| Renal Cell Carcinoma

Lenvima vs Temsirolimus - Temsirolimus

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

Deep comparison between: Lenvima vs Temsirolimus with Prescriber.AI

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

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

Category

Lenvima

Temsirolimus

At A Glance

RouteOral

FrequencyOnce daily

ClassMulti-kinase inhibitor

RouteIV infusion

FrequencyOnce weekly

ClassmTOR inhibitor

Indications

Differentiated Thyroid Gland Carcinoma
Renal Cell Carcinoma
Liver carcinoma
Endometrial Carcinoma

Renal Cell Carcinoma

Dosing

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.

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

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Bilirubin >1.5x ULN

Drug Interactions

1071View drug interactions

1050View drug interactions

Adverse Reactions

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.

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

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.

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.

View Full FDA Information

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Most Common Insurance

Anthem BCBS

Lenvima