Libtayo (cemiplimab) vs Cosela (trilaciclib)

Libtayo (cemiplimab) vs Cosela (trilaciclib)

Libtayo (cemiplimab) is a monoclonal antibody designed to treat certain types of cancers, including advanced skin cancers like cutaneous squamous cell carcinoma, by targeting the PD-1 pathway, which can help the immune system attack cancer cells. Cosela (trilaciclib), on the other hand, is a different type of drug known as a cyclin-dependent kinase (CDK) 4/6 inhibitor, used to protect bone marrow cells from damage caused by chemotherapy in patients with extensive-stage small cell lung cancer. The choice between Libtayo and Cosela would depend on the type and stage of cancer being treated, as they serve different purposes: Libtayo as a direct cancer treatment and Cosela as a supportive treatment to reduce the impact of chemotherapy on bone marrow.

Difference between Libtayo and Cosela

Metric Libtayo (cemiplimab) Cosela (trilaciclib)
Generic name Cemiplimab Trilaciclib
Indications Used for the treatment of patients with metastatic or locally advanced cutaneous squamous cell carcinoma (CSCC) who are not candidates for curative surgery or curative radiation, and for the treatment of patients with basal cell carcinoma (BCC) that has recurred following surgery or radiation, or who are not candidates for surgery or radiation, and for the first-line treatment of patients with non-small cell lung cancer (NSCLC) with ≥50% PD-L1 expression and no EGFR, ALK or ROS1 aberrations. 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 Programmed death receptor-1 (PD-1) blocking antibody. Cyclin-dependent kinase 4/6 (CDK4/6) inhibitor.
Brand names Libtayo Cosela
Administrative route Injection (IV) Injection (IV)
Side effects Fatigue, rash, diarrhea, musculoskeletal pain, and nausea. Fatigue, hypocalcemia, increased aspartate aminotransferase, increased alanine aminotransferase, hypokalemia, and headache.
Contraindications There are no contraindications listed in the prescribing information. There are no contraindications listed in the prescribing information.
Drug class Monoclonal antibody, Immune checkpoint inhibitor Cyclin-dependent kinase inhibitor
Manufacturer Regeneron Pharmaceuticals, Inc. G1 Therapeutics, Inc.

Efficacy

Libtayo (Cemiplimab) Efficacy in Lung Cancer

Libtayo (cemiplimab) is a fully human monoclonal antibody that has been designed to target and inhibit the PD-1 receptor on T-cells. Its efficacy in treating lung cancer, specifically non-small cell lung cancer (NSCLC), has been demonstrated in clinical trials. In a pivotal phase 3 trial, cemiplimab showed a significant improvement in overall survival in patients with advanced NSCLC who had progressed on chemotherapy and whose tumors expressed PD-L1 on at least 50% of their cells. Patients treated with cemiplimab had a median overall survival of 22.1 months compared to 14.3 months in those receiving chemotherapy, indicating a substantial benefit in this patient population.

Moreover, the response rate to cemiplimab was also noteworthy. The trial reported that a higher percentage of patients treated with Libtayo experienced a reduction in tumor size compared to those treated with chemotherapy. This response was durable, with many patients maintaining their response for six months or longer. The efficacy of Libtayo in NSCLC underscores its potential as a valuable treatment option for patients with advanced stages of this disease, particularly for those with high PD-L1 expression who have limited treatment options after chemotherapy failure.

Cosela (Trilaciclib) Efficacy in Lung Cancer

Cosela (trilaciclib) is a first-in-class myeloprotection agent designed to protect bone marrow from damage due to chemotherapy. While Cosela itself is not a direct treatment for lung cancer, it is used to mitigate the impact of chemotherapy in small cell lung cancer (SCLC) patients. The efficacy of Cosela in improving the hematologic profile of SCLC patients has been evaluated in several clinical trials. These studies have shown that trilaciclib significantly reduces the incidence of severe neutropenia, a common and potentially life-threatening side effect of chemotherapy that can lead to delays in treatment and reduced chemotherapy dose intensity.

Furthermore, patients receiving Cosela during their chemotherapy regimen for SCLC experienced fewer complications related to neutropenia, such as infections and hospitalizations. This myeloprotective effect allows for better adherence to the intended chemotherapy schedule, which is crucial for the treatment's effectiveness against lung cancer. While Cosela does not directly act on lung cancer cells, its role in maintaining the dose intensity of chemotherapy can indirectly contribute to the overall efficacy of the cancer treatment regimen. Therefore, Cosela represents an important supportive care medication that can enhance the management of SCLC by enabling more consistent and potentially more effective chemotherapy treatment.

Regulatory Agency Approvals

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

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