| Diffuse Large B-Cell Lymphoma

Adcetris vs Kymriah

Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.

Deep comparison between: Adcetris vs Kymriah with Prescriber.AI

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Safety signalsKymriah has a higher rate of injection site reactions vs Adcetris based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Kymriah but not Adcetris, including UnitedHealthcare

Category

Adcetris

Kymriah

At A Glance

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassCD30-directed antibody-drug conjugate

RouteIV infusion

FrequencySingle dose

ClassCD19-directed CAR T cell therapy

Indications

Hodgkin Disease
Angioimmunoblastic Lymphadenopathy
Peripheral T-Cell Lymphoma
Mycosis Fungoides
Diffuse Large B-Cell Lymphoma

Precursor Cell Lymphoblastic Leukemia Lymphoma
Diffuse Large B-Cell Lymphoma
Lymphoma, Follicular

Dosing

Hodgkin Disease (previously untreated Stage III/IV, adults) 1.2 mg/kg (max 120 mg) IV in combination with chemotherapy every 2 weeks for a maximum of 12 doses.

Hodgkin Disease (previously untreated high risk, pediatric) 1.8 mg/kg (max 180 mg) IV in combination with chemotherapy every 3 weeks for a maximum of 5 doses.

Hodgkin Disease (post-auto-HSCT consolidation) 1.8 mg/kg (max 180 mg) IV every 3 weeks for a maximum of 16 cycles.

Hodgkin Disease (relapsed) 1.8 mg/kg (max 180 mg) IV every 3 weeks until disease progression or unacceptable toxicity.

Peripheral T-Cell Lymphoma, Angioimmunoblastic Lymphadenopathy (previously untreated) 1.8 mg/kg (max 180 mg) IV in combination with cyclophosphamide, doxorubicin, and prednisone every 3 weeks for 6 to 8 doses.

Peripheral T-Cell Lymphoma (relapsed systemic ALCL) 1.8 mg/kg (max 180 mg) IV every 3 weeks until disease progression or unacceptable toxicity.

Mycosis Fungoides (relapsed pcALCL or CD30-expressing) 1.8 mg/kg (max 180 mg) IV every 3 weeks for a maximum of 16 cycles.

Diffuse Large B-Cell Lymphoma (relapsed or refractory) 1.2 mg/kg (max 120 mg) IV in combination with lenalidomide and a rituximab product every 3 weeks until disease progression or unacceptable toxicity.

Precursor Cell Lymphoblastic Leukemia Lymphoma Single IV infusion: 0.2 to 5.0 x 10^6 CAR-positive viable T cells/kg for patients 50 kg or less; 0.1 to 2.5 x 10^8 CAR-positive viable T cells (non-weight-based) for patients above 50 kg. Infuse 2 to 14 days after lymphodepleting chemotherapy (fludarabine 30 mg/m^2 IV daily x 4 days + cyclophosphamide 500 mg/m^2 IV daily x 2 days).

Diffuse Large B-Cell Lymphoma, Lymphoma, Follicular Single IV infusion: 0.6 to 6.0 x 10^8 CAR-positive viable T cells. Infuse 2 to 11 days (DLBCL) or 2 to 6 days (FL) after lymphodepleting chemotherapy (fludarabine 25 mg/m^2 IV daily x 3 days + cyclophosphamide 250 mg/m^2 IV daily x 3 days; bendamustine 90 mg/m^2 IV daily x 2 days as alternate).

Contraindications

Concomitant use with bleomycin due to pulmonary toxicity (e.g., interstitial infiltration and/or inflammation)

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Drug Interactions

782View drug interactions

26View drug interactions

Adverse Reactions

Most common (>=20%) Peripheral neuropathy, fatigue, nausea, diarrhea, musculoskeletal pain, pyrexia, rash, upper respiratory tract infection, constipation, alopecia

Serious Febrile neutropenia, pneumonia, hepatotoxicity, peripheral motor neuropathy, pulmonary toxicity, progressive multifocal leukoencephalopathy, tumor lysis syndrome, serious and opportunistic infections

Postmarketing Febrile neutropenia, acute pancreatitis, gastrointestinal complications, hepatotoxicity, progressive multifocal leukoencephalopathy, serious and opportunistic infections, hyperglycemia, noninfectious pulmonary toxicity including pneumonitis and ARDS, toxic epidermal necrolysis

Most common (>20%) CRS, infections-pathogen unspecified, fever, fatigue, musculoskeletal pain, headache, diarrhea, nausea, hypotension, edema, hemorrhage, hypogammaglobulinemia, viral infectious disorders, febrile neutropenia, vomiting, encephalopathy, cough, hypoxia, tachycardia, decreased appetite, acute kidney injury, dyspnea

Postmarketing Anaphylactic reaction, T cell malignancies, progressive multifocal leukoencephalopathy, blindness

Pharmacology

Brentuximab vedotin is a CD30-directed antibody-drug conjugate (ADC) consisting of a chimeric IgG1 anti-CD30 antibody linked to MMAE, a microtubule-disrupting agent; upon binding to CD30-expressing tumor cells the ADC is internalized and MMAE is released via proteolytic cleavage, disrupting the microtubule network within the cell and inducing cell cycle arrest and apoptosis.

KYMRIAH is a CD19-directed genetically modified autologous T cell immunotherapy that reprograms a patient's own T cells with a chimeric antigen receptor (CAR) to identify and eliminate CD19-expressing malignant and normal cells; the CAR incorporates 4-1BB (CD137) and CD3 zeta intracellular signaling domains that enhance T cell expansion, persistence, and antitumor activity.

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Most Common Insurance

Anthem BCBS

Adcetris