Early Real-World Uptake of Voranigo in Patients With IDH-Mutant Glioma

Early data indicate Voranigo (vorasidenib) is being rapidly adopted in patients with isocitrate dehydrogenase–mutated glioma, including both newly diagnosed and previously treated individuals, according to study findings presented at 2025 SNO Annual Meeting.

The high rate of prior observation highlights a historical unmet need that Voranigo can now address, and its frequent use soon after diagnosis reflects a shift toward earlier intervention, while uptake in later lines suggests clinicians are using Voranigo to meet ongoing needs not addressed by standard therapies.

Results

The cohort included 125 (24%) incident cases and 395 (76%) prevalent cases. Among the incident cases, 43 (34%) initiated Voranigo within 90 days of diagnosis, with most starting within 240 days. For prevalent cases, approximately 50% were diagnosed with glioma one to five years prior to starting Voranigo, and 50% were diagnosed less than five years prior to treatment.

A total of 1121 patients were identified who were treated with Voranigo. Of these, 520 met the study inclusion criteria, and 601 patients were excluded from the primary analysis cohort. The median age was 41 years, and 109 patients (21%) were diagnosed in 2024. Regarding prior therapy, 214 (41%) patients were naive to active treatment before receiving Voranigo, and 217 (42%) patients received Voranigo as their second line of therapy.

Study Design

This retrospective analysis examined Komodo Health claims data from January 2016 to April 2025 to identify patients who started Voranigo in August 2024 or later. Patients were included if they had a confirmed glioma diagnosis, underwent surgery before starting Voranigo, maintained continuous insurance coverage for at least 365 days prior to diagnosis through treatment initiation, and had no other cancer history. Descriptive statistics were used to summarize patient demographics, timing of diagnosis, treatment status at Voranigo initiation and prior therapies.

Sensitivity Analysis

Sensitivity analyses were performed on two specific cohorts. Analysis of 689 patients with evidence of either surgery only or glioma diagnosis only revealed results that were consistent with those of the primary analysis cohort. Additionally, analysis of the 601 patients who were excluded from the primary analysis cohort revealed that their treatment

What is Voranigo and How Does it Work?

Voranigo is a dual inhibitor of mutant isocitrate dehydrogenase (IDH) 1 and 2 enzymes, approved by the US Food and Drug Administration in 2024 as a targeted therapy for grade 2 IDH-mutant glioma following surgery. Patients with grade 2 IDH1-mutant gliomas now have the option of daily targeted therapy. Clinical trials have established the efficacy and safety of Voranigo, but real-world evidence on its early use is limited. Understanding how Voranigo is integrated into routine practice can provide critical insights to guide clinical decision making and future research, according to the poster presentation.

Baseline Characteristics

The final cohort included 520 patients. The mean age at glioma diagnosis was 40.6 years, with a median of 40. Most patients were 18 to 49 years old, followed by 90 (17%) aged 50 to 64, 18 (3.5%) aged 65 and older, and 6 (1%) aged 0 to 18. The cohort included 247 (47.5%) women, 270 (51.9%) men, and 3 (0.6%) with unknown sex.

Most patients (428 [82%]) had commercial insurance, 54 (10%) had Medicaid, and 38 (7%) had Medicare.

The most commonly used therapies before Voranigo were radiation (240 [46%]), Temodar (temozolomide) (191 [38%]), Tibsovo (ivosidenib) (155 [30%]), and PCV — Matulane (procarbazine), Gleostine (lomustine), and Oncovin (vincristine) (43 [8%]). The most common treatment sequence was observation followed by Voranigo. Among incident patients, 59 of 125 (47%) followed this sequence, compared with 119 of 395 (30%) of prevalent patients.

Reference

1. “Real-world utilization of vorasidenib in patients with IDH-mutant glioma” by Dr. Peters et al., Journal of Hematology-Oncology Research.

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