|
| [January 22, 2013] |
 |
ABRAXANE® Plus Gemcitabine Demonstrates Significant Survival Advantage in Phase III Study of Patients with Advanced Pancreatic Cancer
BOUDRY, Switzerland --(Business Wire)--
Celgene International Sàrl, a subsidiary of Celgene Corporation (NASDAQ:
CELG), today announced that its phase III clinical trial of ABRAXANE®
(paclitaxel protein-bound particles for injectable suspension)
(albumin-bound) in combination with gemcitabine in treatment-naïve
patients with metastatic pancreatic cancer demonstrated a statistically
significant improvement in overall survival compared to patients
receiving gemcitabine alone [(median of 8.5 vs. 6.7 months) (HR 0.72,
P=0.000015)].
In the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical
Trial) study, ABRAXANE plus gemcitabine demonstrated a 59%
increase in one-year survival (35% vs. 22%, p=0.0002) and demonstrated
double the rate of survival at two years (9% vs. 4%, p=0.02) as compared
to gemcitabine alone.
ABRAXANE plus gemcitabine also demonstrated a statistically significant
improvement in key secondary endpoints compared to gemcitabine alone,
including a 31% reduction in the risk of progression or death with a
median progression-free survival (PFS) of 5.5 vs. 3.7 months (HR 0.69,
P=0.000024) and an overall response rate (ORR) of 23% compared to 7%
(response rate ratio of 3.19, p=1.1 x 10-10). Another
endpoint assessed included time to treatment failure, which was
significantly improved with the ABRAXANE combination compared to
gemcitabine alone [(median 5.1 vs. 3.6 months) (HR 0.70, P<0.0001)].
"The past few decades have brought us very few treatment advances for
patients with advanced pancreatic cancer, which is both deadly and
incredibly difficult to treat with success," said Daniel D. Von Hoff,
M.D., F.A.C.P., lead principal investigator of the MPACT study and Chief
Scientific Officer for Scottsdale Healthcare's Virginia G. Piper Cancer
Center Clinical Trials and Physician-In-Chief for the Translational
Genomics Research Institute (TGen). "The fact that Abraxane plus
gemcitabine demonstrated an overall survival benefit, and also did so at
one and two years, is a significant step forward in offering potential
new hope for our patients."
The most common grade = 3 treatment-related adverse events in the study
for ABRAXANE plus gemcitabine vs. gemcitabine alone were neutropenia
(38% vs. 27%), fatigue (17% vs. 7%), and neuropathy (17% vs. 1%). In the
ABRAXANE plus gemcitabine arm, the median time to neuropathy improvement
was 29 days. There was no difference in serious life threatening
toxicity (4% in each arm).
"We are excited by the results of the Abraxane MPACT study and the
potential this treatment combination may bring to patients with advanced
pancreatic cancer," said Jean-Pierre Bizzari, M.D., Executive Vice
President, Global Head Hematology & Oncology Clinical Research, Celgene
Corporation. "As the largest phase III real-world clinical trial in
advanced pancreatic cancer, the clinically meaningful findings seen
across key study endpoints and patient subgroups are a reflection of our
ongoing commitment to develop innovative new therapies in critical areas
of need."
Further details of the study will be highlighted in a late-breaking oral
presentation by Dr. Daniel D. Von Hoff:
-
Abstract: LBA #148: Final results of a randomized phase III study of
weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in
patients with metastatic adenocarcinoma of the pancreas. Friday,
January 25th between 2:00 to 3:30 pm PST at the American
Society of Clinical Oncology's (ASCO) 2013 Gastrointestinal Cancers
Symposium in San Francisco, CA (News - Alert).
Based on the results of the MPACT study, Celgene plans to submit
dossiers for registration in the US and Europe during the first half of
2013 followed by submissions in other countries/regions during the
second half of 2013.
These results are from an investigational phase III study. ABRAXANE is
not currently approved for the treatment of advanced pancreatic cancer.
About the MPACT Study
In the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical
Trial) study, a Celgene-sponsored, open-label, randomized,
international study of 861 metastatic pancreatic cancer patients were
randomized to receive either ABRAXANE plus gemcitabine (125 mg/m2
followed by 1000 mg/m2 gemcitabine for 3 weeks followed by a
week of rest) or gemcitabine alone (1000 mg/m2 administered
weekly for 7 weeks followed by a week of rest followed by cycles of
weekly administration for 3 weeks followed by one week of rest). The
primary endpoint for the study is improvement in overall survival.
