The U.S. Food and Drug Administration (FDA) has approved the supplemental New Drug Application (sNDA) for Imbruvica (ibrutinib) capsules for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy. The FDA also approved Imbruvica for CLL patients with del 17p, a genetic mutation that occurs when part of chromosome 17 has been lost. CLL patients with del 17p are considered to have the poorest prognosis. Imbruvica is jointly developed and commercialized by Janssen Biotech Inc. and Pharmacyclics Inc.
The update to the Imbruvica label is based on data from the Phase 3 RESONATE study, which demonstrated Imbruvica significantly improved progression-free survival (PFS) and overall survival (OS) versus ofatumumab in patients with previously treated CLL or small lymphocytic leukemia (SLL).
Imbruvica was initially approved in February 2014 under Subpart H regulation, the FDA’s accelerated approval process, based on data from a Phase 1b/2 study for patients with CLL who have received at least one prior therapy. This indication was based on an overall response rate (ORR). An improvement in survival or disease-related symptoms was not established. In accord with the accelerated approval process, confirmation of clinical benefit in a subsequent Phase 3 study was required, which has resulted in this updated indication for the use of Imbruvica in patients with CLL who have received at least one prior therapy and in CLL patients with del 17p.
“The RESONATE data expands our understanding of the efficacy and safety of Imbruvica to an even greater degree,” said John Byrd, director, Division of Hematology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital & Richard J. Solove Research Institute, and lead investigator for RESONATE. “This approval is particularly exciting for people with del 17p CLL, considering Imbruvica is the first treatment to be approved specifically for this difficult-to-treat patient population.”
CLL is a slow-growing blood cancer of white blood cells called lymphocytes, most commonly B cells. CLL is predominantly a disease of the elderly, with a median age of diagnosis of 72. In CLL, the genetic mutation del 17p occurs when part of chromosome 17 has been lost. CLL patients with del 17p have poor treatment outcomes. Del 17p is reported in seven percent of treatment-naive CLL cases, with approximately 20 to 40 percent of relapsed/refractory patients harboring the mutation.
“We’re very pleased this approval came swiftly,” said Peter Lebowitz, global oncology head, Janssen Research & Development LLC. “These Phase 3 results reinforce the data on which the original approval was granted; they also offer greater clinical understanding of the impact of efficacy related to progression-free and overall survival and, more importantly, the safety of Imbruvica in this patient population.”
Data from this study were recently presented during an oral session at the 50th annual meeting of the American Society of Clinical Oncology (ASCO), featured in the official ASCO press program and simultaneously published online in the New England Journal of Medicine. In January 2014, the RESONATE trial was halted early because results showed a statistically significant difference in PFS, the primary endpoint of the study, as well as in OS, a key secondary endpoint at the time of this interim analysis.
Janssen and Pharmacyclics are continuing an extensive clinical development program for Imbruvica, including Phase 3 study commitments in multiple patient populations.
Date: July 28, 2014
Source: Janssen Biotech Inc.