Afinitor (everolimus) vs Margenza (margetuximab-cmkb)

Afinitor (everolimus) is an mTOR inhibitor used primarily to treat various types of cancers, such as advanced renal cell carcinoma, certain breast cancers, and neuroendocrine tumors, by interfering with cancer cell growth and proliferation. Margenza (margetuximab-cmkb), on the other hand, is a monoclonal antibody designed to target HER2-positive breast cancer, a specific type of tumor that overexpresses the HER2 protein, and it works by flagging cancer cells for destruction by the immune system. The choice between Afinitor and Margenza would depend on the specific type and characteristics of the cancer being treated, as well as the patient's overall health, previous treatments, and potential drug interactions, making it essential for a healthcare provider to determine the most appropriate option based on the individual patient's condition.

Difference between Afinitor and Margenza

Metric	Afinitor (everolimus)	Margenza (margetuximab-cmkb)
Generic name	Everolimus	Margetuximab-cmkb
Indications	Advanced hormone receptor-positive, HER2-negative breast cancer in postmenopausal women; advanced renal cell carcinoma; renal angiomyolipoma and tuberous sclerosis complex; subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex	Metastatic HER2-positive breast cancer in combination with chemotherapy
Mechanism of action	mTOR inhibitor, which inhibits the mammalian target of rapamycin (mTOR) pathway, a key signaling pathway that regulates cell growth, proliferation, and survival	Monoclonal antibody that targets the HER2/neu receptor, leading to immune-mediated destruction of cancer cells
Brand names	Afinitor, Afinitor Disperz, Zortress	Margenza
Administrative route	Oral	Intravenous
Side effects	Mouth ulcers, infections, rash, fatigue, diarrhea, decreased appetite, edema, stomach pain, cough, headache, decreased weight, and taste disturbance	Infusion-related reactions, fatigue, nausea, diarrhea, vomiting, constipation, headache, fever, hair loss, abdominal pain, and extremity pain
Contraindications	Hypersensitivity to everolimus or other rapamycin derivatives	Hypersensitivity to margetuximab-cmkb or its excipients
Drug class	mTOR inhibitor	Monoclonal antibody
Manufacturer	Novartis Pharmaceuticals Corporation	MacroGenics, Inc.

Efficacy

Afinitor (Everolimus) Efficacy in Breast Cancer

Afinitor (everolimus) is an mTOR inhibitor that has been approved for use in hormone receptor-positive, HER2-negative breast cancer. This medication is typically used in combination with exemestane after the failure of treatment with letrozole or anastrozole. Clinical trials have demonstrated that the addition of everolimus to exemestane therapy significantly extends progression-free survival compared to exemestane alone. However, it is important to note that while Afinitor has been shown to delay the progression of the disease, an improvement in overall survival has not been definitively established.

The efficacy of Afinitor was notably demonstrated in the BOLERO-2 clinical trial, where patients receiving the combination of everolimus and exemestane had a median progression-free survival of 7.8 months, compared to 3.2 months in patients receiving placebo and exemestane. This represents a significant improvement in the management of advanced breast cancer, particularly for patients who have become resistant to other hormonal therapies.

Margenza (Margetuximab-cmkb) Efficacy in Breast Cancer

Margenza (margetuximab-cmkb) is a monoclonal antibody designed for the treatment of patients with metastatic HER2-positive breast cancer who have previously received two or more prior anti-HER2 regimens, at least one of which was for metastatic disease. Margenza, in combination with chemotherapy, has been shown to improve progression-free survival in this patient population. The approval of Margenza was based on results from the SOPHIA study, which compared margetuximab plus chemotherapy to trastuzumab plus chemotherapy.

In the SOPHIA trial, patients treated with Margenza and chemotherapy experienced a median progression-free survival of 5.8 months, compared to 4.9 months for patients treated with trastuzumab and chemotherapy. While the improvement in progression-free survival was modest, Margenza offers an additional treatment option for patients with limited therapies available due to the refractory nature of their disease. The overall survival benefit, while not statistically significant at the time of interim analysis, showed a positive trend and continued to be evaluated.

Regulatory Agency Approvals

Afinitor

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

Margenza

Food and Drug Administration (FDA), USA

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