| Mediastinal (Thymic) Large B-Cell Lymphoma
Breyanzi vs Yescarta
Side-by-side clinical, coverage, and cost comparison for mediastinal (thymic) large b-cell lymphoma.Deep comparison between: Breyanzi 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 Breyanzi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Yescarta but not Breyanzi, including UnitedHealthcare
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Category
Breyanzi
Yescarta
At A Glance
IV infusion
Single infusion
CD19-directed CAR T cell therapy
IV infusion
Single infusion
CD19-directed CAR T cell immunotherapy
Indications
- Diffuse Large B-Cell Lymphoma
- High grade B-cell lymphoma
- Mediastinal (Thymic) Large B-Cell Lymphoma
- Lymphoma, Follicular
- Chronic Lymphocytic Leukemia
- Small Lymphocytic Lymphoma
- Mantle cell lymphoma
- Marginal Zone B-Cell Lymphoma
- Diffuse Large B-Cell Lymphoma
- Mediastinal (Thymic) Large B-Cell Lymphoma
- High grade B-cell lymphoma
- Lymphoma, Follicular
Dosing
Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma, Mediastinal (Thymic) Large B-Cell Lymphoma (after one line of therapy) 90 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma, Mediastinal (Thymic) Large B-Cell Lymphoma (after two or more lines of therapy) 50 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, Lymphoma, Follicular, Mantle cell lymphoma, Marginal Zone B-Cell Lymphoma 90 to 110 x 10^6 CAR-positive viable T cells as a single IV infusion, administered 2 to 7 days after lymphodepleting chemotherapy (fludarabine 30 mg/m2/day IV and cyclophosphamide 300 mg/m2/day IV for 3 days).
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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Adverse Reactions
Most common (>=30%) fever, CRS, fatigue, musculoskeletal pain, nausea
Serious CRS, encephalopathy, febrile neutropenia, sepsis, pneumonia, fever, hemorrhage, renal failure, aphasia, delirium, hemophagocytic lymphohistiocytosis
Postmarketing immune effector cell-associated neurotoxicity syndrome (ICANS), T cell malignancies, blindness
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
BREYANZI is a CD19-directed genetically modified autologous T cell immunotherapy; CAR binding to CD19 on tumor and normal B cells triggers CD3 zeta-mediated activation and cytotoxic killing of target cells, while 4-1BB (CD137) costimulatory signaling enhances CAR T cell expansion and persistence.
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.
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Most Common Insurance
Anthem BCBS
Breyanzi
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Yescarta
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Breyanzi
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Yescarta
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Breyanzi
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Yescarta
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Chronic Lymphocytic 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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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.