FDA Approves Nivolumab for Advanced Non-Squamous NSCLC
FDA Anti PD-1 İNHİBİTÖRÜ OLAN İMMÜNOTHERAPİ İLACI NİVOLUMAB(OPDİVO) SKUAMÖZ AKCİĞER KASNERİNDE KULANIMINI MART 2015 ‘DE ONAYLAMIŞTI
Bu onayı CheckMate 057 çalışmanın sonuçlarına göre yapmıştı
2. Seri akciğer kanserinde Nivulumab ile mediyan 12.2 ay sağkalım elde edilirken, dositaksel kemoterapi alanlarda 9.4 ay elde edilmiş.
FDA AKCİĞER KANSERİNDE YENİ OLAN KEYTRUDA İLACININ KULULANIMINI ONAYLADI
FDA Approves Keytruda for Metastatic Non-Small Cell Lung Cancer
FDA, anti-PD-1 BLOKE EDEN AJAN OLAN PEMBROLİZUMAB(KEYTRUDA) daha önce tedavi görmüş, tedaviye dirençli PD-L1 düzeyi pozitif küçük hücreli dışı metastatik akciğer kanserinde kullanımını onayladı.
News | October 09, 2015 | Lung Cancer
By Cancer Network Staff
Nivolumab is now approved for treating squamous and non-squamous NSCLC
The US Food and Drug Administration (FDA) expanded the approval of the anti-PD-1 immunotherapy agent nivolumab (Opdivo) to include advanced non-squamous non–small-cell lung cancer (NSCLC). It was approved in March 2015 for the treatment of squamous NSCLC.
Nivolumab blocks the activation of PD-1, which in turn produces cell-mediated immune responses against tumor cells. It is also approved for the treatment of melanoma.
The new approval is based on results from the CheckMate 057 trial, which included 582 individuals with advanced NSCLC whose disease progressed during or following treatment with platinum-based chemotherapy. In that study, patients were randomized to either nivolumab or docetaxel; the trial was halted early, in April of this year, because of superiority of the study drug at an interim analysis.
Results of the study were published online ahead of print in the New England Journal of Medicine. The nivolumab patients had an overall survival of 12.2 months, compared with 9.4 months for the docetaxel patients. After 18 months, 39% of nivolumab patients remained alive, compared with 23% for docetaxel. The hazard ratio for death with nivolumab was 0.73 (96% confidence interval [CI], 0.59–0.89; P = .002).
The response rate also favored nivolumab, at 19% compared with 12% with docetaxel (P = .02). The progression-free survival was no different between the groups, at 2.3 months for nivolumab and 4.2 months for docetaxel, but at 1 year the PFS rates were 19% with nivolumab and 8% with docetaxel.
Grade 3 or 4 treatment-related adverse events occurred in 10% of patients in the nivolumab group, compared with 54% of docetaxel patients.
The FDA also approved a test to measure PD-L1 expression levels, which the agency says could help identify patients best suited for nivolumab therapy.
“There is still a lot to learn about the PD-1/PD-L1 pathway and its effects in lung cancer, as well as other tumor types,” said Richard Pazdur, MD, of the FDA, in a press release. “While Opdivo showed an overall survival benefit in certain NSCLC patients, it appears that higher expression of PD-L1 in a patient’s tumor predicts those most likely to benefit.
FDA Approves Keytruda for Metastatic Non-Small Cell Lung Cancer
News | October 03, 2015 | Lung Cancer
By Bryant Furlow
The US Food and Drug Administration (FDA) today announced that it has granted accelerated approval for Merck’s anti-PD-1 agent pembrolizumab (Keytruda) for treating patients with refractory metastatic non-small cell lung cancer (NSCLC) tumors that express programmed cell death protein ligand 1 (PD-L1).
It is the first drug approved for patients whose lung tumors express PD-L1, the agency reported. Pembrolizumab is approved for use with the diagnostic PD-L1 HIS 22C3 pharmDx test to detect PD-L1 expression in NSCLC tumors.
“Our growing understanding of underlying molecular pathways and how our immune system interacts with cancer is leading to important advances in medicine,” commented Richard Pazdur, MD, director of the Office of Hematology and Oncology Products at the FDA’s Center for Drug Evaluation and Research.
“Today’s approval of Keytruda gives physicians the ability to target specific patients who may be most likely to benefit from this drug,” he said.
Pembrolizumab is a humanized monoclonal antibody immune checkpoint inhibitor that targets the programmed cell death 1 (PD-1) receptor to facilitate antitumor immune response. Its effectiveness was demonstrated in a subgroup of 61 patients with NSCLC whose PD-L1-positive tumors had progressed following platinum-based chemotherapy or targeted therapy for tumors harboring ALK or EGFR mutations, the FDA announcement stated. Those patients received 10 mg/kg of pembrolizumab every 2 or 3 weeks. Their overall response rate was 41% and responses were durable, lasting between 2.1 and 9.1 months, the FDA reported.
Pembrolizumab’s safety was studied in 550 patients with advanced NSCLC. Common toxicities were found to include fatigue, dyspnea (shortness of breath) and cough, and decreased appetite. It can also cause severe immune-mediated toxicities in the lungs, colon, and hormone-producing glands. Vasculitis (immune-mediated vascular inflammation) was also an uncommon side effect.
“Women who are pregnant or breastfeeding should not take Keytruda because it may cause harm to a developing fetus or newborn baby,” the FDA announcement cautioned. “Across clinical studies, a disorder in which the body’s immune system attacks part of the peripheral nervous system (Guillain-Barre syndrome) also occurred.”
In 2014, pembrolizumab was approved by the FDA for treating patients with advanced melanoma after treatment with ipilimumab immunotherapy. Nivolumab similarly targets the PD-1/PD-L1 pathway and was approved for treatment of squamous NSCLC earlier this year.
The FDA granted pembrolizumab breakthrough therapy designation for metastatic PD-L1-expressing NSCLC based on Merck’s demonstration through preliminary clinical evidence that it may offer “a substantial improvement over available therapies,” the agency announced. “The drug also received priority review status, which is granted to drugs that, at the time the application was submitted, have the potential to be a significant improvement in safety or effectiveness in the treatment of a serious condition.”
Merck is conducting or has planned more than 100 clinical trials for pembrolizumab monotherapy and combination therapy, for more than 30 tumor types.