2013年9月7日讯 --美国生物制药公司赛尔基因（Celgene）9月6日宣布，Abraxane（紫杉醇蛋白质结合颗粒注射悬液）（白蛋白结合）补充新药申请（sNDA）获FDA批准，联合吉西他滨（gemcitabine）用于转移性胰腺癌患者的一线治疗。
迄今为止，吉西他滨作为胰腺癌的标准护理，已有超过15年的时间。而Abraxane+吉西他滨联合疗法，在临床试验中，已被证明对关键疗效终点表现出临床意义的显着改善，包括总生存期，同时具有良好的安全性，该联合疗法将为胰腺癌患者提供一个重要的新治疗选择，并为今后的临床研究奠定基础。
Abraxane+吉西他滨联合疗法，是近8年来获批用于转移性胰腺癌的首个新疗法。该疗法的获批，是基于III期MPACT研究的数据。MPACT是一项开放标签、随机、国际性III期研究，研究中861例初治转移性胰腺癌患者随机接受ABRAXANE+吉西他滨联合疗法或吉西他滨单药疗法，研究数据表明，与吉西他滨单药疗法相比，ABRAXANE+吉西他滨联合疗法在总生存期（OS）、疾病无进展生存期（PFS）、整体响应率（ORR）上均表现出统计学意义的显着改善：OS（8.5个月 vs 6.7个月，HR=0.72，p＜0.0001），死亡风险降低28%；PFS（5.5个月 vs 3.7个月，HR=0.69，p＜0.0001），疾病进展或死亡风险降低31%；ORR（23% vs 7%，p＜0.0001）。
在过去的20年中，在晚期胰腺癌患者中开展了超过30项随机III期临床试验，MPACT研究便是表现出总生存期利益的4项研究之一。
此前，2013年5月，FDA授予Abraxane优先审查资格，PDUFA日期为2013年9月21日。2013年4月，欧洲药品管理局（EMA）也接受审查Abraxane的营销授权申请（MAA），联合吉西他滨用于转移性胰腺癌患者的一线治疗。
关于胰腺癌：
胰腺癌是全球第8大癌症死因，在美国是第4大癌症死因。胰腺主要由2种细胞类型组成：外分泌和内分泌。外分泌肿瘤是目前最常见的一种胰腺癌，恶性腺瘤占胰腺癌症的95%。对于各个阶段的胰腺癌患者，5年的总体生存率约为6%，在美国这低于所有其他癌症的5年总体生存率。在欧洲，报告的5年生存率低于10%。
关于Abraxane：
Abraxane是紫杉醇的白蛋白结合形式，采用nab专利技术生产。Abraxane的配方中含有白蛋白，白蛋白是一种人源性蛋白质，Abraxane的配方中不含溶剂。
Abraxane于2005年1月在美国首先获准用于治疗联合化疗无效的转移性乳腺癌或辅助化疗6个月内复发的乳腺癌 。既往治疗必须包含一种蒽环类，除非有临床禁忌症。Abraxane还在下列地区获准用于治疗转移性乳腺癌：加拿大、印度、欧盟/欧洲经济区(EU/EEA)、韩国、中国、澳大利亚、不丹、阿联酋、尼泊尔、新西兰、日本、俄罗斯、斯里兰卡和阿根廷。
2012年10月，美国FDA批准Abraxane联合卡铂用于不适合治愈性手术或放疗的局部晚期或转移性非小细胞肺癌的一线治疗。此外，Abraxane也获日本和阿根廷获准用于非小细胞肺癌的治疗，并且还在日本获准用于胃癌的治疗。
Abraxane目前处于不同的研究阶段，用于下列癌症的潜在治疗：黑色素瘤、膀胱癌、卵巢癌以及乳腺癌、肺癌的扩展应用。
FDA okays Celgene's Abraxane for pancreatic cancer
U.S. Food and Drug Administration Approves ABRAXANE? in Combination with Gemcitabine as First-Line Treatment of Patients with Metastatic Pancreatic Cancer
-Approval Based on MPACT Study of ABRAXANE in Combination with Gemcitabine Demonstrating a Clinically Meaningful Increase in Overall Survival-
-First New Treatment Approved for Metastatic Adenocarcinoma of the Pancreas in Nearly 8 Years-
SUMMIT, N.J.--(BUSINESS WIRE)--Celgene Corporation (NASDAQ: CELG) today announced that the U.S. Food and Drug Administration (FDA) has approved the Company’s supplemental New Drug Application (sNDA) of ABRAXANE? (paclitaxel protein-bound particles for injectable suspension) (albumin-bound) as first–line treatment for patients with metastatic adenocarcinoma of the pancreas, in combination with gemcitabine. Adenocarcinoma, a sub-type of exocrine tumors, accounts for about 95% of cancers of the pancreas.
“For more than 15 years, treatment with gemcitabine has been the standard of care in this disease. The addition of ABRAXANE to gemcitabine demonstrated meaningful improvements across key efficacy outcomes, including overall survival, with a well-characterized safety profile,” said Jean-Pierre Bizzari, M.D., Executive Vice President of Hematology and Oncology for Celgene Corporation.
