| Renal Cell Carcinoma

Avastin vs Lenvima

Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.

Deep comparison between: Avastin vs Lenvima with Prescriber.AI

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

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

Category

Avastin

Lenvima

At A Glance

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

RouteOral

FrequencyOnce daily

ClassMulti-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

Differentiated Thyroid Gland Carcinoma
Renal Cell Carcinoma
Liver carcinoma
Endometrial 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.

Differentiated Thyroid Gland Carcinoma 24 mg orally once daily until disease progression or unacceptable toxicity.

Renal Cell Carcinoma (first-line, with pembrolizumab) 20 mg orally once daily in combination with pembrolizumab 200 mg IV infusion over 30 minutes every 3 weeks until disease progression or unacceptable toxicity or up to 2 years.

Renal Cell Carcinoma (previously treated, with everolimus) 18 mg orally once daily in combination with everolimus 5 mg orally once daily until disease progression or unacceptable toxicity.

Liver carcinoma 12 mg orally once daily for patients >=60 kg or 8 mg orally once daily for patients <60 kg, until disease progression or unacceptable toxicity.

Endometrial Carcinoma 20 mg orally once daily in combination with pembrolizumab 200 mg IV infusion over 30 minutes every 3 weeks until unacceptable toxicity or disease progression.

Contraindications

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Drug Interactions

232View drug interactions

1071View 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%) Hypertension, fatigue, diarrhea, arthralgia/myalgia, decreased appetite, decreased weight, nausea, stomatitis, headache, vomiting, proteinuria, palmar-plantar erythrodysesthesia syndrome, abdominal pain, dysphonia, hypothyroidism, hemorrhagic events, rash, musculoskeletal pain.

Serious Hepatic encephalopathy, hepatic failure, cardio-respiratory arrest, sepsis, myocardial infarction, pneumonitis, acute kidney injury, renal failure, dehydration, thrombocytopenia, dyspnea, anemia.

Postmarketing Pancreatitis, impaired wound healing, cholecystitis, nephrotic syndrome, arterial aneurysms/dissections/rupture.

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.

Lenvatinib is a multi-kinase inhibitor that inhibits VEGFR1, VEGFR2, and VEGFR3 kinase activities as well as FGFR1-4, PDGFRA, KIT, and RET, suppressing pathogenic angiogenesis and tumor growth; in combination with pembrolizumab or everolimus, it demonstrates enhanced antiangiogenic and antitumor activity.

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Anthem BCBS

Avastin