Select therapeutic use:

Colorectal and other GI cancers:

Indications for CYRAMZA:

As a single agent, or in combination with paclitaxel, for the treatment of advanced or metastatic, gastric or gastro-esophageal junction adenocarcinoma with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy. In combination with FOLFIRI (irinotecan, folinic acid, and 5-fluorouracil), for the treatment of metastatic colorectal cancer (mCRC) with disease progression on or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine. As a single agent for the treatment of hepatocellular carcinoma (HCC) in patients who have an alpha fetoprotein (AFP) of ≥400ng/mL and have been treated with sorafenib.

Adult:

Give by IV infusion over 60mins. Premedicate with IV histamine H1-antagonist (eg, diphenhydramine) prior to each infusion; or with dexamethasone and acetaminophen in those who have experienced Grade 1 or 2 infusion reaction. 8mg/kg every 2 weeks until disease progression or unacceptable toxicity. Gastric cancer: administer prior to paclitaxel when given in combination. mCRC: administer prior to FOLFIRI. Dose modifications: see full labeling.

Children:

Not established.

Warnings/Precautions:

Increased risk of hemorrhage; permanently discontinue if severe bleeding occurs. Control hypertension prior to initiating. Monitor blood pressure every 2 weeks or more frequently as indicated; if severe hypertension develops, temporarily suspend until medically controlled. Monitor for infusion-related reactions during therapy. Have emergency resuscitative equipment available. Permanently discontinue if arterial thromboembolic events, severe uncontrolled hypertension (despite antihypertensives), hypertensive crisis or encephalopathy, Grade 3 or 4 infusion-related reactions, urine protein >3g/24hrs, nephrotic syndrome, or GI perforation occurs. Impaired wound healing: withhold Cyramza for 28 days prior to surgery; resume ≥28 days after major surgery and until wound is fully healed; discontinue if wound healing complications that require medical intervention develop. Clinical deterioration in patients with Child-Pugh B or C cirrhosis (eg, new or worsening encephalopathy, ascites, hepatorenal syndrome). Permanently discontinue if reversible posterior leukoencephalopathy syndrome develops. Monitor proteinuria by urine dipstick and/or urinary protein creatinine ratio. Monitor thyroid function. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 3 months after last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 2 months after last dose).

Pharmacologic Class:

Vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor.

Adverse Reactions:

Hypertension, diarrhea, fatigue, asthenia, neutropenia, epistaxis, stomatitis/mucosal inflammation, decreased appetite, peripheral edema, abdominal pain, proteinuria, nausea, ascites, thrombocytopenia, hypoalbuminemia, hyponatremia.

Generic Availability:

NO

How Supplied:

Single-dose vial (10mL, 50mL)—1

Pricing for CYRAMZA

10ml of 100mg/10ml vial (Qty: 6)
Appx. price $6694
GoodRx

Respiratory and thoracic cancers:

Indications for CYRAMZA:

In combination with docetaxel, for treatment of metastatic non-small cell lung cancer (NSCLC) with disease progression on or after platinum-based chemotherapy; patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to initiation.

Adult:

Give by IV infusion over 60mins. Premedicate with IV histamine H1-antagonist (eg, diphenhydramine) prior to each infusion; or with dexamethasone and acetaminophen in those who have experienced Grade 1 or 2 infusion reaction. 10mg/kg on Day 1 of a 21-day cycle prior to docetaxel; continue until disease progression or unacceptable toxicity. Dose modifications: see full labeling.

Children:

Not established.

Warnings/Precautions:

Increased risk of hemorrhage; permanently discontinue if severe bleeding occurs. Control hypertension prior to initiating. Monitor blood pressure every 2 weeks or more frequently as indicated; if severe hypertension develops, temporarily suspend until medically controlled. Monitor for infusion-related reactions during therapy. Have emergency resuscitative equipment available. Permanently discontinue if arterial thromboembolic events, severe uncontrolled hypertension (despite antihypertensives), hypertensive crisis or encephalopathy, Grade 3 or 4 infusion-related reactions, urine protein >3g/24hrs, nephrotic syndrome, or GI perforation occurs. Impaired wound healing: withhold Cyramza for 28 days prior to surgery; resume ≥28 days after major surgery and until wound is fully healed; discontinue if wound healing complications that require medical intervention develop. Clinical deterioration in patients with Child-Pugh B or C cirrhosis (eg, new or worsening encephalopathy, ascites, hepatorenal syndrome). Permanently discontinue if reversible posterior leukoencephalopathy syndrome develops. Monitor proteinuria by urine dipstick and/or urinary protein creatinine ratio. Monitor thyroid function. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 3 months after last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 2 months after last dose).

Pharmacologic Class:

Vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor.

Adverse Reactions:

Hypertension, diarrhea, fatigue, asthenia, neutropenia, epistaxis, stomatitis/mucosal inflammation, decreased appetite, peripheral edema, abdominal pain, proteinuria, nausea, ascites, thrombocytopenia, hypoalbuminemia, hyponatremia.

Generic Availability:

NO

How Supplied:

Single-dose vial (10mL, 50mL)—1

Pricing for CYRAMZA

10ml of 100mg/10ml vial (Qty: 6)
Appx. price $6694
GoodRx