Enhertu (fam-trastuzumab deruxtecan-nxki) vs Xalkori (crizotinib)

Enhertu (fam-trastuzumab deruxtecan-nxki) is a targeted therapy specifically designed for the treatment of certain types of breast cancer that overexpress the HER2 protein, as well as for HER2-positive gastric or gastroesophageal junction adenocarcinoma. Xalkori (crizotinib), on the other hand, is a tyrosine kinase inhibitor used primarily to treat non-small cell lung cancer (NSCLC) that is positive for anaplastic lymphoma kinase (ALK) or ROS1 mutations. When deciding between these medications, it is crucial to consider the specific type of cancer and its molecular characteristics, as Enhertu is tailored for HER2-positive cancers while Xalkori is effective in cancers with ALK or ROS1 mutations.

Difference between Enhertu and Xalkori

Metric	Enhertu (fam-trastuzumab deruxtecan-nxki)	Xalkori (crizotinib)
Generic name	Fam-trastuzumab deruxtecan-nxki	Crizotinib
Indications	HER2-positive breast cancer, HER2-mutated non-small cell lung cancer	Non-small cell lung cancer, ROS1-positive, ALK-positive metastatic NSCLC
Mechanism of action	Antibody-drug conjugate targeting HER2 receptors	Tyrosine kinase inhibitor targeting ALK, ROS1, and MET
Brand names	Enhertu	Xalkori
Administrative route	IV infusion	Oral
Side effects	Nausea, fatigue, alopecia, vomiting, constipation, decreased appetite, anemia, neutropenia, leukopenia, diarrhea, cough, interstitial lung disease	Visual disturbances, gastrointestinal effects, edema, elevated transaminases, fatigue, decreased appetite, upper respiratory infection, dizziness, neuropathy
Contraindications	Hypersensitivity to fam-trastuzumab deruxtecan-nxki or excipients	Hypersensitivity to crizotinib or any component of the formulation
Drug class	Antineoplastic agent, HER2 inhibitor, Topoisomerase inhibitor	Antineoplastic agent, Tyrosine kinase inhibitor
Manufacturer	Daiichi Sankyo, Inc.	Pfizer Inc.

Efficacy

Enhertu (fam-trastuzumab deruxtecan-nxki) for Lung Cancer

Enhertu, also known by its generic name fam-trastuzumab deruxtecan-nxki, is a novel antibody-drug conjugate that targets HER2, a protein which can promote the growth of cancer cells. In the context of lung cancer, Enhertu has shown promising efficacy in patients with HER2-mutant non-small cell lung cancer (NSCLC). Clinical trials have demonstrated that Enhertu can lead to significant tumor shrinkage and prolonged progression-free survival in this patient population. The drug has been particularly effective in those who have previously undergone treatment with other therapies, offering a new line of defense against the progression of lung cancer.

It is important to note that Enhertu's efficacy is specifically tied to the presence of HER2 mutations or overexpression in lung cancer cells. Therefore, its use is contingent upon the results of diagnostic testing to confirm HER2 positivity. In clinical settings, Enhertu has been associated with a notable response rate, indicating that a substantial proportion of treated patients experience a reduction in tumor size or disease stabilization.

Xalkori (crizotinib) for Lung Cancer

Xalkori, with the generic name crizotinib, is an oral medication that acts as an ALK and ROS1 inhibitor, designed to treat NSCLC that is ALK or ROS1-positive. The efficacy of Xalkori has been well-established through multiple clinical trials for patients with ALK-positive NSCLC. Xalkori has been shown to significantly improve progression-free survival compared to standard chemotherapy, with a higher response rate and a reduction in the risk of disease progression or death in patients with advanced ALK-positive NSCLC.

Furthermore, Xalkori has also demonstrated effectiveness in patients with ROS1-positive NSCLC, providing a crucial treatment option for this subset of lung cancer patients. The targeted nature of Xalkori's action allows for tailored therapy that can lead to better outcomes and a more favorable safety profile compared to traditional chemotherapy. As with Enhertu, the use of Xalkori is dependent on molecular testing to confirm the presence of ALK or ROS1 gene alterations, which are critical for the drug's efficacy in lung cancer treatment.

Regulatory Agency Approvals

Enhertu

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

Xalkori

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

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