| Renal Cell Carcinoma

Cabometyx vs Zirabev

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

Deep comparison between: Cabometyx vs Zirabev with Prescriber.AI

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

Coverage gaps3 major payers require step therapy for Zirabev but not Cabometyx, including UnitedHealthcare

Category

Cabometyx

Zirabev

At A Glance

RouteOral

FrequencyOnce daily

ClassTyrosine kinase inhibitor

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

Renal Cell Carcinoma
Liver carcinoma
Well Differentiated Pancreatic Endocrine Neoplasm
Neuroendocrine Tumors

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

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.

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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Drug Interactions

969View drug interactions

231View drug interactions

Adverse Reactions

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.

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

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.

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.

View Full FDA Information

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Most Common Insurance

Anthem BCBS

Cabometyx