Alvaro Alencar, MD
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SUMMARY
This retrospective observational study characterized post-covalent BTK inhibitor (cBTKi) treatment patterns, time to treatment discontinuation (TTD), next line of therapy (LOT) sequencing, healthcare resource utilization (HCRU), and total cost of care among patients with mantle cell lymphoma (MCL) in routine clinical practice, using the US Optum Clinformatics Data Mart database. Among 15,165 patients with MCL identified, 4,764 (31.4%) had prior cBTKi exposure across any line of therapy (first-line, 24.0%; second-line, 56.4%; third-line, 14.8%); 342 met eligibility criteria and initiated a post-cBTKi regimen. Median follow-up was 8.4 months overall. Pirtobrutinib-based therapy was the most frequently used post-cBTKi regimen (59.9%), followed by other (17.5%), venetoclax (7.9%) and lenalidomide-based (7.0%) approaches, chemoimmunotherapy (5.2%), and CAR T-cell therapy (2.3%). Median TTD was short across treatment categories: 4.9 months overall, 5.3 months for pirtobrutinib- and venetoclax-based regimens, 6.8 months for lenalidomide-based regimens, and 4.7 months for chemoimmunotherapy. The estimated probability of receiving the next LOT by 12 months was 39.9% overall and was highest among venetoclax-based and pirtobrutinib-based regimens. Patients receiving CAR T-cell therapy had the highest observed HCRU and median total cost of care (100% of patients having ≥1 hospitalization; median total cost of care, $306,495), while other post-cBTKi regimens also demonstrated substantial economic burden (range, $97,419-$137,371).
Haitao Wang, PhD
Nakhle S. Saba, MD
Shuhua Yi, MD
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