Real-World Adherence and Healthcare Resource Utilization ofBruton Tyrosine Kinase Inhibitors in Mantle Cell Lymphoma

P2045

Bijal Shah,1 Wesley Furnback,2 Kaitlyn Esselman,3 Po-Ya Chuang,3 Mei Xue,3 Keri Yang3
1Moffitt Cancer Center, Tampa, FL, USA; 2Real Chemistry, New York, NY, USA; 3BeiGene, USA, San Mateo, CA, USA

I N T R OD U C T I O NTable 1. Demographics and Clinical Characteristics• Mantle cell lymphoma (MCL) is a rare and incurable B-cell malignancy• MCL can be controlled for a prolonged period of time but eventuallyIbrutinib(n=725)

Variable1

Acalabrutinib(n=878)

Zanubrutinib(n=519)P Value<.0001

Age at index

becomes refractory or relapsed (R/R), leading to subsequent treatment

2• Bruton tyrosine kinase inhibitors (BTKis) have been shown to be effective forthe treatment of R/R MCL

3-5

Mean (SD)68.31 (9.24)

70.46 (8.2)

70.04 (8.6)

Median (IQR)

70 (62, 77)

72 (65, 77)

72 (65, 77)

in MCL are limited

70 (9.66)

53 (6.04)

32 (6.17)

56-64

167 (23.03)

161 (18.34)

96 (18.5)

65+488 (67.31)

664 (75.63)

391 (75.34)

OBJECTIVESex• To examine treatment adherence and healthcare resource utilization (HCRU)

Maleof patients undergoing BTKi treatment in MCL

.0013

18-55

Female613 (69.82)

183 (25.24)

265 (30.18)

Data Source• Data were sourced from Symphony Integrated Dataverse (IDV , a®

comprehensive, longitudinal, open claims database, and integrated
electronic medical record data)• The study period was from December 2019 to November 2023 with an index
period between January 2020 and October 2023

Inclusion Criteria• Patients aged ≥18 years with ≥1 diagnosis for MCL• Patients who initiated their first BTKi treatment or switched from ibrutinib toacalabrutinib or zanubrutinib during the index period, defined as the date oftreatment initiation• Patients with continuous enrollment in the database for 30 days prior
to and 30 days after the index date

Cohorts• Two cohorts were identified― Patients receiving their first BTKi (acalabrutinib, ibrutinib, zanubrutinib) during theindex period― Patients that received ibrutinib as their first BTKi and initiated acalabrutinib orzanubrutinib as their second BTKi during the index period<.0001index date

― Persistence was measured as the proportion of patients who remained

22 (4.24)

Mean (SD)70.77 (8.7)

68.91 (7.05)

Medicare354 (48.83)

518 (59)249 (47.98)

Median (IQR)

73 (66.5, 77)

68 (64, 76)

Commercial

303 (41.79)

299 (34.05)

243 (46.82)

Age groups, n (%)

Self

16 (2.21)

9 (1.03)1 (0.19)Other

14 (1.93)

2 (0.23)4 (0.77)<.00010.78 (0.63)

0.94 (0.61)

0.91 (0.64)

Median (IQR)

1 (0, 1)1 (1, 1)1 (1, 1)SD, standard deviation; IQR, interquartile range.

Comorbidities• Across the measured comorbidities at baseline, there were significant
differences among the three BTKis for in the rate of atrial fibrillation(acalabrutinib=1.94%; ibrutinib=1.24%; zanubrutinib=3.47%, P=.0232)

Compliance and Persistence

Figure 1. Compliance and Persistence in First-Ever Bruton Tyrosine
Kinase Inhibitor Users
10.00%

20.00%

initiated zanubrutinib• There were significant differences for mean age at index (P<.001), payer type(P<.001), and prior line of therapy (P<.001) (Table 1)

40.00%

16.45%
16.73%• Among patients who switched from ibrutinib to zanubrutinib or acalabrutinib― Zanubrutinib demonstrated numerically better compliance and persistence
than acalabrutinib― Zanubrutinib demonstrated numerically lower outpatient visits and inpatient

3 (3.41)

56-64

19 (13.57)

26 (29.55)

65+

111 (79.29)

59 (67.05)

inpatient services were numerically lower in patients that switched fromibrutinib to zanubrutinib (1.12 [1.67] vs 1.62 [3.17]; P=.1755) than in patients thatswitched to acalabrutinib (0.22 [0.68] vs 0.68 [3.12]; P=.1693; Figure 3)

Figure 3. Healthcare Resource Utilization of Patients Post-Ibrutinib

Sex.1836Male

118 (84.29)

68 (77.27)

Female22 (15.71)

20 (22.73).0201

Medicaid

3 (2.14)5 (5.68)

Medicare90 (64.29)

39 (44.32)

Commercial

46 (32.86)

42 (47.73)

Self

0 (0)

0 (0)

Other

1 (0.71)

2 (2.27)

Mean
inpatient
services

0.68
0.22

Mean
outpatient
visits1.62
1.120

1.36 (1)1.36 (1.03)

Median (IQR)

1 (1, 2)

1 (1, 2)

Switching Status.8654
122 (87.14)

76 (86.36)

SD, standard deviation; IQR, interquartile range.

