| Renal Cell Carcinoma

Sutent vs Zirabev

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

Deep comparison between: Sutent vs Zirabev with Prescriber.AI

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

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

Category

Sutent

Zirabev

At A Glance

RouteOral

FrequencyDaily

ClassMulti-targeted RTK inhibitor

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

Gastrointestinal Stromal Tumors
Renal Cell Carcinoma
Well Differentiated Pancreatic Endocrine Neoplasm

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

Gastrointestinal Stromal Tumors, Renal Cell Carcinoma 50 mg orally once daily on Schedule 4/2 (4 weeks on, 2 weeks off); adjuvant RCC limited to a maximum of nine 6-week cycles.

Well Differentiated Pancreatic Endocrine Neoplasm 37.5 mg orally once daily 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

1265View drug interactions

231View drug interactions

Adverse Reactions

Most common (>=25%) Fatigue/asthenia, diarrhea, mucositis/stomatitis, nausea, decreased appetite/anorexia, vomiting, abdominal pain, hand-foot syndrome, hypertension, bleeding events, dysgeusia/altered taste, dyspepsia, thrombocytopenia.

Serious Hepatotoxicity, cardiovascular events, QT interval prolongation and Torsade de Pointes, hemorrhagic events, tumor lysis syndrome, thrombotic microangiopathy, proteinuria, dermatologic toxicities, reversible posterior leukoencephalopathy syndrome, thyroid dysfunction, hypoglycemia, osteonecrosis of the jaw, impaired wound healing.

Postmarketing Hemorrhage associated with thrombocytopenia, esophagitis, acalculous cholecystitis, hypersensitivity reactions including angioedema, serious infection, fistula formation, myopathy/rhabdomyolysis, renal impairment/failure, pulmonary embolism, pleural effusion, pyoderma gangrenosum, arterial aneurysms/dissections/rupture, arterial thromboembolic events.

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

Sunitinib is a small-molecule inhibitor of multiple receptor tyrosine kinases (RTKs) including PDGFRalpha/beta, VEGFR1/2/3, KIT, FLT3, CSF-1R, and RET, which are implicated in tumor growth, pathologic angiogenesis, and metastatic progression of cancer.

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

Sutent