European Commission Approves Darzalex?(daratumumab) in Combination with Bortezomib, Thalidomide and Dexamethasone (VTd) for Patients with Newly Diagnosed Multiple Myeloma Who Are Transplant E
- Daratumumab-VTd is the first regimen approved in over six years for newly diagnosed patients who are eligible for a stem cell transplant1
- Approval is based on data from the Phase 3 CASSIOPEIA trial, which demonstrated that the addition of daratumumab resulted in deeper response rates and improved progression-free survival (PFS) compared to VTd alone2
- Daratumumab has been used to treat more than 100,000 patients worldwide3
- This is the sixth approval for daratumumab and the third in the frontline setting4
January 20, 2020 01:43 PM Eastern Standard Time
BEERSE, Belgium--(BUSINESS WIRE)--The Janssen Pharmaceutical Companies of Johnson & Johnson announced today that the European Commission (EC) has granted marketing authorisation for Darzalex??(daratumumab) in combination with bortezomib, thalidomide and dexamethasone (VTd) for the treatment of patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant (ASCT). This approval is based on results from Part one of the Phase 3 CASSIOPEIA (MMY3006) study, published in?The Lancet5?in June 2019 and presented at the 2019 American Society of Clinical Oncology (ASCO) Meeting.
1?Johnson & Johnson. European Commission Approves VELCADE? As A Frontline Induction Therapy Before Stem Cell Transplantation. Press release August 8, 2013. Available at:?https://www.jnj.com/media-center/press-releases/european-commission-approves-velcade-as-a-frontline-induction-therapy-before-stem-cell-transplantation?Last accessed January 2020. 2?Moreau P, Attal M, Hulin C, et al. Phase 3 randomized study of daratumumab (DARA) + bortezomib/thalidomide/dexamethasone (D-VTd) vs VTd in transplant-eligible (TE) newly diagnosed multiple myeloma (NDMM): CASSIOPEIA Part 1 results. Presented at Annual Meeting of the American Society of Clinical Oncology (ASCO), Chicago, IL, USA, 31 May ? 4 June 2019. 3?Janssen. Data on file: RF-82203. Daratumumab: New patient starts launch to date. December 2019 4?European Medicines Agency. DARZALEX summary of product characteristics, November 2019. Available at:?https://ec.europa.eu/health/documents/community-register/2019/20191119146548/anx_146548_en.pdf?Last accessed January 2020. 5?Moreau P, Attal M, Hulin C, et al. Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study.?The Lancet.?Volume 394, Issue 10192, P29-38, July 06, 2019. 6?ClinicalTrials.gov. A study to evaluate daratumumab in transplant eligible participants with previously untreated multiple myeloma (Cassiopeia). NCT02541383. Available at:?https://clinicaltrials.gov/ct2/show/NCT02541383?Last accessed January 2020. 7?Sanchez L, Wang Y, Siegel DS, Wang ML. Daratumumab: a first-in-class CD38 monoclonal antibody for the treatment of multiple myeloma.?J Hematol Oncol. 2016;9:51. 8?Fedele G, di Girolamo M, Recine U, et al. CD38 ligation in peripheral blood mononuclear cells of myeloma patients induces release of protumorigenic IL-6 and impaired secretion of IFNgamma cytokines and proliferation.?Mediat Inflamm. 2013;2013:564687. 9?ClinicalTrials.gov. A study comparing daratumumab, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in relapsed or refractory multiple myeloma. NCT02076009. Available at:?https://clinicaltrials.gov/ct2/show/NCT02076009?Last accessed January 2020. 10?ClinicalTrials.gov. Addition of daratumumab to combination of bortezomib and dexamethasone in participants with relapsed or refractory multiple myeloma. NCT02136134. Available at:?https://clinicaltrials.gov/ct2/show/NCT02136134?Last accessed January 2020. 11?ClinicalTrials.gov. A study of combination of daratumumab and Velcade (bortezomib) melphalan-prednisone (DVMP) compared to Velcade melphalan-prednisone (VMP) in participants with previously untreated multiple myeloma. NCT02195479. Available at:?https://clinicaltrials.gov/ct2/show/NCT02195479?Last accessed January 2020. 12?ClinicalTrials.gov. Study comparing daratumumab, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in participants with previously untreated multiple myeloma. NCT02252172. Available at:?https://clinicaltrials.gov/ct2/show/NCT02252172Last accessed January 2020. 