| Renal Cell Carcinoma

Lenvima vs Zirabev

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

Deep comparison between: Lenvima vs Zirabev with Prescriber.AI

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

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

Category

Lenvima

Zirabev

At A Glance

RouteOral

FrequencyOnce daily

ClassMulti-kinase inhibitor

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

Differentiated Thyroid Gland Carcinoma
Renal Cell Carcinoma
Liver carcinoma
Endometrial Carcinoma

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

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.

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

1071View drug interactions

231View 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 (>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

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.

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.

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Most Common Insurance

Anthem BCBS

Lenvima