| Diffuse Large B-Cell Lymphoma
Breyanzi vs Zynlonta
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Breyanzi vs Zynlonta 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 signalsZynlonta has a higher rate of injection site reactions vs Breyanzi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zynlonta but not Breyanzi, including UnitedHealthcare
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Category
Breyanzi
Zynlonta
At A Glance
IV infusion
Single infusion
CD19-directed CAR T cell therapy
IV infusion
Every 3 weeks
CD19-directed antibody-drug conjugate
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
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 0.15 mg/kg IV over 30 minutes every 3 weeks for 2 cycles, then 0.075 mg/kg every 3 weeks for subsequent cycles; premedicate with dexamethasone 4 mg orally or IV twice daily for 3 days beginning the day before administration.
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%) Thrombocytopenia, increased GGT, neutropenia, anemia, hyperglycemia, transaminase elevation, fatigue, hypoalbuminemia, rash, edema, nausea, musculoskeletal pain.
Serious Febrile neutropenia, pneumonia, edema, pleural effusion, sepsis.
Postmarketing Telangiectasia, cutaneous collagenous vasculopathy, blister, rash vesicular.
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.
Loncastuximab tesirine-lpyl is a CD19-directed antibody-drug conjugate (ADC); upon binding to CD19, the conjugate is internalized and releases SG3199, a PBD dimer alkylating agent that forms cytotoxic DNA interstrand crosslinks, inducing cell death in B-lineage cells.
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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)
Zynlonta
- Covered on 5 commercial plans
- PA (10/12) · 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)
Zynlonta
- 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)
Zynlonta
- Covered on 0 commercial plans
- PA (3/3) · 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 availableADVANCING Patient Support Patient Assistance Program: Zynlonta
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.