TECARTUS (brexucabtagene autoleucel) - CAR T -behandeling vir terugval of vuurvaste mantelsel limfoom

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Julie 25, 2021: Kite, 'n Gilead Company (Nasdaq: GILD), het vandag aangekondig dat die FDA Tecartus (brexucabtagene autoleucel, voorheen KTE-X19), die eerste en enigste goedgekeurde chimere antigeenreseptor CAR T-selterapie for the treatment of adult patients with relapsed or refractory mantle cell lymphoma, accelerated approval (MCL). The FDA granted priority review and breakthrough therapy designation to this one-time therapy, which was based on the results of ZUMA-2, a single-arm, open-label study in which 87 percent of patients responded to a single infusion of Tecartus, with 62 percent achieving a complete response (CR). 18% of patients who were evaluated for safety had sitokienvrystellingsindroom (CRS) of Grade 3 or higher, and 37% had neurologic toxicities of Grade 3 or higher.

“Despite promising advances, there are still significant gaps in treatment for MCL patients who progress after initial therapy,” said Michael Wang, MD, ZUMA-2 Lead Investigator and Professor, Department of Lymphoma and Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center. “Many patients have high-risk disease, which means they are more likely to progress despite treatment. “Tecartus is the first cell therapy available to people with relapsed or refractory MCL. It has an impressive response rate of nearly 90% and early clinical evidence suggests that remissions may last through later lines of therapy. This makes it an important choice for these patients.”

“Ons is trots om ons tweede selterapie te begin, want Kite is daartoe verbind om die belofte van CAR T -terapie to patients with haematological cancers,” said Christi Shaw, Kite’s Chief Executive Officer. “I would like to express my gratitude to the patient study participants, caregivers, clinical researchers, regulators, and dedicated Kite colleagues who contributed to this approval, and we look forward to working with the limfoom community to bring this potentially transformative therapy to patients with relapsed or refractory MCL.”

Tecartus’ product label includes a boxed warning about the risks of CRS and neurologic toxicities. The FDA has approved a Risk Evaluation and Mitigation Strategy (REMS) for Tecartus, which has been combined with the REMS for Yescarta® (axicabtagene ciloleucel). The REMS programme will inform and educate healthcare professionals about the risks associated with Tecartus therapy, and training and certification in the REMS programme will be a requirement for centres offering Tecartus therapy to receive final authorization.

MCL is a rare type of nie-Hodgkin-limfoom (NHL) that develops from cells in the lymph node’s “mantle zone” and primarily affects men over the age of 60. Following a relapse, MCL is extremely aggressive, and many patients progress after treatment.

The Lymphoma Research Foundation’s Chief Executive Officer, Meghan Gutierrez, said, “This approval marks the first CAR T cell therapy approved for mantle cell lymphoma patients and represents a new frontier in the treatment of this disease.” “Researchers have made significant progress in our understanding of this disease over the last decade, and we’ve seen an increase in patient clinical trials, which we hope will continue to improve treatment strategies and options for people with mantle cell lymphoma. Today’s news builds on that progress and gives mantle cell patients and their families reason to be hopeful.”

Kite’s commercial manufacturing facility in El Segundo, California, will produce Tecartus. Kite achieved a 96 percent manufacturing success rate in the ZUMA-2 trial, with a median manufacturing turnaround time of 15 days from leukapheresis to product delivery. Patients with advanced disease, who are severely ill and at risk of rapid progression, require manufacturing speed in particular.

Kite Konnect®, 'n geïntegreerde tegnologieplatform wat inligting en hulp bied tydens die terapieproses vir Kite se gekommersialiseerde CAR T -terapieë, including courier tracking for shipments and manufacturing status updates, is available to patients whose healthcare professionals have prescribed Tecartus therapy. Kite Konnect is a support system for patients who are receiving Yescarta or Tecartus, as well as information for the healthcare teams who are supporting them.

KTE-X19 word tans in die Europese Unie geëvalueer, en die European Medicines Agency het dit Priority Medicines (PRIME) aanwysing gegee vir herhalende of vuurvaste MCL.

Tecartus -proefresultate

Die goedkeuring van Tecartus is gebaseer op resultate van die voortgesette ZUMA-2 spilpuntproef, wat 'n enkelarm, oop-etiket studie is. 74 volwasse pasiënte met terugval of refraktêre MCL wat voorheen antrasiklien- of bendamustienbevattende chemoterapie, anti-CD20-teenliggaampiebehandeling of 'n Bruton-tyrosienkinase-inhibeerder ontvang het, is by die proef ingeskryf (ibrutinib of acalabrutinib). Die primêre eindpunt was die objektiewe responskoers (ORR), wat gedefinieer is as die gekombineerde koers van CR en gedeeltelike response soos beoordeel deur 'n Onafhanklike Radiologiese Hersieningskomitee volgens die Lugano Klassifikasie (2014). (IRRC).

In die navorsing het 87 persent van die pasiënte (n = 60 evalueerbaar vir doeltreffendheidsanalise) gereageer op 'n enkele Tecartus -infusie, met 62 persent wat 'n volledige reaksie bereik het. Die opvolg was ten minste ses maande na die eerste objektiewe siekte-reaksie vir alle pasiënte. Die mediaan reaksietyd moet nog bepaal word.

In the experiment, 18% of patients (n=82 evaluable for safety) had Grade 3 or higher CRS, while 37% of patients had neurologic problems. Anemia, neutropenia, thrombocytopenia, hypotension, hypophosphatemia, encephalopathy, leukopenia, hypoxia, pyrexia, hyponatremia, hypertension, infection-pathogen unclear, pneumonia, hypocalcemia, and lymphopenia were the most prevalent Grade 3 or higher adverse effects (10%). With a Risk Evaluation and Mitigation Strategy, the FDA approved Tecartus (REMS). The Yescarta (axicabtagene ciloleucel) and Tecartus (brexucabtagene autoleucel) REMS Program has been integrated with the Tecartus REMS and is now known as the “Yescarta (axicabtagene ciloleucel) and Tecartus (brexucabtagene autoleucel) REMS Program”

Oor Tecartus

Tecartus is an autologous, anti-CD19 CAR T cell therapy. Tecartus uses the XLP manufacturing process that includes T cell enrichment, a necessary step in certain B-cell malignancies in which circulating lymphoblasts are a common feature. In addition to MCL, Tecartus is also currently in Phase 1/2 trials in acute lymphoblastic leukemia (ALL) and chroniese limfositiese leukemie (CLL). The use of Tecartus in ALL and CLL is investigational, and its safety and efficacy have not been established in these cancer types.

Tecartus aanduiding
Tecartus is 'n CD19-gerigte geneties gemodifiseerde outoloë T-sel-immunoterapie wat aangedui is vir die behandeling van volwasse pasiënte met terugval of refraktêre mantelsellimfoom (MCL).

Hierdie aanduiding word goedgekeur onder versnelde goedkeuring, gebaseer op die algehele reaksietempo en duursaamheid van die reaksie. Voortgesette goedkeuring vir hierdie aanduiding kan afhang van die verifikasie en beskrywing van die kliniese voordeel in 'n bevestigende proef.

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