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Australian TGA approves BeiGene’s Brukinsa to treat patients with mantle cell lymphoma

Sydney
Tuesday, October 12, 2021, 16:00 Hrs  [IST]

BeiGene, a global, science-driven biotechnology company, announced that Brukinsa (zanubrutinib) has been approved in Australia for the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.

On October 7, 2021, Brukinsa received its initial approval in Australia for the treatment of adult patients with Waldenström’s macroglobulinemia (WM) who have received at least one prior therapy or in first line treatment for patients unsuitable for chemo-immunotherapy.

Following registration of Brukinsa with the Therapeutic Goods Administration (TGA) in both approved indications, these patients will have immediate access to Brukinsa through the BeiGene sponsored post-approval, pre-reimbursement access programme.

“Mantle cell lymphoma is an uncommon form of non-Hodgkin lymphoma that is generally considered incurable. While the majority of patients respond well to their initial treatment, virtually all will develop progressive lymphoma over time. Existing therapies for patients with recurrent or refractory MCL are often ineffective or have side effects that can lead to treatment discontinuation,” said Professor Stephen Opat, director of clinical haematology at Monash Health and a principal investigator in the zanubrutinib clinical programme. “I’m encouraged that zanubrutinib – a highly selective BTK inhibitor with promising clinical results from two trials in relapsed or refractory MCL – will provide a new treatment option for these patients living in Australia.”

“Australia has some of the highest rates of non-Hodgkin’s lymphoma in the world, and these patients need options for treatment beyond those that exist today,” said Sharon Winton, CEO, Lymphoma Australia. “MCL patients will certainly welcome the news that BeiGene is providing access to Brukinsa by sponsoring a pre-reimbursement program, as new therapies are critical, especially to those diagnosed later in life when it may be challenging to tolerate more aggressive types of treatment.”

BeiGene submitted for reimbursement of Brukinsa to the Pharmaceutical Benefits Advisory Committee (PBAC), with MCL recommended for listing in July 2021.

“Brukinsa was designed to provide deep and durable responses while reducing off-target side effects compared to first-generation BTK inhibitors,” said Jane Huang, M.D., chief medical officer, Hematology at BeiGene. “Our early Brukinsa clinical trials started in Australia and coming off the heels of Brukinsa’s TGA registration for the treatment of WM, we are delighted to be able to provide Brukinsa to more Australians in need of new treatment options.”

More than 6,000 people are diagnosed with non-Hodgkin’s lymphoma (NHL) in Australia each year, making it the sixth most common cancer in adults. MCL is a B-cell NHL that develops in the outer edge of a lymph node called the mantle zone.3 MCL usually has a poor prognosis, with a median survival of three to six years, and is often diagnosed at a later stage of disease.3

The Australian registration for Brukinsa in MCL is based on efficacy results from two single-arm clinical trials. Across both trials, as assessed by independent review committee (IRC) per 2014 Lugano Classification, Brukinsa achieved an overall response rate (ORR) of 83.7%, defined as the combined rate of complete responses (CRs) and partial responses (PRs).

In the multicentre phase 2 trial of zanubrutinib in patients with relapsed or refractory (R/R) MCL BGB-3111-206 (NCT03206970), with a median follow-up time of 18.4 months, the ORR was 83.7% (95% CI: 74.2, 90.8), including 68.6% CRs (FDG-PET scan required) and 15.1% PRs; the median duration of response (DoR) was 19.5 months (95% CI: 16.6, NE). In the global Phase 1/2 trial BGB-3111-AU-003 (NCT02343120), with a media follow-up time of 14.75 months, the ORR was 84.4% (95% CI: 67.2, 94.7), including 25.0% CRs (FDG-PET scan not required) and 59.4% PRs; the median DoR was 18.5 months (95% CI: 12.6, NE).

Of the 118 patients with MCL who received at least one prior therapy and received BRUKINSA treatment, 13.6% of patients discontinued treatment due to adverse events in the trials, with the most frequent being pneumonia (3.4%). Adverse events leading to dose reduction occurred in 3.4% of patients, including hepatitis B, neutropenia, allergic dermatitis, and peripheral sensory neuropathy (in one patient each).

The overall safety profile of Brukinsa is based on pooled data from 779 patients with B-cell malignancies treated with Brukinsa in clinical trials. The most common adverse reactions (=20%) with BRUKINSA were neutropenia, thrombocytopenia, upper respiratory tract infection, hemorrhage/hematoma, rash, bruising, anemia, musculoskeletal pain, diarrhea, pneumonia, and cough. The most common Grade 3 or higher adverse reactions (=5%) were neutropenia, thrombocytopenia, pneumonia, and anemia.

The recommended dose of Brukinsa is either 160 mg twice daily or 320 mg once daily, taken orally with or without food. The dose may be adjusted for adverse reactions and reduced for patients with severe hepatic impairment and certain drug interactions.

Brukinsa is a small molecule inhibitor of Bruton’s tyrosine kinase (BTK) discovered by BeiGene scientists that is currently being evaluated globally in a broad clinical program as a monotherapy and in combination with other therapies to treat various B-cell malignancies. Because new BTK is continuously synthesised, Brukinsa was specifically designed to deliver complete and sustained inhibition of the BTK protein by optimising bioavailability, half-life, and selectivity. With differentiated pharmacokinetics compared to other approved BTK inhibitors, Brukinsa has been demonstrated to inhibit the proliferation of malignant B cells within a number of disease relevant tissues.

Brukinsa is approved in the United States, China, Australia, Canada, and other international markets in selected indications and under development for additional approvals globally.

 

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