| Acute lymphocytic leukemia
Besponsa vs Leukine
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Besponsa vs Leukine with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsLeukine has a higher rate of injection site reactions vs Besponsa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Leukine but not Besponsa, including UnitedHealthcare
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Category
Besponsa
Leukine
At A Glance
IV infusion
Days 1, 8, and 15 per cycle
CD22-directed antibody-drug conjugate
IV infusion or SC injection
Once daily
GM-CSF
Indications
- Acute lymphocytic leukemia
- Leukemia, Myelocytic, Acute
- Lymphoma, Non-Hodgkin
- Acute lymphocytic leukemia
- Hodgkin Disease
- Hematopoietic subsyndrome of acute radiation syndrome
Dosing
Acute lymphocytic leukemia Cycle 1: 1.8 mg/m2/cycle as 0.8 mg/m2 on Day 1 and 0.5 mg/m2 on Days 8 and 15 (21-day cycle, extendable to 28 days); subsequent cycles (CR/CRi): 1.5 mg/m2/cycle as 0.5 mg/m2 on Days 1, 8, and 15 (28-day cycle); subsequent cycles (non-CR/CRi): 1.8 mg/m2/cycle as 0.8 mg/m2 on Day 1 and 0.5 mg/m2 on Days 8 and 15 (28-day cycle); administered by IV infusion over 1 hour with premedication (corticosteroid, antipyretic, antihistamine).
Leukemia, Myelocytic, Acute 250 mcg/m2/day IV over a 4-hour period starting day 11 or four days after induction chemotherapy completion; continue until ANC >1500 cells/mm3 for 3 consecutive days or up to 42 days.
Lymphoma, Non-Hodgkin, Acute lymphocytic leukemia, Hodgkin Disease 250 mcg/m2/day IV over 24 hours or SC once daily beginning immediately following progenitor cell infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Autologous or allogeneic bone marrow transplantation 250 mcg/m2/day IV over a 2-hour period beginning 2-4 hours after bone marrow infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Delayed neutrophil recovery or graft failure 250 mcg/m2/day for 14 days as a 2-hour IV infusion; may repeat after 7 days off therapy if neutrophil recovery has not occurred, up to three courses.
Hematopoietic subsyndrome of acute radiation syndrome SC injection once daily: 7 mcg/kg for adults and pediatric patients >40 kg, 10 mcg/kg for pediatric patients 15-40 kg, 12 mcg/kg for pediatric patients <15 kg; continue until ANC >1000/mm3 for three consecutive CBCs.
Contraindications
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- History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product
Adverse Reactions
Most common (>=20%) Thrombocytopenia, neutropenia, infection, anemia, leukopenia, fatigue, hemorrhage, pyrexia, nausea, headache, febrile neutropenia, transaminases increased, abdominal pain, gamma-glutamyltransferase increased, hyperbilirubinemia
Serious Infection, febrile neutropenia, hemorrhage, abdominal pain, pyrexia, veno-occlusive disease (VOD), fatigue
Most common (>=10%) Fever, nausea, diarrhea, vomiting, rash, alopecia, stomatitis, asthenia, malaise, anorexia, edema, headache, chills, peripheral edema, dyspnea
Serious Hypersensitivity and anaphylaxis, infusion-related reactions, severe myelosuppression, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis
Postmarketing Infusion-related reactions, serious allergic reactions including anaphylaxis, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis including eosinophilia, thromboembolic events, injection site reactions
Pharmacology
CD22-directed antibody-drug conjugate (ADC); inotuzumab binds CD22-expressing tumor cells, enabling internalization and intracellular release of N-acetyl-gamma-calicheamicin dimethylhydrazide, which induces double-strand DNA breaks leading to cell cycle arrest and apoptotic cell death.
Sargramostim (GM-CSF) is a colony-stimulating factor that supports survival, clonal expansion, and differentiation of hematopoietic progenitor cells, inducing partially committed progenitors to divide and differentiate into granulocyte-macrophage pathways including neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells; it can also activate mature granulocytes and macrophages and promote proliferation of megakaryocytic and erythroid progenitors.
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Most Common Insurance
Anthem BCBS
Besponsa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Leukine
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (6/12) · Qty limit (0/12)
UnitedHealthcare
Besponsa
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Leukine
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Besponsa
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Leukine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Acute Lymphoblastic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Chemotherapy Induced Neutropenia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.