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Takeda says cancer drug Alunbrig (brigatinib) results in longer benefit vs crizotinib After Two Years of Follow-Up

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Nov 23, 2019: Data updated by Takeda Pharmaceutical from its Phase 3 ALTA-1L trial  evaluating ALUNBRIG versus crizotinib in adults with advanced anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC) who had not been received a prior ALK inhibitor.

After two years, ALUNBRIG reduced the risk of disease progression or death by 76% as appraised by investigators in newly diagnosed patients whose disease have spread to the brain at time of registration.

Study investigators and a blinded independent review committee (BIRC) evaluates the ALTA-1L trial and results from both assessments were reported, the BIRC-assessed HR of progression-free survival (PFS), which is the primary endpoint, was 95% whereas demonstrating a reduced risk of disease progression or death by 51%.

Study showed that as compared with the ALTA study in a post-crizotinib population, the frequency of early pulmonary events (interstitial lung disease/pneumonitis) in the ALTA-1L trial was somewhat lower. https://www.takeda.com/newsroom/newsreleases/2019/takeda-presents-long-term-data-in-alk-nsclc-showing-alunbrig-brigatinib-continues-to-demonstrate-superiority-in-the-first-line-after-two-years-of-follow-up/

Roche presents pivotal First Phase III cancer immunotherapy Tecentriq in combination with Avastin to show an improvement in liver cancer patients

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Nov 22,2019: Roche presents positive results from the Phase III IMbrave150 study evaluating Tecentriq® (atezolizumab) in combination with Avastin® (bevacizumab) for the treatment  of loiver cancer.

As compared with sorafenib results shows that Tecentriq in combination with Avastin reduced the risk of death (OS) by 42% hazard ratio and reduced the risk of disease worsening or death (PFS) by 41%.

Every year, more that 750,000 individuals worldwide are diagnosed with HCC, the most common form of liver cancer and this is increasing day by day.                                                                                   https://www.roche.com/media/releases/med-cor-2019-11-22b.htm

ViiV Healthcare announces exclusive licensing agreement with NIH to develop investigational bNAb N6LS for treatment & prevention of HIV-1

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Nov 21,2019 : ViiV Healthcare, the global specialist HIV company majority owned by GSK, with Pfizer Inc. and Shionogi Limited as shareholders, announced that as part of an exclusive licensing agreement between GSK and the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), the company develop an nvestigational broadly neutralising antibody (bNAb) N6LS for the treatment and prevention of HIV-1.

These antibodies can recognise and block the entry of different strains of HIV into healthy cells.

is an antiviral bNAb that works by binding to a specific site (gp120) on the surface of HIV that prevents its entry into uninfected immune system cells (CD4+ T-cells).

By blocking HIV’s entry into human CD4+ cells, HIV replication stops, and the HIV transmission procedure may be prevented. https://viivhealthcare.com/en-gb/media/press-releases/2019/november/viiv-healthcare-announces-exclusive-licensing-agreement-with-the/

BioMarin seeks European marketing Authorization for valoctocogene roxaparvovec to treat severe hemophilia A

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Nov 21,2019: BioMarin Pharmaceutical Inc. announced that the company submitted a Marketing Authorization Application (MAA) to the European Medicines Agency (EMA) for its investigational gene therapy, valoctocogene roxaparvovec, for adults with severe hemophilia A. 

BioMarin is going to provide an update in January 2020. This submission will results in the first marketing application submission for a gene therapy product for any type of hemophilia.

If satisfactory justification for an accelerated assessment provided by the applicant time-frame will reduced to 150 days byThe CHMP and CAT, although an application initially designated can revert to the standard procedure during the review for a multiple reasons.

https://investors.biomarin.com/2019-11-21-BioMarin-Submits-Marketing-Authorization-Application-to-European-Medicines-Agency-for-Valoctocogene-Roxaparvovec-to-Treat-Severe-Hemophilia-A

Medical Device Registration in Japan-Todokede, Ninsho and Shonin Pathways

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Let’s start with brief introduction about regulatory bodies

Minister of health, labour and welfare and PMDA: It is the main regulatory body which deals with drafting and implementing rules for the safety standards, manufacturing and approval process for the drug and medical devices. It also ensures the proper implementation of those rules at ground level.

