On March 25, 2022 Novartis reported that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion recommending the European Commission to approve Kymriah (tisagenlecleucel), a CAR-T cell therapy, for the treatment of adult patients with relapsed or refractory (r/r) follicular lymphoma (FL) after two or more lines of systemic therapy (Press release, Novartis, MAR 25, 2022, View Source [SID1234610997]).
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"Follicular lymphoma patients will often relapse, many having shorter responses to treatment with each subsequent line of therapy," said Catherine Thieblemont, MD, PhD, Professor of Hematology in the Paris VII- University, France and Head of the Hemato-Oncology Unit of St-Louis Hospital in Paris. "If approved, Kymriah may offer an effective new option with potentially definitive results for these patients with a highly favorable safety profile."
The CHMP positive opinion is based on results from the global Phase II ELARA trial, in which 94 infused patients were evaluated for efficacy with a median follow-up of approximately 17 months. Among patients treated with Kymriah, 86% had a response, including 69% who experienced a complete response (CR). Prolonged durable response to treatment was demonstrated with an estimated 87% of patients who experienced a CR still in response nine months after initial response1.
In the ELARA trial, for the 97 patients evaluable for safety, the safety profile of Kymriah was remarkable. Within eight weeks of infusion, 49% of patients experienced cytokine release syndrome (CRS) and there were no reported cases of high-grade (grade 3 or higher) CRS, as defined by the Lee scale. Grade 3 or 4 neurological events occurred in 3% of patients within eight weeks of infusion1.
"With today’s positive opinion, we are closer to bringing the life-changing potential of Kymriah to patients with advanced follicular lymphoma in the EU who are in need of a treatment that may provide long-lasting remission," said Susanne Schaffert, PhD, President, Novartis Oncology. "We are proud to bring our transformative cell therapy innovation to more people around the world who continue to have unmet medical needs."
If approved, r/r FL would be the third indication for which Kymriah is available to patients in the European Union (EU). Kymriah is currently approved for the treatment of pediatric and young adult patients up to and including 25 years of age with B cell acute lymphoblastic leukemia (ALL) that is refractory, in relapse post transplant or in second or later relapse, and adult patients with r/r diffuse large B cell lymphoma (DLBCL) after two or more lines of systemic therapy.
The European Commission will review the CHMP recommendation and deliver a final decision in approximately two months. The decision will be applicable to all 27 EU member states plus Iceland, Norway and Liechtenstein. Additional regulatory filings are underway with other health authorities worldwide.
About follicular lymphoma
While follicular lymphoma is typically an indolent type of cancer, patients with FL may be exposed to a median of four lines of treatment, with an upper range of 13 lines3,4. Although there are multiple systemic therapies available, the efficacy of these regimens drops rapidly in later lines5.
About Novartis commitment to Oncology Cell Therapy
As part of the unique Novartis Oncology strategy to pursue four cancer treatment platforms – radioligand therapy, targeted therapy, immunotherapy and cell and gene therapy – we strive for cures through cell therapies in order to enable more patients to live cancer-free. We will continue to pioneer the science and invest in our manufacturing and supply chain process to further advance transformative innovation.
Novartis was the first pharmaceutical company to significantly invest in pioneering CAR-T research and initiate global CAR-T trials. Kymriah, the first approved CAR-T cell therapy, developed in collaboration with the Perelman School of Medicine at the University of Pennsylvania, is the foundation of the Novartis commitment to CAR-T cell therapy.
We have made strong progress in broadening our delivery of Kymriah, which is currently available for use in at least one indication in 30 countries and at more than 365 certified treatment centers, with clinical and real-world experience from administration to more than 6,200 patients. We continue to pioneer in cell therapy, leveraging our vast experience to develop next-generation CAR-T cell therapies. These therapies will focus on new targets and utilize our new T-Charge platform being evaluated to expand across hematological malignancies and bring the hope for a cure to patients with other cancer types.
Novartis has a comprehensive, integrated global CAR-T manufacturing footprint that strengthens the flexibility, resilience and sustainability of the Novartis manufacturing and supply chain.