Bayer Pharmaceuticals Corporation and Onyx Pharmaceuticals, Inc. announced that Nexavar (sorafenib) tablets has been granted Fast Track designation by the US Food and Drug Administration (FDA) for the treatment of metastatic hepatocellular carcinoma (HCC), or liver cancer. Nexavar was approved by the FDA in December 2005 for the treatment of patients with advanced renal cell carcinoma (RCC).
The Fast Track programme is designed to expedite the review of drug compounds for the treatment of patients with serious or life-threatening diseases where there is an unmet medical need for new therapeutic approaches and where the product has the potential to demonstrate an effect on a serious or life-threatening aspect of the condition.
Fast Track designation allows a company to file a New Drug Application (NDA) on a rolling basis as data become available. This permits the FDA to review the filing as it is received, rather than waiting for the entire document prior to commencing the review process. With Fast Track designation, there may be more frequent interactions with the FDA and there may be the possibility of a priority review, which could decrease the typical review period.
"We are pleased that Nexavar has received Fast Track designation by the FDA for this difficult-to-treat patient population, and we look forward to submitting our Phase III data when the analyses are complete," said Susan Kelley, M.D., vice president, Oncology, Bayer Pharmaceuticals Corporation.
A phase III trial of Nexavar administered as a single agent to patients with advanced liver cancer is currently underway. Recently, this trial completed patient enrolment. The study is designed to measure differences in overall survival, time-to-symptom progression and time-to-tumour progression (TTP) of Nexavar versus placebo. A randomized Phase II trial for liver cancer patients to evaluate the efficacy of Nexavar in combination with the chemotherapeutic agent doxorubicin is currently open and recruiting patients.
Hepatocellular carcinoma, also known as primary liver cancer, is the most common form of liver cancer and is responsible for 80 per cent of the primary malignant liver tumours in adults. It is the fifth most common cancer in the world. In 2002, approximately 626,000 HCC cases were reported worldwide, with 15,000 cases in the United States and 53,600 in Europe. HCC is most prevalent in developing countries, particularly in East and South-east Asia, the Pacific Basin, and sub-Saharan Africa. Of the 626,000 cases worldwide, approximately 410,000 were reported in Eastern Asia (with 346,000 in China and 40,000 in Japan alone). HCC causes more than 600,000 deaths annually worldwide. The five-year relative survival rate is about seven per cent.
Nexavar is an oral multi-kinase inhibitor that targets both the tumour cell and tumour vasculature. In preclinical models, Nexavar targeted members of two classes of kinases known to be involved in both cell proliferation (growth) and angiogenesis (blood supply) - two important processes that enable cancer growth. These kinases included RAF kinase, VEGFR-2, VEGFR-3, PDGFR-?, KIT, and FLT-3.
Nexavar has been studied in more than 20 tumour types and in more than 8,000 clinical trial patients. It has demonstrated combinability with multiple anticancer agents. Nexavar is also being evaluated in Phase III clinical trials for the treatment of metastatic melanoma, or skin cancer, and non-small cell lung cancer (NSCLC). In addition to company-sponsored trials, there are a variety of Nexavar studies being sponsored by government agencies, cooperative groups and individual investigators.