Cosela (trilaciclib) vs Krazati (adagrasib)
Cosela (trilaciclib) vs Krazati (adagrasib)
Cosela (trilaciclib) is a cyclin-dependent kinase inhibitor designed to protect bone marrow cells from damage caused by chemotherapy in patients with small cell lung cancer, potentially reducing the occurrence of chemotherapy-induced myelosuppression. Krazati (adagrasib) is a KRAS G12C inhibitor indicated for the treatment of adults with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer, as determined by an FDA-approved test, who have received at least one prior systemic therapy. When deciding between these two medications, it is important to consider the type and stage of lung cancer, the specific genetic mutations present, and the goal of treatment, as Cosela is used to mitigate side effects of chemotherapy, while Krazati is a targeted therapy for a specific mutation in lung cancer.
Difference between Cosela and Krazati
| Metric | Cosela (trilaciclib) | Krazati (adagrasib) |
|---|---|---|
| Generic name | Trilaciclib | Adagrasib |
| Indications | To decrease the incidence of chemotherapy-induced myelosuppression | Treatment of KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA-approved test, after at least one prior systemic therapy |
| Mechanism of action | CDK4/6 inhibitor that helps protect bone marrow cells from damage caused by chemotherapy | Covalent inhibitor of KRAS G12C mutations, which are common in specific types of cancers |
| Brand names | Cosela | Krazati |
| Administrative route | Intravenous injection | Oral |
| Side effects | Fatigue, hypocalcemia, hypokalemia, hypophosphatemia, increased aspartate aminotransferase, headache, pneumonia | Nausea, diarrhea, fatigue, vomiting, abdominal pain, decreased appetite, musculoskeletal pain, cough, dyspnea, constipation |
| Contraindications | None known | None known |
| Drug class | CDK4 & CDK6 inhibitor | KRAS G12C inhibitor |
| Manufacturer | G1 Therapeutics | Mirati Therapeutics |
Efficacy
Efficacy of Cosela (Trilaciclib) in Lung Cancer
Trilaciclib, marketed under the brand name Cosela, is a novel therapeutic agent that has shown efficacy in the management of small cell lung cancer (SCLC). It is a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor that is designed to protect bone marrow from damage caused by chemotherapy. In clinical trials, Trilaciclib has demonstrated the ability to improve the overall health of bone marrow, thereby potentially reducing the need for supportive care interventions such as growth factor and blood transfusions. Specifically, in lung cancer, Trilaciclib has been shown to reduce the incidence of severe neutropenia, a common and serious side effect of chemotherapy that can lead to infections and hospitalizations.
The efficacy of Trilaciclib in SCLC was evaluated in multiple clinical trials where it was administered before chemotherapy. The results indicated that patients receiving Trilaciclib had a statistically significant improvement in myelopreservation compared to those who did not receive the drug. This benefit was observed across various chemotherapy regimens. However, while Trilaciclib has shown promise in improving hematologic outcomes, its direct impact on survival outcomes in lung cancer patients is still being investigated, and more data are needed to fully understand its role in the treatment of SCLC.
Efficacy of Krazati (Adagrasib) in Lung Cancer
Adagrasib, known by the brand name Krazati, is a targeted therapy that has shown efficacy in the treatment of non-small cell lung cancer (NSCLC) with a specific mutation known as KRAS G12C. This mutation is present in a subset of NSCLC tumors and has historically been challenging to target. Adagrasib functions as a covalent inhibitor of the KRAS G12C mutant protein, thereby blocking the signaling pathways that drive tumor growth and survival.
In clinical studies, Krazati has demonstrated promising antitumor activity in patients with NSCLC harboring the KRAS G12C mutation. The response rates observed in these studies suggest that adagrasib can induce significant tumor shrinkage in a proportion of patients. Moreover, the duration of response and progression-free survival data indicate that the benefits of adagrasib can be sustained over time for some patients. It is important to note that the efficacy of adagrasib is specifically linked to the presence of the KRAS G12C mutation, and therefore, its use is contingent upon the identification of this mutation in the tumor.
Regulatory Agency Approvals
Cosela
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Food and Drug Administration (FDA), USA
Krazati
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European Medical Agency (EMA), European Union
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Food and Drug Administration (FDA), USA
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