| Diffuse Large B-Cell Lymphoma

Epkinly vs Xpovio

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

Deep comparison between: Epkinly vs Xpovio 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 signalsXpovio has a higher rate of injection site reactions vs Epkinly based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Xpovio but not Epkinly, including UnitedHealthcare

Category

Epkinly

Xpovio

At A Glance

RouteSC injection

FrequencyEvery 1-4 weeks

ClassCD20xCD3 bispecific antibody

RouteOral

FrequencyOnce or twice weekly

ClassXPO1 inhibitor

Indications

Diffuse Large B-Cell Lymphoma
High grade B-cell lymphoma
Lymphoma, Follicular

Multiple Myeloma
Diffuse Large B-Cell Lymphoma

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.

Multiple Myeloma (with Bortezomib and Dexamethasone) 100 mg orally once weekly on Day 1 of each week in combination with bortezomib 1.3 mg/m2 SC once weekly and dexamethasone 20 mg orally twice weekly on Days 1 and 2.

Multiple Myeloma (with Dexamethasone) 80 mg orally on Days 1 and 3 of each week in combination with dexamethasone 20 mg orally on Days 1 and 3 of each week.

Diffuse Large B-Cell Lymphoma 60 mg orally on Days 1 and 3 of each week until disease progression or unacceptable toxicity.

Contraindications

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Drug Interactions

694View drug interactions

898View drug interactions

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%) Fatigue, nausea, thrombocytopenia, decreased appetite, diarrhea, vomiting, weight decreased, anemia, peripheral neuropathy, upper respiratory tract infection, hyponatremia, cataract

Serious Thrombocytopenia, neutropenia, gastrointestinal toxicity (nausea, vomiting, diarrhea, weight loss), hyponatremia, serious infection (including pneumonia and sepsis), neurological toxicity, cataract

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).

Selinexor reversibly inhibits exportin 1 (XPO1), blocking nuclear export of tumor suppressor proteins and oncogenic mRNAs, causing nuclear accumulation of tumor suppressors, downregulation of oncoproteins such as c-myc and cyclin D1, cell cycle arrest, and apoptosis of cancer cells.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Epkinly