Janssen Receives Positive CHMP Opinion Recommending IMBRUVICA™ for use in the Treatment of Two Forms of Blood Cancer

On July 25, 2014 Janssen-Cilag International reported that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion recommending the granting of a marketing authorisation for IMBRUVICA (ibrutinib) in the European Union (Press release Johnson & Johnson, JUL 25, 2014, View Source [SID:1234500662]). The recommendation is for the treatment of adult patients with relapsed or refractory mantle cell lymphoma (MCL), or adult patients with chronic lymphocytic leukaemia (CLL) who have received at least one prior therapy, or in first line in the presence of 17p deletion or TP53 mutation in patients unsuitable for chemo-immunotherapy.1 The positive opinion of the CHMP was based on data from the Phase 3 (RESONATE PCYC-1112) and Phase 1b-2 (PCYC-1102) studies in CLL, and the Phase 2 study (PCYC-1104) in MCL.

Ibrutinib is being co-developed by Janssen and Pharmacyclics Switzerland GmbH. Once approved, Janssen will market ibrutinib in EMEA (Europe, Middle East, Africa) as well as the rest of the world, except for the United States, where both companies co-market it.

MCL is a rare and aggressive type of B-cell lymphoma that can be challenging to treat and is associated with a poor prognosis.2,3 CLL in most patients is a slow-growing blood cancer, starting from white blood cells (called lymphocytes) in the bone marrow.4 Chromosomal abnormalities deletion 17p (del17p) and TP53 mutation are associated with aggressive, treatment-resistant disease.5

Ibrutinib is a novel, investigational compound that could offer a new approach to treating these blood cancers, as part of a class of medicines called Bruton’s Tyrosine Kinase (BTK) inhibitors. Studies have shown ibrutinib works by blocking BTK, a protein that helps certain cancer cells live and grow.6

“We are working to bring new therapies to patients living with complex and challenging-to-treat blood cancers. We’ve been closely collaborating with the CHMP on the IMBRUVICA submission and are delighted to receive the positive opinion earlier than expected. There is a high unmet medical need and recent clinical trials have demonstrated positive results for IMBRUVICA,” said Jane Griffiths, Company Group Chairman, Janssen, Europe, Middle East and Africa (EMEA). “The CHMP opinion brings us one step closer to offering new treatment options for CLL and MCL patients.”

CLL Study and Efficacy Results
RESONATE (PCYC-1112) is a Phase 3, multi-centre, international, open-label, randomised study that examined ibrutinib monotherapy versus ofatumumab monotherapy in relapsed or refractory patients with CLL (n=391).

The results from the study showed single agent ibrutinib significantly improved progression-free survival (PFS), overall survival (OS) and overall response rate (ORR) in this difficult-to-treat patient population, regardless of baseline characteristics.7

The median PFS in the ofatumumab arm was 8.1 months and was not reached in the ibrutinib arm because progression events occurred more slowly. The PFS results represent a 78 percent reduction in the risk of progression or death in patients treated with ibrutinib compared to ofatumumab.7 The OS median was not reached in either arm, but the results represent a 57 percent reduction in the risk of death in patients receiving ibrutinib versus those in the ofatumumab arm. Results were consistent across all baseline sub-groups, including those with del17p.

MCL Study and Efficacy Results
The efficacy of ibrutinib in patients with relapsed or refractory MCL was evaluated in an open-label, multi-centre, single-arm Phase 2 study (PCYC-1104) of 111 treated patients. A response rate of 68 percent was observed, with a complete response rate of 21 percent and a partial response rate of 47 percent. With a median follow up of 15.3 months, the median duration of response was 17.5 months; the median progression-free survival was 13.9 months.8

CLL and MCL Safety Results
The most commonly occurring adverse reactions (≥ 20%) were diarrhoea, musculoskeletal pain, upper respiratory tract infection, bruising, rash, nausea, pyrexia (fever), neutropenia (abnormally low number of white blood cells) and constipation. The most common grade 3/4 adverse reactions (≥ 5%) were anaemia, neutropenia, pneumonia and thrombocytopenia (low platelet count).7,8

The CHMP’s positive opinion will now be reviewed by the European Commission, which has the authority to grant marketing authorisation for medicines in the European Economic Area. A final decision on ibrutinib by the European Commission is anticipated later this year.

