Copiktra (duvelisib) vs Asparlas (calaspargase pegol-mknl)

Copiktra (duvelisib) vs Asparlas (calaspargase pegol-mknl)

Copiktra (duvelisib) and Asparlas (calaspargase pegol-mknl) are used to treat different types of cancer; Copiktra is an oral PI3K inhibitor used primarily for chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and follicular lymphoma, while Asparlas is an intravenous asparagine-specific enzyme indicated for the treatment of acute lymphoblastic leukemia (ALL). The choice between these medications would depend on the specific type of leukemia a patient has; Copiktra is suitable for some types of non-Hodgkin lymphoma, whereas Asparlas is part of a multi-agent chemotherapeutic regimen for ALL. Side effect profiles also differ significantly, with Copiktra commonly causing diarrhea, neutropenia, and rash, while Asparlas can cause liver toxicity, blood clotting abnormalities, and hypersensitivity reactions, thus the decision should be guided by a healthcare professional based on the patient's specific condition and overall health status.

Difference between Copiktra and Asparlas

Metric Copiktra (duvelisib) Asparlas (calaspargase pegol-mknl)
Generic name duvelisib calaspargase pegol-mknl
Indications Chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and follicular lymphoma (FL) Acute lymphoblastic leukemia (ALL)
Mechanism of action PI3K inhibitor, targets the delta and gamma isoforms of the PI3K enzyme Modified enzyme that catalyzes the conversion of L-asparagine to aspartic acid and ammonia, depleting L-asparagine which some leukemia cells cannot synthesize
Brand names Copiktra Asparlas
Administrative route Oral Intravenous
Side effects Diarrhea, neutropenia, rash, fatigue, pyrexia, cough, nausea, anemia, upper respiratory infection Allergic reactions, elevated liver enzymes, decreased albumin blood level, decreased platelet count, decreased white blood cell count, pancreatitis, abnormal clotting tests
Contraindications History of serious allergic reactions to duvelisib or any other ingredient in the formulation History of serious thrombosis, history of serious pancreatitis, history of serious hemorrhagic events, known hypersensitivity to pegaspargase or L-asparaginase
Drug class Antineoplastic agent, PI3K inhibitor Antineoplastic agent, enzyme
Manufacturer Secura Bio, Inc. Servier Pharmaceuticals LLC

Efficacy

Efficacy of Copiktra (Duvelisib) in Treating Leukemia

Copiktra (duvelisib) is a kinase inhibitor approved by the U.S. Food and Drug Administration (FDA) for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or follicular lymphoma (FL) after at least two prior therapies. In CLL and SLL, the efficacy of Copiktra was evaluated in a clinical trial where the overall response rate (ORR) was a primary endpoint. The trial demonstrated that duvelisib produced an ORR of 73.8% in patients with CLL/SLL. The duration of response (DOR) varied among patients, with some responses lasting up to 16.4 months.

For patients with CLL or SLL, the efficacy of Copiktra is particularly notable in the context of relapsed or refractory disease. In these cases, patients have limited treatment options, and Copiktra offers a new mechanism of action as it inhibits phosphoinositide 3-kinase (PI3K) delta and gamma, which are involved in the growth and survival of malignant B-cells. The ability of Copiktra to induce a response in a significant proportion of patients highlights its value in the treatment landscape for these leukemias.

Efficacy of Asparlas (Calaspargase Pegol-mknl) in Treating Leukemia

Asparlas (calaspargase pegol-mknl) is an asparagine-specific enzyme indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) in pediatric and young adult patients aged 1 month to 21 years. This medication is a novel formulation of asparaginase, an enzyme that depletes the amino acid asparagine, which leukemic cells are unable to synthesize and are thus dependent upon for survival and proliferation. The efficacy of Asparlas was primarily assessed on the basis of achieving and maintaining nadir serum asparaginase activity (NSAA) above a threshold thought to correlate with asparagine depletion and antileukemic effects.

In clinical trials, Asparlas demonstrated efficacy in maintaining the targeted NSAA levels with less frequent dosing compared to other asparaginase products. This extended activity profile allows for dosing every three weeks instead of the more frequent dosing required by other formulations. The ability to maintain therapeutic levels of asparaginase activity with less frequent dosing can potentially improve patient quality of life and adherence to treatment regimens. However, it is important to note that the use of Asparlas should be integrated into a comprehensive chemotherapeutic regimen and the overall efficacy of treatment for ALL depends on the combination of agents used.

Regulatory Agency Approvals

Copiktra
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
Asparlas
  • Food and Drug Administration (FDA), USA

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