Pharmaceutical Medical Devices Agency (PMDA) is an independent entity which works along with Minister of health, labour and welfare (MHLW) and can be considered a technical arm for MHLW. PMDA keeps an eye on ADR (adverse drug reaction) and inspection of site and labs for proper compliance for GCP and GLP. PMDA works can be summarized in a single sentence: It is like FDA for JAPAN.

How Medical device is defined by the Japanese regulatory body

  • The definition of medical devices is stipulated in Article 2, Paragraph 4 of the Pharmaceutical and Medical Device Act as”
  • “Devices and equipment which are used for the purpose of diagnosis, treatment or prevention of diseases of human or animal, or affecting the structure or function of the human or animal body, and designated by the Enforcement Ordinance of the Pharmaceutical and Medical Device Act.”

Classification of Medical devices

Medical devices are classified based on the risk they impart on the body. There are four classes of Medical Devices and there are three pathways by which these devices can be approved. The approval process depends on the type of devices so first, let’s understand the type of the device.

Class I: They carry the least risk to human body in case any malfunction occurs. Let’s take an example of x ray films which are considered class I , just think what harm they can do to human body????

Class II (or controlled Medical Devices): it carries relative low risk (more than class I). MRI devices and Ultrasound devices etc.

Class III (Specially Controlled Medical Devices): The risk is high to human body if this type of devices malfunctions.

Class IV (Specially Controlled Medical Devices): Life threatening consequences can occur if this type of devices malfunctions. They are quite invasive in nature. Pacemaker and artificial heart valves are the good example for this type of devices

Approval Process-Three Pathways

1. Todokede (Notification): The applicant needs to file a notification to the PMDA. PMDA does not do any assessment. It is applicable for Class I medical devices.

2. Ninsho (certification by third party): In this process, third party provides the certificate to applicants for their Medical devices. This third party is accredited by MHLW. Many Class II devices follow this pathway.

3. Shonin (complete review and approval process): It is robust process for approval. PMDA checks the technical documents and thorough review process is required. Many Class III and all Class IV Medical devices follow this path.

Few Class III devices which have an associated certification standard (JIS), are subject to pre-market certification (Ninsho process)  Few class II devices without a Specific certification standard are subjected to follow Shonin pathway.

Is Clinical Data required?

New Medical Devices: A completely new devices need to establish its safety and efficacy in clinical trial for getting approved by PMDA.

Improved Medical Devices: A Improvement in already existing medical devices (between New and Generic).  Clinical Data may be required for approval.

Generic devices: Clinical Data is not required for approval.

Applicants must know about class (I, II, III, IV) and type (New, Improved, Generic) of Medical Devices prior seeking approval/certification/notification pathway. Japan does not accept CE labeling and/or certification from the FDA, whereas European and US approval helps speed up the review process

Market Authorization Holder

Company that gets a marketing authorization license is known as a market authorization holder (MAH). It should be noted that only registered MAH agency may import and sell medical products to the Japanese market. So it becomes compulsion for all foreign manufacturers to  designate a MAH or Designated Marketing Authorization Holder (DMAH) to manage their product registrations in Japan.

The Pharmaceuticals and Medical Devices Act (PMD Act)

It came into effect on  November 25, 2014 and replaces the Pharmaceutical Affairs Law (PAL). Key points:

  • Some Class III medical devices can be approved by  third party certification (Ninsho)
  • regulation of medical software
  • , Manufacturers are required to be registered rather than be licensed.
  • Quality management systems (QMS) are streamlined.
  • Manufacturers must comply with the new PMD Act to sell medical devices in Japan.
  • Ref: https://www.regdesk.co/an-overview-of-medical-device-regulations-in-japan/ https://www.emergobyul.com/services/japan/pmda-medical-device-registration-approval-process

Related:

Amgen Completes Acquisition Of Otezla® (apremilast) for the treatment of moderate-to-severe plaque psoriasis, psoriatic arthritis

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Nov. 21, 2019: Amgen announced the successful completion of its acquisition of worldwide rights to Otezla® (apremilast), the only oral, non-biologic treatment for moderate-to-severe plaque psoriasis,  psoriatic arthritis and also used for the treatment of adult patients with oral ulcers allied with Behçet’s Disease.

