| Diffuse Large B-Cell Lymphoma
Breyanzi vs Kymriah
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Breyanzi vs Kymriah 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 signalsKymriah has a higher rate of injection site reactions vs Breyanzi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kymriah but not Breyanzi, including UnitedHealthcare
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Category
Breyanzi
Kymriah
At A Glance
IV infusion
Single infusion
CD19-directed CAR T cell therapy
IV infusion
Single dose
CD19-directed CAR T cell therapy
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
- Precursor Cell Lymphoblastic Leukemia Lymphoma
- Diffuse Large 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).
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
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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, 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
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.
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
Breyanzi
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Kymriah
- Covered on 5 commercial plans
- PA (0/12) · 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)
Kymriah
- 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)
Kymriah
- Covered on 0 commercial plans
- PA (0/3) · 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 availableCancerCare: Acute Lymphoblastic 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.