Zepzelca (lurbinectedin) vs Xalkori (crizotinib)

Zepzelca (lurbinectedin) vs Xalkori (crizotinib)

Zepzelca (lurbinectedin) is a chemotherapy drug specifically approved for the treatment of adults with metastatic small cell lung cancer (SCLC) that has progressed after prior platinum-based chemotherapy. Xalkori (crizotinib), on the other hand, is a targeted therapy designed to treat non-small cell lung cancer (NSCLC) that is positive for anaplastic lymphoma kinase (ALK) or ROS1 mutations, which are specific genetic alterations. When deciding between these two medications, it is crucial to consider the type of lung cancer and its molecular profile, as Zepzelca is used for SCLC, while Xalkori is tailored for patients with certain genetic markers in NSCLC.

Difference between Zepzelca and Xalkori

Metric Zepzelca (lurbinectedin) Xalkori (crizotinib)
Generic name Lurbinectedin Crizotinib
Indications Metastatic Small Cell Lung Cancer Non-small cell lung cancer, ROS1-positive, ALK-positive metastatic NSCLC
Mechanism of action Inhibits transcription and induces DNA breaks ALK and ROS1 tyrosine kinase inhibitor
Brand names Zepzelca Xalkori
Administrative route Intravenous Oral
Side effects Myelosuppression, fatigue, increased liver enzymes, nausea, decreased appetite, musculoskeletal pain, and others Visual disorders, gastrointestinal effects, edema, elevated transaminases, and others
Contraindications Hypersensitivity to lurbinectedin or excipients Hepatic impairment, concomitant use with strong CYP3A inhibitors or inducers
Drug class Alkylating drug Tyrosine kinase inhibitor
Manufacturer Pharma Mar Pfizer

Efficacy

Zepzelca (Lurbinectedin) for Small Cell Lung Cancer

Zepzelca (lurbinectedin) is a medication specifically indicated for the treatment of adults with metastatic small cell lung cancer (SCLC) that has progressed after platinum-based chemotherapy. As an alkylating drug, lurbinectedin works by binding to the DNA in cancer cells, thereby inhibiting tumor growth. The efficacy of Zepzelca was evaluated in a multi-center, single-arm, open-label clinical trial. In this study, a significant number of patients with relapsed SCLC experienced a reduction in tumor size, which is an important indicator of the drug's efficacy in this patient population.

The clinical trial demonstrated an overall response rate (ORR) of 35.2% in patients treated with Zepzelca. This response was measured by the rate of complete or partial shrinkage of tumors, as assessed by independent review using the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The median duration of response (DoR) was also a critical component of the drug's efficacy profile, with a median DoR of 5.3 months reported, indicating that the responses achieved were sustained over a meaningful period of time.

Xalkori (Crizotinib) for Non-Small Cell Lung Cancer

Xalkori (crizotinib) is a targeted therapy approved for the treatment of patients with non-small cell lung cancer (NSCLC) who have an anaplastic lymphoma kinase (ALK) or ROS1-positive tumor. Crizotinib is a tyrosine kinase inhibitor that works by blocking the activity of the ALK or ROS1 protein, thereby inhibiting the growth and spread of cancer cells. The efficacy of Xalkori has been established through multiple clinical trials, particularly in patients with ALK-positive metastatic NSCLC who have shown significant improvements in progression-free survival (PFS) and ORR compared to chemotherapy.

In pivotal clinical trials, Xalkori has demonstrated an ORR of 50-60% in ALK-positive NSCLC patients, with a median PFS ranging from 7 to 11 months, which is substantially longer than the PFS typically observed with standard chemotherapy in this patient population. Additionally, Xalkori has shown efficacy in patients with ROS1-positive NSCLC, with an ORR of approximately 72% and a median PFS of 19.2 months. These results highlight the substantial impact of Xalkori on the treatment of NSCLC patients with specific genetic alterations and underscore its role as a personalized treatment option in the oncology landscape.

Regulatory Agency Approvals

Zepzelca
  • Food and Drug Administration (FDA), USA
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

Access Zepzelca or Xalkori today

If Zepzelca or Xalkori 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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