| Chronic Lymphocytic Leukemia
Brukinsa vs Breyanzi
Side-by-side clinical, coverage, and cost comparison for chronic lymphocytic leukemia.Deep comparison between: Brukinsa vs Breyanzi 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 signalsBreyanzi has a higher rate of injection site reactions vs Brukinsa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Breyanzi but not Brukinsa, including UnitedHealthcare
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Category
Brukinsa
Breyanzi
At A Glance
Oral
Once or twice daily
BTK inhibitor
IV infusion
Single infusion
CD19-directed CAR T cell therapy
Indications
- Mantle cell lymphoma
- Waldenstrom Macroglobulinemia
- Marginal Zone B-Cell Lymphoma
- Chronic Lymphocytic Leukemia
- Small Lymphocytic Lymphoma
- Lymphoma, Follicular
- Diffuse Large B-Cell Lymphoma
- High grade B-cell lymphoma
- Mediastinal (Thymic) Large B-Cell Lymphoma
- Lymphoma, Follicular
- Chronic Lymphocytic Leukemia
- Small Lymphocytic Lymphoma
- Mantle cell lymphoma
- Marginal Zone B-Cell Lymphoma
Dosing
Mantle cell lymphoma, Waldenstrom Macroglobulinemia, Marginal Zone B-Cell Lymphoma, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma 160 mg orally twice daily or 320 mg orally once daily, with or without food, until disease progression or unacceptable toxicity.
Lymphoma, Follicular 160 mg orally twice daily in combination with obinutuzumab, with or without food, until disease progression or unacceptable toxicity.
Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma, Mediastinal (Thymic) Large B-Cell Lymphoma (after one line of therapy) 90 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma, Mediastinal (Thymic) Large B-Cell Lymphoma (after two or more lines of therapy) 50 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, Lymphoma, Follicular, Mantle cell lymphoma, Marginal Zone B-Cell Lymphoma 90 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
Contraindications
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Adverse Reactions
Most common (>=30%) Neutrophil count decreased, platelet count decreased, upper respiratory tract infection, hemorrhage, musculoskeletal pain
Serious Hemorrhage, pneumonia, cytopenias, second primary malignancies, cardiac arrhythmias, hepatotoxicity including drug-induced liver injury
Postmarketing Drug-induced liver injury
Most common (>=30%) fever, CRS, fatigue, musculoskeletal pain, nausea
Serious CRS, encephalopathy, febrile neutropenia, sepsis, pneumonia, fever, hemorrhage, renal failure, aphasia, delirium, hemophagocytic lymphohistiocytosis
Postmarketing immune effector cell-associated neurotoxicity syndrome (ICANS), T cell malignancies, blindness
Pharmacology
Zanubrutinib is a small-molecule inhibitor of Bruton's tyrosine kinase (BTK) that forms a covalent bond with a cysteine residue in the BTK active site, inhibiting BTK activity and thereby blocking B-cell proliferation, trafficking, chemotaxis, and adhesion pathways driven by B-cell antigen receptor and cytokine receptor signaling.
BREYANZI is a CD19-directed genetically modified autologous T cell immunotherapy; CAR binding to CD19 on tumor and normal B cells triggers CD3 zeta-mediated activation and cytotoxic killing of target cells, while 4-1BB (CD137) costimulatory signaling enhances CAR T cell expansion and persistence.
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Most Common Insurance
Anthem BCBS
Brukinsa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Breyanzi
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Brukinsa
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (5/8) · Qty limit (4/8)
Breyanzi
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Brukinsa
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Breyanzi
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Brukinsa.
Cost estimate not availableCancerCare: Chronic Lymphocytic Leukemia
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.