Time Toxicity of Bispecific Antibody (BsAb) Options in Relapsed or Refractory (R/R) Follicular Lymphoma (FL): Fixed-Duration Mosunetuzumab Versus Treat to Progression Epcoritamab

Author(s)

Esprit Ma, MPH, Mei Wu, PharmD, Katherine L. Rosettie, MPH;
Genentech, Inc., South San Francisco, CA, USA
OBJECTIVES: Evaluate time burden of BsAbs available for patients with R/R FL: fixed-duration mosunetuzumab and treat to progression epcoritamab.
METHODS: Patient time alive in a 1-year time horizon was assumed to be spent either on healthcare contact (HC) or non-HC home days (based on Gupta, et al. JCO 2022). A matching adjusted indirect comparison estimated the 1-year mean overall survival (OS) for mosunetuzumab versus epcoritamab, based on 365.25 days/year. Based on each registrational study (intravenous mosunetuzumab: GO29781; epcoritamab: EPCORE NHL-1), United States prescribing information, and expert input, we assumed one HC day was required for each initial assessment, administration (mean duration of treatment), response assessment (PET/MRI), and routine care. The number of adverse event (AE) management days was calculated from hospital stay length, based on the 2021 Healthcare Cost and Utilization Project National Inpatient Sample database.
RESULTS: Over a 1-year time horizon, the mean OS was 337.86 versus 294.76 days with mosunetuzumab and epcoritamab, respectively. Total HC days for mosunetuzumab was 26.35 (days: initial assessment: 1; administration: 10; PET/MRI: 3; routine care: 8; AE management: 4.35). Total HC days for epcoritamab was 43.34 (days: initial assessment: 1; administration: 24; PET/MRI: 5; routine care: 8; AE management: 5.34). Overall, there were 16.99 fewer HC days with mosunetuzumab versus epcoritamab. Total home days for mosunetuzumab and epcoritamab were 311.50 and 251.42, respectively (60.08 more with mosunetuzumab). When censored for COVID-19 deaths, the mean OS was 337.86 versus 322.15 days with mosunetuzumab and epcoritamab, respectively. HC days remained the same (16.98 fewer with mosunetuzumab than epcoritamab), and mosunetuzumab continued to have more home days at 311.50 versus 278.81 with epcoritamab (32.69 more with mosunetuzumab).
CONCLUSIONS: Overall, fixed-duration mosunetuzumab had fewer HC days and more home days than treat to progression epcoritamab. These data provide important considerations to ensure more patient-centered treatment choices can be made.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

EE31

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies, Novel & Social Elements of Value

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology

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