FDA approves Novartis Scemblix (asciminib), with novel mechanism of action for the treatment of chronic myeloid leukemia
Basel, October 29, 2021?? Novartis announced today that the US Food and Drug Administration (FDA) approved Scemblix (asciminib) for the treatment of chronic myeloid leukemia (CML) in two distinct indications. The FDA granted Scemblix accelerated approval for adult patients with Philadelphia chromosome-positive CML in chronic phase (Ph+ CML-CP) previously treated with two or more tyrosine kinase inhibitors (TKIs), based on major molecular response (MMR) rate at 24 weeks; and full approval for adult patients with Ph+ CML-CP with the T315I mutation1. In accordance with the Accelerated Approval Program, continued approval for the first indication may be contingent upon verification and description of clinical benefit from confirmatory evidence1. Scemblix is the first FDA-approved CML treatment that works by binding to the ABL myristoyl pocket,?and represents an important development for patients who experience resistance and/or intolerance to currently available TKI therapies1-3. Also known as a STAMP inhibitor in scientific literature, Scemblix is being studied across multiple treatment lines for CML-CP, including the ASC4FIRST Phase III study evaluating Scemblix as a first-line treatment2-18.
?The introduction of TKIs twenty years ago revolutionized treatment for CML; however, there remain many patients who do not respond adequately to at least two available treatments and often experience challenging side effects that add a burden to their daily lives,? said Lee Greenberger, Chief Scientific Officer at The Leukemia & Lymphoma Society. ?The approval of Scemblix may offer hope to patients by addressing gaps in CML care.?
For many patients, current treatment for CML may be limited by intolerance or resistance, and sequential use of available TKIs is associated with increased failure rates19-26. In an analysis of patients with CML treated with two prior TKIs, approximately 55% reported intolerance to previous treatment27. Additionally, a pooled analysis in the second-line setting showed that up to 70% of patients are unable to achieve major molecular response (MMR) within two years of follow-up28-30. Moreover, patients who develop the T315I mutation are resistant to most available TKIs, leaving them at an increased risk of disease progression4.
?CML can be difficult to treat when currently available treatments fail patients, when treatment side effects cannot be tolerated, or sometimes both,? expressed Dr. Michael J. Mauro**, Hematologist and Myeloproliferative Neoplasms Program Leader at Memorial Sloan Kettering Cancer Center (MSK). ?The addition of Scemblix into the CML treatment landscape gives us a novel approach to combat this blood cancer, helping address clinical challenges in patients struggling after switching to a second treatment, as well as in patients who develop the T315I mutation and face significantly worse outcomes.?
The FDA approval of Scemblix is based on results from the Phase III ASCEMBL trial and a Phase I (NCT02081378) study that included patients with Ph+ CML-CP with the T315I mutation.
In patients with Ph+ CML-CP who had experienced resistance or intolerance to at least two TKIs, the ASCEMBL trial showed that1-3:
Novartis Investor Relations
Central investor relations line: +41 61 324 7944
E-mail:?investor.relations@novartis.com
- Scemblix nearly doubled the MMR rate vs. Bosulif??(bosutinib)* at 24 weeks (25% vs. 13% [P=0.029])
- The proportion of patients who discontinued treatment due to adverse reactions was more than three times lower in the Scemblix arm (n = 156) vs. patients in the Bosulif arm (n = 76) (7% vs. 25%)
- The most common (incidence = 20%) adverse reactions and laboratory abnormalities in the Scemblix arm were, respectively: upper respiratory tract infections and musculoskeletal pain; decrease in platelet and neutrophil counts, decrease in hemoglobin; increase in triglycerides, creatine kinase and alanine aminotransferase (ALT)
- Scemblix [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2021.
- Rea D, et al. A Phase 3, Open-Label, Randomized Study of Asciminib, a STAMP Inhibitor, vs Bosutinib in CML After= 2 Prior TKIs.?Blood. 2021. DOI: 10.1182/blood.2020009984. PMID: 34407542.
- Novartis Data on File, 2021.
- Cortes JE, et al. Asciminib, a First-in-Class STAMP Inhibitor, Provides Durable Molecular Response in Patients (pts) with Chronic Myeloid Leukemia (CML) Harboring the T315I Mutation: Primary Efficacy and Safety Results from a Phase 1 Trial. Oral presentation at: ASH Annual Meeting; Dec. 7, 2020
- Wylie AA, et al. The allosteric inhibitor ABL001 enables dual targeting of BCR?ABL1.?Nature. 2017;543(7647):733-737.
- Schoepfer J, et al. Discovery of Asciminib (ABL001), an Allosteric Inhibitor of the Tyrosine Kinase Activity of BCR-ABL1.?J Med Chem. 2018;61(18):8120-8135.
- Hughes TP, et al. Asciminib in Chronic Myeloid Leukemia after ABL Kinase Inhibitor Failure. N Engl J Med. 2019; 381(24):2315-2326.
- Hughes TP, et al. Expanded Phase 1 Study of ABL001, a Potent, Allosteric Inhibitor of BCR-ABL, Reveals Significant and Durable Responses in Patients with CML-Chronic Phase with Failure of Prior TKI Therapy. Poster presented at: ASH Annual Meeting & Exposition; Dec. 5, 2016.
- Ottmann OG, et al. ABL001, a Potent, Allosteric Inhibitor of BCR-ABL, Exhibits Safety and Promising Single- Agent Activity in a Phase I Study of Patients with CML with Failure of Prior TKI Therapy.?Blood. 2015;126(23):138.
