e14057 Background: Vorasidenib, a dual inhibitor of mutant IDH1/2 enzymes, was approved in August 2024 as a targeted therapy for patients with IDH-mutant glioma. We aimed to evaluate the real-world utilization patterns, treatment adherence and persistence with vorasidenib among these IDH-mutant glioma patients. Methods: This was a retrospective cohort study using Komodo Health claims dataset dated between January 1, 2016 and June 30, 2025. Patients who had ≥1 prescription claim for vorasidenib on or after August 2024, with confirmed diagnosis of glioma, a surgery or biopsy within ±90 days of first glioma diagnosis, ≥365 days of continuous enrollment before index glioma diagnosis through vorasidenib initiation, and no diagnosis for other cancers were included. Patient baseline characteristics, treatment patterns, proportion of patients with at least one refill for vorasidenib, rejection rates, vorasidenib medication adherence as assessed by medication possession ratio (MPR), and persistence were evaluated, stratified by prior therapy and at 3, 6, and 9 months of follow-up. Results: Overall, 186 patients met the study inclusion criteria. Median age was 40 years; ~51% were male. Most (80%) had commercial insurance, followed by Medicaid (15.1%). Three quarters of patients had a Charlson comorbidity score of 0. Treatment patterns indicate that over half (101, 54.3%) of patients received first line vorasidenib (1L VORA), i.e., without exposure to other chemotherapy and/or radiation therapy (CT/RT), while 58 (31.2%) received CT/RT before vorasidenib initiation (prior CT/RT), and 27 (14.5%) were previously treated with ivosidenib (prior IVO). Among those patients with at least 3 (n=140), 6 (n=81), and 9 (n=24) months of follow-up, over 95% of patients received at least one refill for vorasidenib. In addition, 23.1% of patients had at least one rejected vorasidenib claim. Among all rejected vorasidenib claims, the most frequently recorded reasons for rejection were refilling too soon (9.1%) and requiring prior authorization (8.1%). Mean MPR at 3, 6, and 9 months of follow-up were 0.92, 0.92, and 0.85 for the 1L VORA group; 0.89, 0.87, and not reportable (NR, n <10) for prior CT/RT group; and 0.92, 0.87, and NR for prior IVO group, respectively. Persistence at 3, 6, and 9 months of follow-up were 100%, 84.1%, and 76.9% for the 1L VORA group; 100%, 81.0%, and NR for the prior CT/RT group; and 100%, 75.0% and NR for the prior IVO group, respectively. Conclusions: In this real-world cohort, vorasidenib was used by both treatment-naive and previously treated IDH-mutant glioma patients. Refill rate and treatment adherence to vorasidenib were generally high across different follow-up periods. Extended follow-up is needed to evaluate clinical outcomes of vorasidenib-treated IDH-mutant glioma patients and further assess long-term adherence patterns and factors enabling vorasidenib adherence.
Xu et al. (Thu,) studied this question.