| Renal Cell Carcinoma
Keytruda vs Temsirolimus - Temsirolimus
Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.Deep comparison between: Keytruda 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 Keytruda based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Temsirolimus but not Keytruda, including UnitedHealthcare
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Category
Keytruda
Temsirolimus
At A Glance
IV infusion
Every 3 weeks or Every 6 weeks
PD-1 inhibitor
IV infusion
Once weekly
mTOR inhibitor
Indications
- 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
- Renal Cell Carcinoma
Dosing
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
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, 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
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
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.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Keytruda
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Temsirolimus
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Keytruda
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Temsirolimus
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Keytruda
- 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
No savings programs available for Keytruda.
No savings programs available for Temsirolimus.
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KeytrudaView full Keytruda profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.