Tagraxofusp
Tagraxofusp is a fusion of the growth factor IL-3 with a bacterial toxin that homes to CD123 on a rare, aggressive blood cancer.
Approved 2018 for blastic plasmacytoid dendritic cell neoplasm (BPDCN), the first CD123-directed therapy (CR/CRc 57% in untreated patients). Capillary leak syndrome is the boxed warning. Under study in CD123+ AML and CMML, usually in combination. Now joined in BPDCN by the CD123 ADC pivekimab sunirine (2026).
1.IL-3 moiety binds CD123 on the blast
- Route
- IV over 15 minutes
- Schedule
- 12 µg/kg daily on days 1-5 of a 21-day cycle; first cycle inpatient
- Monitoring
- Capillary leak syndrome (boxed warning): albumin, weight, oedema; hepatic enzymes
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. First cycle given inpatient for capillary leak syndrome monitoring (Part A).
- Commercial insurance
- covered with prior authorisation
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
- Assistance programmes
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
- Leukemia & Lymphoma Society financial support
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- EU-licensed 2021 for BPDCN; UK licence and NICE position not yet researched.
Sources: NICE search: tagraxofusp. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2018 | Blastic plasmacytoid dendritic cell neoplasm, adults and children ≥2 |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Capillary leak syndrome | 55% | 9% |
| Hypoalbuminaemia | 51% | — |
| Transaminase elevation | 60% | — |
Boxed warning. Rates read from the US prescribing information. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Tagraxofusp" OR ABSTRACT:"Tagraxofusp" OR TITLE:"Elzonris" OR ABSTRACT:"Elzonris") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Tagraxofusp, not a curated reading list.