Boehringer Ingelheim, one of the world’s leading pharmaceutical companies, has submitted a marketing authorisation application to the European Medicines Agency for the approval of its oral triple angiokinase inhibitor nintedanib, in combination with docetaxel, for the treatment of patients with locally advanced, metastatic or recurrent non-small cell lung cancer (NSCLC) of adenocarcinoma tumour histology after first line chemotherapy. Nintedanib, when added to chemotherapy, is the first lung cancer treatment that extended patient survival beyond one year in a broad population of adenocarcinoma patients, after initial chemotherapy had failed.
Prof. Dr Klaus Dugi, Corporate senior vice president medicine, Boehringer Ingelheim, said, "Improving patients’ lives remains at the forefront of Boehringer Ingelheim’s commitment to evidence based progress in the treatment of cancer." He further added, "We are proud that nintedanib, a compound out of our innovative oncology research programme, is the second compound in our portfolio to be filed with the European Medicines Agency."
The EU Marketing Authorization Application for the approval of nintedanib is based on the international, double-blind, phase III LUME-Lung 1 trial, which was the first trial to show a survival benefit of an add-on treatment in a broad second line adenocarcinoma patient population versus an active comparator (standard-of-care/chemotherapy). In this trial in advanced NSCLC patients, the combination of nintedanib plus docetaxel demonstrated a statistically significant prolonged progression-free survival (PFS), versus placebo (3.4 vs. 2.7 months, respectively) regardless of tumour histology, reducing the risk of renewed tumour growth by 21 per cent.
Overall survival was significantly prolonged in adenocarcinoma patients treated with nintedanib plus docetaxel versus placebo plus docetaxel (12.6 vs. 10.3 months respectively).1 The results demonstrated that patients with adenocarcinoma who have failed initial treatment with chemotherapy received on average a 20 per cent extension of overall survival. In addition, the data demonstrated that the earlier adenocarcinoma patients failed first line chemotherapy, the bigger the benefit nintedanib provided, as patients who progressed within nine months (T<9 months) after start of their first-line treatment, achieved a median overall survival benefit of 3 months (10.9 vs. 7.9 months).
The trial results showed patients benefitted from the additional efficacy of nintedanib without further impacting their quality of life. The most common adverse events (AEs) in LUME-Lung 1 were gastrointestinal side effects and reversible liver enzyme elevations which were manageable by supportive treatment or dose reduction (adverse events nintedanib vs. placebo: nausea 24% vs. 18%, vomiting 17% vs. 9%, diarrhoea 42% vs. 22%and liver enzyme elevation 29% vs. 8%). Withdrawal due to adverse events was similar in both arms, as were Grade 3, bleeding or thromboembolic events.
Nintedanib is an oral triple angiokinase inhibitor which targets the three receptors crucially involved in angiogenesis and tumour growth.
Boehringer Ingelheim endeavours to make nintedanib available to patients around the world. Further submissions worldwide are planned.
Nintedanib is an oral triple angiokinase inhibitor that targets three growth factor receptors simultaneously: vascular endothelial growth factor receptors (VEGFR 1-3), platelet-derived growth factor receptors (PDGFR alpha and beta), and fibroblast growth factor receptors (FGFR 1-3).5 All three receptors are crucially involved in the formation and maintenance of new blood vessels (angiogenesis); their blockade may lead to the inhibition of angiogenesis, which plays a critical role in tumour growth and spread.
Nintedanib is currently being investigated in patients with various solid tumours including advanced NSCLC, ovarian cancer, liver cancer (hepatic cell carcinoma), kidney cancer (renal cell carcinoma), and colorectal cancer.
Building on scientific expertise and excellence in the fields of pulmonary and cardiovascular medicine, metabolic disease, neurology, virology and immunology, Boehringer Ingelheim has embarked on a major research programme to develop innovative cancer drugs.