On February 10, 2022 Innovent Biologics reported that The U.S. Food and Drug Administration (FDA) held a public Oncology Drug Advisory Committee (ODAC) for sintilimab, which is under review for the first-line treatment of people with non-squamous non-small cell lung cancer (nsqNSCLC) based on the ORIENT-11 trial conducted exclusively in China (Press release, Innovent Biologics, FEB 10, 2022, View Source [SID1234608050]). On the single voting question, the advisory committee voted that additional clinical trial(s) should be required to demonstrate applicability to the U.S. population and U.S. medical practice prior to a final regulatory decision. Sintilimab is a novel PD-1 inhibitor being developed and commercialized under a collaboration agreement between Innovent and Lilly.
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"We appreciate this opportunity to share our data of ORIENT-11 with FDA and the advisory committee. While conducted in China, ORIENT-11 was well designed and conducted in compliance with ICH GCP standards. The data of sintilimab generated from ORIENT-11 has suggested a positive risk and benefit profile, with no safety issue identified by the FDA." said Dr. Yongjun Liu, President of Innovent. "While we are disappointed by the ODAC outcome, we together with Lilly will continue to work with FDA as the agency completes its review of our BLA application. We remain confident in the value of sintilimab, and the interaction with FDA will help us to pave the way to advance our exciting pipeline and globally develop innovative medicines for patients around the world."
"While we are disappointed with the outcome of today’s ODAC as it relates to the investigational product sintilimab, we appreciated the opportunity to publicly discuss the application and broader issues related to single-country clinical trials," said Jacob Van Naarden, President, Lilly Oncology. "Along with Innovent, we will continue to work with the FDA as it completes its review of the sintilimab application."
The ODAC provides the FDA with independent advice and recommendations from outside experts on marketed and investigational medicines for use in the treatment of cancer. The FDA will consider the vote as it reviews the application and is not bound by the committee’s guidance. Innovent and Lilly will continue to work closely with the agency as they complete their review of the application.
About the ORIENT-11 Trial
ORIENT-11 is a randomized, double-blind, Phase 3 clinical trial conducted in China assessing the efficacy and safety of sintilimab in combination with pemetrexed and platinum chemotherapy compared to placebo in combination with pemetrexed and platinum chemotherapy as a first-line treatment for patients with advanced or metastatic nonsquamous non-small cell lung cancer (nsqNSCLC), with no sensitizing EGFR mutations or ALK rearrangements. The primary endpoint is progression-free survival (PFS) as assessed by Independent Radiographic Review Committee (IRRC) based on RECIST v1.1., and secondary endpoints include overall survival (OS), ORR and safety profile.
A total of 397 patients were enrolled and randomized 2:1 to receive either sintilimab injection 200mg or placebo in combination with pemetrexed and platinum chemotherapy every three weeks for up to four cycles, followed by either sintilimab injection or placebo plus pemetrexed maintenance therapy. Patients received treatment until radiographic disease progression, unacceptable toxicity or any other conditions that required treatment discontinuation. Conditional crossover was permitted. The results of the ORIENT-11 study were published in 2020.
About Lung Cancer
Globally, lung cancer is the leading cause of cancer death, killing nearly 1.8 million people worldwide each year.[i] In the U.S., lung cancer is the second most common cancer (not counting skin cancer) and the leading cause of cancer death, responsible for nearly 25 percent of all cancer deaths – more than those from colorectal, breast and prostate cancers combined.[ii] Non-small cell lung cancer (NSCLC) accounts for approximately 85 percent of all lung cancers, and about 70 percent of those with NSCLC have the nonsquamous subtype.[iii] Fifty percent of NSCLC patients present with advanced or metastatic disease at diagnosis.[iv]
About Sintilimab
Sintilimab, marketed as TYVYT (sintilimab injection) in China, is an innovative PD-1 inhibitor with global quality standards jointly developed by Innovent and Lilly. Sintilimab is a type of immunoglobulin G4 monoclonal antibody, which binds to PD-1 molecules on the surface of T-cells, blocks the PD-1 / PD-Ligand 1 (PD-L1) pathway, and reactivates T-cells to kill cancer cells. Innovent is currently conducting more than 20 clinical studies of sintilimab to evaluate its safety and efficacy in a wide variety of cancer indications, including more than 10 registrational or pivotal clinical trials.
In China, sintilimab has been approved and included in the National Reimbursement Drug List (NRDL) for four indications, including:
The treatment of relapsed or refractory classic Hodgkin’s lymphoma after two lines or later of systemic chemotherapy;
In combination with pemetrexed and platinum chemotherapy, for the first-line treatment of non-squamous non-small cell lung cancer;
In combination with gemcitabine and platinum chemotherapy, for the first-line treatment of squamous non-small cell lung cancer;
In combination with bevacizumab biosimilar for the first-line treatment of unresectable or advanced hepatocellular carcinoma.
Additionally, Innovent currently has three regulatory submissions under review in China’s NMPAfor sintilimab:
In combination with cisplatin plus paclitaxel or cisplatin plus 5-fluorouracil for the first-line treatment of esophageal squamous cell carcinoma;
In combination with chemotherapy for the first-line treatment of unresectable, locally advanced, recurrent or metastatic gastric or gastroesophageal junction adenocarcinoma;
In combination with bevacizumab biosimilar and chemotherapy for EGFR-mutated non-squamous NSCLC following EGFR-TKI treatment.
Additionally, two clinical studies of sintilimab have met their primary endpoints:
Phase 2 study as second-line treatment of esophageal squamous cell carcinoma;
Phase 3 study as second-line treatment for squamous NSCLC with disease progression following platinum-based chemotherapy.