| Diffuse Large B-Cell Lymphoma
Epkinly vs Kymriah
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Epkinly 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 Epkinly based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kymriah but not Epkinly, including UnitedHealthcare
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Category
Epkinly
Kymriah
At A Glance
SC injection
Every 1-4 weeks
CD20xCD3 bispecific antibody
IV infusion
Single dose
CD19-directed CAR T cell therapy
Indications
- Diffuse Large B-Cell Lymphoma
- High grade B-cell lymphoma
- Lymphoma, Follicular
- Precursor Cell Lymphoblastic Leukemia Lymphoma
- Diffuse Large B-Cell Lymphoma
- Lymphoma, Follicular
Dosing
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.
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 (>=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)
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
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).
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
Epkinly
- Covered on 5 commercial plans
- PA (9/12) · 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
Epkinly
- 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
Epkinly
- Covered on 0 commercial plans
- PA (2/3) · 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 availableGenmab Patient Assistance Program: Epkinly
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.