High Rates of Real-World Adherence and Persistence Are Seen With Vorasidenib in IDH-Mutant Glioma

Patients with IDH1- or IDH2-mutant glioma who started to receive vorasidenib (Voranigo) after surgery largely adhered to treatment and remained on therapy, according to real-world data from the GLIO-ADHERE study presented at the 2026 SNO Annual Meeting.¹

Among patients with at least 12 months of follow-up and 2 or more filled prescriptions who were evaluated for compliance (n = 108), the mean medication possession ratio at 12 months was 0.85 (standard deviation, 0.24), and the median medication possession ratio (MPR) was 0.99 (interquartile range, 0.74-1.00); the persistence rate was 72.2%. Among those who received vorasidenib as frontline therapy after surgery (n = 65), the mean MPR was 0.88 (standard deviation, 0.20), the median MPR was 0.99 (IQR, 0.87-1.00), and the persistence rate was 76.9%.

In multivariable logistic regression, the available baseline characteristics were not associated with adherence.

“These findings provide insights into real-world treatment patterns and adherence with vorasidenib beyond the clinical trial setting and may help inform treatment management strategies in routine clinical practice,” Katherine B. Peters, MD, PhD, of Duke University Medical Center in Durham, North Carolina, and colleagues wrote in a poster of the data.

What was the design of the real-world GLIO-ADHERE study of vorasidenib in IDH-mutant glioma?

Vorasidenib, an oral dual IDH1 and IDH2 inhibitor that crosses the blood-brain barrier, gained FDA approval in 2024 for the treatment of adult and pediatric patients aged 12 years and older with grade 2 IDH1- or IDH2-mutant glioma.² The FDA approval was based on data from the phase 3 INDIGO trial (NCT04164901), a randomized, double-blind, placebo-controlled study of patients with grade 2 glioma that had persisted or recurred after surgery and carried an IDH1 or IDH2 mutation. INDIGO showed improved progression-free survival and time to next intervention with vorasidenib vs placebo and also demonstrated that delaying progression and the need for further anticancer therapy may defer chemoradiotherapy and help preserve quality of life.^1,2

However, real-world evidence on how vorasidenib is used and how well patients comply with treatment remains limited, according to the GLIO-ADHERE study authors.¹

GLIO-ADHERE is a retrospective United States cohort study that examined vorasidenib use patterns, adherence, and persistence in the Komodo Health Claims database, which captures medical and pharmacy claims for more than 330 million longitudinal patient lives; the data in this trial covered January 1, 2016, to April 26, 2026. To be included, patients needed at least 1 vorasidenib claim on or after August 2024, a confirmed glioma diagnosis, and at least 1 glioma surgery before starting vorasidenib. Patients also needed continuous enrollment from at least 365 days before the initial glioma diagnosis through vorasidenib initiation and no diagnosis of another cancer before starting treatment. Of 957 patients with a vorasidenib claim during the study period, 327 met these criteria.

Follow-up continued until disenrollment or the end of the study period. The MPR was calculated by dividing total days of supply (including early refills, truncated at the end of follow-up) by follow-up duration, persistence was defined as time to treatment discontinuation, and logistic regression was used to identify characteristics associated with better adherence.

What were the baseline characteristics of patients receiving vorasidenib in the GLIO-ADHERE study?

Patients had a median age of 39.5 years (IQR, 31.5-46.6), 52.6% (n = 172) were male, 79.8% (n = 261) had commercial insurance, and 73.7% (n = 241) had a Charlson Comorbidity Index score of 0. The index surgery was a resection in 92.7% (n = 303) and a biopsy in 7.3% (n = 24) of patients, and the cohort was evenly distributed across the Northeast, South, Midwest, and West regions of the United States.

More than half of patients (52.9%; n = 173) received vorasidenib as frontline therapy. Immediately before vorasidenib, 10.1% (n = 33) had received ivosidenib (Tibsovo), 3.1% (n = 10) had undergone an additional surgery, and 33.9% (n = 111) had received other systemic therapy, radiotherapy, or both. The median time from the index glioma diagnosis to vorasidenib initiation was 16.5 months (IQR, 4.0-44.0), the median time from the last resection or biopsy to initiation was 9.5 months (IQR, 2.1-13.9), and the median follow-up after vorasidenib initiation was 8.3 months (IQR, 3.8-13.8).

What are the limitations of the GLIO-ADHERE analysis of vorasidenib in IDH-mutant glioma?

The investigators noted that administrative claims data can be missing, incomplete, or miscoded. The database did not include tumor grade or IDH mutation status and could not differentiate among astrocytoma, oligodendroglioma, and glioblastoma. Additionally, the reasons patients stopped vorasidenib therapy were unavailable. Moreover, the findings may not be generalizable to populations that are underrepresented in the database. The authors concluded that many patients continue to receive vorasidenib and take it as directed for at least 1 year. The authors also called for further research into why patients discontinue or interrupt treatment, which they noted would need a more comprehensive dataset.

Disclosures: Peters reported receiving grant or research support from BioMimetix, Novocure Inc., NuVox Therapeutics, Ono Pharmaceutical, Servier Pharmaceuticals LLC, and Varian; and consultant fees from Sapience and Servier Pharmaceuticals LLC.

References

1. Xu Q, Patel MP, Nsiah I, Elkholi R, Papademetriou E, Peters KB. One-year compliance to vorasidenib among patients with IDH-mutant glioma: real-world evidence from the GLIO-ADHERE study. Presented at: 2026 SNO Annual Meeting; November 12-15, 2026; Philadelphia, PA. Abstract
2. FDA approves vorasidenib for grade 2 astrocytoma or oligodendroglioma with a susceptible IDH1 or IDH2 mutation. FDA. August 6, 2024. Accessed November 15, 2026. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-vorasidenib-grade-2-astrocytoma-or-oligodendroglioma-susceptible-idh1-or-idh2-mutation