Kisqali (ribociclib) vs Afinitor (everolimus)

Kisqali (ribociclib) and Afinitor (everolimus) are both used in the treatment of certain types of cancer, but they work in different ways and are approved for different indications. Kisqali is primarily used in combination with an aromatase inhibitor for the treatment of hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced or metastatic breast cancer in postmenopausal women, whereas Afinitor is used for various cancers, including advanced hormone receptor-positive, HER2-negative breast cancer in postmenopausal women, but also for renal cell carcinoma and neuroendocrine tumors. The choice between Kisqali and Afinitor will depend on the specific type and stage of cancer, previous treatments, patient's health status, and potential side effects, and should be made in consultation with an oncologist.

Difference between Kisqali and Afinitor

Metric	Kisqali (ribociclib)	Afinitor (everolimus)
Generic name	Ribociclib	Everolimus
Indications	HR-positive, HER2-negative advanced or metastatic breast cancer	Advanced hormone receptor-positive, HER2-negative breast cancer, advanced neuroendocrine tumors, renal cell carcinoma, tuberous sclerosis complex-associated seizures, subependymal giant cell astrocytoma (SEGA), renal angiomyolipoma
Mechanism of action	Cyclin-dependent kinase 4/6 (CDK4/6) inhibitor	mTOR inhibitor
Brand names	Kisqali	Afinitor, Afinitor Disperz, Zortress
Administrative route	Oral	Oral
Side effects	Neutropenia, nausea, infections, fatigue, diarrhea, leukopenia, vomiting, alopecia, headache, cough	Mouth ulcers, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, pneumonitis
Contraindications	Hypersensitivity to ribociclib, QT prolongation, liver impairment	Hypersensitivity to everolimus or other rapamycin derivatives, immunosuppression, infections, lung or breathing problems, liver impairment
Drug class	Antineoplastic agent, kinase inhibitor	Antineoplastic agent, mTOR kinase inhibitor
Manufacturer	Novartis Pharmaceuticals Corporation	Novartis Pharmaceuticals Corporation

Efficacy

Efficacy of Kisqali (Ribociclib) in Breast Cancer Treatment

Ribociclib, marketed under the brand name Kisqali, is a targeted therapy used in the treatment of certain types of breast cancer. Specifically, it is approved for use in combination with an aromatase inhibitor for the treatment of pre/perimenopausal or postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced or metastatic breast cancer, as initial endocrine-based therapy. In postmenopausal women, it is also approved for use in combination with fulvestrant for the treatment of HR+/HER2- advanced or metastatic breast cancer as initial endocrine-based therapy or following disease progression on endocrine therapy.

The efficacy of Kisqali has been demonstrated in multiple clinical trials. One such pivotal trial is the MONALEESA-2 study, which showed that when used in combination with letrozole, Kisqali significantly improved progression-free survival (PFS) compared to letrozole alone in postmenopausal women with HR+/HER2- advanced breast cancer. The trial results indicated a marked improvement in PFS, with the median not reached in the Kisqali plus letrozole arm at the time of the interim analysis, compared to 14.7 months in the placebo plus letrozole arm.

Efficacy of Afinitor (Everolimus) in Breast Cancer Treatment

Afinitor (everolimus) is another medication used in the treatment of HR+/HER2- advanced breast cancer. It is specifically indicated for postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer in combination with exemestane, after failure of treatment with letrozole or anastrozole. Everolimus works by inhibiting the mammalian target of rapamycin (mTOR), a protein that plays a crucial role in the growth and proliferation of cancer cells.

The efficacy of Afinitor was established in the BOLERO-2 clinical trial, where it demonstrated a significant improvement in PFS when combined with exemestane, compared to exemestane alone in patients with HR+/HER2- advanced breast cancer who had recurred or progressed on letrozole or anastrozole. The combination of everolimus and exemestane increased the median PFS to 7.8 months, compared to 3.2 months for patients receiving exemestane alone. This represented a 57% reduction in the risk of cancer progression.

Regulatory Agency Approvals

Kisqali

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

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

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