Secondary endpoints were progression-free survival, and overall response
rate determined by independent radiological review. Other endpoints
included progression-free survival, overall response rate determined by
investigator and the safety and tolerability of this combination in this
patient population.
About Advanced Pancreatic Cancer
Advanced pancreatic cancer is a difficult-to-treat cancer with the
lowest survival rates among all cancer types. Across all patients with
pancreatic cancer, relative 5-year survival is 6% and is less than 2%
for those with advanced disease. There are two main types of pancreatic
cancer - adenocarcinomas, which accounts for approximately 90% of all
pancreatic cancer, and neuroendocrine tumors. Pancreatic cancer is
relatively uncommon with new cases accounting for only 2.1% of all newly
diagnosed cancers. However, pancreatic cancer is the fourth most common
cause of cancer death in the United States and eighth globally.
About ABRAXANE®
ABRAXANE is an albumin-bound form of paclitaxel that is manufactured
using patented nab® technology. ABRAXANE is
formulated with albumin, a human protein, and is free of solvents.
In the United States, ABRAXANE was first approved in January 2005 for
the treatment of breast cancer after failure of combination chemotherapy
for metastatic disease or relapse within 6 months of adjuvant
chemotherapy. Prior therapy should have included an anthracycline unless
clinically contraindicated. ABRAXANE is also approved in the European
Union/European Economic Area (EU/EEA), Canada, Russia, Australia, New
Zealand, India, Japan, South Korea, Sri Lanka, Bhutan, Nepal, United
Arab Emirates and China for the treatment of metastatic breast cancer.
In October 2012, ABRAXANE was approved by the U.S. Food and Drug
Administration for the first-line treatment of locally advanced or
metastatic non-small cell lung cancer, in combination with carboplatin,
in patients who are not candidates for curative surgery r radiation
therapy.
For the full prescribing information for ABRAXANE please visit http://www.abraxane.com.
ABRAXANE is currently in various stages of investigation for the
treatment of the following cancers: pancreatic, metastatic melanoma,
bladder, ovarian, and expanded applications for breast cancer.
U.S. Regulatory Information for Abraxane
ABRAXANE® for Injectable Suspension
(paclitaxel protein-bound particles for injectable suspension) (albumin
bound) is indicated for the treatment of breast cancer after failure of
combination chemotherapy for metastatic disease or relapse within 6
months of adjuvant chemotherapy. Prior therapy should have included an
anthracycline unless clinically contraindicated.
ABRAXANE is indicated for the first-line treatment of locally
advanced or metastatic non-small cell lung cancer, in combination with
carboplatin, in patients who are not candidates for curative surgery or
radiation therapy.
Important Safety Information
WARNING - NEUTROPENIA
-
Do not administer ABRAXANE therapy to patients who have baseline
neutrophil counts of less than 1,500 cells/mm3.
In order to monitor the occurrence of bone marrow suppression,
primarily neutropenia, which may be severe and result in infection, it
is recommended that frequent peripheral blood cell counts be performed
on all patients receiving ABRAXANE
-
Note: An albumin form of paclitaxel may substantially affect a
drug's functional properties relative to those of drug in solution. DO
NOT SUBSTITUTE FOR OR WITH OTHER PACLITAXEL FORMULATIONS
CONTRAINDICATIONS
Neutrophil Counts
-
ABRAXANE should not be used in patients who have baseline neutrophil
counts of < 1,500 cells/mm3
Hypersensitivity
-
Patients who experience a severe hypersensitivity reaction to ABRAXANE
should not be rechallenged with the drug
WARNINGS AND PRECAUTIONS
