Cyramza (ramucirumab) vs Tabrecta (capmatinib)

Cyramza (ramucirumab) is a monoclonal antibody designed to target and inhibit the vascular endothelial growth factor receptor 2 (VEGFR2), which can slow the growth of new blood vessels that tumors need to grow; it is commonly used to treat various types of cancers, including stomach cancer, colorectal cancer, and non-small cell lung cancer (NSCLC) with certain characteristics. Tabrecta (capmatinib), on the other hand, is a selective inhibitor of the c-Met receptor tyrosine kinase, which is implicated in the growth and development of some cancers, and is specifically approved for the treatment of adults with metastatic NSCLC that has a mutation leading to MET exon 14 skipping. When deciding between these two medications, it is crucial to consider the specific type of cancer and its molecular profile, as Tabrecta is tailored for a specific genetic alteration in NSCLC, while Cyramza is used for a broader range of cancers but requires the presence of a suitable target for VEGFR2 inhibition.

Difference between Cyramza and Tabrecta

Metric	Cyramza (ramucirumab)	Tabrecta (capmatinib)
Generic name	ramucirumab	capmatinib
Indications	Gastric cancer, non-small cell lung cancer, colorectal cancer, hepatocellular carcinoma	Non-small cell lung cancer (NSCLC) with MET exon 14 skipping mutations
Mechanism of action	Angiogenesis inhibitor by VEGFR-2 antagonism	Small molecule kinase inhibitor targeting MET
Brand names	Cyramza	Tabrecta
Administrative route	Intravenous	Oral
Side effects	Hypertension, diarrhea, headache, hyponatremia	Nausea, vomiting, fatigue, edema, dyspnea
Contraindications	Hypersensitivity to ramucirumab or any excipients	Hypersensitivity to capmatinib or any excipients
Drug class	Monoclonal antibody	Tyrosine kinase inhibitor
Manufacturer	Eli Lilly and Company	Novartis Pharmaceuticals

Efficacy

Efficacy of Cyramza (Ramucirumab) in Lung Cancer

Cyramza (ramucirumab) is a monoclonal antibody that targets the vascular endothelial growth factor receptor 2 (VEGFR2), which is implicated in the growth of blood vessels that supply tumors with nutrients and oxygen. In the context of non-small cell lung cancer (NSCLC), Cyramza has been evaluated for its efficacy in patients with advanced-stage disease. Clinical trials have demonstrated that when used in combination with docetaxel, Cyramza can provide a statistically significant improvement in overall survival compared to docetaxel alone in patients with metastatic NSCLC who have progressed on or after platinum-based chemotherapy. This improvement in survival indicates Cyramza's potential as a second-line treatment option for NSCLC.

Efficacy of Tabrecta (Capmatinib) in Lung Cancer

Tabrecta (capmatinib) is an oral kinase inhibitor specifically designed to inhibit the activity of the MET proto-oncogene, which can lead to MET exon 14 skipping mutations. These mutations are a recognized driver of certain types of NSCLC. The efficacy of Tabrecta has been evaluated in a multicenter, non-randomized, open-label, multi-cohort study. The results have shown that Tabrecta led to a high rate of objective response rate (ORR) in patients with metastatic NSCLC harboring MET exon 14 skipping mutations. The ORR and duration of response (DoR) observed in these studies suggest that Tabrecta is a promising targeted therapy for this specific patient population.

Comparative Considerations

While both Cyramza and Tabrecta are used in the treatment of NSCLC, their mechanisms of action and the specific patient populations they target differ significantly. Cyramza is generally considered for a broader NSCLC patient population as a second-line treatment, whereas Tabrecta is tailored for a subset of patients with MET exon 14 skipping mutations. The choice of therapy is highly dependent on the molecular profile of the tumor and previous treatments the patient has undergone. Therefore, molecular testing for MET exon 14 skipping mutations is crucial in determining the suitability of Tabrecta for individual patients.

Conclusion

In conclusion, both Cyramza and Tabrecta have shown efficacy in treating certain populations of patients with NSCLC. Cyramza, in combination with docetaxel, has been shown to improve overall survival in a second-line setting, while Tabrecta has demonstrated a high ORR in patients with MET exon 14 skipping mutations. The selection of either drug should be based on a comprehensive evaluation of the patient's specific type of lung cancer and genetic mutations present, as well as considering the patient's overall health and prior treatments.

Regulatory Agency Approvals

Cyramza

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Tabrecta

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

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