Therapeutic equivalents

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This page is very much under construction at the moment.


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 similar 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)


These are "nearly identical" products to a parent compound, with what is considered interchangeable efficacy and toxicity. Note that EMA approvals do not include the four-letter suffix at this time, which we have added to distinguish the generic ingredient from the parent compound.

Class of agent Parent compound Biosimilar(s)
Anti-VEGF antibody Bevacizumab (Avastin) Bevacizumab-adcd (Vegzelga)
Bevacizumab-awwb (Mvasi)
Bevacizumab-bvzr (Zirabev)
Bevacizumab-alym (Alymsys/Oyavas)
Bevacizumab-aybi (Aybintio)
Bevacizumab-equi (Equidacent)
Bevacizumab-onbe (Onbevzi)
Anticoagulant Enoxaparin (Lovenox) Enoxaparin-inhi (Inhixa)
Red cell growth factor Epoetin alfa (Procrit) Epoetin alfa-epbx (Retacrit)
Epoetin alfa-abse (Abseamed)
Epoetin alfa-bino (Binocrit)
Epoetin alfa-hexa (Epoetin Alfa Hexal)
Red cell growth factor Epoetin zeta (Eprex) Epoetin zeta-reta (Retacrit)
Epoetin zeta-sila (Silapo)
Myeloid growth factor Filgrastim (Neupogen) Filgrastim-aafi (Nivestym)
Filgrastim-sndz (Zarxio)
Filgrastim-acco (Accofil)
Filgrastim-hexa (Filgrastim Hexal)
Filgrastim-gras (Grastofil)
Filgrastim-rati (Ratiograstim)
Filgrastim-teva (Tevagrastim)
Myeloid growth factor Pegfilgrastim (Neulasta) Pegfilgrastim-apgf (Nyvepria)
Pegfilgrastim-bmez (Ziextenzo)
Pegfilgrastim-cbqv (Udenyca)
Pegfilgrastim-jmdb (Fulphila)
Pegfilgrastim-cegf (Cegfila)
Pegfilgrastim-gras (Grasustek)
Pegfilgrastim-pelg (Pelgraz)
Pegfilgrastim-pelm (Pelmeg)
Pegfilgrastim-stim (Stimufend)
Anti-CD20 antibody Rituximab (Rituxan) Rituximab-abbs (Truxima)
Rituximab-arrx (Riabni)
Rituximab-pvvr (Ruxience)
Rituximab-blit (Blitzima)
Rituximab-rite (Ritemvia)
Rituximab-rixa (Rixathon)
Rituximab-rixi (Riximyo)
Anti-HER2 antibody Trastuzumab (Herceptin) Trastuzumab-anns (Kanjinti)
Trastuzumab-dkst (Ogivri)
Trastuzumab-dttb (Ontruzant)
Trastuzumab-pkrb (Herzuma)
Trastuzumab-qyyp (Trazimera)
Trastuzumab-zerc (Zercepac)

Same drug, different route

These agents generally are first approved as IV formulations, and then are approved for a more convenient route, usually with a different vehicle. Efficacy is considered to be equivalent, but toxicity may differ.

Class of agent Original formulation Alternative formulation
Anti-CD38 antibody Daratumumab (Darzalex) Daratumumab and hyaluronidase (Darzalex Faspro)
Hypomethylating agent Decitabine (Dacogen) Decitabine and cedazuridine (Inqovi)
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)

Depot formulations

Enantiomers and racemic mixtures

Same drug, different dose/frequency


(e.g., capecitabine & 5-FU, although this is tricky because of LCV...)

Same class

(e.g., possibly cisplatin and carboplatin; definitely prednisone and prednisolone)