Otezla was received from Celgene Corporation from previously announced merger with BMS which was completed on Nov. 20.

Drug approved in the European Union and Japan including 50 other markets. 30 mg tablets of OTEZLA is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine monophosphate (cAMP).

This inhibition results in increased intracellular cAMP levels, which is thought to indirectly regulate the production of inflammatory mediators. Old patients (65 years or more )and patients taking medications that can lead to volume depletion or hypotension may be at a high risk complications from severe diarrhea, nausea, or vomiting. https://www.amgen.com/media/news-releases/2019/11/amgen-completes-acquisition-of-otezla-apremilast/

Aquestive Therapeutics’ treatment approved by FDA for neurological disorder amyotrophic lateral sclerosis (ALS)

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Nov 22, 2019: The U.S. Food and Drug Administration approved Aquestive Therapeutics’ treatment for neurological disorder amyotrophic lateral sclerosis (ALS).

According to the ALS Association, ALS is an ultra-rare neurodegenerative disorder that causes the death of neurons that controls the  voluntary muscles, in United States more than 6,000 people diagnosed with this disease.

Company’s Shares, which developed riluzole oral film (ROF) and will market the film with the brand name Exservan, rose 4% at $6.76 after the bell. https://kfgo.com/news/articles/2019/nov/22/fda-approves-aquestives-als-treatment/960323/

AbbVie to present Ibrutinib (IMBRUVICA®) plus venetoclax (VENCLEXTA®/ VENCLYXTO®) , in American Society of Hematology (ASH) Annual Meeting for the treatment of Leukemias, Lymphomas and Other Blood Cancers

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Nov 21, 2019 : AbbVie, a research-based global biopharmaceutical company announced that between Dec 7- 10  in American Society of Hematology (ASH) Annual Meeting & Exposition,  in Orlando more than 40 abstracts, including 18 oral presentations will be presented that include presentations on Ibrutinib (IMBRUVICA®) plus venetoclax (VENCLEXTA®/VENCLYXTO®) , which helps improving  the lives of people living with various difficult-to-treat blood cancers.

IMBRUVICA (ibrutinib)  blocks a protein called Bruton’s tyrosine kinase (BTK). It is an oral, once-daily medicine that works in a different way than chemotherapy.

VENCLEXTA®/VENCLYXTO® (venetoclax) selectively binds and inhibits the B-cell lymphoma-2 (BCL-2) protein. VENCLEXTA/VENCLYXTO targets the BCL-2 protein and helps to restore the apoptosis process. https://news.abbvie.com/news/press-releases/abbvie-to-present-latest-clinical-research-in-treatment-leukemias-lymphomas-and-other-blood-cancers-at-2019-ash-annual-meeting.htm

Harpoon Therapeutics and AbbVie Announce an elite worldwide option and license transaction for HPN217 and Expand Existing Discovery Collaboration

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Nov 21, 2019: Harpoon Therapeutics, Inc. a clinical-stage immunotherapy company developing a novel class of T cell engagers, and AbbVie Inc, a global biopharmaceutical company, announced an elite worldwide option and license transaction for HPN217, Harpoon’s B cell maturation antigen (BCMA)-targeting Tri-specific T cell Activating Construct (TriTAC®), and an expansion of their existing discovery collaboration for up to six additional targets established by the two companies in October 2017.

