What to Know About Tecartus for Leukemia and Lymphoma

Tecartus (brexucabtagene autoleucel) is a type of CAR T-cell therapy. It’s a treatment that’s designed to use your own immune system to fight cancer, also known as immunotherapy. 

CAR T-cell therapies, like Tecartus, are offering hope for many people living with certain hard-to-treat cancers, like mantle cell lymphoma (MCL). People with MCL — and other types of cancer — may not respond well to other treatments, such as acalabrutinib (Calquence). 

Tecartus is a relatively new medication for people with MCL whose cancer has come back or is resistant to other forms of treatment. In fact, it’s the only CAR T-cell therapy approved for treating adults with MCL. But can it treat any other types of cancer? How does it work?

Here, we’ll discuss what Tecartus is, how effective it is, and possible side effects to be aware of.

What is Tecartus?

As mentioned, Tecartus is a CAR T-cell therapy. This means it’s a cancer medication that’s made using your own T cells. It can only be given to the person whose cells were used to make it, so each dose of Tecartus is unique. 

It may be an option for you if your cancer has come back or it’s resisting other treatments — meaning it’s refractory or relapsed. It treats a couple specific types of cancer.

The first of these cancers being MCL. This is a rare type of non-Hodgkin lymphoma that affects B lymphocytes, a type of white blood cell in your immune system.

The second type of cancer is B-cell precursor acute lymphoblastic leukemia (ALL) in adults that has relapsed or is refractory. This is also a type of blood cancer that affects B lymphocytes.

How does it work for leukemia and lymphoma?

Tecartus harnesses your body’s immune system to fight cancer. It does this by utilizing T cells from your immune system. T cells are a type of white blood cell that helps fight foreign invaders like bacteria, viruses, and even cancer. But, sometimes, T cells can have a hard time finding cancer cells. 

Tecartus works by attaching a special connector, called a chimeric antigen receptor (CAR), to your T cells. This helps them work better at recognizing and killing cancer cells. It’s also a type of gene therapy because your T cells are genetically modified in this process.

More specifically, Tecartus is a CD-19 directed CAR T-cell therapy. CD-19 is an antigen (protein) found on the surface of different cells. It helps regulate your immune response. CD-19 is found on B cells — both cancerous and non-cancerous. There’s often a high expression of CD-19 on cells in cancers like MCL and B-cell precursor ALL. 

Tecartus — which acts as the connector on your modified T-cells — binds to CD-19 on B cells and kills them. This helps clear the cancer out of your body. 

How is Tecartus given?

The first step in the process of getting Tecartus is collecting your blood through an infusion. This is done by a process called leukapheresis. It usually takes about 3 to 4 hours.

After this, your T cells are separated out from your other cells. They’re then sent to a lab so they can be manufactured (genetically modified) into your unique Tecartus dose. A special connector, called a CAR, is attached to your T cells in the lab. The “CAR” connector will help your T cells latch on to cancer cells and destroy them. This modification process can take 2 to 3 weeks.

Before you receive your Tecartus dose, you’ll receive a couple days of chemotherapy beforehand in order to prepare your body to receive the medication. This is called a preparative chemotherapy regimen, and usually consists of the medications fludarabine and cyclophosphamide. 

Afterwards, you’ll receive your dose of Tecartus as a single, 30-minute infusion into your vein at an authorized treatment center.

What are the potential side effects?

Tecartus can cause a number of side effects. One of the most common is cytokine release syndrome (CRS). Side effects of CRS are usually mild, but they can become serious and life-threatening.

Common side effects

Some common side effects of Tecartus include:

• Fever 

• Tiredness

• Chills

• Tremors

• Low blood pressure

• Fast heart beat

• Confusion

• Difficulty speaking

• Nausea

• Constipation

• Diarrhea

• Swelling caused by fluid buildup

Serious side effects

CRS, including potentially life-threatening reactions, can occur after receiving Tecartus. CRS is an inflammatory response that can happen from all CAR T-cell medications. Symptoms of CRS include fever, chills, low blood pressure, and others.

