| Renal Cell Carcinoma

Temsirolimus - Temsirolimus vs Yervoy

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

Deep comparison between: Temsirolimus vs Yervoy with Prescriber.AI

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

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

Category

Temsirolimus

Yervoy

At A Glance

RouteIV infusion

FrequencyOnce weekly

ClassmTOR inhibitor

RouteIV infusion

FrequencyEvery 3 weeks (monotherapy) or every 6 weeks (combination)

ClassCTLA-4 antagonist

Indications

Renal Cell Carcinoma

melanoma
Renal Cell Carcinoma
Colorectal Carcinoma
Liver carcinoma
Non-Small Cell Lung Carcinoma
Malignant Pleural Mesothelioma
Squamous cell carcinoma of esophagus

Dosing

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.

Melanoma (unresectable or metastatic) 3 mg/kg IV every 3 weeks for 4 doses, or 3 mg/kg IV with nivolumab 1 mg/kg IV every 3 weeks for 4 doses followed by nivolumab monotherapy

Melanoma (adjuvant) 3 mg/kg IV every 3 weeks for 4 doses, then 3 mg/kg every 12 weeks for up to 4 additional doses

Renal Cell Carcinoma 1 mg/kg IV with nivolumab 3 mg/kg IV every 3 weeks for 4 doses, followed by nivolumab monotherapy

Colorectal Carcinoma 1 mg/kg IV with nivolumab 240 mg or 3 mg/kg IV (weight-based) every 3 weeks for 4 doses, followed by nivolumab monotherapy

Liver carcinoma 3 mg/kg IV with nivolumab 1 mg/kg IV every 3 weeks for up to 4 doses, followed by nivolumab monotherapy

Non-Small Cell Lung Carcinoma 1 mg/kg IV every 6 weeks with nivolumab 360 mg every 3 weeks, or with nivolumab and 2 cycles of platinum-doublet chemotherapy

Malignant Pleural Mesothelioma 1 mg/kg IV every 6 weeks with nivolumab 360 mg every 3 weeks

Squamous cell carcinoma of esophagus 1 mg/kg IV every 6 weeks with nivolumab 3 mg/kg every 2 weeks or 360 mg every 3 weeks

Contraindications

Bilirubin >1.5x ULN

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Drug Interactions

1872View drug interactions

676View drug interactions

Adverse Reactions

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)

Most common (>=20%) fatigue, diarrhea, rash, pruritus, nausea, pyrexia, musculoskeletal pain, decreased appetite, cough, headache, dyspnea, vomiting, abdominal pain, arthralgia

Serious immune-mediated colitis, hepatitis, pneumonitis, endocrinopathies, nephritis, dermatologic reactions, neurological toxicities, myocarditis, adrenal insufficiency, hypophysitis, hyperthyroidism, hypothyroidism

Pharmacology

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.

Ipilimumab blocks CTLA-4, a negative regulator of T-cell activity, thereby augmenting T-cell activation and proliferation including tumor-infiltrating T-effector cells and reducing T-regulatory cell function.

View Full FDA Information

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Most Common Insurance

Anthem BCBS

Temsirolimus