| Diffuse Large B-Cell Lymphoma

Kymriah vs Xpovio

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

Deep comparison between: Kymriah vs Xpovio with Prescriber.AI

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Safety signalsXpovio has a higher rate of injection site reactions vs Kymriah based on FDA-approved prescribing information

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

Category

Kymriah

Xpovio

At A Glance

RouteIV infusion

FrequencySingle dose

ClassCD19-directed CAR T cell therapy

RouteOral

FrequencyOnce or twice weekly

ClassXPO1 inhibitor

Indications

Precursor Cell Lymphoblastic Leukemia Lymphoma
Diffuse Large B-Cell Lymphoma
Lymphoma, Follicular

Multiple Myeloma
Diffuse Large B-Cell Lymphoma

Dosing

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).

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

26View drug interactions

898View drug interactions

Adverse Reactions

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

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

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.

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

Kymriah