| Diffuse Large B-Cell Lymphoma
Kymriah vs Zynlonta
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Kymriah 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 Kymriah based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zynlonta but not Kymriah, including UnitedHealthcare
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Category
Kymriah
Zynlonta
At A Glance
IV infusion
Single dose
CD19-directed CAR T cell therapy
IV infusion
Every 3 weeks
CD19-directed antibody-drug conjugate
Indications
- Precursor Cell Lymphoblastic Leukemia Lymphoma
- Diffuse Large B-Cell Lymphoma
- Lymphoma, Follicular
- 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).
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 (>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%) 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
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.
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
Kymriah
- 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
Kymriah
- 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
Kymriah
- 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: Acute Lymphoblastic 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.