13?ClinicalTrials.gov. A study of Velcade (bortezomib) melphalan-prednisone (VMP) compared to daratumumab in combination with VMP (D-VMP), in participants with previously untreated multiple myeloma who are ineligible for high-dose therapy (Asia Pacific region). NCT03217812. Available at:?https://clinicaltrials.gov/ct2/show/NCT03217812?Last accessed January 2020. 14?ClinicalTrials.gov. Comparison of pomalidomide and dexamethasone with or without daratumumab in subjects with relapsed or refractory multiple myeloma previously treated with lenalidomide and a proteasome inhibitor daratumumab/pomalidomide/dexamethasone vs pomalidomide/dexamethasone (EMN14). NCT03180736. Available at:?https://clinicaltrials.gov/ct2/show/NCT03180736?Last accessed January 2020. 15?ClinicalTrials.gov. Study of carfilzomib, daratumumab and dexamethasone for patients with relapsed and/or refractory multiple myeloma (CANDOR). NCT03158688. Available at:?https://clinicaltrials.gov/ct2/show/NCT03158688?Last accessed January 2020. 16?ClinicalTrials.gov. A study to evaluate 3 dose schedules of daratumumab in participants with smoldering multiple myeloma. NCT02316106. Available at:?https://clinicaltrials.gov/ct2/show/NCT02316106?Last accessed January 2020. 17?ClinicalTrials.gov. An efficacy and safety proof of concept study of daratumumab in relapsed/refractory mantle cell lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. NCT02413489. Available at:?https://clinicaltrials.gov/ct2/show/NCT02413489?Last accessed January 2020. 18?Johnson & Johnson. Janssen Biotech announces global license and development agreement for investigational anti-cancer agent daratumumab. Press release August 30, 2012. Available at:?https://www.jnj.com/media-center/press-releases/janssen-biotech-announces-global-license-and-development-agreement-for-investigational-anti-cancer-agent-daratumumab?Last accessed January 2020. 19?American Society of Clinical Oncology. Multiple myeloma: introduction. Available at:?https://www.cancer.net/cancer-types/multiple-myeloma/introduction?Last accessed January 2020. 20?GLOBOCAN 2018. Cancer Today Population Factsheets: Europe Region. Available at:?https://gco.iarc.fr/today/data/factsheets/populations/908-europe-fact-sheets.pdf?Last accessed January 2020. 21?De Angelis R, Minicozzi P, Sant M, et al. Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000-2007: results of EUROCARE-5 population-based study.?Eur J Cancer.?2015;51:2254-68. 22?Abdi J, Chen G, Chang H, et al. Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms.?Oncotarget. 2013;4:2186?207. 23?National Cancer Institute. NCI dictionary of cancer terms: refractory. Available at:?https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=350245?Last accessed January 2020. 24?Richardson P, Mitsiades C, Schlossman R, et al. The treatment of relapsed and refractory multiple myeloma.?Hematology Am Soc Hematol Educ Program. 2007:317-23. 25?National Cancer Institute. NCI dictionary of cancer terms: relapsed. Available at:?https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=45866?Last accessed January 2020. 26?American Cancer Society. Multiple myeloma: early detection, diagnosis and staging. Available at:?https://www.cancer.org/content/dam/CRC/PDF/Public/8740.00.pdf?Last accessed January 2020. 27?Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study.?Leukemia. 2012;26:149-57. January 2020 CP-132210
?The effectiveness of first-line treatment is critical to maximise time until relapse. So, we asked ourselves, can we improve the standard of care that is bortezomib, thalidomide and dexamethasone (VTd) to provide patients with valuable extra time?? said Philippe Moreau, M.D., principal investigator and Head of the Haematology Department at the University Hospital of Nantes, France. ?The CASSIOPEIA study answered that question definitively, demonstrating that the addition of daratumumab in combination with VTd can lead to very deep remissions and also prolong PFS. I?m pleased to see the European Commission have recognised this as well.? ?Today?s approval marks the first opportunity for newly diagnosed, transplant eligible patients to be treated with a monoclonal antibody, and the first new treatment for this patient population in over six years,? said Dr Patrick Laroche, Haematology Therapy Area Lead, Europe, Middle East and Africa (EMEA), Janssen-Cilag. ?We are thrilled that newly diagnosed patients with multiple myeloma and their doctors will have a long-awaited additional frontline therapy.? The Phase 3 CASSIOPEIA trial is a two-part study. Results from this first part of the trial showed that after consolidation, the stringent complete response (sCR) rate was significantly higher in the daratumumab-VTd arm (29 percent) compared to VTd alone (20 percent) (Odds Ratio [OR] = 1.60; 95 percent confidence interval [CI], 1.21-2.12; P<0.0010).2?At a median follow-up of 18.8 months, PFS was significantly improved in the daratumumab-VTd group compared to VTd alone (Hazard Ratio [HR] = 0.47; 95 percent CI, 0.33-0.67; P<0.0001), and the median PFS was not reached in either arm.2?The addition of daratumumab to VTd resulted in an 18-month PFS rate of 93 percent compared to 85 percent for VTd alone.2 The most common (=10%) Grade 3/4 treatment-emergent adverse events (TEAEs) for daratumumab-VTd and VTd, respectively, were neutropenia (28 percent vs. 15 percent), lymphopenia (17 percent vs. 10 percent), stomatitis (13 percent vs. 16 percent) and thrombocytopenia (11 percent vs. 7 percent).2?In the daratumumab-VTd combination arm, infusion-related reactions occurred in 35 percent of patients.2 ?This approval represents our commitment to investigate daratumumab in earlier disease stages of multiple myeloma and to develop more effective frontline treatment options for newly diagnosed patients who are eligible for transplantation,? adds Craig Tendler, M.D., Vice President, Clinical Development and Global Medical Affairs, Oncology, Janssen Research & Development, LLC.?This approval represents our commitment to investigate daratumumab in earlier disease stages of multiple myeloma and to develop more effective frontline treatment options for newly diagnosed patients who are eligible for transplantation?
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In Europe, daratumumab is indicated:4- in combination with lenalidomide and dexamethasone or with bortezomib, melphalan and prednisone for the treatment of adult patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant
- in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior therapy
- as monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy
1?Johnson & Johnson. European Commission Approves VELCADE? As A Frontline Induction Therapy Before Stem Cell Transplantation. Press release August 8, 2013. Available at:?https://www.jnj.com/media-center/press-releases/european-commission-approves-velcade-as-a-frontline-induction-therapy-before-stem-cell-transplantation?Last accessed January 2020. 2?Moreau P, Attal M, Hulin C, et al. Phase 3 randomized study of daratumumab (DARA) + bortezomib/thalidomide/dexamethasone (D-VTd) vs VTd in transplant-eligible (TE) newly diagnosed multiple myeloma (NDMM): CASSIOPEIA Part 1 results. Presented at Annual Meeting of the American Society of Clinical Oncology (ASCO), Chicago, IL, USA, 31 May ? 4 June 2019. 3?Janssen. Data on file: RF-82203. Daratumumab: New patient starts launch to date. December 2019 4?European Medicines Agency. DARZALEX summary of product characteristics, November 2019. Available at:?https://ec.europa.eu/health/documents/community-register/2019/20191119146548/anx_146548_en.pdf?Last accessed January 2020. 5?Moreau P, Attal M, Hulin C, et al. Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study.?The Lancet.?Volume 394, Issue 10192, P29-38, July 06, 2019. 6?ClinicalTrials.gov. A study to evaluate daratumumab in transplant eligible participants with previously untreated multiple myeloma (Cassiopeia). NCT02541383. Available at:?https://clinicaltrials.gov/ct2/show/NCT02541383?Last accessed January 2020. 7?Sanchez L, Wang Y, Siegel DS, Wang ML. Daratumumab: a first-in-class CD38 monoclonal antibody for the treatment of multiple myeloma.?J Hematol Oncol. 2016;9:51. 8?Fedele G, di Girolamo M, Recine U, et al. CD38 ligation in peripheral blood mononuclear cells of myeloma patients induces release of protumorigenic IL-6 and impaired secretion of IFNgamma cytokines and proliferation.?Mediat Inflamm. 2013;2013:564687. 9?ClinicalTrials.gov. A study comparing daratumumab, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in relapsed or refractory multiple myeloma. NCT02076009. Available at:?https://clinicaltrials.gov/ct2/show/NCT02076009?Last accessed January 2020. 