Severe neurologic toxicities have also occurred in people receiving Tecartus, with or without CRS. Signs or symptoms of neurologic events can include seizures, changes in consciousness, and speech problems.

Because of these risks and side effects, it’s available only through a Risk Evaluation and Mitigation Strategy (REMS) program, called the Tecartus REMS Program. REMS programs are implemented by the FDA for certain medications to help make sure their benefits outweigh their risks. 

Other potentially serious side effects of Tecartus can include:

• Hypersensitivity reactions, including anaphylaxis; and may also include symptoms like difficulty breathing, low blood pressure, or swelling

• Severe infection

• Prolonged low blood cell counts for several weeks following your Tecartus infusion

• Hypogammaglobulinemia (when the level of immunoglobulins in your body are low), which can raise your risk of infection

• Secondary cancers, or the recurrence of your cancer, after getting Tecartus

• Coordination and memory problems (do not drive or operate heavy machinery for 2 months after receiving Tecartus)

How effective is Tecartus when treating leukemia and lymphoma?

Most of what we know about Tecartus’ effectiveness comes from a few small studies that led to its FDA approval.

Mantle cell lymphoma

In one clinical study of 60 people with MCL who had previous treatment failures, Tecartus helped 62% of people achieve complete remission. A complete remission means there was a disappearance in all signs of cancer and blood counts are within normal range. In this same study, Tecartus also helped about 25% of people achieve partial remission. Overall, about 87% of people saw an improvement in their cancer.

Acute lymphoblastic leukemia

Tecartus was also studied in 54 adults with ALL who had previous treatment failures. Here, Tecartus helped 65% of people in the study achieve complete remission. This includes people who achieved complete remission and people who achieved complete remission with incomplete hematologic recovery. 

A complete remission with incomplete hematologic recovery means that the cancer can’t be detected anymore, but some blood counts still aren’t completely back to normal yet.

How much does Tecartus cost?

Tecartus can be very expensive. The price of one infusion of Tecartus is listed at $373,000. But there are often ways you can save. 

If you have insurance, Tecartus would likely be covered by your medical benefits, not your prescription coverage. This is because it’s administered by your healthcare provider — meaning you can’t fill this medication at a traditional community pharmacy. Your cancer care team, hospital, or clinic will provide this medication to you.

In addition to insurance, other support options are also available. Kite Konnect, a financial assistance program from the manufacturer of Tecartus, can provide support for eligible people. This includes reimbursement support and programs to help cover the cost of Tecartus. 

For more information, call 1-844-454-5483 or visit Kite Konnect online.

What are some alternatives to Tecartus?

There aren’t any other CAR T-cell therapies that can treat adults with relapsed or refractory MCL. Tecartus is the first and only CAR T-cell therapy approved for treatment of MCL.

But there are other CAR T-cell therapy options available for treatment of other types of cancer, including other types of leukemia and lymphoma. These include medications like Breyanzi (lisocabtagene maraleucel), Kymriah (tisagenlecleucel), and Yescarta (axicabtagene ciloleucal). 

You can read more about CAR T-cell medications in a previous GoodRx Health article.

Is one better than the rest?

At this time, there aren’t any head-to-head studies that compare one CAR T-cell medication to another. So, we don’t know if one is better than another. Each product works slightly differently, and they each cause different side effects. 

Each CAR T-cell medication also has different approvals to treat various types of cancer.

Why trust our experts?

Written by:

Sonja Jacobsen, PharmD, BCPS, BCOP

Sonja Jacobsen, PharmD, BCPS, BCOP,  is a clinical oncology pharmacy specialist currently practicing in Seattle. She has been practicing as a pharmacist since 2015 and is licensed to practice in Washington state and North Carolina.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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