Onureg (azacitidine) vs Brukinsa (zanubrutinib)

Onureg (azacitidine) vs Brukinsa (zanubrutinib)

Onureg (azacitidine) is a hypomethylating agent used primarily for the treatment of adults with acute myeloid leukemia (AML) who are in remission but still at high risk of relapse, and who are not able to undergo stem cell transplant. Brukinsa (zanubrutinib) is a Bruton's tyrosine kinase (BTK) inhibitor indicated for the treatment of mantle cell lymphoma (MCL) in adults who have received at least one prior therapy, and for other B-cell malignancies. The choice between Onureg and Brukinsa would depend on the specific type of blood cancer a patient has, as they are approved for different indications and work through distinct mechanisms of action.

Difference between Onureg and Brukinsa

Metric Onureg (azacitidine) Brukinsa (zanubrutinib)
Generic name Azacitidine Zanubrutinib
Indications Acute myeloid leukemia (AML) Mantle cell lymphoma (MCL), Waldenström's macroglobulinemia (WM), Marginal zone lymphoma (MZL)
Mechanism of action Hypomethylating agent Bruton's tyrosine kinase (BTK) inhibitor
Brand names Onureg Brukinsa
Administrative route Oral Oral
Side effects Nausea, vomiting, diarrhea, hematological abnormalities Neutropenia, thrombocytopenia, upper respiratory tract infection, rash
Contraindications Advanced malignant hepatic tumors, hypersensitivity to azacitidine or mannitol Hypersensitivity to zanubrutinib
Drug class Nucleoside metabolic inhibitor Small molecule kinase inhibitor
Manufacturer Bristol Myers Squibb BeiGene

Efficacy

Onureg (Azacitidine) Efficacy in Leukemia

Onureg, the brand name for azacitidine, is a chemotherapeutic agent that has shown efficacy in the treatment of acute myeloid leukemia (AML), particularly in patients who are in the first remission after conventional chemotherapy and are not eligible for hematopoietic stem cell transplant. Azacitidine is a hypomethylating agent that incorporates into RNA and DNA, leading to a decrease in abnormal cell growth and an increase in normal cell growth. In a pivotal phase III clinical trial, azacitidine was shown to significantly improve overall survival in patients with AML in remission compared to placebo. The median overall survival was extended, indicating that Onureg can be an effective maintenance therapy for AML patients who are not candidates for stem cell transplantation.

The efficacy of Onureg has been particularly noted in AML patients with specific genetic mutations. For instance, patients with TP53 mutations, which are associated with poor prognosis, have shown responses to azacitidine treatment. However, it is important to note that the response rates and overall efficacy can vary based on the patient's genetic profile and disease characteristics. As with all medications, the benefits of Onureg must be weighed against the potential risks and side effects in the context of the individual patient's health status.

Brukinsa (Zanubrutinib) Efficacy in Leukemia

Brukinsa, known generically as zanubrutinib, is a Bruton's tyrosine kinase (BTK) inhibitor used in the treatment of mantle cell lymphoma (MCL), a type of leukemia. While Brukinsa is primarily indicated for MCL, its efficacy in other forms of leukemia such as chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has also been investigated. Zanubrutinib has been designed to bind covalently to BTK, thereby inhibiting the growth and survival of malignant B cells that overexpress BTK. Clinical trials have demonstrated that Brukinsa can achieve high response rates in patients with B-cell malignancies, including those with relapsed or refractory MCL.

For patients with CLL or SLL, ongoing studies are evaluating the efficacy of zanubrutinib. Early results suggest that Brukinsa may offer a favorable safety profile and high response rates in these patient populations. It is important to recognize that Brukinsa's approval and use in leukemia are contingent upon the ongoing evaluation of clinical trial data and the specific subtype of leukemia being treated. As research progresses, Brukinsa may become a more prominent treatment option for various leukemic conditions, with its efficacy being further clarified through comprehensive clinical studies.

Regulatory Agency Approvals

Onureg
  • Food and Drug Administration (FDA), USA
Brukinsa
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA

Access Onureg or Brukinsa today

If Onureg or Brukinsa are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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