The U.S.
Food and Drug Administration today approved Adcetris (brentuximab vedotin) to
treat Hodgkin lymphoma (HL) and a rare lymphoma known as systemic anaplastic
large cell lymphoma (ALCL). Adcetris
is an antibody-drug conjugate that combines an antibody and drug, allowing the
antibody to direct the drug to a target on lymphoma cells known as CD30.
Adcetris
is to be used in patients with HL whose disease has progressed after autologous
stem cell transplant or after two prior chemotherapy treatments for those who
cannot receive a transplant. Autologous stem cell transplant is a procedure
using a patient’s own bone marrow that is designed to repair damaged bone
marrow after the use of high chemotherapy doses. Adcetris may also be used in
patients with ALCL whose disease has progressed after one prior chemotherapy
treatment.
“Early
clinical data suggest that patients who received Adcetris for Hodgkin lymphoma
and systemic anaplastic lymphoma experienced a significant response to the
therapy,” said Richard Pazdur, M.D., director of the Office of Oncology Drug
Products in the FDA’s Center for Drug Evaluation and Research.
According
to the National Cancer Institute (NCI), common symptoms of HL include the
enlargement of lymph nodes, spleen, fever, weight loss, fatigue, or night
sweats. NCI estimates that 8,830 new cases of HL will be diagnosed in the United
States in 2011 and about 1,300 people will die from the disease.
Systemic
ALCL is a rare malignant tumor (non-Hodgkin lymphoma) that may appear in
several parts of the body including the lymph nodes, skin, bones, soft tissue,
lungs or liver, according to the NCI.
Adcetris
is the first new FDA-approved treatment for HL since 1977 and the first
specifically indicated to treat ALCL.
The
effectiveness of Adcetris in patients with HL was evaluated in a single
clinical trial involving 102 patients. In the single-arm trial, patients were
only treated with Adcetris. The study’s primary endpoint was objective response
rate, the percentage of patients who experienced complete or partial cancer
shrinkage or disappearance after treatment. Seventy-three percent of patients
achieved either a complete or partial response to the treatment. On average,
these patients responded to the therapy for 6.7 months.
The
effectiveness of Adcetris in patients with systemic ALCL was evaluated in a
single clinical trial in 58 patients. In the single-arm trial, patients were
only treated with Adcetris. Similar to the HL trial, the trial’s primary
endpoint was objective response rate. Of the patients receiving Adcetris for
ALCL, 86 percent experienced either a complete or partial response and
responded on average for 12.6 months.
The most
common side effects experienced with Adcetris were a decrease in
infection-fighting white blood cells (neutropenia), nerve damage (peripheral
sensory neuropathy), fatigue, nausea, anemia, upper respiratory infection,
diarrhea, fever, cough, vomiting, and low blood platelet levels
(thrombocytopenia). Pregnant
women should be aware that Adcetris might cause harm to their unborn
baby.
The drug
is being approved under the FDA’s accelerated approval program, which allows
the agency to approve a drug to treat a serious disease based on clinical data
showing that the drug has an effect on a surrogate endpoint that is reasonably
likely to predict a clinical benefit to patients. The program is designed to
provide patients with earlier access to promising new drugs, but the company
will be required to submit additional clinical information after approval to
confirm the drug’s clinical benefit.
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