0.5

1Acalabrutinib (n=140).9962

Mean (SD)

Direct switchfrom ibrutinib• HCRU showed that the mean (SD) number of outpatient visits and

1.5

2

Zanubrutinib (n=88)

REFERENCES
1. Shah BD, et al. Cancer Control. 2012;19(3):227-235.
2. Burkart M, Karmali R. J Pers Med. 2022;12(3):376.
3. Song Y, et al. Blood. 2022;139(21):3148-3158.
4. Wang M, et al. Leukemia. 2019;33(11):2762-2766.
5. Rule S, et al. Leukemia. 2018;32(8):1799-1803.

(P=.2687; P=.6270) (Figure 2)

30.60%
Persistence at
1 yearD I S C LO S U R E S
Figure 2. Compliance and Persistence of Patients Post-Ibrutinib

32.80%
33.10%

other medical/hospital services per-patient-per-month during BTKi treatment― Among these patients, 725 initiated ibrutinib, 878 initiated acalabrutinib, and 519

10 (7.14)• Among patients who switched from ibrutinib to zanubrutinib or acalabrutinib― Zanubrutinib had numerically better 1-year compliance (P=.2176)― Zanubrutinib had numerically better treatment persistence at 1 and 2 years• HCRU was measured by all-cause outpatient visits, inpatient services, andFirst-Ever BTKi Patients• A total of 2122 patients initiated their first-ever BTKi during the index period.

30.00%

11.80%
Compliance at
1 year18-55

Prior line of therapy• Compliance and persistence results are shown in Figure 10.00%

compliance, persistence, and HCRU when used as the first BTKi and after
prior ibrutinib.0091

Payer typeon treatment among patients with sufficient follow-up periods

R E S U LTS.0781

50 (5.69)

Prior line of therapy

P ValueAge at index

38 (5.24)• Adherence was evaluated by compliance and persistence― Compliance was calculated as the proportion of days covered using 30-day

intervals from initiation on treatment to 1 year. Proportion of days covered > 0.80
indicated compliance

Zanubrutinib(n=88)

MedicaidStudy Measures• Demographics, clinical characteristics, and comorbidities were measured atAcalabrutinib(n=140)

Variable144 (27.75)

Mean (SD)• In this study, zanubrutinib was associated with a trend towards improved

Table 2. Demographics and Clinical Characteristics of Patients Post-Ibrutinib

375 (72.25)

Payer type

METHODSof therapy between patients receiving acalabrutinib or zanubrutinib postibrutinib (Table 2)• There were no significant differences in baseline comorbidities between
patients receiving acalabrutinib or zanubrutinib post-ibrutinib

C O N C LU S I O N S

services than acalabrutinib.0895
542 (74.76)― Over 85% of patients switched directly from ibrutinib to acalabrutinib or zanubrutinib• There were no significant differences in mean age, sex, or prior lines

Age groups, n (%)• However, real-world data for the treatment patterns and outcomes of BTKis

Acalabrutinib and Zanubrutinib as the Second BTKi After Ibrutinib• A total of 228 patients switched from ibrutinib to acalabrutinib (n=140) or
zanubrutinib (n=88).

0.00%
Compliance at
1 year

15.70%
Persistence at
2 years

16.30%
18.60%
Ibrutinib (n=725)

Acalabrutinib (n=878)

10.00%

20.00%

19.45%

followed by acalabrutinib (16.45%) and ibrutinib (11.80%) (P=.1476)

AC K N OW L E D G E M E N TS

30.20%38.60%

Zanubrutinib (n=519)• Compliance at 1 year was numerically highest for zanubrutinib (16.73%)

40.00%

10.26%

Persistence at
1 yearPersistence at
2 years

30.00%

BS: Employment: Moffitt Cancer Center. Research Funding: Jazz Pharmaceuticals,Servier, Kite. Travel accommodations for Kite. Other relationships with DSMB,Pepromene Bio. WF: Employment and equity holder in Real Chemistry.
KE: Employment in Real Chemistry. PC: Employment in Real Chemistry.
MX: Employemnt in BeiGene. KY: Employment and equity holder in BeiGene

This study was sponsored by BeiGene, Ltd. Editorial assistance was provided by Real
Chemistry, and supported by BeiGene.

13.00%
16.30%• Treatment persistence at 1 and 2 years was also numerically highest for

zanubrutinib (33.1%; 18.6%) compared to acalabrutinib (32.8%; 16.3%) andibrutinib (30.6%; 15.7%) (P=.2180; P=.2275)

Acalabrutinib (n=140)

Zanubrutinib (n=88)

Presented at EHA 2024; June 13-16, 2024; Madrid, Spain/Virtual Conference