but not Rybrevant, including UnitedHealthcare
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Category
Rybrevant
Zirabev
At A Glance
Intravenous
Weekly x 4-5 weeks, then every 2-3 weeks
Bispecific EGFR/MET antibody
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 (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.
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
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Adverse Reactions
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.
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
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.
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
Rybrevant
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Zirabev
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (0/12)
UnitedHealthcare
Rybrevant
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Zirabev
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Rybrevant
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · 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.