| Renal Cell Carcinoma
Afinitor vs Keytruda
Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.Deep comparison between: Afinitor vs Keytruda 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 signalsKeytruda has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Keytruda but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Keytruda
At A Glance
Oral
Daily
mTOR inhibitor
IV infusion
Every 3 weeks or Every 6 weeks
PD-1 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
- melanoma
- Non-Small Cell Lung Carcinoma
- Malignant Pleural Mesothelioma
- Squamous cell carcinoma of the head and neck
- Classic Hodgkin Lymphoma
- Mediastinal (Thymic) Large B-Cell Lymphoma
- Urothelial Carcinoma
- Colorectal Carcinoma
- Stomach Carcinoma
- Esophageal carcinoma
- Cervix carcinoma
- Liver carcinoma
- Biliary Tract Cancer
- Merkel cell carcinoma
- Renal Cell Carcinoma
- Endometrial Carcinoma
- Triple-Negative Breast Carcinoma
- Malignant neoplasm of ovary
- Squamous cell carcinoma of skin
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.
melanoma 200 mg every 3 weeks or 400 mg every 6 weeks IV; 2 mg/kg (up to 200 mg) every 3 weeks IV for pediatrics
Non-Small Cell Lung Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Malignant Pleural Mesothelioma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Squamous cell carcinoma of the head and neck 200 mg every 3 weeks or 400 mg every 6 weeks IV
Classic Hodgkin Lymphoma 200 mg every 3 weeks or 400 mg every 6 weeks IV for adults; 2 mg/kg (up to 200 mg) every 3 weeks IV for pediatrics
Mediastinal (Thymic) Large B-Cell Lymphoma 200 mg every 3 weeks or 400 mg every 6 weeks IV for adults; 2 mg/kg (up to 200 mg) every 3 weeks IV for pediatrics
Urothelial Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Colorectal Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV for adults; 2 mg/kg (up to 200 mg) every 3 weeks IV for pediatrics
Stomach Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Esophageal carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Cervix carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Liver carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Biliary Tract Cancer 200 mg every 3 weeks or 400 mg every 6 weeks IV
Merkel cell carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV for adults; 2 mg/kg (up to 200 mg) every 3 weeks IV for pediatrics
Renal Cell Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV as single agent or in combination with axitinib 5 mg orally twice daily or lenvatinib 20 mg orally once daily
Endometrial Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV in combination with carboplatin and paclitaxel, or with lenvatinib 20 mg orally once daily, or as single agent for MSI-H or dMMR tumors
Triple-Negative Breast Carcinoma 200 mg every 3 weeks or 400 mg every 6 weeks IV
Malignant neoplasm of ovary 200 mg every 3 weeks or 400 mg every 6 weeks IV
Squamous cell carcinoma of skin 200 mg every 3 weeks or 400 mg every 6 weeks IV
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 (>=20%) fatigue, musculoskeletal pain, decreased appetite, rash, diarrhea, nausea, cough, dyspnea, constipation, pruritus, hypothyroidism
Serious pneumonitis, colitis, hepatitis, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, myocarditis, neurological toxicities, infusion-related reactions, immune-mediated adverse reactions
Postmarketing exocrine pancreatic insufficiency, sclerosing cholangitis
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.
Pembrolizumab is a PD-1 blocking antibody that releases PD-1 pathway-mediated inhibition of the immune response by preventing the interaction of PD-1 with its ligands PD-L1 and PD-L2, thereby restoring anti-tumor immune response.
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)
Keytruda
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Keytruda
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Keytruda
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
No savings programs available for Keytruda.
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AfinitorView full Afinitor profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.