Lynparza在欧盟被批准作为贝伐单抗治疗hrd阳性晚期卵巢癌的一线维持治疗

5 November 2020 07:15 GMT
 

接受Lynparza和bevacizumab治疗的患者无疾病进展的中位生存期为37年.2 months vs. 17.7 months with bevacizumab alone

每两个患有晚期卵巢癌的女性中就有一个患有hrd阳性肿瘤
 

AstraZeneca and MSD’s Lynparza (olaparib)已在欧盟(EU)批准用于同源重组缺陷(HRD)阳性晚期卵巢癌患者的贝伐单抗一线维持治疗.

卵巢癌是欧盟癌症死亡的第五大常见原因,五年生存率约为45%, 部分原因是女性通常被诊断为疾病晚期(III期或IV期).1-3

欧盟委员会的批准是基于PAOLA-1 III期临床试验的生物标志物亚组分析 Lynparza, in combination with bevacizumab maintenance treatment, 与单独使用贝伐单抗相比,hrd阳性晚期卵巢癌患者的无进展生存期(PFS)显著改善. It follows the recommendation for approval 由欧洲药品管理局人用药品委员会于2020年9月提交.

Isabelle Ray-Coquard, PAOLA-1 III期试验的首席研究员和医学肿瘤学家, Centre Léon Bérard and President of the GINECO group, Paris, France, said: “For women with advanced ovarian cancer, 一线治疗的目标是尽可能延缓疾病进展,以达到长期缓解的目的. 不幸的是,从历史上看,一旦患者的癌症复发,就无法治愈. Lynparza 贝伐单抗联合贝伐单抗已显示出令人印象深刻的中位无进展生存期超过3年,并有望成为欧盟符合条件的hrd阳性肿瘤患者的标准治疗.”

Dave Fredrickson, Executive Vice President, Oncology Business Unit, 他说:“在所有新诊断的晚期卵巢癌患者中,有一半患有hrd阳性肿瘤. Women treated with Lynparza 在PAOLA-1 III期临床试验中,联合贝伐单抗的患者无进展生存期中位数超过3年, 表明HRD检测应成为临床诊断的重要组成部分. HRD状态可以帮助医生为患者选择个性化的一线治疗方案,从而大大延缓这种毁灭性疾病的复发.”

Roy Baynes, 高级副总裁兼全球临床开发主管, Chief Medical Officer, MSD Research Laboratories, 他说:“生物标志物测试迅速增强了澳门葡京赌博游戏对PARP抑制如何帮助靶向这种疾病的理解. 欧盟的批准强化了HRD阳性肿瘤代表晚期卵巢癌的一个独特子集,HRD检测对这种情况下的女性至关重要.”

The PAOLA-1 Phase III trial showed that Lynparza, in combination with bevacizumab maintenance treatment, 将疾病进展或死亡风险降低67%(基于风险比为0.33; 95% confidence interval 0.25-0.45). The addition of Lynparza improved PFS to a median of 37.2 months versus 17.7例hrd阳性晚期卵巢癌患者单独使用贝伐单抗. The data from the PAOLA-1 trial was published in The New England Journal of Medicine in 2019.

最近在2020年欧洲肿瘤医学学会虚拟会议上公布的进一步结果显示,关键次要终点到第二次疾病进展的时间(PFS2)在统计学上有显着改善。. Lynparza 贝伐单抗提供了超越首次疾病进展的益处,将PFS2改善至中位数50.3 months versus 35.3 with bevacizumab alone.

The full EU indication is for Lynparza 与贝伐单抗联合用于晚期(FIGO III期和IV期)高级别上皮性卵巢成年患者的维持治疗, 输卵管癌或原发性腹膜癌,在完成一线铂基化疗联合贝伐单抗后(完全或部分)有反应,并且其癌症与HRD阳性状态相关,该状态由乳腺癌易感基因1/2 (BRCA1/2)突变和/或基因组不稳定性定义.

Lynparza in combination with bevacizumab is approved in the US 并在其他几个国家作为hrd阳性晚期卵巢癌患者的一线维持治疗,目前正在世界其他国家接受监管审查.

Financial considerations

Following this approval for Lynparza in the EU, 澳门葡京网赌游戏将从默沙东获得2500万美元的监管里程碑付款, 预计将在2020年第四季度作为合作收入入账.

Ovarian cancer

In 2018, there were nearly 68,在欧盟诊断出的卵巢癌新病例有5000例,大约有45例,000 deaths.3  大约50%的卵巢癌是hrd阳性,包括BRCA1/2突变.4,5 大约15%的卵巢癌有BRCA1/2突变.6  一线治疗的主要目的是尽可能延缓疾病进展,以达到长期缓解的目的.7-9

Homologous recombination deficiency

HRD, which defines a subgroup of ovarian cancer, encompasses a wide range of genetic abnormalities, including BRCA mutations and beyond. As with BRCA gene mutations, HRD干扰正常细胞DNA修复机制,并赋予PARP抑制剂敏感性,包括 Lynparza.10

PAOLA-1

PAOLA-1是一项双盲III期临床试验,用于检测抗肿瘤药物的有效性和安全性 Lynparza 添加到标准护理贝伐单抗与单独贝伐单抗, 作为新诊断的晚期FIGO III-IV期高级别浆液性或子宫内膜样卵巢的一线维持治疗, fallopian tube, 或对铂基化疗和贝伐单抗一线治疗有完全或部分反应的腹膜癌患者. AstraZeneca and MSD announced in August 2019 该试验在总体试验人群中达到了PFS的主要终点.

