Olutasidenib vs ivosidenib for R/R IDH1m AML: Matching‑adjusted indirect comparison

Results from an unanchored, matching-adjusted indirect comparison (MAIC), evaluating the comparative effectiveness of olutasidenib and ivosidenib monotherapy in patients with relapsed/refractory (R/R) IDH1-mutated (IDH1m) acute myeloid leukemia (AML), were published in Advances in Therapy by Watts et al. Data from the phase I/II 2102‑HEM‑101 (NCT02719574; n = 147) and phase I AG120‑C‑001 (NCT02074839; n = 174) studies were analyzed to compare the efficacy of olutasidenib and ivosidenib, respectively.

Key data: MAIC-adjusted complete remission (CR) rates were comparable between olutasidenib and ivosidenib (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.61–2.08); the rate of CR + CR with partial hematologic recovery (CRh) was also similar between treatments (OR, 0.83; 95% CI, 0.46–1.50). The median duration of complete remission (DoCR) was numerically longer with olutasidenib (difference in medians, 11.18 months; 95% CI, −4.30 to 22.72), while the median duration of CR+CRh was significantly longer with olutasidenib (difference in medians, 9.84 months; 95% CI, 3.24–22.28). Median overall survival (OS) numerically favored olutasidenib (hazard ratio [HR], 0.75; 95% CI, 0.53–1.07).

Key learning: While non-confirmatory, this MAIC suggests that response durability may differentiate olutasidenib from ivosidenib in R/R IDH1m AML, supporting its consideration when selecting isocitrate dehydrogenase 1 (IDH1) inhibitor therapy in this challenging clinical setting.