Afinitor (everolimus) vs Phesgo (pertuzumab, trastuzumab, and hyaluronidase)
Afinitor (everolimus) vs Phesgo (pertuzumab, trastuzumab, and hyaluronidase)
Afinitor (everolimus) is a targeted therapy known as an mTOR inhibitor, primarily used to treat certain types of cancers such as advanced renal cell carcinoma, breast cancer, and neuroendocrine tumors. Phesgo, on the other hand, combines two monoclonal antibodies, pertuzumab and trastuzumab, with hyaluronidase, and is specifically designed for the treatment of HER2-positive breast cancer, where it targets the HER2 protein overexpressed in these cancer cells. The choice between Afinitor and Phesgo would depend on the specific type of cancer a patient has, with Phesgo being the choice for HER2-positive breast cancer, while Afinitor might be used for other cancer types and is not specific to HER2-positive tumors.
Difference between Afinitor and Phesgo
Metric | Afinitor (everolimus) | Phesgo (pertuzumab, trastuzumab, and hyaluronidase) |
---|---|---|
Generic name | Everolimus | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf |
Indications | Advanced hormone receptor-positive, HER2-negative breast cancer, advanced neuroendocrine tumors, renal cell carcinoma, tuberous sclerosis complex-associated seizures, subependymal giant cell astrocytoma, and renal angiomyolipoma | HER2-positive breast cancer (in combination with chemotherapy or as a single agent in specific settings) |
Mechanism of action | mTOR inhibitor | Monoclonal antibodies targeting HER2/neu receptor, and enzyme aiding in subcutaneous administration |
Brand names | Afinitor, Afinitor Disperz, Zortress | Phesgo |
Administrative route | Oral | Subcutaneous injection |
Side effects | Mouth ulcers, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, decreased appetite, headache, cough | Hair loss, nausea, diarrhea, anemia, fatigue, vomiting, joint pain, decreased appetite, headache, constipation |
Contraindications | Hypersensitivity to everolimus or other rapamycin derivatives, concomitant live vaccines, impaired wound healing | Hypersensitivity to active substances or excipients, severe dyspnea at rest from complications of advanced malignancy or requiring supplementary oxygen therapy |
Drug class | Antineoplastic agent, mTOR kinase inhibitor | Antineoplastic agents, monoclonal antibodies |
Manufacturer | Novartis Pharmaceuticals Corporation | Genentech, Inc. |
Efficacy
Efficacy of Afinitor (Everolimus) in Breast Cancer
Afinitor (everolimus) is an mTOR inhibitor that has been shown to be effective in the treatment of hormone receptor-positive, HER2-negative breast cancer. It is specifically used in combination with exemestane after the failure of treatment with letrozole or anastrozole. Clinical trials have demonstrated that Afinitor significantly extends progression-free survival in patients with this type of breast cancer. The BOLERO-2 (Breast cancer trials of OraL EveROlimus-2) study, a phase III trial, showed that the addition of everolimus to exemestane in postmenopausal women with advanced breast cancer resulted in a 6.9-month median progression-free survival compared to 2.8 months with placebo plus exemestane. This improvement in progression-free survival represents a significant therapeutic benefit in this patient population.
Efficacy of Phesgo (Pertuzumab, Trastuzumab, and Hyaluronidase) in Breast Cancer
Phesgo is a combination of two monoclonal antibodies, pertuzumab and trastuzumab, with the enzyme hyaluronidase, which aids in the subcutaneous administration of the drug. This combination is approved for the treatment of HER2-positive breast cancer and has shown efficacy in both early and metastatic settings. In the pivotal trial, the CLEOPATRA study, the addition of pertuzumab to trastuzumab and docetaxel chemotherapy significantly improved median progression-free survival by 6.1 months compared to trastuzumab and chemotherapy alone. Moreover, the final analysis of the study confirmed an overall survival benefit, with the addition of pertuzumab resulting in a 15.7-month improvement in median overall survival.
The efficacy of Phesgo has also been demonstrated in the early breast cancer setting. The APHINITY trial, a phase III study, evaluated the addition of pertuzumab to trastuzumab and chemotherapy in the adjuvant treatment of HER2-positive early breast cancer. The study showed a modest but statistically significant improvement in invasive disease-free survival with the pertuzumab combination compared to trastuzumab and chemotherapy alone. This benefit was particularly notable in patients with lymph node-positive and hormone receptor-negative disease, indicating that certain subgroups of patients may derive more significant benefit from this combination therapy.
Both Afinitor and Phesgo represent important advancements in the treatment of different subtypes of breast cancer. Afinitor has expanded options for patients with hormone receptor-positive, HER2-negative disease, while Phesgo has improved outcomes for those with HER2-positive breast cancer. The administration of Phesgo as a subcutaneous injection also offers a more convenient dosing regimen, potentially enhancing patient quality of life during treatment. It is important for healthcare providers to consider individual patient characteristics and disease subtypes when selecting appropriate treatment regimens, and to stay informed about the latest clinical data to optimize therapeutic outcomes.
Regulatory Agency Approvals
Afinitor
Phesgo
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