Libtayo (cemiplimab) vs Krazati (adagrasib)

Libtayo (cemiplimab) and Krazati (adagrasib) are both used in the treatment of certain types of cancer, but they have different mechanisms of action and indications. Libtayo is an immune checkpoint inhibitor that works by blocking the PD-1 receptor, enhancing the body's immune response against cancer cells, and is approved for use in certain patients with advanced skin cancers, non-small cell lung cancer, and basal cell carcinoma. Krazati, on the other hand, is a small molecule inhibitor targeting the KRAS G12C mutation, specifically designed for use in non-small cell lung cancer with this mutation, and is not suitable for patients whose cancers do not carry the KRAS G12C mutation. When deciding which medicine is right for an individual, it is crucial to consider the specific type of cancer, its genetic makeup, and the overall health and treatment history of the patient, as well as consulting with a healthcare professional to determine the most appropriate treatment option.

Difference between Libtayo and Krazati

Metric	Libtayo (cemiplimab)	Krazati (adagrasib)
Generic name	Cemiplimab	Adagrasib
Indications	Cutaneous squamous cell carcinoma, basal cell carcinoma, non-small cell lung cancer	Non-small cell lung cancer with KRAS G12C mutation
Mechanism of action	PD-1 inhibitor	KRAS G12C inhibitor
Brand names	Libtayo	Krazati
Administrative route	Injection	Oral
Side effects	Fatigue, rash, diarrhea	Nausea, vomiting, diarrhea
Contraindications	Severe hypersensitivity to cemiplimab or its excipients	None known specifically; caution in patients with severe hepatic impairment
Drug class	Monoclonal antibody	Small molecule kinase inhibitor
Manufacturer	Regeneron Pharmaceuticals	Mirati Therapeutics

Efficacy

Libtayo (Cemiplimab) Efficacy in Lung Cancer

Libtayo (cemiplimab) is a fully human monoclonal antibody designed to block the immune checkpoint receptor PD-1 (programmed death-1) on T-cells. By doing so, it helps the body’s immune system to attack and destroy cancer cells. In the context of non-small cell lung cancer (NSCLC), Libtayo has shown significant efficacy. A pivotal phase 3 trial demonstrated that Libtayo improved overall survival in patients with advanced NSCLC whose cancer has high PD-L1 expression and who do not have EGFR, ALK, or ROS1 aberrations. The study indicated that patients treated with Libtayo had a 32% reduction in the risk of death compared to those treated with chemotherapy.

The efficacy of Libtayo for the treatment of NSCLC is particularly notable in the subset of patients with ≥50% PD-L1 expression in their tumors. In these patients, Libtayo has been reported to provide a greater survival benefit. The treatment is generally used for patients who have either progressed during or after platinum-based chemotherapy or for those who are not candidates for surgical intervention or definitive chemoradiation.

Krazati (Adagrasib) Efficacy in Lung Cancer

Krazati (adagrasib) is a small molecule designed to inhibit the KRAS G12C mutation, which is a common mutation in NSCLC. While Krazati is a relatively new entrant in the lung cancer treatment landscape, it has shown promise in early clinical trials. The efficacy of Krazati in lung cancer was assessed in patients with the KRAS G12C mutation who had previously received systemic therapy. Initial results from phase 1/2 trials have indicated that Krazati achieved a notable response rate in these patients, with a significant number experiencing tumor shrinkage.

It is important to note that the KRAS G12C mutation is present in approximately 12-13% of patients with NSCLC, making Krazati a targeted therapy for a specific subset of lung cancer patients. The drug's efficacy in this group suggests a new line of treatment for patients who have limited options after first-line therapy. However, as Krazati is newer to the market, ongoing studies are required to further define its long-term efficacy and optimal place in the treatment paradigm for NSCLC.

Regulatory Agency Approvals

Libtayo

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

Krazati

Food and Drug Administration (FDA), USA

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