Alecensa (alectinib) vs Enhertu (fam-trastuzumab deruxtecan-nxki)
Alecensa (alectinib) vs Enhertu (fam-trastuzumab deruxtecan-nxki)
Alecensa (alectinib) is specifically indicated for the treatment of ALK-positive non-small cell lung cancer (NSCLC) and works by targeting and inhibiting the activity of the ALK protein, which can drive tumor growth in this subset of lung cancer patients. Enhertu (fam-trastuzumab deruxtecan-nxki), on the other hand, is designed to treat HER2-positive breast cancer and certain types of non-small cell lung cancer by delivering a cytotoxic agent directly to the cancer cells that overexpress the HER2 protein. For a patient deciding on which medicine is right for them, it is essential to determine the specific molecular characteristics of their cancer—ALK-positive for Alecensa and HER2-positive for Enhertu—to ensure the appropriate targeted therapy is chosen.
Difference between Alecensa and Enhertu
Metric | Alecensa (alectinib) | Enhertu (fam-trastuzumab deruxtecan-nxki) |
---|---|---|
Generic name | Alectinib | Fam-trastuzumab deruxtecan-nxki |
Indications | ALK-positive metastatic non-small cell lung cancer (NSCLC) | HER2-positive breast cancer, HER2-positive gastric or gastroesophageal junction adenocarcinoma |
Mechanism of action | ALK inhibitor | HER2-directed antibody and topoisomerase inhibitor conjugate |
Brand names | Alecensa | Enhertu |
Administrative route | Oral | Intravenous |
Side effects | Fatigue, constipation, edema, myalgia, anemia | Nausea, fatigue, vomiting, alopecia, constipation, decreased appetite |
Contraindications | Hypersensitivity to alectinib or any component of the formulation | Hypersensitivity to trastuzumab deruxtecan or any component of the formulation |
Drug class | Tyrosine kinase inhibitor | Antibody-drug conjugate |
Manufacturer | Genentech (Roche) | Daiichi Sankyo and AstraZeneca |
Efficacy
Alecensa (Alectinib) Efficacy in Lung Cancer
Alecensa (alectinib) is a targeted therapy approved by the Food and Drug Administration (FDA) for the treatment of non-small cell lung cancer (NSCLC) with specific genetic alterations, namely the anaplastic lymphoma kinase (ALK) positive mutations. Clinical trials have demonstrated that alectinib is highly effective in treating ALK-positive NSCLC. The ALEX trial, a pivotal phase III clinical study, compared alectinib to crizotinib, another ALK inhibitor, and found that alectinib significantly improved progression-free survival in patients with ALK-positive NSCLC. Moreover, alectinib has shown efficacy in controlling central nervous system (CNS) metastases, which is a common complication in ALK-positive NSCLC patients.
Patients treated with Alecensa have shown a reduction in the risk of disease worsening or death compared to those treated with crizotinib. The drug is generally well-tolerated, with a safety profile that is favorable when compared to other ALK inhibitors. As a result, alectinib has become a preferred first-line treatment option for patients with ALK-positive NSCLC, offering a significant improvement in disease management and quality of life.
Enhertu (Fam-Trastuzumab Deruxtecan-nxki) Efficacy in Lung Cancer
Enhertu (fam-trastuzumab deruxtecan-nxki) is a novel antibody-drug conjugate that targets HER2, a protein that can be overexpressed in various cancers, including a subset of non-small cell lung cancers (NSCLC). It has been granted accelerated approval by the FDA for the treatment of adult patients with unresectable or metastatic HER2-positive NSCLC who have received a prior systemic therapy. The efficacy of Enhertu in lung cancer was demonstrated in a pivotal phase II clinical trial, which showed a significant response rate in patients with HER2-mutant NSCLC.
The DESTINY-Lung01 trial revealed that patients treated with Enhertu experienced a notable tumor response, with a median duration of response that suggests a potential for long-term benefit. The therapy has been hailed as a breakthrough for patients with HER2-mutant NSCLC, who previously had limited treatment options. Enhertu's efficacy in lung cancer underscores the importance of molecular profiling in NSCLC to identify patients who may benefit from targeted therapies such as this antibody-drug conjugate.
Regulatory Agency Approvals
Alecensa
Enhertu
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