Enhertu (fam-trastuzumab deruxtecan-nxki) vs Gavreto (pralsetinib)

Enhertu (fam-trastuzumab deruxtecan-nxki) is a targeted therapy specifically designed for the treatment of patients with HER2-positive breast cancer, and it works by combining an antibody that targets the HER2 protein with a chemotherapy drug. Gavreto (pralsetinib), on the other hand, is a targeted treatment for patients with specific types of non-small cell lung cancer (NSCLC) that have RET gene alterations, functioning as a RET inhibitor to block cancer cell growth. When deciding between Enhertu and Gavreto, it is crucial to consider the type of cancer and its molecular profile, as each medication is tailored to target different genetic markers and is approved for use in distinct cancer types.

Difference between Enhertu and Gavreto

Metric	Enhertu (fam-trastuzumab deruxtecan-nxki)	Gavreto (pralsetinib)
Generic name	Fam-trastuzumab deruxtecan-nxki	Pralsetinib
Indications	HER2-positive breast cancer, HER2-positive gastric or gastroesophageal junction adenocarcinoma	RET fusion-positive non-small cell lung cancer, RET-mutant medullary thyroid cancer, RET fusion-positive thyroid cancer
Mechanism of action	Antibody-drug conjugate targeting HER2 receptors and delivering cytotoxic chemotherapy	Tyrosine kinase inhibitor targeting RET fusions and mutations
Brand names	Enhertu	Gavreto
Administrative route	Intravenous	Oral
Side effects	Nausea, fatigue, vomiting, alopecia, constipation, decreased appetite, anemia, neutropenia, diarrhea, cough	Increased AST/ALT, increased blood pressure, fatigue, constipation, musculoskeletal pain, decreased white blood cell count
Contraindications	History of interstitial lung disease, pneumonitis, severe hypersensitivity to fam-trastuzumab deruxtecan-nxki	Hypersensitivity to pralsetinib
Drug class	Antibody-drug conjugate	Tyrosine kinase inhibitor
Manufacturer	Daiichi Sankyo and AstraZeneca	Blueprint Medicines Corporation

Efficacy

Efficacy of Enhertu in Lung Cancer

Enhertu (fam-trastuzumab deruxtecan-nxki) is a targeted therapy designed for the treatment of various cancers, including lung cancer. Specifically, it has shown efficacy in patients with HER2-mutant non-small cell lung cancer (NSCLC). In clinical trials, Enhertu has demonstrated a significant response rate in patients with this subtype of lung cancer. Patients treated with Enhertu have experienced notable tumor shrinkage, and the duration of response has been encouraging. However, it is important to note that Enhertu is generally considered for use when other treatments have failed or are not suitable.

Efficacy of Gavreto in Lung Cancer

Gavreto (pralsetinib) is a kinase inhibitor that has been approved for the treatment of adults with metastatic RET fusion-positive non-small cell lung cancer (NSCLC). The efficacy of Gavreto in lung cancer was established in a series of clinical trials, where it was shown to have a high response rate in patients with RET fusion-positive NSCLC. These responses were also durable, with many patients experiencing prolonged periods of disease control. Gavreto provides an important treatment option for patients with this genetic alteration, which is relatively rare but actionable when identified.

Comparison of Enhertu and Gavreto in Lung Cancer

While both Enhertu and Gavreto are effective in treating lung cancer, they target different genetic alterations within the cancer cells. Enhertu is directed towards HER2-mutant cancers, whereas Gavreto targets RET fusion-positive cancers. This specificity underscores the importance of genetic profiling in lung cancer to identify the most effective treatment for individual patients. Both drugs represent a shift towards personalized medicine in lung cancer treatment, offering new hope for patients with these specific genetic profiles.

Considerations and Limitations

It is critical to consider that the efficacy of both Enhertu and Gavreto can vary based on several factors, including the patient's overall health, the presence of other mutations, and previous treatments. Additionally, as with all medications, there are potential side effects and risks associated with their use. Therefore, the decision to use these therapies should be made in consultation with a healthcare provider, taking into account the specific characteristics of the patient's cancer and their individual health profile.

Regulatory Agency Approvals

Enhertu

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Pharmaceuticals and Medical Devices Agency (PMDA), Japan

Gavreto

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

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