Indirect treatment comparison of ivosidenib and other therapies in patients with newly diagnosed acute myeloid leukemia

AIM: To assess the relative efficacy of ivosidenib + azacitidine versus other therapies (venetoclax, glasdegib, azacitidine, decitabine and low-dose cytarabine [LDAC]) for the treatment of patients with newly diagnosed IDH1-mutated (mIDH1) acute myeloid leukemia (AML) ineligible for intensive induction chemotherapy. METHODS: A systematic literature review (SLR) was conducted to identify evidence from studies assessing the clinical efficacy of therapies in the population of interest. The relative efficacy of ivosidenib + azacitidine was estimated using a network meta-analysis (NMA) for overall survival (OS) and event-free survival (EFS). In addition, an anchored matching-adjusted indirect comparison (MAIC) of OS was conducted against venetoclax + azacitidine to account for population imbalances. RESULTS: Following the SLR and feasibility assessment, six studies were considered eligible for inclusion in the NMA. The NMA included all population types identified in the relevant studies (including patients with and without mIDH1) and determined ivosidenib + azacitidine as the treatment with the greatest effect. The MAIC showed that ivosidenib + azacitidine was associated with numerically favorable OS compared to venetoclax + azacitidine. CONCLUSION: Both NMA and MAIC methods generated consistent results, demonstrating a benefit of ivosidenib + azacitidine versus other therapies for the treatment of newly diagnosed IDH1m AML.