The TriTAC platform produces novel T cell engagers targeting both solid tumors and hematologic malignancie.“Harpoon has built a unique and unshared  biologics platform that utilizes the patient’s own immune system to attack cancer. HPN217, targeting BCMA, is poised to proceed to clinical development for the treatment of multiple myeloma”,

Harpoon’s BCMA TriTAC combined with AbbVie’s development expertise, has the potential to generate innovative new medicines for patients with cancer. Under the terms of the license and option agreement, Harpoon granted to AbbVie an option to license worldwide exclusive rights to HPN217 through Phase 1/2 clinical trials. https://news.abbvie.com/news/press-releases/harpoon-therapeutics-and-abbvie-announce-licensing-and-option-collaboration-to-advance-hpn217-harpoons-bcma-targeting-tritac-and-expand-existing-discovery-collaboration.htm

XCOPRI (cenobamate tablets) approved by FDA for the treatment partial-onset seizures in adults

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Nov 21, 2019: SK Life Science new option to treat adults with partial-onset seizures, XCOPRI (cenobamate tablets) approved by FDA which has an often difficult-to-control condition that can have a significant impact on patient quality of life.

Seizures occur when group of nerve cells (neurons) in the brain undergo uncontrolled activation generally for short period of abnormal electrical activity in the brain also uncontrolled movements, abnormal thinking or behavior, and abnormal sensations are reported,Movements can be violent, and changes in consciousness can occur.

XCOPRI causses Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), also known as multiorgan hypersensitivity also patients with hypersensitivity to cenobamate should avoid XCOPRI. https://fda.einnews.com/pr_news/502878004/fda-approves-new-treatment-for-adults-with-partial-onset-seizures

US Food and Drug Administration (FDA) approved Calquence (acalabrutinib) for adult patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

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Nov 21,2019: AstraZeneca announced that the US Food and Drug Administration (FDA) has approved Calquence (acalabrutinib) for adult patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL).

This approval is based on positive reports from the interim analyses of two Phase III clinical trials, ELEVATE-TN in patients with previously untreated CLL and ASCEND in patients with relapsed or refractory CLL.

Calquence in combination with obinutuzumab or as a monotherapy significantly reduced the relative risk of disease development or death versus the comparator arms in both 1st-line and relapsed or refractory CLL.

Results from both trials shows that safety and tolerability of Calquence were consistent with its established profile.

This approval of Calquence provides new hope for patients with one of the most common types of adult leukaemia, offering incomparable efficacy and a constructive tolerability profile.

In the Calquence combination arm, risk of disease progression or death was reduced by 90%and in the monotherapy arm it was reduced by 80%. https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2019/calquence-approved-in-the-us-for-adult-patients-with-chronic-lymphocytic-leukaemia-21112019.html

U.S. FDA approved IN.PACT AV paclitaxel-coated balloon for the treatment of Arteriovenous Fistula Lesions

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Nov. 21, 2019: Medtronic  announced U.S. Food and Drug Administration (FDA) approval of the IN.PACT™ AV drug (paclitaxel)-coated balloon for the treatment of failing arteriovenous (AV) access in patients with end-stage renal disease (ESRD) undergoing dialysis. vessel restenosis limits the ability to use AV fistulae effectively.

Patients often undergo one to three maintenance procedures per year which can result in significant disruptions to critical hemodialysis care and increased costs to the healthcare system,so in order to minimize the the cost and maximizing a patient’s uninterrupted access to lifesaving dialysis care, Pivotal randomized trial results from the IN.PACT AV Access trial have shown IN.PACT AV DCB can extend the time between reinterventions by maintaining AV access site patency.

IN.PACT AV DCB, holds the technology from Medtronic’s IN.PACT™ Admiral™ platform, increases blood flow and reduces thickening of the vessel wall by delivering the proven anti-proliferative drug paclitaxel (penetrates deep into the vessel wall to prevent restenosis and  extend time between reinterventions). http://newsroom.medtronic.com/news-releases/news-release-details/medtronic-drug-coated-balloon-receives-us-fda-approval-treat