- Mauro MJ, et al. Combination of Asciminib Plus Nilotinib (NIL) or Dasatinib (DAS) in Patients (PTS) with Chronic Myeloid Leukemia (CML): Results from a Phase 1 Study. Poster presented at: EHA Annual Meeting; June 15, 2019.
- Cortes JE, et al. Combination Therapy Using Asciminib Plus Imatinib (IMA) in Patients (PTS) with Chronic Myeloid Leukemia (CML): Results from a Phase 1 Study. Poster presented at: EHA Annual Meeting; June 15, 2019.
- ClinicalTrials.gov. 2017. Study of Efficacy of CML-CP Patients Treated with ABL001 Versus Bosutinib, Previously Treated With 2 or More TKIs. [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT03106779.
- ClinicalTrials.gov. 2021. A Study of Oral Asciminib Versus Other TKIs in Adult Patients With Newly Diagnosed Ph+ CML-CP. [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT04971226.
- ClinicalTrials.gov. 2020. Asciminib in Monotherapy for Chronic Myeloid Leukemia in Chronic Phase (CML-CP) With and WithoutT315I Mutation (AIM4CML). [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT04666259.
- ClinicalTrials.gov. 2018. Study of Efficacy And Safety Of Asciminib In Combination With Imatinib In Patients With Chronic Myeloid Leukemia In Chronic Phase (CML-CP). [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT03578367.
- ClinicalTrials.gov. 2021. Study of Efficacy and Safety of CML-CP Patients Treated With Asciminib Versus Best Available Therapy, Previously Treated With 2 or More Tyrosine Kinase Inhibitors. [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT04795427.
- ClinicalTrials.gov. 2014. A Phase I Study of Oral ABL001 in Patients With CML or Ph+ ALL. [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT02081378.
- ClinicalTrials.gov. 2021 Asciminib Treatment Optimization in = 3rd Line CML-CP. [online] Available at:?https://clinicaltrials.gov/ct2/show/NCT04948333
- Flis S, et al. Chronic myelogenous leukemia, a still unsolved problem: pitfalls and new therapeutic possibilities.?Drug Des Devel Ther.?2019;13:825-843.
- Akard LP, et al. The ?Hit Hard and Hit Early? Approach to the Treatment of Chronic Myeloid Leukemia: Implications of the Updated National Comprehensive Cancer Network Clinical Practice Guidelines for RoutinePractice.?Clin Adv Hematol Oncol.?2013;11(7):421-432.
- Cortes JE, et al. Long-term bosutinib for chronic phase chronic myeloid leukemia after failure of imatinib plus dasatinib and/or nilotinib.?Am J Hematol.?2016;91(12):1206-1214.
- Cortes JE, et al. Ponatinib efficacy and safety in Philadelphia chromosome?positive leukemia: Final 5-yearresults of the phase 2 PACE trial.?Blood. 2018;132(4):393-404.
- Garg RJ, et al. The use of nilotinib or dasatinib after failure to 2 prior tyrosine kinase inhibitors: long-term follow-up. Blood. 2009;114(20):4361-4368
- Hochhaus A, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020;34:966-984
- Cortes JE., et al. Final 5-Year Study Results of DASISION: The Dasatinib Versus Imatinib Study in Treatment-Na?ve Chronic Myeloid Leukemia Patients Trial. J Clin Oncol. 2016;34:2333-2340.
- Steegmann JL., et al. European LeukemiaNet recommendations for the management and avoidance of adverse events of treatment in chronic myeloid leukaemia. Leukemia. 2016;30:1648-1671.
- Giles FJ, et al. Nilotinib is active in chronic and accelerated phase chronic myeloid leukemia following failure of imatinib and dasatinib therapy. Leukemia. 2010; 24(7):1299?1301.
- Kantarjian HM, et al. Nilotinib is effective in patients with chronic myeloid leukemia in chronic phase after imatinib resistance or intolerance: 24-month follow-up results. Blood. 2011;117(4):1141-1145.
- Shah NP, et al. Potent, transient inhibition of BCR-ABL with dasatinib 100 mg daily achieves rapid and durable cytogenetic responses and high transformation-free survival rates in chronic phase chronic myeloid leukemia patients with resistance, suboptimal response or intolerance to imatinib.?Haematologica. 2010;95:232-240
- Gambacorti-Passerini C., et al. Bosutinib efficacy and safety in chronic phase chronic myeloid leukemia after imatinib resistance or intolerance: Minimum 24-month follow-up.?Am J Hematol.?2014;89:732-742.
- Manley P., et al. The specificity of asciminib, a potential treatment for chronic myeloid leukemia, as a myristate-pocket binding ABL inhibitor and analysis of its interactions with mutant forms of BCR-ABL1 kinase.?Leukemia Research. 2020;98
# # #
Novartis Media Relations E-mail:?media.relations@novartis.comAnja von Treskow Novartis External Communications +41 79 392 8697 (mobile) anja.von_treskow@novartis.com Julie Masow Novartis US External Communications +1 862 579 8456 Julie.masow@novartis.com | Floriana Riccio Furnari Novartis Oncology Communications +1 862 778 1866 (direct) +1 862 210 5317 (mobile) floriana.riccio_furnari@novartis.com |
Central | North America | ||
Samir Shah | +41 61 324 7944 | Sloan Simpson | +1 862 345 4440 |
Thomas Hungerbuehler | +41 61 324 8425 | Alina Levchuk | +1 862 778 3372 |
Isabella Zinck | +41 61 324 7188 | Parag Mahanti | +1 973-876-4912 |