| Lymphoma, Follicular
Kymriah vs Zevalin
Side-by-side clinical, coverage, and cost comparison for lymphoma, follicular.Deep comparison between: Kymriah vs Zevalin 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 signalsZevalin has a higher rate of injection site reactions vs Kymriah based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zevalin but not Kymriah, including UnitedHealthcare
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Category
Kymriah
Zevalin
At A Glance
IV infusion
Single dose
CD19-directed CAR T cell therapy
IV infusion
Single course
CD20-directed radioimmunotherapy
Indications
- Precursor Cell Lymphoblastic Leukemia Lymphoma
- Diffuse Large B-Cell Lymphoma
- Lymphoma, Follicular
- Lymphoma, Follicular
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).
Lymphoma, Follicular Day 1: rituximab 250 mg/m2 IV; Day 7, 8, or 9: rituximab 250 mg/m2 IV then Y-90 Zevalin 0.4 mCi/kg IV over 10 minutes (platelets >=150,000/mm3) or 0.3 mCi/kg IV over 10 minutes (platelets 100,000-149,000/mm3, relapsed or refractory); maximum dose 32 mCi; single course.
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 (>=5%) Cytopenias (thrombocytopenia, neutropenia, anemia, leukopenia, lymphopenia), fatigue, nasopharyngitis, nausea, abdominal pain, asthenia, cough, diarrhea, pyrexia
Serious Prolonged and severe cytopenias (thrombocytopenia, anemia, lymphopenia, neutropenia), MDS/AML, serious infusion reactions, severe cutaneous and mucocutaneous reactions
Postmarketing Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous dermatitis, exfoliative dermatitis, infusion site erythema and ulceration, radiation injury
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.
Ibritumomab tiuxetan is a murine IgG1 kappa monoclonal antibody immunoconjugate that binds specifically to the CD20 antigen on pre-B and mature B lymphocytes and >90% of B-cell NHL; the covalently linked Y-90 chelate (tiuxetan) delivers targeted beta radiation, inducing cellular damage via free radical formation in CD20-expressing and neighboring 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)
No coverage data available for Zevalin.
UnitedHealthcare
Kymriah
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
No coverage data available for Zevalin.
Humana
Kymriah
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
No coverage data available for Zevalin.
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 availableCancerCare: Non-Hodgkin Lymphoma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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KymriahView full Kymriah profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.