European CHMP Adopts Positive Opinion for Gilead’s Zydelig® (idelalisib) for the Treatment of Chronic Lymphocytic Leukemia and Follicular Lymphoma – See more at: http://investors.gilead.com/phoenix.zhtml?c=69964&p=irol-newsArticle&ID=1951496&highlight=#sthash.jYa9teqd.dpuf

On July 25, 2014 Gilead Sciences reported that the Committee for Medicinal Products for Human Use (CHMP), the scientific committee of the European Medicines Agency (EMA), has adopted a positive opinion on the company’s Marketing Authorization Application (MAA) for Zydelig (idelalisib 150 mg film-coated tablets), a first-in-class treatment for patients with chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL), the most common subtype of indolent non-Hodgkin lymphoma (iNHL) (Press release Gilead Sciences, JUL 25, 2014, View Source [SID:1234500650]). The CHMP opinion supports the use of Zydelig in combination with rituximab for the treatment of adult patients with CLL who have received at least one prior therapy or, as first-line treatment in CLL patients in the presence of 17p deletion or TP53 mutation in patients unsuitable for chemo-immunotherapy and also as monotherapy for the treatment of adult patients with FL that is refractory to two prior lines of treatment. The CHMP’s recommendation will now be reviewed by the European Commission, which has the authority to approve medicines for use in the 28 countries of the European Union (EU).

CLL and FL are slow-growing incurable blood cancers that can lead to life-threatening complications such as anemia, serious infection and bone marrow failure requiring treatment. Relapse commonly occurs after initial chemo-immunotherapy and many patients with relapsed CLL or FL are unable to tolerate chemotherapy, which may limit their treatment options.

The CHMP positive opinion for Zydelig is based on data from two clinical trials – Study 116 and Study 101-09. Study 116, a pivotal Phase 3 trial, investigated the efficacy and safety of Zydelig in combination with rituximab in patients with previously treated CLL. The Phase 2 101-09 study assessed the efficacy and safety of Zydelig in patients with iNHL who are refractory to rituximab and alkylating agents. Results of Study 116 and Study 101-09 were published in The New England Journal of Medicine in March 2014.

The most commonly reported adverse reactions (incidence ≥20 percent) were diarrhea, pyrexia, fatigue, nausea, cough, abdominal pain and chills. Additionally, grade 3 or 4 elevations in ALT and AST (indicators of liver function) have been observed in clinical trials of Zydelig. Grade 3 or 4 pneumonitis and Grade 3 or 4 diarrhea/colitis were also observed in some patients in the clinical trials.

Zydelig is an investigational product and its safety and efficacy have not been established in the European Union.

(Press release, New Amsterdam Sciences, JUL 24, 2014, View Source!news/nws17/B4AC07CF-F280-403F-8F82-EB563B103820/nas911-being-evaluated-by-the-%28nih%29-national-institute-of-health-as-co-therapeutic-for-treatment-of-influenza [SID:1234505525])

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Celgene Reports Second Quarter 2014 Operating and Financial Results

Submitted REVLIMID for newly diagnosed multiple myeloma (NDMM) in the U.S. and Europe. FDA assigned a U.S. Prescription Drug User Fee Act (PDUFA) goal date of February 22, 2015 for REVLIMID in NDMM (Press release Celgene, JUL 24, 2014, View Source [SID:1234500647]).

