The FDA granted a flurry of end-of-year approvals, including green lights for Mirati, Gilead and TG Therapeutics. A handful of surprises were also thrown in for good measure, including an early decision for Rigel and Forma’s Rezlidhia in relapsed/refractory IDH1-mutated AML. Grabbing a share of this tiny market will be tough as Servier’s Tibsovo dominates the space. Another surprise was the approval of Adstiladrin, the first gene therapy for bladder cancer, handed to the private group Ferring. Two years ago the project was knocked back by manufacturing issues. Merck & Co’s Keytruda is on the market in the same setting − high-risk BCG-unresponsive non-muscle-invasive bladder cancer. The big pharma also had an early hand in Adstiladrin. In 2011 the project, alongside Merck’s gene therapy portfolio, was handed over to FKD Therapies, with Merck taking an equity stake in the private Finnish company. FKD then signed over Adstiladrin's global commercialisation rights to Ferring in 2018. The approval of Adstiladrin follows other gene therapy thumbs ups in 2022, including those of Skysona and Zynteglo from Bluebird and CSL/Uniqure's Hemgenix.
| Notable first-time US approval decisions in December | ||||
|---|---|---|---|---|
| Project | Company | Indication(s) | 2028e SBI ($m) | Outcome |
| Sunlenca (lenacapavir) | Gilead | HIV-1 infection in heavily treatment-experienced people with multidrug-resistant infection | 1,602 | Approved |
| Krazati (adagrasib) | Mirati/Zai Lab | 2L Kras G12C-mutated NSCLC | 1,474 | Approved (accelerated) |
| Briumvi (ublituximab) | TG Therapeutics | Relapsing forms of MS to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults | 842 | Approved |
| Tuoyi (toripalimab) | Coherus | Nasopharyngeal carcinoma | 468 | Delayed (China facility inspections pending owing to Covid-19 related travel restrictions) |
| Lunsumio (mosunetuzumab) | Roche/Biogen | 3L follicular lymphoma | 251* | Approved (accelerated) |
| Sohonos (palovarotene) | Ipsen | Fibrodysplasia ossificans progressiva | 152 | CRL (additional info on clinical trial data) |
| Nexobrid | Mediwound/Vericel/ Kaken | Eschar removal (debridement) in adults with deep partial-thickness and/or full-thickness thermal burns | 78 | Approved |
| Tislelizumab | Beigene/Novartis | 2L oesophageal squamous cell carcinoma | 83 | Pending (Chinese facility inspections) |
| Olpruva (ACER-001) | Acer/Relief | Urea cycle disorder | 73 | Approved |
| Annik/Anniko (penpulimab) | Akeso/Sino | 3L nasopharyngeal carcinoma | - | Pending (Chinese facility inspections) |
| Rezlidhia (olutasidenib) | Rigel/Forma | R/r AML with a IDH1 mutation | - | Approved (2 months early) |
| Adstiladrin (nadofaragene firadenovec) | Ferring (private) | Adults with high-risk BCG-unresponsive non-muscle-invasive bladder cancer with carcinoma in situ with or without papillary tumors | - | Approved |
| Xenoview (hyperpolarised Xe-129) | Polarean Imaging | Drug/device combination to evaluate pulmonary function and imaging | - | Approved |
| SBI = sales by indication. *SBI not split out. Source: Evaluate Pharma & company releases. | ||||
| Advisory committee meetings in December | ||||
|---|---|---|---|---|
| Project | Company | Indication | 2028e SBI ($m) | Outcome |
| Omecamtiv | Cytokinetics | Reduce the risk of CV death and heart failure events in patients with symptomatic chronic HFrEF | 326* | 8-3 against |
| *Forecasts pre-adcom. HFrEF: heart failure with reduced ejection fraction. Source: Evaluate Pharma, company releases, FDA adcom calendar. | ||||
| Supplementary and other notable approval decisions in December | |||
|---|---|---|---|
| Product | Company | Indication (clinical trial) | Outcome |
| Vraylar | Abbvie | Adjunctive treatment of major depressive disorder (NCT03738215) | Approved |
| Tymlos (abaloparatide) | Radius | Men with osteoporosis at high risk for fracture (Atom) | Approved |
| Actemra | Roche | Hospitalised Covid patients (EUA in Jun 2021; Empacta, Covacta, Remdacta, Recovery) | Approved |
| Tecentriq | Roche | Adult and paediatric patients 2 years of age and older with unresectable or metastatic alveolar soft part sarcoma (Study ML39345) | Approved |
| Idacio (Humira biosimilar) | Fresenius Kabi | Chronic autoimmune diseases for all eligible indications of the reference product, Humira | Approved |
| Cytalux | On Target Laboratories | Injectable imaging agent for adults with lung cancer (Elucidate) | Approved |
| Moderna and Pfizer/Biontech bivalent Covid-19 vaccines | Moderna, Pfizer/Biontech | Covid 19, include use in children down to 6 months of age | EUA amended |
| Abrilada (Humira biosimilar) | Pfizer | Interchangeability designation | Pending |
| Lynparza + Zytiga + prednisone/prednisolone | Astrazeneca | Metastatic castration-resistant prostate cancer (Propel) | Delayed by 3 months |
| AVT02 (Humira biosimilar) | Alvotech/Teva | Interchangeability designation | CRL (facility reinspection, Pdufa set for April) |
| Pepaxto | Oncopeptides | R/r multiple myeloma after at least 4 lines of therapy | FDA requested withdrawal of NDA (failed confirmatory Ocean study) |
| Source: Evaluate Pharma, company releases. https://www.evaluate.com/vantage/articles/insights/nme-approvals-snippets/us-approval-tracker-december-2022 | |||
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