Are There Disparities in Novel Therapy Uptake For AML?

Nearly half of adults with acute myeloid leukemia (AML) received a novel therapy within 24 months of approval by the US Food and Drug Administration (FDA), but certain patients were more likely to receive a novel therapy, according to a recent analysis.

Andrew Hantel, MD, of the Dana-Farber Cancer Institute and colleagues conducted the research and presented their findings during the 2023 American Society of Clinical Oncology Annual Meeting.

They conducted the research because “inequities in the uptake of novel treatments have been seen in other cancers but are not known for this population.”

Dr. Hantel and colleagues performed a retrospective analysis of the nationwide Flatiron Health electronic health record-derived deidentified database. They used it to assess sociodemographic associations with the use of novel therapies for AML within two years of their FDA approval from January 2014 to August 2022. The novel therapies for AML that they assessed were glasdegib, venetoclax, ivosidenib, midostaurin, CPX-351, gilteritinib, enasidenib, and gemtuzumab ozogamicin.

The analysis included 8,081 patients at 280 clinics. Of those patients, 38% received at least one novel therapy. The median patient age was 69 years, most patients were male (56%), White (88%), and received care at a community practice (75%).

Of the 8,081 patients, 4,808 received treatment within 24 months of a novel therapy approval. Of those 4,808 patients, 40% received a novel therapy. More than half (59%) of novel treatments prescribed were venetoclax.

The study showed bivariate associations between receiving a novel therapy within 24 months of approval and having a high socioeconomic status and a non-Hispanic White ethnicity.

“Similar associations were seen when assessed at the treatment regimen level,” Dr. Hantel and colleagues wrote.

In a logistic regression model of community practices including 2,459 patients, the researchers found that patients who were older were more likely to receive a novel therapy (odds ratio [OR], 1.01; 95% CI 1.00-1.02). Patients who were female (OR, 1.2; 95% CI, 1.0-1.4), and those who had a high socioeconomic status (OR, 1.4; 95% CI, 1.1-1.6) were also more likely to receive a novel therapy. There were no associations with sex or race-ethnicity, according to the researchers.

“In this large national database of adults with AML, almost half received novel therapy within 24 months of FDA approval,” Dr. Hantel and colleagues concluded. “Though there was no dichotomous difference in uptake by race-ethnicity in community practices, younger and more affluent patients were more likely to receive novel therapy, concerning for disparities in uptake.”

Reference

Hantel A, Cernik C, Uno H, et al. Disparities in uptake of novel therapies for acute myeloid leukemia. Abstract #6540. Presented at the 2023 American Society of Clinical Oncology Annual Meeting; June 2-6, 2023; Chicago, Illinois.