Lynparza

Lynparza (olaparib)是一种一流的PARP抑制剂,也是第一个靶向治疗,用于阻断同源重组修复(HRR)缺陷的细胞/肿瘤中的DNA损伤反应(DDR)。, such as mutations in BRCA1 and/or BRCA2. Inhibition of PARP with Lynparza 导致捕获与DNA单链断裂结合的PARP, stalling of replication forks, 它们的崩溃,DNA双链断裂和癌细胞死亡. Lynparza 正在一系列parp依赖性肿瘤类型中进行测试,这些肿瘤类型在DDR通路中存在缺陷和依赖性.

Lynparza is currently approved in a number of countries, including those in the EU, 用于铂敏感复发卵巢癌的维持治疗. It is approved in the US, the EU, Japan, China, 和其他几个国家作为brca突变的晚期卵巢癌在铂类化疗后的一线维持治疗. 在美国,它也被批准作为贝伐单抗治疗hrd阳性晚期卵巢癌(BRCAm和/或基因组不稳定)患者的一线维持治疗。. Lynparza is approved in the US, Japan, and a number of other countries for germline BRCA-mutated, HER2-negative, metastatic breast cancer, previously treated with chemotherapy; in the EU, this includes locally advanced breast cancer. It is also approved in the US, 用于治疗种系BRCAm转移性胰腺癌. Lynparza 在美国被批准用于同源重组修复(HRR)基因突变的转移性去势抵抗性前列腺癌(BRCAm和其他HRR基因突变). 一些国家正在对卵巢癌进行监管审查, breast, pancreatic and prostate cancers.

Lynparza, 澳门葡京网赌游戏和默沙东联合开发并商业化的药物, has been used to treat over 30,000 patients worldwide. Lynparza 是否拥有所有PARP抑制剂中最广泛和最先进的临床试验开发计划, 澳门葡京网赌游戏和默沙东正在合作,以了解它如何作为单一疗法影响多种parp依赖性肿瘤,以及在多种癌症类型中联合使用. Lynparza 澳门葡京网赌游戏行业领先的靶向癌细胞DDR机制的潜在新药组合的基础是什么.

The AstraZeneca and MSD strategic oncology collaboration

In July 2017, AstraZeneca and Merck & Co., Inc., Kenilworth, NJ, US, known as MSD outside the US and Canada, 宣布全球肿瘤学战略合作,共同开发和共同商业化 Lynparza, the world’s first PARP inhibitor, and Koselugo selumetinib是一种丝裂原活化蛋白激酶(MEK)抑制剂,用于多种癌症类型. Working together, the companies will develop Lynparza and Koselugo 与其他潜在的新药联合使用或作为单一疗法. Independently, the companies will develop Lynparza and Koselugo 联合各自的PD-L1和PD-1药物.

AstraZeneca in oncology

澳门葡京网赌游戏在肿瘤学领域有着深厚的传统,并提供快速增长的药物组合 有可能改变患者生活和公司未来的新药. 2014年至2020年期间有7种新药上市,并且有广泛的研发渠道 of small molecules and biologics in development, 公司致力于将肿瘤作为澳门葡京网赌游戏专注于肺部的关键增长动力, ovarian, breast and blood cancers.

通过利用四个科学平台的力量——免疫肿瘤学, Tumour Drivers and Resistance, DNA损伤反应和抗体药物偶联物-并通过倡导个性化组合的发展, 澳门葡京网赌游戏的愿景是重新定义癌症治疗, one day, eliminate cancer as a cause of death.

AstraZeneca

AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, 以科学为主导的澳门葡京赌博游戏公司,专注于发现, 处方药的开发和商业化, 主要用于治疗肿瘤等三个治疗领域的疾病, Cardiovascular, Renal & Metabolism, and Respiratory & Immunology. Based in Cambridge, UK, 澳门葡京网赌游戏在100多个国家开展业务,其创新药物被全球数百万患者使用. Please visit jc200.net and follow the Company on Twitter @AstraZeneca.

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References

1. EuroHealth. (2018). Ovarian Cancer: The Silent Killer. Available at: http://eurohealth.ie/policy-brief-women-and-ovarian-cancer-in-the-eu-2018/ [Accessed October 2020].

2. ECIS. (2020).2020年所有癌症部位的癌症发病率和死亡率估计数. Available here [Accessed October 2020].

3. The World Health Organization. IARC. Globocan. (2018). Available at: http://gco.iarc.fr/ [Accessed October 2020].

4.  Moschetta et al. (2016). 浆液性卵巢癌的BRCA体细胞突变和表观遗传修饰. Annals of Oncology, 27(8), pp.1449-1455.

5. Bonadio et al. (2018). 卵巢癌同源重组缺乏症的流行病学及治疗进展. Clinics, 73(Suppl 1): e450s.

6. Ramus. (2009). The Contribution of BRCA1 and BRCA2 to Ovarian Cancer. Molecular Oncology, 3(2), pp.138–150.

7. Raja et al. (2012). Optimal first-line treatment in ovarian cancer. Annals on Oncology. 23 Suppl 10, x118-127.

8. NHS Choices, Ovarian Cancer Available at: http://www.nhs.uk/conditions/ovarian-cancer/treatment/ [Accessed October 2020].

9. Ledermann et al. (2013). 新诊断和复发的上皮性卵巢癌:ESMO临床实践诊断指南, treatment and follow-up. Annals of Oncology, 24, pp.vi24-vi32.

10. Moore, K. (2018). 奥拉帕尼在新诊断晚期卵巢癌患者中的维持作用. New England Journal of Medicine, 379(26), pp.2495-2505.


Adrian Kemp
Company Secretary
AstraZeneca PLC

 

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