Umbralisib Carries Tolerability, Cost Benefits in Follicular Lymphoma, Says Research

An abstract presented at the annual meeting of the Academy of Managed Care Pharmacy is suggesting tolerability and efficacy benefits with umbralisib for the treatment of relapsed/refractory (R/R) follicular lymphoma compared with other phosphoinositide 3-kinase inhibitors (PI3Kis).

Through matching-adjusted indirect comparison, the authors of the abstract compared the use of umbralisib with other PI3Kis in this setting, finding that the treatment yielded the lowest discontinuation rates due to adverse events (AEs), had a lower AE management cost burden, and achieved a favorable duration of responses.

“Targeted therapies, such as phosphoinositide 3-kinase inhibitors (PI3Kis), provide chemotherapy-free options for relapsed / refractory (R/R) follicular lymphoma (FL) patients,” wrote the authors of the abstract. “PI3Kis provide viable treatment options for R/R FL patients, but are associated with some significant toxicities, creating an unmet need for improved tolerability. In addition to the burden on patients, payers are known to be concerned about the high cost of management associated with adverse events (AEs) for their R/R FL patients.”

These findings presented in the abstract were based on the comparison against 3 other PI3KIs: copanlisib, duvelisib, and idelalisib. Compared with the other treatments, umbralisib reduced discontinuations by approximately 30%.

“The annual per patient cost of managing AEs was determined to be lowest for umbralisib ($2123) compared to copanlisib ($5211), duvelisib ($6209), and idelalisib ($4880),” noted the researchers.

Compared with copanlisib, umbralisib had a stronger duration of response (DOR); 12.2 months compared with 11.1 months. Similar results were seen when comparing umbralisib and idelalisib with DORs of 12.4 and 10.8 months, respectively.

The researchers note that in the absence of head-to-head trials, matching-adjusted indirect comparison can be a valuable tool for comparing the effectiveness of treatments.

The findings are not without limitations, note the researchers, explaining that not all patient characteristics were reported across the trials, resulting in an inability to match characteristics in certain cases; not all prognostic factors could be adjusted for within their analyses; and not all AEs were included as part of the economic impact analysis.

Reference

Jeyakumar S, Shreay S, Barnes J, Smith N, Hsu Y, Miskin H. Umbralisib improves tolerability and associated cost burden of adverse events over PI3K inhibitors in relapsed/refractory follicular lymphoma patients; results from matching-adjusted indirect comparison. Presented at: AMCP 2021; April 12-16, 2021