Hematologic Effects
-
Bone marrow suppression (primarily neutropenia) is dose-dependent and
a dose-limiting toxicity of ABRAXANE
-
Monitor for myelotoxicity by performing complete blood cell counts
frequently, including prior to dosing on Day 1 for metastatic breast
cancer (MBC) and Days 1, 8, and 15 for non-small cell lung cancer
(NSCLC)
-
Do not administer ABRAXANE to patients with baseline absolute
neutrophil counts (ANC) of less than 1,500 cells/mm3
-
In the case of severe neutropenia (<500 cells/mm3 for
seven days or more) during a course of ABRAXANE therapy, reduce the
dose of ABRAXANE in subsequent courses in patients with either MBC or
NSCLC
-
In patients with MBC, resume treatment with every-3-week cycles of
ABRAXANE after ANC recovers to a level >1,500 cells/mm3
and platelets recover to >100,000 cells/mm3
-
In patients with NSCLC, resume treatment if recommended at permanently
reduced doses for both weekly ABRAXANE and every-3-week carboplatin
after ANC recovers to at least 1,500 cells/mm3 and platelet
count of at least 100,000 cells/mm3 on Day 1 or to an ANC
of at least 500 cells/mm3 and platelet count of at least
50,000 cells/mm3 on Days 8 or 15 of the cycle
Nervous System
-
Sensory neuropathy is dose- and schedule-dependent
-
The occurrence of Grade 1 or 2 sensory neuropathy does not generally
require dose modification
-
If = Grade 3 sensory neuropathy develops, treatment should be withheld
until resolution to Grade 1 or 2 for MBC or until resolution to =
Grade1 for NSCLC followed by a dose reduction for all subsequent
courses of ABRAXANE
Hypersensitivity
-
Severe and sometimes fatal hypersensitivity reactions, including
anaphylactic reactions, have been reported
-
Patients who experience a severe hypersensitivity reaction to ABRAXANE
should not be re-challenged with this drug
Hepatic Impairment
-
Because the exposure and toxicity of paclitaxel can be increased with
hepatic impairment, administration of ABRAXANE in patients with
hepatic impairment should be performed with caution
-
The starting dose should be reduced for patients with moderate or
severe hepatic impairment
Albumin (Human)
-
ABRAXANE contains albumin (human), a derivative of human blood
Use in Pregnancy: Pregnancy Category D
-
ABRAXANE can cause fetal harm when administered to a pregnant woman
-
If this drug is used during pregnancy, or if the patient becomes
pregnant while receiving this drug, the patient should be apprised of
the potential hazard to the fetus
-
Women of childbearing potential should be advised to avoid becoming
pregnant while receiving ABRAXANE
Use in Men
-
Men should be advised not to father a child while receiving ABRAXANE
ADVERSE REACTIONS
Randomized Metastatic Breast Cancer (MBC) Study
-
The most common adverse reactions (=20%) with single-agent use of
ABRAXANE in the MBC study were alopecia (90%), neutropenia (all cases
80%; severe 9%), sensory neuropathy (any symptoms 71%; severe 10%),
abnormal ECG (all patients 60%; patients with normal baseline 35%),
fatigue/asthenia (any 47%; severe 8%), myalgia/arthralgia (any 44%;
severe 8%), AST elevation (any 39%), alkaline phosphatase elevation
(any 36%), anemia (all cases 33%; severe 1%), nausea (any 30%; severe
3%), diarrhea (any 27%; severe <1%) and infections (24%)
-
Sensory neuropathy was the cause of ABRAXANE discontinuation in 7/229
(3%) patients
-
Other adverse reactions of note included vomiting (any 18%; severe
4%), renal dysfunction (any 11%; severe 1%), fluid retention (any 10%;
severe 0%); mucositis (any 7%; severe <1%), hepatic dysfunction
(elevations in bilirubin 7%), hypersensitivity reactions (any 4%;
severe 0%), thrombocytopenia (any 2%; severe <1%), and injection site
reactions (<1%). In all ABRAXANE treated patients (n=366)
ocular/visual disturbances were reported (any 13%; severe 1%).
