| Acute lymphocytic leukemia
Oncaspar vs Leukine
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Oncaspar 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 Oncaspar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Leukine but not Oncaspar, including UnitedHealthcare
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Category
Oncaspar
Leukine
At A Glance
IM injection or IV infusion
Every 14 days
PEGylated L-asparaginase
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 2,500 IU/m2 (age <=21 years) or 2,000 IU/m2 (age >21 years) IM or IV, no more frequently than every 14 days.
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
- History of serious hypersensitivity reactions, including anaphylaxis, to ONCASPAR or any excipient
- History of serious thrombosis with prior L-asparaginase therapy
- History of pancreatitis, including pancreatitis related to prior L-asparaginase therapy
- History of serious hemorrhagic events with prior L-asparaginase therapy
- Severe hepatic impairment
- History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product
Adverse Reactions
Most common (>5%) Elevated transaminase, febrile neutropenia, hypertriglyceridemia, hypoalbuminemia, bilirubin increased, hyperglycemia, pancreatitis, abnormal clotting studies, embolic and thrombotic events, hypersensitivity, sepsis, infections
Serious Anaphylaxis and serious hypersensitivity reactions, thrombosis, pancreatitis, glucose intolerance, hemorrhage, hepatotoxicity including veno-occlusive disease
Postmarketing Coagulopathy, hepatic impairment, pancreatic cyst, veno-occlusive disease, anaphylactic shock, blood cholesterol increased, hyperglycemia, hyperammonemia, osteonecrosis, hemorrhage including CNS hemorrhage, thrombosis including superior sagittal sinus thrombosis
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
ONCASPAR is a PEGylated L-asparaginase that catalyzes the conversion of L-asparagine to aspartic acid and ammonia, depleting plasma asparagine and killing leukemic cells that have low asparagine synthetase expression and depend on an exogenous asparagine source for survival.
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
Oncaspar
- 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
Oncaspar
- Covered on 4 commercial plans
- PA (0/8) · 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
Oncaspar
- Covered on 0 commercial plans
- PA (3/3) · 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.