“We are pleased that patients with advanced pancreatic cancer now have a new treatment option helping to expand the treatment landscape for the fourth leading cause of cancer death in the United States,” said Julie Fleshman, president and CEO of the Pancreatic Cancer Action Network. “The FDA approval of ABRAXANE is an important step for a disease that desperately needs treatment advances to improve patient outcomes. The Pancreatic Cancer Action Network will continue to work with the medical community to build upon this success and advance our goals in the fight against pancreatic cancer.”
ABRAXANE in combination with gemcitabine is the first new treatment approved for metastatic adenocarcinoma of the pancreas in nearly eight years. The approval was based on results from MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial), an open-label, phase III, randomized, international study, that were featured at this year’s ASCO annual meeting and have been submitted for publication in a peer-reviewed journal. Over the past two decades, more than 30 randomized, phase III studies have been conducted in patients with advanced pancreatic cancer and the MPACT study was one of four studies to show an overall survival benefit. In the MPACT study, which involved 861 chemotherapy-na?ve patients with metastatic pancreatic cancer, ABRAXANE plus gemcitabine demonstrated a statistically significant improvement in median overall survival compared to gemcitabine alone (8.5 vs. 6.7 months) (HR 0.72, P<0.0001); a 28% overall reduction in risk of death. ABRAXANE plus gemcitabine demonstrated a median progression-free survival (PFS) of 5.5 vs. 3.7 months for gemcitabine alone (HR 0.69, P<0.0001); a 31% reduction in the risk of progression or death. The Overall Response Rate (ORR) was 23% for the ABRAXANE plus gemcitabine arm versus 7% in the gemcitabine alone arm (p<0.0001).
“Historically, patients with pancreatic cancer have not experienced benefit with many of the drugs so useful in other malignancies. This is beginning to change,” said Margaret A. Tempero, M.D., Director and Professor of Medicine, UCSF Pancreas Center. “The combination of ABRAXANE and gemcitabine represents an important new therapeutic option for patients with pancreatic cancer. It also provides a foundation for future clinical research.”
The most common adverse reactions (≥ 20%) with a ≥ 5% higher incidence in the ABRAXANE/gemcitabine treatment group are neutropenia, fatigue, peripheral neuropathy, nausea, alopecia, peripheral edema, diarrhea, pyrexia, vomiting, decreased appetite, rash, and dehydration. For additional safety information, please see Boxed Warning and Contraindications in the Important Safety Information.
The FDA had granted ABRAXANE a Priority Review designation in May 2013 with a PDUFA date of September 21, 2013. In April 2013, the European Medicines Agency (EMA) also accepted for review a Type II Variation to the current Marketing Authorization Application (MAA) for ABRAXANE, in combination with gemcitabine, for the first–line treatment of patients with metastatic adenocarcinoma of the pancreas. Celgene has submitted dossiers for registration in other countries/regions.
About the MPACT Study
In the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study, a Celgene-sponsored, open-label, randomized, international study, a total of 861 patients were randomized 1:1 (431 patients to the ABRAXANE/gemcitabine group and 430 patients to the gemcitabine group). Patients randomized to ABRAXANE/gemcitabine received ABRAXANE as an intravenous infusion over 30-40 minutes at a dose of 125 mg/m2 followed by gemcitabine as an intravenous infusion over 30-40 minutes at a dose of 1000 mg/m2 given on Days 1, 8 and 15 of each 28-day cycle. In the comparator treatment group, gemcitabine monotherapy was administered at a dose of 1000 mg/m2 given weekly for 7 weeks followed by a 1-week rest period in Cycle 1 and in Cycle 2 and onwards was administered on Days 1, 8 and 15 of a 28 day cycle. The primary endpoint for the study was overall survival. Secondary endpoints were progression-free survival and overall response rate determined by independent radiological review. Other endpoints included progression-free survival and overall response rate as determined by the investigator, and the safety and tolerability of the combination in this patient population.
About Pancreatic Cancer
Pancreatic cancer is the fourth-leading cause of cancer-related death in the U.S. The pancreas is composed of two main cell types: exocrine and endocrine. Exocrine tumors are by far the most common type of pancreatic cancer. Adenocarcinoma is a sub-type of exocrine tumors and accounts for about 95% of cancers of the pancreas. For all stages of pancreatic cancer combined, the five-year survival rate is about 6%, which is the lowest of any cancer in the U.S. For metastatic pancreatic cancer, the five-year survival is approximately 2%.
About ABRAXANE?
ABRAXANE is an albumin-bound form of paclitaxel that is manufactured using patented nab? technology. ABRAXANE is formulated with albumin, a human protein, and is free of solvents.
In the United States, ABRAXANE was first approved in January 2005 for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated. ABRAXANE has been globally approved in more than forty countries for the treatment of metastatic breast cancer (MBC).
In October 2012, ABRAXANE was approved by the FDA for the first-line treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC), in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy. ABRAXANE is also approved for the treatment of NSCLC in Argentina, Australia, Japan, and New Zealand. In addition, ABRAXANE is approved for gastric cancer in Japan.
In September 2013, the FDA approved ABRAXANE as first–line treatment of patients with metastatic adenocarcinoma of the pancreas, in combination with gemcitabine.
U.S. Regulatory Information for ABRAXANE
ABRAXANE is indicated for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated
ABRAXANE is indicated for the first-line treatment of locally advanced or metastatic non-small cell lung cancer, in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy
ABRAXANE is indicated for the first-line treatment of patients with metastatic adenocarcinoma of the pancreas, in combination with gemcitabine.
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