| Renal Cell Carcinoma
Fotivda vs Temsirolimus - Temsirolimus
Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.Deep comparison between: Fotivda vs Temsirolimus 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 signalsTemsirolimus has a higher rate of injection site reactions vs Fotivda based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Temsirolimus but not Fotivda, including UnitedHealthcare
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Category
Fotivda
Temsirolimus
At A Glance
Oral
Once daily
VEGFR tyrosine kinase inhibitor
IV infusion
Once weekly
mTOR inhibitor
Indications
- Renal Cell Carcinoma
- Renal Cell Carcinoma
Dosing
Renal Cell Carcinoma 1.34 mg orally once daily for 21 days on treatment followed by 7 days off treatment (28-day cycle); reduce to 0.89 mg once daily for moderate hepatic impairment.
Advanced Renal Cell Carcinoma 25 mg administered as an intravenous infusion over a 30-60 minute period once weekly; continue until disease progression or unacceptable toxicity. Premedicate with IV diphenhydramine 25-50 mg approximately 30 minutes before each dose.
Dose Modification - Hepatic Impairment Reduce dose to 15 mg/week in patients with mild hepatic impairment (bilirubin >1-1.5x ULN or AST >ULN but bilirubin <=ULN); contraindicated if bilirubin >1.5x ULN.
Dose Modification - Strong CYP3A4 Inhibitors Avoid concomitant use; if unavoidable, reduce dose to 12.5 mg/week and allow approximately 1-week washout after inhibitor discontinuation before returning to prior dose.
Dose Modification - Strong CYP3A4 Inducers Avoid concomitant use; if unavoidable, increase dose from 25 mg/week up to 50 mg/week, then return to prior dose once inducer is discontinued.
Dose Modification - Toxicity Hold for ANC or platelet nadirs meeting threshold criteria or NCI CTCAE grade >=3 adverse reactions; once resolved to grade <=2, restart at dose reduced by 5 mg/week to no lower than 15 mg/week.
Contraindications
—
- Bilirubin >1.5x ULN
Adverse Reactions
Most common (>=20%) fatigue, hypertension, diarrhea, decreased appetite, nausea, dysphonia, hypothyroidism, cough, stomatitis
Serious bleeding, venous thromboembolism, arterial thromboembolism, acute kidney injury, hepatobiliary disorders
Postmarketing gastrointestinal perforation, pancreatitis
Most common (>=30%) clinical adverse reactions Rash, asthenia, mucositis, nausea, edema, anorexia
Most common (>=30%) laboratory abnormalities Anemia, hyperglycemia, hyperlipidemia, hypertriglyceridemia, lymphopenia, elevated alkaline phosphatase, elevated serum creatinine, hypophosphatemia, thrombocytopenia, elevated AST, leukopenia
Serious Hypersensitivity/infusion reactions, hepatic impairment, hyperglycemia/glucose intolerance, infections, interstitial lung disease, hyperlipidemia, bowel perforation, renal failure, wound healing complications, intracerebral hemorrhage
Postmarketing Angioedema, rhabdomyolysis, Stevens-Johnson Syndrome, complex regional pain syndrome (reflex sympathetic dystrophy), pancreatitis, cholecystitis, cholelithiasis, extravasation reactions (swelling, pain, warmth, erythema)
Pharmacology
Tivozanib is a tyrosine kinase inhibitor that inhibits phosphorylation of VEGFR-1, VEGFR-2, and VEGFR-3, as well as c-kit and PDGFR-beta, thereby inhibiting angiogenesis, vascular permeability, and tumor growth including human renal cell carcinoma.
Temsirolimus binds to the intracellular protein FKBP-12, and the resulting protein-drug complex inhibits mTOR (mammalian target of rapamycin), blocking its ability to phosphorylate downstream effectors p70S6k and S6 ribosomal protein, leading to G1 growth arrest in tumor cells and reduced levels of HIF-1, HIF-2 alpha, and vascular endothelial growth factor.
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Most Common Insurance
Anthem BCBS
Fotivda
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (12/12)
Temsirolimus
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Fotivda
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Temsirolimus
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Fotivda
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Temsirolimus
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Renal Cell Carcinoma (RCC): Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Temsirolimus.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.