Real-World Patient Characteristics and Outcomes Associated With Antibody Drug Conjugate Therapy: A Large Cohort Study
Author(s)
Allison R. Brosso, BA, Douglas Londono, PhD, Diane Faraone, PharmD, Nathan J. Markward, PhD.
PurpleLab, Wayne, PA, USA.
PurpleLab, Wayne, PA, USA.
OBJECTIVES: Antibody drug conjugates (ADCs) are an expanding class of targeted oncology therapies. Despite their promise, few studies have evaluated ADC-related toxicity across cancer types or post-initiation healthcare resource utilization. This study addresses this gap using a large-scale claims repository to describe ADC patient characteristics, utilization patterns, and real-world outcomes.
METHODS: A retrospective cohort study (N = 16,839) was conducted using PurpleLab® CLEAR claims incurred between January 1, 2019, and June 30, 2024. Patients were included in the study if they had 1) a new (index) medical or pharmacy claim for ADC therapy between January 1, 2020, and June 30, 2023 and, 2) a confirmed ADC cancer indication during the 12-month pre-index period. Patients were required to have been continuously enrolled in a health plan for 12 months before initiation of therapy. Demographic and social determinants of health variables were determined at each patient’s index date, and outcomes were tracked for 12 months post-index.
RESULTS: The cohort was predominantly female (87.9%), married (54.4%), non-Hispanic (84.4%), and employed in white-collar occupations (69.0%), with a mean age of 60.7 years. The most common cancer indications were breast cancer (75.5%), urothelial carcinoma (7.2%), and ovarian cancer (7.2%). The most frequently utilized ADCs were fam-trastuzumab deruxtecan (40.1%), ado-trastuzumab emtansine (25.1%), sacituzumab govitecan (16.5%), enfortumab vedotin (7.8%), and brentuximab vedotin (5.3%). The average time from diagnosis to ADC initiation was 177.8 days. Notably, 40.4% of the sample had a secondary cancer at the time of ADC initiation, and 45.9% died during the follow-up period.
CONCLUSIONS: This real-world analysis highlights variation in patient characteristics and ADC utilization patterns. The findings underscore the need for timely ADC initiation and careful patient selection to optimize clinical outcomes in precision oncology, particularly as evidence increasingly supports ADC use in earlier lines of therapy.
METHODS: A retrospective cohort study (N = 16,839) was conducted using PurpleLab® CLEAR claims incurred between January 1, 2019, and June 30, 2024. Patients were included in the study if they had 1) a new (index) medical or pharmacy claim for ADC therapy between January 1, 2020, and June 30, 2023 and, 2) a confirmed ADC cancer indication during the 12-month pre-index period. Patients were required to have been continuously enrolled in a health plan for 12 months before initiation of therapy. Demographic and social determinants of health variables were determined at each patient’s index date, and outcomes were tracked for 12 months post-index.
RESULTS: The cohort was predominantly female (87.9%), married (54.4%), non-Hispanic (84.4%), and employed in white-collar occupations (69.0%), with a mean age of 60.7 years. The most common cancer indications were breast cancer (75.5%), urothelial carcinoma (7.2%), and ovarian cancer (7.2%). The most frequently utilized ADCs were fam-trastuzumab deruxtecan (40.1%), ado-trastuzumab emtansine (25.1%), sacituzumab govitecan (16.5%), enfortumab vedotin (7.8%), and brentuximab vedotin (5.3%). The average time from diagnosis to ADC initiation was 177.8 days. Notably, 40.4% of the sample had a secondary cancer at the time of ADC initiation, and 45.9% died during the follow-up period.
CONCLUSIONS: This real-world analysis highlights variation in patient characteristics and ADC utilization patterns. The findings underscore the need for timely ADC initiation and careful patient selection to optimize clinical outcomes in precision oncology, particularly as evidence increasingly supports ADC use in earlier lines of therapy.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD162
Topic
Clinical Outcomes, Real World Data & Information Systems, Study Approaches
Disease
Biologics & Biosimilars, No Additional Disease & Conditions/Specialized Treatment Areas, Oncology, Personalized & Precision Medicine