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Bristol-Myers Squibb Reports Second Quarter 2014 Financial Results

On July 24, 2014 Bristol-Myers Squibb Company (NYSE:BMY) reported financial results for the second quarter of 2014, which was highlighted by strong global sales for the company’s key brands; the achievement of important regulatory milestones for key brands in Japan, Europe and the U.S.; a new strategic immuno-oncology collaboration agreement with Ono Pharmaceutical Co., Ltd.; and the initiation of several research collaborations that will strengthen the company’s leadership position in immuno-oncology. In addition, the company adjusted 2014 GAAP guidance and confirmed 2014 non-GAAP guidance.

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"During the second quarter we delivered strong financial and operating results, invested in key business development opportunities, and achieved important regulatory milestones for products in HCV and immuno-oncology," said Lamberto Andreotti, chief executive officer, Bristol-Myers Squibb. "These results reflect the promise of our late-stage pipeline, the strong performance of our in-line products and the continued success of our strategy in driving growth for the company."

Second Quarter
$ amounts in millions, except per share amounts
2014 2013 Change
Total Revenues $3,889 $4,048 (4)%
GAAP Diluted EPS 0.20 0.32 (38)%
Non-GAAP Diluted EPS 0.48 0.44 9%

SECOND QUARTER FINANCIAL RESULTS

Bristol-Myers Squibb posted second quarter 2014 revenues of $3.9 billion, a decrease of 4% compared to the same period a year ago. Excluding the divested Diabetes Alliance, global revenues increased 7%.
U.S. revenues decreased 7% to $1.9 billion in the quarter compared to the same period a year ago. International revenues decreased 1% to $2.0 billion.
Gross margin as a percentage of revenues was 74.5% in the quarter compared to 72.6% in the same period a year ago.
Marketing, selling and administrative expenses decreased 9% to $951 million in the quarter.
Advertising and product promotion spending decreased 14% to $187 million in the quarter.
Research and development expenses increased 49% to $1.4 billion in the quarter and included impairment and acquisition-related charges of $458 million.
The effective tax rate on earnings before income taxes was 25.4% in the quarter, compared to 0% in the second quarter last year. Income taxes in the second quarter last year reflect a more favorable earnings mix between high and low tax jurisdictions, primarily driven by specified items.
The company reported net earnings attributable to Bristol-Myers Squibb of $333 million, or $0.20 per share, in the quarter compared to $536 million, or $0.32 per share, a year ago.
The company reported non-GAAP net earnings attributable to Bristol-Myers Squibb of $798 million, or $0.48 per share, in the second quarter, compared to $730 million, or $0.44 per share, for the same period in 2013. An overview of specified items is discussed under the "Use of Non-GAAP Financial Information" section.
Cash, cash equivalents and marketable securities were $11.1 billion, with a net cash position of $3.3 billion, as of June 30, 2014.
SECOND QUARTER PRODUCT AND PIPELINE UPDATE

Bristol-Myers Squibb’s global sales in the second quarter included Eliquis, which grew by $159 million, Yervoy, which grew 38%, Sprycel, which grew 18%, and Orencia, which grew 14%.

Daklinza+Sunvepra

In July, the company announced that the Japanese Ministry of Health, Labor and Welfare has approved Daklinza (daclatasvir), the company’s potent, pan-genotypic NS5A replication complex inhibitor (in vitro), and Sunvepra (asunaprevir), the company’s NS3/4A protease inhibitor. The approvals are Japan’s first for an all-oral, interferon- and ribavirin-free treatment regimen for patients with genotype 1 chronic hepatitis C virus infection, particularly those with compensated cirrhosis. The Daklinza+Sunvepra Dual Regimen provides a new treatment alternative that can lead to cure for many patients in Japan who currently have no treatment options. Daklinza and Sunvepra are expected to be commercially available in Japan in early September.
In June, the company announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has adopted a positive opinion recommending that Daklinza be granted approval for use in combination with other medicinal products for the treatment of chronic hepatitis C virus infection in adults. This is the first positive opinion given by the CHMP for an NS5A inhibitor. It will now be reviewed by the European Commission (EC), which has the authority to approve medicines for all European Union (EU) member states plus Iceland and Norway.
In April, the company announced the submission of New Drug Applications (NDAs) for Daklinza and Sunvepra to the U.S. Food and Drug Administration (FDA). The data submitted in the NDAs support use of the Daklinza+Sunvepra Dual Regimen in patients with genotype 1b hepatitis C. The Daklinza NDA also seeks approval for use of this compound in combination with other agents for multiple genotypes. The FDA accepted the submissions for filing and assigned both submissions priority review with a user fee goal date of November 30, 2014.
Opdivo

