Afinitor (everolimus) vs Retsevmo (selpercatinib)

Afinitor (everolimus) is an mTOR inhibitor used to treat various types of cancer, such as advanced renal cell carcinoma, certain breast cancers, and neuroendocrine tumors, as well as tuberous sclerosis complex. Retsevmo (selpercatinib), on the other hand, is a selective RET kinase inhibitor indicated for the treatment of lung and thyroid cancers with RET gene alterations. When deciding between these medications, it is crucial to consider the specific type of cancer and its genetic profile, as the effectiveness of Afinitor and Retsevmo is highly dependent on the presence of certain molecular targets in the cancer cells.

Difference between Afinitor and Retsevmo

Metric	Afinitor (everolimus)	Retsevmo (selpercatinib)
Generic name	Everolimus	Selpercatinib
Indications	Advanced hormone receptor-positive, HER2-negative breast cancer, advanced neuroendocrine tumors, renal cell carcinoma, subependymal giant cell astrocytoma, tuberous sclerosis complex	RET-altered thyroid cancers, RET fusion-positive non-small cell lung cancer
Mechanism of action	mTOR inhibitor	RET kinase inhibitor
Brand names	Afinitor, Zortress	Retsevmo
Administrative route	Oral	Oral
Side effects	Mouth ulcers, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, pneumonitis	Dry mouth, diarrhea, hypertension, fatigue, edema, rash, constipation, abdominal pain
Contraindications	Hypersensitivity to everolimus or other rapamycin derivatives	Hypersensitivity to selpercatinib
Drug class	Immunosuppressant, Antineoplastic agent	Kinase inhibitor
Manufacturer	Novartis	Eli Lilly and Company

Efficacy

Efficacy of Afinitor (Everolimus) in Lung Cancer

Afinitor (everolimus) is a medication primarily known for its use in certain types of advanced hormone receptor-positive breast cancer, pancreatic neuroendocrine tumors, and renal cell carcinoma. Its efficacy in lung cancer, specifically non-small cell lung cancer (NSCLC), has been explored due to its mechanism of action as an mTOR inhibitor, which is involved in cell growth, proliferation, and angiogenesis. Clinical trials have assessed everolimus in various settings of lung cancer treatment, often in combination with other therapies. However, it is not primarily indicated for lung cancer and is not a standard treatment option for this disease. The efficacy of everolimus in lung cancer patients may vary and is generally considered in the context of clinical trials or off-label use.

Efficacy of Retsevmo (Selpercatinib) in Lung Cancer

Retsevmo (selpercatinib) is a more recent addition to the lung cancer treatment landscape. It is specifically indicated for the treatment of non-small cell lung cancer (NSCLC) with RET (rearranged during transfection) gene alterations. Selpercatinib is a selective RET kinase inhibitor that has shown significant efficacy in patients with RET fusion-positive NSCLC. Clinical trials have demonstrated that selpercatinib can lead to high response rates and durable responses in this subset of lung cancer patients. It has been granted accelerated approval by the FDA for its use in RET fusion-positive NSCLC based on the outcomes of these trials.

The efficacy of selpercatinib in RET-altered lung cancer represents a shift towards personalized medicine, where treatments are tailored based on specific genetic alterations in a patient's tumor. The targeted nature of selpercatinib allows for the direct inhibition of the oncogenic driver in RET fusion-positive lung cancer, which may result in better outcomes and fewer side effects compared to traditional chemotherapy. Ongoing studies continue to evaluate the long-term benefits and optimal use of selpercatinib in the treatment of lung cancer with RET alterations.

In summary, while Afinitor (everolimus) has been studied in lung cancer, it is not a standard treatment for this indication and is typically considered in a research setting or for off-label use. On the other hand, Retsevmo (selpercatinib) has shown promising efficacy in treating RET fusion-positive non-small cell lung cancer and has been approved for this specific indication, marking an important advancement in the targeted therapy approach for lung cancer treatment.

Regulatory Agency Approvals

Afinitor

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia

Retsevmo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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