10?ClinicalTrials.gov. Addition of daratumumab to combination of bortezomib and dexamethasone in participants with relapsed or refractory multiple myeloma. NCT02136134. Available at:?https://clinicaltrials.gov/ct2/show/NCT02136134?Last accessed January 2020. 11?ClinicalTrials.gov. A study of combination of daratumumab and Velcade (bortezomib) melphalan-prednisone (DVMP) compared to Velcade melphalan-prednisone (VMP) in participants with previously untreated multiple myeloma. NCT02195479. Available at:?https://clinicaltrials.gov/ct2/show/NCT02195479?Last accessed January 2020. 12?ClinicalTrials.gov. Study comparing daratumumab, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in participants with previously untreated multiple myeloma. NCT02252172. Available at:?https://clinicaltrials.gov/ct2/show/NCT02252172Last accessed January 2020. 13?ClinicalTrials.gov. A study of Velcade (bortezomib) melphalan-prednisone (VMP) compared to daratumumab in combination with VMP (D-VMP), in participants with previously untreated multiple myeloma who are ineligible for high-dose therapy (Asia Pacific region). NCT03217812. Available at:?https://clinicaltrials.gov/ct2/show/NCT03217812?Last accessed January 2020. 14?ClinicalTrials.gov. Comparison of pomalidomide and dexamethasone with or without daratumumab in subjects with relapsed or refractory multiple myeloma previously treated with lenalidomide and a proteasome inhibitor daratumumab/pomalidomide/dexamethasone vs pomalidomide/dexamethasone (EMN14). NCT03180736. Available at:?https://clinicaltrials.gov/ct2/show/NCT03180736?Last accessed January 2020. 15?ClinicalTrials.gov. Study of carfilzomib, daratumumab and dexamethasone for patients with relapsed and/or refractory multiple myeloma (CANDOR). NCT03158688. Available at:?https://clinicaltrials.gov/ct2/show/NCT03158688?Last accessed January 2020. 16?ClinicalTrials.gov. A study to evaluate 3 dose schedules of daratumumab in participants with smoldering multiple myeloma. NCT02316106. Available at:?https://clinicaltrials.gov/ct2/show/NCT02316106?Last accessed January 2020. 17?ClinicalTrials.gov. An efficacy and safety proof of concept study of daratumumab in relapsed/refractory mantle cell lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. NCT02413489. Available at:?https://clinicaltrials.gov/ct2/show/NCT02413489?Last accessed January 2020. 18?Johnson & Johnson. Janssen Biotech announces global license and development agreement for investigational anti-cancer agent daratumumab. Press release August 30, 2012. Available at:?https://www.jnj.com/media-center/press-releases/janssen-biotech-announces-global-license-and-development-agreement-for-investigational-anti-cancer-agent-daratumumab?Last accessed January 2020. 19?American Society of Clinical Oncology. Multiple myeloma: introduction. Available at:?https://www.cancer.net/cancer-types/multiple-myeloma/introduction?Last accessed January 2020. 20?GLOBOCAN 2018. Cancer Today Population Factsheets: Europe Region. Available at:?https://gco.iarc.fr/today/data/factsheets/populations/908-europe-fact-sheets.pdf?Last accessed January 2020. 21?De Angelis R, Minicozzi P, Sant M, et al. Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000-2007: results of EUROCARE-5 population-based study.?Eur J Cancer.?2015;51:2254-68. 22?Abdi J, Chen G, Chang H, et al. Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms.?Oncotarget. 2013;4:2186?207. 23?National Cancer Institute. NCI dictionary of cancer terms: refractory. Available at:?https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=350245?Last accessed January 2020. 24?Richardson P, Mitsiades C, Schlossman R, et al. The treatment of relapsed and refractory multiple myeloma.?Hematology Am Soc Hematol Educ Program. 2007:317-23. 25?National Cancer Institute. NCI dictionary of cancer terms: relapsed. Available at:?https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=45866?Last accessed January 2020. 26?American Cancer Society. Multiple myeloma: early detection, diagnosis and staging. Available at:?https://www.cancer.org/content/dam/CRC/PDF/Public/8740.00.pdf?Last accessed January 2020. 27?Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study.?Leukemia. 2012;26:149-57. January 2020 CP-132210