Therapeutic equivalents
This page is very much under construction at the moment.
Introduction
Generally speaking, prospective clinical trials are very specific in the drugs that they use in their evaluation. In clinical practice, one drug is often substituted for another, using the clinical concept of therapeutic equivalence. The purpose of this page is to gather various categories of therapeutic equivalence for general reference, and also to inform the HemOnc ontology. Please keep checking back as the page develops!
Categories of therapeutically equivalent drugs
Recombinant proteins
These are identical products to a parent natural protein, which are created through synthetic methods.
| Parent compound | Recombinant protein |
|---|---|
| Asparaginase Erwinia chrysanthemi (Erwinaze) | Asparaginase erwinia chrysanthemi-rywn (Rylaze) |
Biosimilars
These are "nearly identical" products to a parent compound, with what is considered interchangeable efficacy and toxicity.
| Class of agent | Parent compound | Biosimilar(s) |
|---|---|---|
| Anti-VEGF antibody | Bevacizumab (Avastin) | Bevacizumab-adcd (Vegzelga) Bevacizumab-awwb (Mvasi) Bevacizumab-bvzr (Zirabev) Bevacizumab (Alymsys/Oyavas) Bevacizumab (Aybintio) Bevacizumab (Equidacent) Bevacizumab (Onbevzi) |
| Anticoagulant | Enoxaparin (Lovenox) | Enoxaparin (Inhixa) |
| Red cell growth factor | Epoetin alfa (Procrit) | Epoetin alfa-epbx (Retacrit) Epoetin alfa (Abseamed) Epoetin alfa (Binocrit) Epoetin alfa (Epoetin Alfa Hexal) |
| Red cell growth factor | Epoetin zeta (Eprex) | Epoetin zeta (Silapo) |
| Myeloid growth factor | Filgrastim (Neupogen) | Filgrastim-aafi (Nivestym) Filgrastim-sndz (Zarxio) Filgrastim (Accofil) Filgrastim (Filgrastim Hexal) Filgrastim (Grastofil) Filgrastim (Ratiograstim) Filgrastim (Tevagrastim) |
| Myeloid growth factor | Pegfilgrastim (Neulasta) | Pegfilgrastim-apgf (Nyvepria) Pegfilgrastim-bmez (Ziextenzo) Pegfilgrastim-cbqv (Udenyca) Pegfilgrastim-jmdb (Fulphila) Pegfilgrastim (Cegfila) Pegfilgrastim (Grasustek) Pegfilgrastim (Pelgraz) Pegfilgrastim (Pelmeg) |
| Anti-CD20 antibody | Rituximab (Rituxan) | Rituximab-abbs (Truxima) Rituximab-arrx (Riabni) Rituximab-pvvr (Ruxience) Rituximab (Blitzima) Rituximab (Ritemvia) Rituximab (Rixathon) Rituximab (Riximyo) |
| Anti-HER2 antibody | Trastuzumab (Herceptin) | Trastuzumab-anns (Kanjinti) Trastuzumab-dkst (Ogivri) Trastuzumab-dttb (Ontruzant) Trastuzumab-pkrb (Herzuma) Trastuzumab-qyyp (Trazimera) Trastuzumab (Zercepac) |
Same drug, different route
These agents generally are first approved as IV formulations, and then are approved as SC with an additional vehicle. Efficacy is considered to be equivalent, but toxicity may differ.
| Class of agent | IV formulation | SC formulation |
|---|---|---|
| Anti-CD38 antibody | Daratumumab (Darzalex) | Daratumumab and hyaluronidase (Darzalex Faspro) |
| Anti-CD20 antibody | Rituximab (Rituxan) | Rituximab and hyaluronidase human (Rituximab Hycela) |
| Anti-HER antibody | Trastuzumab (Herceptin) | Trastuzumab and hyaluronidase (Herceptin Hylecta) |
Combinations of agents
(e.g., Phesgo is combined pertuzumab & trastuzumab)
Enantiomers and racemic mixtures
Pro-drugs
(e.g., capecitabine & 5-FU, although this is tricky because of LCV...)
Same class
(e.g., cisplatin and carboplatin)