Dehydration and pyrexia were also reported
-
Severe cardiovascular events possibly related to single-agent ABRAXANE
occurred in approximately 3% of patients and included cardiac
ischemia/infarction, chest pain, cardiac arrest, supraventricular
tachycardia, edema, thrombosis, pulmonary thromboembolism, pulmonary
emboli, and hypertension
-
Cases of cerebrovascular attacks (strokes) and transient ischemic
attacks have been reported
Non-Small Cell Lung (NSCLC) Cancer Study
-
Adverse reactions with a difference of =2%, Grade 3 or higher, with
combination use of ABRAXANE and carboplatin in NSCLC were: anemia
(28%); neutropenia (47%); thrombocytopenia (18%), and peripheral
neuropathy (3%)
-
The most common adverse reactions (= 20%) of ABRAXANE in combination
with carboplatin for NSCLC were anemia, neutropenia, thrombocytopenia,
alopecia, peripheral neuropathy, nausea, and fatigue
-
The most common serious adverse reactions of ABRAXANE in combination
with carboplatin for NSCLC were anemia (4%) and pneumonia (3%)
-
The most common adverse reactions resulting in permanent
discontinuation of ABRAXANE were neutropenia (3%), thrombocytopenia
(3%), and periopheral neuropathy (1%)
-
The most common adverse reactions resulting in dose reduction of
ABRAXANE were neutropenia (24%), thrombocytopenia (13%), and anemia
(6%)
-
The most common adverse reactions leading to withholding or delay in
ABRAXANE dosing were neutropenia (41%), thrombocytopenia (30%), and
anemia (16%)
-
The following common (=10% incidence) adverse reactions were observed
at a similar incidence in ABRAXANE plus carboplatin-treated and
paclitaxel injection plus carboplatin-treated patients: alopecia 56%,
nausea 27%, fatigue 25%, decreased appetite 17%, asthenia 16%,
constipation 16%, diarrhea 15%, vomiting 12%, dyspnea 12%, and rash
10% (incidence rates are for the ABRAXANE plus carboplatin treatment
group)
Post-Marketing Experience with ABRAXANE and other Paclitaxel
Formulations
-
Severe and sometimes fatal hypersensitivity reactions have been
reported with ABRAXANE. The use of ABRAXANE in patients previously
exhibiting hypersensitivity to paclitaxel injection or to human
albumin has not been studied
-
There have been reports of congestive heart failure and left
ventricular dysfunction with ABRAXANE, primarily among individuals
with underlying cardiac history or prior exposure to cardiotoxic drugs
-
There have been reports of extravasation of ABRAXANE. Given the
possibility of extravasation, it is advisable to monitor closely the
ABRAXANE infusion site for possible infiltration during drug
administration
DRUG INTERACTIONS
-
Caution should be exercised when administering ABRAXANE concomitantly
with medicines known to inhibit or induce either CYP2C8 or CYP3A4
USE IN SPECIFIC POPULATIONS
Nursing Mothers
-
It is not known whether paclitaxel is excreted in human milk. Because
many drugs are excreted in human milk and because of the potential for
serious adverse reactions in nursing infants, a decision should be
made to discontinue nursing or to discontinue the drug, taking into
account the importance of the drug to the mother
Pediatric
-
The safety and efficacy of ABRAXANE in pediatric patients have not
been evaluated
Geriatric
-
No toxicities occurred notably more frequently among patients = 65
years of age who received ABRAXANE for MBC
-
Myelosuppression, peripheral neuropathy, and arthralgia were more
frequent in patients =65 years of age treated with ABRAXANE and
carboplatin in NSCLC
Renal Impairment
-
The use of ABRAXANE has not been studied in patients with renal
impairment
DOSAGE AND ADMINISTRATION
-
Dose adjustment is recommended for patients with moderate and severe
hepatic impairment and patients who experience severe neutropenia or
severe sensory neuropathy during treatment with ABRAXANE
-
Withhold ABRAXANE if AST >10 x ULN or bilirubin > 5 x ULN
-
Dose reductions or discontinuation may be needed based on severe
hematologic or neurologic toxicities
-
Monitor patients closely
Please see full Prescribing Information, including Boxed WARNING,
CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS, and ADVERSE REACTIONS.
About Celgene Celgene International Sàrl, located in Boudry, in
the Canton of Neuchâtel, Switzerland, is a wholly owned subsidiary and
international headquarters of Celgene Corporation. Celgene Corporation,
headquartered in Summit, New Jersey, is an integrated global
pharmaceutical company engaged primarily in the discovery, development
and commercialization of innovative therapies for the treatment of
cancer and inflammatory diseases through gene and protein regulation.
For more information, please visit the Company's website at www.celgene.com.
Forward-Looking Statements
This press release contains forward-looking statements, which are
generally statements that are not historical facts. Forward-looking
statements can be identified by the words "expects," "anticipates,"
"believes," "intends," "estimates," "plans," "will," "outlook" and
similar expressions. Forward-looking statements are based on
management's current plans, estimates, assumptions and projections, and
speak only as of the date they are made. We undertake no obligation to
update any forward-looking statement in light of new information or
future events, except as otherwise required by law. Forward-looking
statements involve inherent risks and uncertainties, most of which are
difficult to predict and are generally beyond our control. Actual
results or outcomes may differ materially from those implied by the
forward-looking statements as a result of the impact of a number of
factors, many of which are discussed in more detail in our Annual Report
on Form 10-K and our other reports filed with the Securities and
Exchange Commission.

[ Back To Technology News's Homepage ]
|