In July, the company announced that, following discussions with the FDA, the company is planning a third quarter submission of a Biologics License Application (BLA) for Opdivo (nivolumab) for previously treated advanced melanoma. This will mark the second tumor type for which Bristol-Myers Squibb has a regulatory submission under way for Opdivo in the U.S. In April, the company initiated a rolling BLA submission for Opdivo in third-line squamous cell non-small cell lung cancer (NSCLC). The company expects to complete the first submission by the end of the year.
In June, the company announced that a randomized, blinded comparative Phase III study evaluating Opdivo versus dacarbazine in patients with previously untreated BRAF wild-type advanced melanoma (CheckMate -066) was stopped early because an analysis conducted by the independent Data Monitoring Committee showed evidence of superior overall survival in patients receiving Opdivo compared to the control arm.
Also in June, at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) meeting in Chicago, the company announced results from several clinical trials for Opdivo, both as monotherapy and in combination with Yervoy, in advanced cancers of the lungs, skin and kidneys. Bristol-Myers Squibb is at the forefront of research and discovery in the field of immuno-oncology and these data add to the growing body of research from its leading immuno-oncology pipeline, further supporting the scientific rationale for the potential of these checkpoint inhibitors as single agents or as part of a combination regimen.
In May, the FDA granted Opdivo Breakthrough Therapy Designation for the treatment of patients with Hodgkin lymphoma after failure of autologous stem cell transplant and brentuximab. The designation is based on data from a cohort of patients with Hodgkin lymphoma in the company’s ongoing Phase Ib study of relapsed and refractory hematological malignancies.
Eliquis

In July, the company and its partner, Pfizer, announced that the first patient has enrolled in a Phase IV clinical trial assessing the effectiveness and safety of Eliquis in patients with nonvalvular atrial fibrillation undergoing cardioversion.
In June, the company and its partner, Pfizer, announced that CHMP has adopted a positive opinion recommending that Eliquis be granted marketing authorization for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and the prevention of recurrent DVT and PE, in adults. The CHMP’s positive opinion will now be reviewed by the EC, which has the authority to approve medicines for all EU member states plus Iceland and Norway.
Elotuzumab

In May, the company and its partner, AbbVie, announced that the FDA has granted elotuzumab, an investigational humanized monoclonal antibody, Breakthrough Therapy Designation for use in combination with lenalidomide and dexamethasone for the treatment of multiple myeloma in patients who have received one or more prior therapies. The designation is based on findings from a randomized Phase II, open-label study that evaluated two dose levels of elotuzumab in combination with lenalidomide and low-dose dexamethasone in previously-treated patients, including the 10 mg/kg dose that is being studied in Phase III trials.
Yervoy

In June, at the ASCO (Free ASCO Whitepaper) meeting in Chicago, the company announced results from a Phase III randomized, double-blind study demonstrating that Yervoy 10 mg/kg (n=475) significantly improved recurrence-free survival (RFS, the length of time before recurrence or death) vs. placebo (n=476) for patients with Stage 3 melanoma who are at high risk of recurrence following complete surgical resection, an adjuvant setting. A 25% reduction in the risk of recurrence or death was observed. At three years, an estimated 46.5% of patients treated with Yervoy were free of disease recurrence compared to an estimated 34.8% of patients on placebo. The median RFS was 26.1 months for Yervoy vs. 17.1 months for placebo, with a median follow-up of 2.7 years.
Orencia

