| Diffuse Large B-Cell Lymphoma

Xpovio vs Yescarta

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

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

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

Category

Xpovio

Yescarta

At A Glance

RouteOral

FrequencyOnce or twice weekly

ClassXPO1 inhibitor

RouteIV infusion

FrequencySingle infusion

ClassCD19-directed CAR T cell immunotherapy

Indications

Multiple Myeloma
Diffuse Large B-Cell Lymphoma

Diffuse Large B-Cell Lymphoma
Mediastinal (Thymic) Large B-Cell Lymphoma
High grade B-cell lymphoma
Lymphoma, Follicular

Dosing

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.

Diffuse Large B-Cell Lymphoma, Mediastinal (Thymic) Large B-Cell Lymphoma, High grade B-cell lymphoma Target dose 2 x 10^6 CAR-positive viable T cells per kg body weight (max 2 x 10^8 cells) as a single IV infusion; pretreat with cyclophosphamide 500 mg/m2 IV and fludarabine 30 mg/m2 IV on days -5, -4, and -3 before infusion.

Lymphoma, Follicular Target dose 2 x 10^6 CAR-positive viable T cells per kg body weight (max 2 x 10^8 cells) as a single IV infusion; pretreat with cyclophosphamide 500 mg/m2 IV and fludarabine 30 mg/m2 IV on days -5, -4, and -3 before infusion.

Contraindications

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Drug Interactions

897View drug interactions

26View drug interactions

Adverse Reactions

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

Most common (>=30%) CRS, fever, hypotension, encephalopathy, fatigue, tachycardia, headache, nausea, febrile neutropenia, diarrhea, musculoskeletal pain, infections with pathogen unspecified, chills, decreased appetite

Serious CRS, fever, encephalopathy, hypotension, infection with unspecified pathogen, pneumonia, febrile neutropenia, cardiac arrhythmia, cardiac failure, aphasia, hypoxia

Postmarketing Spinal cord edema, myelitis, quadriplegia, dysphagia, status epilepticus, infusion related reactions, T cell malignancies

Pharmacology

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.

CD19-directed genetically modified autologous T cell immunotherapy; upon engagement with CD19-expressing target cells, the CD28 and CD3-zeta co-stimulatory domains activate downstream signaling cascades leading to T cell activation, proliferation, and killing of CD19-expressing cancer cells and normal B cells.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Xpovio