Genzyme Corporation has submitted marketing applications in both the United States and the European Union for Mozobil (plerixafor), a product candidate intended to enhance mobilization of haematopoietic stem cells for collection and subsequent autologous transplantation in patients with lymphoma and multiple myeloma.
The company has requested priority review of its US application and, if granted, Mozobil could be approved by the end of this year. European approval is expected in 2009. Additional global applications in up to 60 countries are expected to follow.
Mozobil, a novel small molecule CXCR4 chemokine receptor antagonist, has been shown in multiple earlier studies to rapidly and effectively increase the number of stem cells in circulation in the blood. Once circulating in the blood, stem cells can be collected for use in a stem cell transplant. Mozobil has been granted orphan drug status in the United States and European Union and the pivotal trials have undergone Special Protocol Assessment by the FDA and Protocol Assistance by the EMEA. Genzyme has been developing Mozobil since its acquisition of AnorMED, Inc. in 2006.
Mozobil is designed to mobilize stem cells from the bone marrow into the bloodstream where they can be collected, making it more likely for a patient with certain types of cancers to receive a successful transplant. Specifically, patients with non-Hodgkin's and Hodgkin's lymphomas and multiple myeloma often receive high-dose chemotherapy, a process that destroys bone marrow. A stem cell transplant is required to replenish blood-forming bone marrow cells destroyed by high-dose chemotherapy. Stem cells differentiate into the mature red blood cells, white blood cells, and platelets that a healthy person needs.
Currently, before a transplant can take place, patients may receive a prescribed dose of chemotherapy and/or other drugs, called growth factors, to help mobilize their haematopoietic stem cells into the bloodstream. Once the cells are released into the bloodstream, they are easier to collect in preparation for a transplant.
In order for the transplant to take place, a minimum number of approximately 2 million cells per kilogram of body weight must be collected. For many patients, this process can take three or four hours over multiple days to complete. Even then, some patients are not able to mobilize enough cells, and a transplant is not possible.
Genzyme conducted two phase 3 studies that confirmed the potential of Mozobil to effectively and predictably prepare lymphoma and multiple myeloma patients for an autologous transplant. Both studies successfully met primary and secondary endpoints. Patients who received Mozobil in conjunction with a growth factor achieved more rapid and effective mobilization of stem cells in preparation for autologous transplant than patients treated with growth factor alone. In addition, more patients treated with Mozobil plus a growth factor achieved a composite endpoint of optimal stem cell collection and successful transplantation, compared to patients mobilized with placebo plus a growth factor. Mozobil was well tolerated in both trials, with the most common adverse events being gastrointestinal effects and injection site reactions.
"There is a lot of excitement among treating physicians about Mozobil," said Mark Goldberg, M.D., senior vice president of clinical research at Genzyme. "The product has great potential to meet an important, unmet medical need and has numerous potential benefits for patients."
More than 900 patients have received Mozobil through a compassionate use program in the United States, and similar compassionate use programs have recently begun in Europe.
Genzyme plans to launch Mozobil in the US and Europe in 2009. Upon commercial launch, Mozobil will be marketed and sold by Genzyme's existing Transplant sales force, which has a commercial presence in more than 55 countries worldwide. In addition, the company will leverage its Oncology business and clinical infrastructure.
Approximately 55,000 stem cell transplants are performed each year for multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma, and other conditions in markets where Genzyme has a commercial infrastructure, including the United States, Europe, Latin America and the Asian Pacific countries. Genzyme believes that over time, Mozobil will be used in the majority of these procedures, and peak sales of the product in the transplant setting are expected to reach $400 million annually.
In addition to the patient benefit, Mozobil also may offer significant economic benefits for transplant centres. Mozobil has the potential to decrease the number of apheresis days and provide transplant centres with more predictable and efficient use of the apheresis centre, while reducing the number of patients who may fail to mobilize sufficient numbers of cells and therefore require a second mobilization procedure.
One of the world's leading biotechnology companies, Genzyme is dedicated to making a major positive impact on the lives of people with serious diseases. Since 1981, the company has grown from a small start-up to a diversified enterprise with more than 10,000 employees in locations spanning the globe and 2007 revenues of $3.8 billion.