In June, at the European League Against Rheumatism meeting in Paris, the company presented data from the Phase IIIb AVERT trial showing that treatment with Orencia, a T-cell co-stimulation modulator, in combination with methotrexate (MTX) achieved significantly higher rates of DAS-defined (DAS28 CRP <2.6) remission at 12 months than treatment with standard of care agent MTX (60.9% vs. 45.2%, respectively), in biologic and MTX-naïve patients with early active rheumatoid arthritis (RA). A small but statistically significantly higher number of patients treated with Orencia plus MTX, versus MTX alone, for 12 months maintained remission 6 months after all RA treatment, including Orencia, MTX or steroids, was withdrawn.
Baraclude

In June, the U.S. Court of Appeals for the Federal Circuit denied the company’s appeal of a February 2013 ruling by the U.S. District Court for the District of Delaware that found invalid the patent covering Baraclude (U.S. patent 5,206,244). In July, the company filed a petition for an en banc rehearing of the case by the full U.S. Court of Appeals.
SECOND QUARTER BUSINESS DEVELOPMENT UPDATE

In July, the company and Ono Pharmaceutical Co., Ltd., signed a collaboration agreement to jointly develop and commercialize Opdivo, Yervoy and three immunotherapy agents in early clinical development as single agents and combination regimens in Japan, South Korea and Taiwan. Also in July, Ono announced that Opdivo received manufacturing and marketing approval in Japan for the treatment of unresectable melanoma. Opdivo is the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world.
In June, the company and Syngene International announced a five-year extension of their drug discovery and development collaboration at the Biocon Bristol-Myers Squibb Research Center in Bangalore, India.
In May, the company announced a clinical trial collaboration with Incyte Corporation to evaluate the safety, tolerability and preliminary efficacy of a combination regimen of Opdivo and INCB24360, Incyte’s oral indoleamine dioxygenase-1 inhibitor, in a Phase I/II study.
In May, the company also announced a clinical trial collaboration with Celldex Therapeutics to evaluate the safety, tolerability and preliminary efficacy of Opdivo and varlilumab, Celldex’s CD27 targeting investigational antibody, in a Phase I/II study. Multiple tumor types will be explored in the study, which could potentially include NSCLC, metastatic melanoma, ovarian, colorectal and squamous cell head and neck cancers.
In May, the company and CytomX Therapeutics announced a worldwide research collaboration and license agreement to discover, develop and commercialize novel therapies against multiple immuno-oncology targets using CytomX’s proprietary Probody Platform.
SECOND QUARTER RESEARCH & DEVELOPMENT UPDATE

In June, the company announced a collaboration with Duke University, through its Duke Clinical Research Institute (DCRI), that will focus on clinical trial transparency. The company will expand access to a broader set of clinical trial information from in-scope company-sponsored studies and enable an independent scientific review through DCRI of requests from researchers that meet pre-specified requirements.
2014 FINANCIAL GUIDANCE

Bristol-Myers Squibb is adjusting its 2014 GAAP EPS guidance range from $1.70-$1.80 to $1.50-$1.60 as a result of impairment and expected additional restructuring charges. The company is also confirming its non-GAAP EPS guidance range of $1.70-$1.80. Both GAAP and non-GAAP guidance assume current exchange rates and that we retain exclusivity on Baraclude sales in the U.S. at least through the end of 2014. Key 2014 non-GAAP line-item guidance assumptions remain unchanged.

The financial guidance for 2014 does not include the impact of any potential strategic acquisition and divestitures, or any specified items that have not yet been identified and quantified. The non-GAAP 2014 guidance also excludes specified items as discussed under "Use of Non-GAAP Financial Information." Details reconciling adjusted non-GAAP amounts with the amounts reflecting specified items are provided in supplemental materials available on the company’s website.