INNV-41. Real-World utilization of vorasidenib in patients with IDH-mutant glioma: early insights on patient characteristics, disease history, and prior treatment patterns

Abstract BACKGROUND Vorasidenib, a dual inhibitor of mutant IDH1/2 enzymes, was approved in mid-2024 as a targeted therapy for patients with IDH-mutant glioma. While clinical trials have established its efficacy and safety, real-world evidence regarding its early use is limited. Understanding how vorasidenib is being integrated into routine practice can provide critical insights to inform clinical decision-making and future research. METHODS This retrospective study used Komodo Health claims data (January 2016–April 2025) to identify patients who initiated vorasidenib since August 2024. Eligible patients had a confirmed glioma diagnosis, evidence of surgical intervention prior to vorasidenib initiation, continuous coverage from ≥365 days prior to their initial glioma diagnosis to vorasidenib initiation, and no other cancer history. Descriptive analyses were conducted to assess demographics, diagnostic timing, treatment status at vorasidenib initiation, and prior therapies. RESULTS Among 520 patients (median age 40 years), 24% were diagnosed within 12 months prior to vorasidenib initiation (incident cases), while 76% were prevalent cases—half diagnosed 1–5 years earlier and half over 5 years earlier. Of incident cases, 34% initiated vorasidenib within 90 days of diagnosis, with most starting within 240 days. Notably, 41% were treatment-naïve at initiation, and approximately 65% had been managed with observation alone prior to vorasidenib or any other therapy. The most common prior therapies were radiation (46.2%), temozolomide (36.7%), ivosidenib (29.8%), and PCV (8.3%). CONCLUSION Early findings show that vorasidenib is being rapidly integrated across a diverse patient population, including both newly-diagnosed and previously-treated patients with IDH-mutant glioma. The high rate of prior observation (65%) underscores a historical unmet need, now addressed by vorasidenib. Its frequent use soon after diagnosis reflects a shift toward earlier therapeutic intervention, while uptake in later lines suggests clinicians are turning to vorasidenib to address persistent needs beyond standard therapies.