| Multiple Myeloma

Abecma vs Velcade

Side-by-side clinical, coverage, and cost comparison for multiple myeloma.

Deep comparison between: Abecma vs Velcade with Prescriber.AI

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

Coverage gaps3 major payers require step therapy for Velcade but not Abecma, including UnitedHealthcare

Category

Abecma

Velcade

At A Glance

RouteIV infusion

FrequencySingle infusion

ClassBCMA-directed CAR-T cell therapy

RouteSC or IV injection

FrequencyTwice weekly

ClassProteasome inhibitor

Indications

Multiple Myeloma

Multiple Myeloma
Carcinoma in situ of other and unspecified small intestine NOS

Dosing

Multiple Myeloma Lymphodepleting chemotherapy: cyclophosphamide 300 mg/m2 IV and fludarabine 30 mg/m2 IV for 3 days; administer ABECMA 300 to 510 x 10^6 CAR-positive T cells by IV infusion two days after completion of lymphodepleting chemotherapy; premedicate with acetaminophen and an H1-antihistamine approximately 30 to 60 minutes before infusion.

Multiple Myeloma 1.3 mg/m2 SC or IV; previously untreated: twice weekly (Days 1, 4, 8, 11) in cycles 1-4 then once weekly (Days 1, 8, 22, 29) in cycles 5-9 with melphalan and prednisone for 9 six-week cycles; relapsed: twice weekly (Days 1, 4, 8, 11) every 3 weeks as single agent or with dexamethasone.

Carcinoma in situ of other and unspecified small intestine NOS 1.3 mg/m2 IV twice weekly (Days 1, 4, 8, 11) for 2 weeks followed by a 10-day rest period, in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (VcR-CAP) for 6 three-week cycles.

Contraindications

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Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
Intrathecal administration

Drug Interactions

26View drug interactions

1286View drug interactions

Adverse Reactions

Most common (>=20%) CRS, pyrexia, any infection, febrile neutropenia, hypogammaglobulinemia, musculoskeletal pain, hypotension, infections-pathogen unspecified, fatigue, tachycardia, diarrhea, nausea, headache, encephalopathy, dyspnea, edema

Serious infections-pathogen unspecified, pneumonia, viral infections, encephalopathy, pyrexia, sepsis

Postmarketing Immune effector cell-associated neurotoxicity syndrome (ICANS), T cell malignancies

Most common (>=10%) Nausea, diarrhea, fatigue, peripheral neuropathies, thrombocytopenia, vomiting, constipation, pyrexia, anorexia, anemia, headache, neutropenia, rash, paresthesia, dizziness, weakness

Serious Diarrhea, vomiting, pyrexia, nausea, dehydration, thrombocytopenia, pneumonia, dyspnea, peripheral neuropathies, herpes zoster

Postmarketing Cardiac tamponade, bilateral deafness, optic neuropathy, blindness, ischemic colitis, progressive multifocal leukoencephalopathy, herpes meningoencephalitis, posterior reversible encephalopathy syndrome, Guillain-Barre syndrome, demyelinating polyneuropathy, acute diffuse infiltrative pulmonary disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, acute febrile neutrophilic dermatosis

Pharmacology

ABECMA is a BCMA-directed CAR-positive T cell therapy; the CAR construct uses an anti-BCMA scFv-targeting domain linked to CD3-zeta and 4-1BB intracellular signaling domains, resulting in CAR-positive T cell proliferation, cytokine secretion, and cytolytic killing of BCMA-expressing plasma cells.

Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells; inhibition of this pathway disrupts homeostatic proteolysis, affecting multiple signaling cascades and leading to cell death in various cancer cell types including multiple myeloma.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Abecma