| Renal Cell Carcinoma

Afinitor vs Cabometyx

Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.
Deep comparison between: Afinitor vs Cabometyx with Prescriber.AI
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Safety signalsCabometyx has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Cabometyx but not Afinitor, including UnitedHealthcare
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Afinitor
Cabometyx
At A Glance
Oral
Daily
mTOR inhibitor
Oral
Once daily
Tyrosine kinase inhibitor
Indications
  • Hormone receptor positive breast cancer
  • Neuroendocrine tumor of pancreas
  • Gastro-enteropancreatic neuroendocrine tumor
  • Renal Cell Carcinoma
  • Angiomyolipoma of kidney
  • Subependymal Giant Cell Astrocytoma
  • Seizures, Focal
  • Renal Cell Carcinoma
  • Liver carcinoma
  • Well Differentiated Pancreatic Endocrine Neoplasm
  • Neuroendocrine Tumors
Dosing
Hormone receptor positive breast cancer 10 mg orally once daily in combination with exemestane until disease progression or unacceptable toxicity.
Neuroendocrine tumor of pancreas, Gastro-enteropancreatic neuroendocrine tumor 10 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma 10 mg orally once daily until disease progression or unacceptable toxicity.
Angiomyolipoma of kidney 10 mg orally once daily until disease progression or unacceptable toxicity.
Subependymal Giant Cell Astrocytoma Starting dose 4.5 mg/m2 orally once daily (AFINITOR or AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Starting dose 5 mg/m2 orally once daily (AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Renal Cell Carcinoma (single agent) 60 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma (+ nivolumab) 40 mg orally once daily in combination with nivolumab (240 mg every 2 weeks or 480 mg every 4 weeks, or subcutaneous formulations) until disease progression or unacceptable toxicity.
Liver carcinoma 60 mg orally once daily until disease progression or unacceptable toxicity.
Differentiated Thyroid Cancer, Well Differentiated Pancreatic Endocrine Neoplasm, Neuroendocrine Tumors 60 mg orally once daily for adults and pediatric patients >=40 kg; 40 mg orally once daily for pediatric patients 12 years and older with bodyweight <40 kg, until disease progression or unacceptable toxicity.
Contraindications
  • Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
—
Adverse Reactions
Most common (>=30%) Stomatitis, infections, rash, fatigue, diarrhea, decreased appetite.
Serious Non-infectious pneumonitis, infections, severe hypersensitivity reactions, angioedema, stomatitis, renal failure, impaired wound healing, metabolic disorders (hyperglycemia, dyslipidemia), myelosuppression, radiation sensitization and recall.
Postmarketing Thrombotic microangiopathy, cardiac failure (including with pulmonary hypertension), acute pancreatitis, cholecystitis, cholelithiasis, sepsis, reflex sympathetic dystrophy, arterial thrombotic events, lymphedema, radiation sensitization and recall.
Most common (>=25%) Diarrhea, fatigue, palmar-plantar erythrodysesthesia, hypertension, decreased appetite, nausea, vomiting, weight decreased, constipation, stomatitis, rash, hypothyroidism, musculoskeletal pain.
Serious Hemorrhage, perforations and fistulas, thromboembolic events, hypertensive crisis, cardiac failure, hepatotoxicity, adrenal insufficiency, proteinuria, osteonecrosis of the jaw, reversible posterior leukoencephalopathy syndrome, thyroid dysfunction, hypocalcemia.
Postmarketing Arterial (including aortic) aneurysms, dissections, and rupture.
Pharmacology
Everolimus is an mTOR inhibitor that binds the intracellular protein FKBP-12 to form an inhibitory complex with mTORC1, suppressing downstream effectors (S6K1, 4E-BP1) involved in protein synthesis, cell proliferation, and angiogenesis, and reducing HIF-1 and VEGF expression; mTOR pathway dysregulation occurs in several human cancers and in tuberous sclerosis complex.
Cabozantinib is a tyrosine kinase inhibitor that inhibits MET, VEGFR-1/-2/-3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2 - receptor tyrosine kinases involved in oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Afinitor
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
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Cabometyx
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
View full coverage details ›
UnitedHealthcare
Afinitor
  • Covered on 4 commercial plans
  • PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
View full coverage details ›
Cabometyx
  • Covered on 4 commercial plans
  • PA (6/8) · Step Therapy (0/8) · Qty limit (6/8)
View full coverage details ›
Humana
Afinitor
  • Covered on 0 commercial plans
  • PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
View full coverage details ›
Cabometyx
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
No savings programs available for Cabometyx.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.