| Diffuse Large B-Cell Lymphoma
Breyanzi vs Epkinly
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Breyanzi vs Epkinly 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 signalsEpkinly has a higher rate of injection site reactions vs Breyanzi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Epkinly but not Breyanzi, including UnitedHealthcare
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Category
Breyanzi
Epkinly
At A Glance
IV infusion
Single infusion
CD19-directed CAR T cell therapy
SC injection
Every 1-4 weeks
CD20xCD3 bispecific antibody
Indications
- 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
- Diffuse Large B-Cell Lymphoma
- High grade B-cell lymphoma
- Lymphoma, Follicular
Dosing
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).
Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8); then 48 mg weekly through Cycle 3; 48 mg every 2 weeks for Cycles 4-9; 48 mg monthly from Cycle 10 until disease progression or unacceptable toxicity.
Lymphoma, Follicular (monotherapy) Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8), 3 mg (Day 15); then 48 mg weekly through Cycle 3; 48 mg every 2 weeks for Cycles 4-9; 48 mg monthly from Cycle 10 until disease progression or unacceptable toxicity.
Lymphoma, Follicular (+ lenalidomide and rituximab) Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8), 3 mg (Day 15); then 48 mg weekly through Cycle 3; 48 mg monthly for Cycles 4-12 with lenalidomide 20 mg (Days 1-21) and rituximab 375 mg/m2 (Cycles 1-5); total 12 cycles or until progression.
Contraindications
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Adverse Reactions
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
Most common (>=20%) CRS, fatigue, injection site reactions, musculoskeletal pain, pyrexia, abdominal pain, nausea, diarrhea, rash, upper respiratory tract infections, constipation, pneumonia, COVID-19, fever, cough, headache
Serious CRS, infections (sepsis, COVID-19, pneumonia, upper respiratory tract infections), pleural effusion, febrile neutropenia, fever, ICANS
Postmarketing Hemophagocytic Lymphohistiocytosis (HLH)
Pharmacology
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.
Epcoritamab-bysp is a bispecific CD20-directed CD3 T-cell engager (humanized IgG1) that simultaneously binds CD3 on T-cells and CD20 on lymphoma and healthy B-lineage cells, activating T-cells, inducing cytokine release, and causing B-cell lysis; in combination with rituximab it also mediates NK cell antibody-dependent cellular cytotoxicity (ADCC).
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Most Common Insurance
Anthem BCBS
Breyanzi
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Epkinly
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Breyanzi
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Epkinly
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Breyanzi
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Epkinly
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Chronic Lymphocytic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableGenmab Patient Assistance Program: Epkinly
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.