Gavreto (pralsetinib) vs Vegzelma (bevacizumab-adcd)

Gavreto (pralsetinib) is a targeted therapy specifically designed to treat certain types of thyroid cancer and non-small cell lung cancer with a specific genetic mutation (RET mutation). On the other hand, Vegzelma (bevacizumab-adcd), a biosimilar to Avastin (bevacizumab), is an anti-angiogenic therapy used to treat various forms of cancer, including colorectal, lung, glioblastoma, kidney, and ovarian cancers, by inhibiting the growth of blood vessels that feed tumors. The choice between Gavreto and Vegzelma would depend on the patient's specific type of cancer, the presence of a RET mutation, and the overall treatment plan determined by the healthcare provider, as these medications are not directly interchangeable.

Difference between Gavreto and Vegzelma

Metric	Gavreto (pralsetinib)	Vegzelma (bevacizumab-adcd)
Generic name	Pralsetinib	Bevacizumab-adcd
Indications	For the treatment of adult patients with metastatic RET fusion-positive non-small cell lung cancer (NSCLC)	For the treatment of metastatic colorectal cancer, non-squamous non-small cell lung cancer, glioblastoma, metastatic renal cell carcinoma, cervical cancer, and epithelial ovarian, fallopian tube, or primary peritoneal cancer
Mechanism of action	RET kinase inhibitor	Monoclonal antibody that inhibits angiogenesis by binding to vascular endothelial growth factor A (VEGF-A)
Brand names	Gavreto	Vegzelma
Administrative route	Oral	Intravenous
Side effects	Constipation, hypertension, fatigue, musculoskeletal pain, and diarrhea	Hypertension, proteinuria, hemorrhage, arterial thromboembolism, infusion-related reactions, and gastrointestinal perforation
Contraindications	Hypersensitivity to pralsetinib	Hypersensitivity to bevacizumab or its excipients, uncontrolled hypertension, history of gastrointestinal perforation, serious hemorrhage, or recent surgery
Drug class	Tyrosine kinase inhibitor	Monoclonal antibody, angiogenesis inhibitor
Manufacturer	Blueprint Medicines Corporation	Celltrion, Inc.

Efficacy

Gavreto (pralsetinib) for Lung Cancer

Gavreto (pralsetinib) is a targeted therapy approved for the treatment of adults with metastatic non-small cell lung cancer (NSCLC) associated with RET (rearranged during transfection) gene alterations. Clinical trials have demonstrated that pralsetinib is effective in shrinking tumors in a significant proportion of patients with RET fusion-positive NSCLC. The efficacy of Gavreto was evaluated in a multi-center, open-label, multi-cohort clinical trial, where the objective response rate (ORR) and duration of response (DoR) were the primary endpoints. The results showed that patients treated with pralsetinib experienced a high ORR, indicating a substantial reduction in tumor size, and many of these responses were durable over time.

Vegzelma (bevacizumab-adcd) for Lung Cancer

Vegzelma (bevacizumab-adcd) is a biosimilar to the original bevacizumab product, which is a monoclonal antibody that inhibits vascular endothelial growth factor (VEGF). Bevacizumab, in combination with chemotherapy, is used for the treatment of non-squamous NSCLC. The efficacy of bevacizumab in lung cancer was established in several pivotal trials, which demonstrated improved survival outcomes when added to standard chemotherapy regimens. As a biosimilar, Vegzelma is designed to have no clinically meaningful differences in terms of safety, purity, and potency compared to the reference product, and is intended to provide a more cost-effective treatment option without compromising efficacy.

For Vegzelma, the demonstration of biosimilarity involves comprehensive analytical, preclinical, and clinical data. Clinical studies in NSCLC specifically focus on pharmacokinetics, immunogenicity, safety, and effectiveness. These studies aim to confirm that Vegzelma's therapeutic effects in lung cancer are equivalent to those of the original bevacizumab product, ensuring that patients can expect similar outcomes in terms of tumor response and progression-free survival when treated with the biosimilar.

In conclusion, both Gavreto (pralsetinib) and Vegzelma (bevacizumab-adcd) have shown efficacy in the treatment of specific types of lung cancer. Gavreto is particularly effective for patients with RET fusion-positive NSCLC, while Vegzelma, as a bevacizumab biosimilar, offers an alternative option for the treatment of non-squamous NSCLC in combination with chemotherapy. The use of these medications should be guided by a healthcare professional, taking into account the individual patient's health status and the specific characteristics of their cancer.

Regulatory Agency Approvals

Gavreto

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

Vegzelma

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

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