Piqray (alpelisib) vs Kadcyla (trastuzumab emtansine)
Piqray (alpelisib) vs Kadcyla (trastuzumab emtansine)
Piqray (alpelisib) is an alpha-specific PI3K inhibitor used in combination with fulvestrant for the treatment of postmenopausal women, and men, with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-), PIK3CA-mutated, advanced or metastatic breast cancer following progression on or after an endocrine-based regimen. Kadcyla (trastuzumab emtansine) is an antibody-drug conjugate combining the HER2-targeting properties of trastuzumab with the chemotherapy agent emtansine, indicated for the treatment of HER2-positive breast cancer in various settings, including patients who have previously received trastuzumab and a taxane, separately or in combination. The choice between Piqray and Kadcyla would depend on the specific molecular characteristics of the breast cancer, such as hormone receptor and HER2 status, and prior treatments, making it crucial to discuss with an oncologist to determine the most appropriate therapy based on the individual's cancer profile and treatment history.
Difference between Piqray and Kadcyla
| Metric | Piqray (alpelisib) | Kadcyla (trastuzumab emtansine) |
|---|---|---|
| Generic name | Alpelisib | Trastuzumab emtansine |
| Indications | Advanced or metastatic breast cancer with a PIK3CA mutation, in combination with fulvestrant | HER2-positive metastatic breast cancer |
| Mechanism of action | PI3K inhibitor, targeting the PIK3CA mutation | Combines HER2 targeted therapy with a chemotherapy drug |
| Brand names | Piqray | Kadcyla |
| Administrative route | Oral | Intravenous |
| Side effects | Hyperglycemia, rash, diarrhea, decreased appetite, nausea, fatigue, etc. | Fatigue, nausea, musculoskeletal pain, hemorrhage, hepatotoxicity, etc. |
| Contraindications | Hypersensitivity to alpelisib or any of its components, severe hepatic impairment | Hypersensitivity to trastuzumab emtansine or any of its components, severe hepatic impairment |
| Drug class | Antineoplastic agent, PI3K inhibitor | Antibody-drug conjugate, antineoplastic agent |
| Manufacturer | Novartis Pharmaceuticals Corporation | Genentech, Inc. |
Efficacy
Efficacy of Piqray (alpelisib) in Breast Cancer
Piqray (alpelisib) is a medication approved by the FDA for the treatment of hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, advanced or metastatic breast cancer. This indication is for patients who have received prior endocrine-based therapy. Alpelisib, in combination with fulvestrant, has shown efficacy in this subset of breast cancer patients by targeting the PI3K pathway, which is often activated in PIK3CA-mutated tumors. Clinical trials, such as the SOLAR-1 study, have demonstrated that patients treated with the combination of alpelisib and fulvestrant had a significant improvement in progression-free survival compared to those who received fulvestrant alone.
Efficacy of Kadcyla (trastuzumab emtansine) in Breast Cancer
Kadcyla (trastuzumab emtansine) is an antibody-drug conjugate that combines the HER2-targeting properties of trastuzumab with the cytotoxic agent DM1 (emtansine). Kadcyla is specifically indicated for the treatment of HER2-positive metastatic breast cancer in patients who previously received trastuzumab and a taxane, separately or in combination. Patients with residual invasive disease after neoadjuvant taxane and trastuzumab-based treatment may also be candidates for Kadcyla. Clinical trials have shown that Kadcyla significantly extends both progression-free and overall survival in patients with HER2-positive metastatic breast cancer compared to the standard therapy of lapatinib plus capecitabine.
Both Piqray and Kadcyla represent targeted therapies that have expanded the treatment options for specific subtypes of breast cancer. Their efficacy is closely tied to the molecular characteristics of the tumor, such as PIK3CA mutation status for Piqray and HER2 overexpression for Kadcyla. These medications underscore the importance of precision medicine in oncology, where treatment is increasingly tailored to the genetic makeup of the cancer.
In conclusion, the efficacy of Piqray and Kadcyla in the treatment of breast cancer has been substantiated through rigorous clinical trials. These therapies provide significant benefits for patients with advanced or metastatic breast cancer, offering hope for improved outcomes and extending the range of effective treatment options available to this patient population.
Regulatory Agency Approvals
Piqray
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European Medical Agency (EMA), European Union
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Food and Drug Administration (FDA), USA
Kadcyla
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European Medical Agency (EMA), European Union
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Food and Drug Administration (FDA), USA
-
Health Canada
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Therapeutic Goods Administration (TGA), Australia
-
Medsafe (NZ)
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