Vizimpro (dacomitinib) vs Zepzelca (lurbinectedin)

Vizimpro (dacomitinib) vs Zepzelca (lurbinectedin)

Vizimpro (dacomitinib) is a tyrosine kinase inhibitor specifically designed to target and inhibit the epidermal growth factor receptor (EGFR), which is often mutated in non-small cell lung cancer (NSCLC). It is indicated for the first-line treatment of patients with NSCLC with EGFR exon 19 deletion or exon 21 L858R substitution mutations. In contrast, Zepzelca (lurbinectedin) is a selective oncogenic transcription inhibitor used for the treatment of adults with metastatic small cell lung cancer (SCLC) who have progressed on or after platinum-based chemotherapy, and it works by binding to DNA and inhibiting the transcription of oncogenic proteins. For a patient deciding between these two medications, the choice would depend on the specific type of lung cancer they have (NSCLC with specific EGFR mutations for Vizimpro, versus SCLC for Zepzelca), their previous treatment history, and the molecular characteristics of their tumor. It is crucial to consult with an oncologist to determine the most appropriate treatment based on individual patient factors and the latest clinical guidelines.

Difference between Vizimpro and Zepzelca

Metric Vizimpro (dacomitinib) Zepzelca (lurbinectedin)
Generic name Dacomitinib Lurbinectedin
Indications First-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations. Treatment of adults with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy.
Mechanism of action Irreversible inhibitor of the EGFR/HER1, HER2, and HER4 tyrosine kinases. Trabectedin analogue that binds to the minor groove of DNA, causing a disruption of the cell cycle and apoptosis.
Brand names Vizimpro Zepzelca
Administrative route Oral Intravenous
Side effects Diarrhea, rash, paronychia, stomatitis, decreased appetite, dry skin, decreased weight, alopecia. Myelosuppression, fatigue, increased creatinine, increased alanine aminotransferase, increased glucose, nausea, decreased appetite, musculoskeletal pain, dyspnea, constipation.
Contraindications None known specifically; however, should not be used in patients with a history of severe hypersensitivity to dacomitinib or its components. None known specifically; however, should not be used in patients with a history of severe hypersensitivity to lurbinectedin or its components.
Drug class Kinase inhibitor Alkylating drug
Manufacturer Pfizer Pharma Mar

Efficacy

Vizimpro (Dacomitinib) for Non-Small Cell Lung Cancer

Vizimpro (dacomitinib) is an oral, once-daily, irreversible pan-human epidermal growth factor receptor (HER) tyrosine kinase inhibitor. It is specifically indicated for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations as detected by an FDA-approved test. The efficacy of Vizimpro was demonstrated in a randomized, multicenter, open-label, active-controlled trial (ARCHER 1050). Patients treated with Vizimpro showed a significant improvement in progression-free survival compared to those treated with gefitinib, another EGFR inhibitor. This marked Vizimpro as an effective first-line treatment option for patients with EGFR-mutated NSCLC.

Zepzelca (Lurbinectedin) for Small Cell Lung Cancer

Zepzelca (lurbinectedin) is a selective inhibitor of oncogenic transcription and an alkylating drug. It is approved for the treatment of adults with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy. The efficacy of Zepzelca was evaluated in a multicenter, single-arm, open-label clinical trial, which included a cohort of patients with SCLC who had disease progression following platinum-based chemotherapy. Results from the trial demonstrated a meaningful overall response rate and duration of response, indicating that Zepzelca provides a viable treatment option for patients with relapsed SCLC, a particularly aggressive form of lung cancer with limited treatment options after first-line therapy.

Comparative Efficacy in Lung Cancer Treatment

While both Vizimpro and Zepzelca are used in the treatment of lung cancer, they are indicated for different types of the disease and are not directly comparable. Vizimpro is used for the treatment of NSCLC with specific EGFR mutations and has shown efficacy in improving progression-free survival in a first-line setting. On the other hand, Zepzelca is used for the treatment of SCLC after the failure of initial chemotherapy and has shown efficacy in terms of overall response rate and duration of response. Both drugs represent important advancements in the treatment of their respective indications and provide new options for patients with these challenging forms of lung cancer.

Conclusion

In conclusion, Vizimpro and Zepzelca have shown efficacy in treating different forms of lung cancer. Vizimpro is effective in treating NSCLC with specific genetic mutations and is used as a first-line treatment, while Zepzelca is effective for patients with SCLC who have experienced disease progression after chemotherapy. Both medicines offer hope for improved outcomes in lung cancer treatment, addressing the needs of distinct patient populations within this disease area. As with any medication, the use of Vizimpro and Zepzelca should be under the guidance of a healthcare provider, with consideration given to the specific characteristics of the disease and the patient's overall health profile.

Regulatory Agency Approvals

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

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If Vizimpro or Zepzelca are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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