Vizimpro (dacomitinib) vs Cosela (trilaciclib)

Vizimpro (dacomitinib) vs Cosela (trilaciclib)

Vizimpro (dacomitinib) is a kinase inhibitor specifically designed to treat certain types of non-small cell lung cancer (NSCLC) with specific genetic mutations by blocking the activity of epidermal growth factor receptor (EGFR). In contrast, Cosela (trilaciclib) is used to protect bone marrow cells from damage caused by chemotherapy in patients with extensive-stage small cell lung cancer (SCLC); it is not a treatment for the cancer itself but rather a supportive care medication. When deciding between these medications, it is crucial to consider the type of lung cancer, the presence of specific genetic mutations, and the goal of treatment (targeting the cancer directly with Vizimpro or protecting bone marrow during chemotherapy with Cosela).

Difference between Vizimpro and Cosela

Metric Vizimpro (dacomitinib) Cosela (trilaciclib)
Generic name Dacomitinib Trilaciclib
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. Used to decrease the incidence of chemotherapy-induced myelosuppression in adult patients when administered prior to a platinum/etoposide-containing regimen or topotecan-containing regimen for extensive-stage small cell lung cancer (ES-SCLC).
Mechanism of action An irreversible inhibitor of the EGFR/HER1, HER2, and HER4 tyrosine kinases. A cyclin-dependent kinase inhibitor that transiently arrests bone marrow cells in the G1 phase of the cell cycle, protecting them from damage by chemotherapy.
Brand names Vizimpro Cosela
Administrative route Oral Intravenous
Side effects Diarrhea, rash, paronychia, stomatitis, decreased appetite, dry skin, decreased weight, alopecia, cough, pruritus. Fatigue, hypocalcemia, hypokalemia, hypophosphatemia, increased aspartate aminotransferase, headache, pneumonia, increased blood creatinine, decreased weight.
Contraindications Patients with a history of severe hypersensitivity to dacomitinib or any component of the formulation. None known specifically; however, it should be used with caution in patients with pre-existing myelosuppression or who are taking drugs that cause myelosuppression.
Drug class Tyrosine kinase inhibitor Cyclin-dependent kinase inhibitor
Manufacturer Pfizer Inc. G1 Therapeutics, Inc.

Efficacy

Vizimpro (Dacomitinib) Efficacy in Lung Cancer

Vizimpro (dacomitinib) is a kinase inhibitor specifically designed to target the epidermal growth factor receptor (EGFR) tyrosine kinase, which is known to play a critical role in the pathogenesis of various cancers, including non-small cell lung cancer (NSCLC). The efficacy of Vizimpro for the first-line treatment of patients with metastatic NSCLC with EGFR exon 19 deletion or exon 21 L858R substitution mutations has been demonstrated in clinical trials. One pivotal study, the ARCHER 1050 trial, compared Vizimpro to gefitinib, another EGFR inhibitor. The results showed a significant improvement in progression-free survival (PFS) for patients treated with Vizimpro, indicating a delay in disease progression or death compared to gefitinib.

In the ARCHER 1050 trial, the median PFS for patients treated with Vizimpro was 14.7 months, compared to 9.2 months for those treated with gefitinib. Furthermore, Vizimpro also showed an improvement in overall survival (OS), with a median OS of 34.1 months compared to 26.8 months for gefitinib. These results suggest that Vizimpro may be a more effective first-line treatment option for patients with EGFR-mutated NSCLC. However, it is important to note that Vizimpro is associated with a distinct side effect profile that requires careful management.

Cosela (Trilaciclib) Efficacy in Lung Cancer

Cosela (trilaciclib) is a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor that is used to decrease the incidence of chemotherapy-induced myelosuppression in adult patients when administered prior to a platinum/etoposide-containing regimen or topotecan-containing regimen for extensive-stage small cell lung cancer (ES-SCLC). Myelosuppression is a common and serious side effect of chemotherapy that can lead to complications such as anemia, neutropenia, and thrombocytopenia. By protecting bone marrow cells from damage by chemotherapy, Cosela can help maintain the patient's immune system and reduce the need for supportive treatments such as growth factors or blood transfusions.

The efficacy of Cosela was evaluated in several clinical trials, including three randomized, double-blind, placebo-controlled trials. In these studies, patients treated with Cosela experienced a statistically significant reduction in the duration of severe neutropenia during the first cycle of chemotherapy. This result indicates that Cosela is effective in reducing the risk of severe neutropenia, which is a common dose-limiting toxicity of chemotherapy. By reducing the occurrence of severe neutropenia, Cosela has the potential to improve the tolerability of chemotherapy and allow patients to receive their treatment on schedule, which is crucial for the best possible outcomes in lung cancer therapy.

Regulatory Agency Approvals

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

Access Vizimpro or Cosela today

If Vizimpro or Cosela 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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