| Small cell carcinoma of lung

Imfinzi vs Zepzelca

Side-by-side clinical, coverage, and cost comparison for small cell carcinoma of lung.

Deep comparison between: Imfinzi vs Zepzelca 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 signalsZepzelca has a higher rate of injection site reactions vs Imfinzi based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Zepzelca but not Imfinzi, including UnitedHealthcare

Category

Imfinzi

Zepzelca

At A Glance

RouteIV infusion

FrequencyEvery 2 to 4 weeks

ClassPD-L1 antagonist

RouteIV infusion

FrequencyEvery 21 days

ClassAlkylating drug

Indications

Non-Small Cell Lung Carcinoma
Small cell carcinoma of lung
Biliary Tract Cancer
Liver carcinoma
Endometrial Carcinoma
Carcinoma of bladder
Stomach Carcinoma
Gastroesophageal junction cancer

Small cell carcinoma of lung
Small cell lung cancer extensive stage
Small cell lung cancer metastatic

Dosing

Resectable NSCLC Neoadjuvant: 1,500 mg IV every 3 weeks in combination with chemotherapy for up to 4 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks as a single agent for up to 12 cycles after surgery (or 20 mg/kg if weight <30 kg).

Unresectable Stage III NSCLC 1,500 mg IV every 4 weeks or 10 mg/kg every 2 weeks as a single agent until disease progression or unacceptable toxicity (maximum 12 months) (or 10 mg/kg every 2 weeks if weight <30 kg).

Metastatic NSCLC 1,500 mg IV in combination with tremelimumab-actl 75 mg and platinum-based chemotherapy every 3 weeks for 4 cycles, then 1,500 mg every 4 weeks as a single agent with pemetrexed maintenance for non-squamous (or 20 mg/kg and 1 mg/kg tremelimumab-actl if weight <30 kg).

Limited Stage SCLC 1,500 mg IV every 4 weeks as a single agent until disease progression or unacceptable toxicity (maximum 24 months) (or 20 mg/kg if weight <30 kg).

Extensive Stage SCLC 1,500 mg IV every 3 weeks in combination with etoposide and carboplatin or cisplatin for 4 cycles, then 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg if weight <30 kg).

Biliary Tract Cancer 1,500 mg IV every 3 weeks in combination with gemcitabine and cisplatin for up to 8 cycles, then 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg if weight <30 kg).

Unresectable Hepatocellular Carcinoma 1,500 mg IV in combination with a single dose of tremelimumab-actl 300 mg at Cycle 1/Day 1, followed by 1,500 mg every 4 weeks as a single agent until disease progression (or 20 mg/kg and 4 mg/kg tremelimumab-actl if weight <30 kg).

dMMR Endometrial Carcinoma 1,120 mg IV in combination with carboplatin and paclitaxel every 3 weeks for 6 cycles, followed by 1,500 mg every 4 weeks as a single agent until disease progression (or 15 mg/kg followed by 20 mg/kg if weight <30 kg).

Muscle Invasive Bladder Cancer Neoadjuvant: 1,500 mg IV in combination with gemcitabine and cisplatin every 3 weeks for 4 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks as a single agent for up to 8 cycles after surgery (or 20 mg/kg if weight <30 kg).

Resectable Gastric/Gastroesophageal Junction Adenocarcinoma Neoadjuvant: 1,500 mg IV every 4 weeks with FLOT for up to 2 cycles prior to surgery (or 20 mg/kg if weight <30 kg). Adjuvant: 1,500 mg IV every 4 weeks with FLOT for up to 2 cycles, followed by 1,500 mg as a single agent every 4 weeks for up to 10 cycles (or 20 mg/kg if weight <30 kg).

Small cell lung cancer extensive stage 3.2 mg/m2 IV infusion over 60 minutes every 21 days in combination with atezolizumab or atezolizumab and hyaluronidase-tqjs until disease progression or unacceptable toxicity; reduce to 1.6 mg/m2 every 21 days for moderate or severe hepatic impairment.

Small cell lung cancer metastatic 3.2 mg/m2 IV infusion over 60 minutes every 21 days as a single agent until disease progression or unacceptable toxicity; reduce to 1.6 mg/m2 every 21 days for moderate or severe hepatic impairment.

Contraindications

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Drug Interactions

203View drug interactions

884View drug interactions

Adverse Reactions

Most common (>=10%) Nausea, fatigue, cough, pneumonitis, rash, diarrhea, decreased appetite, musculoskeletal pain, constipation, dyspnea, upper respiratory tract infections, pyrexia, pruritus, headache, vomiting, abdominal pain, hypothyroidism, peripheral neuropathy, alopecia, insomnia

Serious Pneumonitis, pneumonia, hepatitis, colitis, myocarditis, nephritis, endocrinopathies, infusion-related reactions, exfoliative dermatologic conditions

Postmarketing Not specified in label

Most common (>=30%) Decreased lymphocytes, decreased platelets, decreased hemoglobin, decreased neutrophils, nausea, fatigue

Serious Pneumonia, sepsis, cardio-respiratory arrest, myocardial infarction, febrile neutropenia

Postmarketing Extravasation with tissue necrosis requiring debridement, rhabdomyolysis, tumor lysis syndrome

Pharmacology

Durvalumab is a human IgG1 kappa monoclonal antibody that binds to PD-L1 and blocks the interaction of PD-L1 with PD-1 and CD80, releasing the inhibition of immune responses without inducing antibody-dependent cell-mediated cytotoxicity.

Lurbinectedin is an alkylating drug that binds guanine residues in the minor groove of DNA, forming adducts that disrupt DNA binding proteins and repair pathways, leading to cell cycle perturbation and cell death; it also inhibits monocyte activity and reduces macrophage tumor infiltration in vivo.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Imfinzi