The US Food and Drug Administration (FDA) has accepted for Priority Review Janssen Research & Development, LLC's (Janssen) Biologics License Application (BLA) for daratumumab as a treatment for patients with multiple myeloma who are refractory to both a proteasome inhibitor (PI) and an immunomodulatory agent (IMiD), or who have received three or more prior lines of therapy, including a PI and an ImiD.
This is referred to as "double refractory" multiple myeloma, which occurs when a patient's disease has become resistant to at least two of the most commonly utilised and active classes of anti-myeloma agents. Daratumumab, an investigational human anti-CD38 monoclonal antibody, received Breakthrough Therapy designation from the FDA for this patient population in May 2013.
The FDA grants Priority Review to investigational therapies that if approved, may offer significant improvements in the treatment, prevention or diagnosis of a serious condition. This designation shortens the review period to six months compared to 10 months for Standard Review. With this announcement, the FDA has assigned a Prescription Drug User Fee Act (PDUFA) target date of March 9, 2016 to render a decision on the daratumumab application.
"Daratumumab has the potential to be the first anti-CD38 monoclonal antibody approved to treat multiple myeloma, offering these patients an important new treatment pathway. The FDA's acceptance of our application for daratumumab marks an important step for people affected by multiple myeloma. We look forward to working with the FDA during this Priority Review," said Craig Tendler, M.D., vice president, late development and global medical affairs, oncology, Janssen.
The regulatory submission for daratumumab, which was initiated on June 5, 2015, is primarily supported by data from the phase 2 MMY2002 (SIRIUS) monotherapy study, which were presented in May/June 2015 at the 51st Annual Meeting of the American Society of Clinical Oncology (ASCO). Additional data from four other studies, including the phase 1/2 GEN501 monotherapy study, recently published in The New England Journal of Medicine, also support the submission. Daratumumab is the second medicine in the Janssen oncology portfolio to receive Breakthrough Therapy Designation, which is intended to expedite the development and review time for a potential new medicine.
In August 2012, Janssen Biotech, Inc. and Genmab A/S entered a worldwide agreement that granted Janssen an exclusive license to develop, manufacture and commercialise daratumumab. Janssen is the global sponsor of all but one clinical studies for daratumumab. If approved, daratumumab would be commercialised in the US by Janssen Biotech, Inc.
Multiple myeloma is an incurable blood cancer that starts in the bone marrow and is characterized by an excess proliferation of plasma cells. Multiple myeloma is the third most common blood cancer in the US, behind only leukemia and lymphoma. Approximately 26,850 new patients will be diagnosed with multiple myeloma, and approximately 11,240 people will die from the disease in the US in 2015. Globally, it is estimated that 124,225 people will be diagnosed and 87,084 will die from the disease in 2015. While some patients with multiple myeloma have no symptoms at all, most patients are diagnosed due to symptoms which can include bone problems, low blood counts, calcium elevation, kidney problems or infections. Patients who relapse after treatment with standard therapies, including PIs or IMiDs, have poor prognoses and few treatment options.
Daratumumab is an investigational human monoclonal antibody (mAb) that binds with high affinity to the CD38 molecule, which is highly expressed on the surface of multiple myeloma cells. It is believed to induce rapid tumour cell death through multiple immune-mediated mechanisms, including complement-dependent cytotoxicity, antibody-dependent cellular phagocytosis and antibody-dependent cellular cytotoxicity, as well as via induction of apoptosis. Five phase 3 clinical studies with daratumumab in relapsed and frontline settings are currently ongoing. Additional studies are ongoing or planned to assess its potential in other malignant and pre-malignant diseases on which CD38 is expressed, such as smoldering myeloma and non-Hodgkin lymphoma.