Celgene International Sàrl, a subsidiary of Celgene Corporation (NASDAQ:
CELG) today announced results of its phase III, randomized,
international study (CA033) of ABRAXANE® (paclitaxel
protein-bound particles for injectable suspension) (albumin-bound) in
chemotherapy-naïve patients with metastatic melanoma. In the study, the
primary endpoint was met with patients receiving ABRAXANE demonstrating
a statistically significant improvement in progression-free survival
compared to patients receiving dacarbazine (DTIC) chemotherapy.
The safety profile of ABRAXANE observed in the CA033 study is consistent
with other ABRAXANE pivotal clinical trials. Data from this study will
be presented at the Society for Melanoma Research (SMR) Congress 2012 in
Los Angeles in November. Future regulatory and clinical strategies are
being reviewed in light of these results.
The CA033 study is a Celgene-sponsored, open-label, controlled,
randomized study comparing ABRAXANE to standard chemotherapy, DTIC, in
patients with metastatic melanoma. DTIC is the only chemotherapy
approved since 1975 by the U.S. Food and Drug Administration for
metastatic melanoma. In the study, 529 chemotherapy-naïve patients were
randomized to receive either ABRAXANE (150mg/m2 weekly for 3
out of 4 weeks) or DTIC (1000 mg/m2 every three weeks). The
primary study endpoint was independently-assessed progression free
survival. Secondary endpoints included overall survival, overall
response rate and disease control, safety and tolerability.
These results are from an investigational study. ABRAXANE® is
not approved for the treatment of metastatic melanoma.
ABRAXANE® for Injectable Suspension
(paclitaxel protein-bound particles for injectable suspension) 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.
Important Safety Information
WARNING - NEUTROPENIA
- ABRAXANE therapy should not be administered to patients with
metastatic breast cancer who have baseline neutrophil counts of less
than 1,500 cells/mm3. In order to monitor the
occurrence of bone marrow suppression, primarily neutropenia, which
may be severe and result in infection, it is recommended that frequent
peripheral blood cell counts be performed on all patients receiving
ABRAXANE.
- Note: An albumin form of paclitaxel may substantially affect a
drug’s functional properties relative to those of drug in solution. DO
NOT SUBSTITUTE FOR OR WITH OTHER PACLITAXEL FORMULATIONS.
CONTRAINDICATIONS
Neutrophil Counts
-
ABRAXANE should not be used in patients who have baseline neutrophils
counts of < 1,500 cells/mm3
Hypersensitivity
-
Patients who experience a severe hypersensitivity reaction to ABRAXANE
should not be rechallenged with the drug
WARNINGS AND PRECAUTIONS
Hematologic Effects
-
Bone marrow suppression (primarily neutropenia) is dose dependent and
a dose limiting toxicity
-
In order to monitor the occurrence of myelotoxicity, perform frequent
peripheral blood cell counts
-
Retreat with subsequent cycles of ABRAXANE after neutrophils recover
to a level >1,500 cells/mm3 and platelets recover to
>100,000 cells/mm3
-
In the case of severe neutropenia (<500 cells/mm3 for 7
days or more), during a course of ABRAXANE therapy, dose reduce for
subsequent courses of therapy
Nervous System
-
Sensory neuropathy occurs frequently with ABRAXANE
-
The occurrence of grade 1 or 2 sensory neuropathy does not generally
require dose modification
-
If grade 3 sensory neuropathy develops, treatment should be withheld
until resolution to grade 1 or 2 followed by a dose reduction for all
subsequent courses of ABRAXANE
Hypersensitivity
-
Severe and sometimes fatal hypersensitivity reactions, including
anaphylactic reactions, have been reported
-
Patients who experience severe hypersensitivity reaction to ABRAXANE
should not be re-challenged with this drug
Hepatic Impairment
-
Because the exposure and toxicity of paclitaxel can be increased with
hepatic impairment, administration of ABRAXANE in patients with
hepatic impairment should be performed with caution
-
The starting dose should be reduced for patients with moderate and
severe hepatic impairment
Albumin (Human)
-
ABRAXANE contains albumin (human), a derivative of human blood
Use in Pregnancy: Pregnancy Category D
-
ABRAXANE can cause fetal harm when administered to a pregnant woman
-
There are no adequate and well-controlled studies in pregnant women
receiving ABRAXANE
-
If this drug is used during pregnancy, or if the patient becomes
pregnant while receiving this drug, the patient should be apprised of
the potential hazard to the fetus
-
Women of childbearing potential should be advised to avoid becoming
pregnant while receiving ABRAXANE
Use in Men:
-
Men should be advised to not father a child while receiving ABRAXANE
ADVERSE REACTIONS - Randomized Metastatic Breast Cancer Study
-
Severe cardiovascular events possibly related to single-agent ABRAXANE
occurred in approximately 3% of patients. These events included
cardiac ischemia/infarction, chest pain, cardiac arrest,
supraventricular tachycardia, edema, thrombosis, pulmonary
thromboembolism, pulmonary emboli, and hypertension
-
Cases of cerebrovascular attacks (strokes) and transient ischemic
attacks have been reported
-
In the randomized metastatic breast cancer study, the most common
adverse events (≥20%) were alopecia (90%), neutropenia (all cases 80%;
severe 9%), sensory neuropathy (any symptoms 71%; severe 10%),
abnormal ECG (all patients 60%, patients with normal baseline 35%),
asthenia (any 47%; severe 8%), myalgia/arthralgia (any 44%; severe
8%), AST (SGOT) elevations (any 39%), alkaline phosphatase elevations
(any 36%), anemia (all cases 33%; severe 1%), nausea (any 30%; severe
3%), diarrhea (any 27%; severe <1%) and infections (24%). Other
adverse events of note include vomiting (any 18%; severe 4%), and
mucositis (any 7%; severe <1%). 3% (7 of 229) of patients discontinued
the use of ABRAXANE due to sensory neuropathy
-
Other adverse events have included ocular/visual disturbances (any
13%; severe 1%), renal dysfunction (any 11%; severe 1%), fluid
retention (any 10%; severe 0%), hepatic dysfunction (elevations in
bilirubin 7%), hypersensitivity reactions (any 4%; severe 0%),
cardiovascular reactions (severe 3%), thrombocytopenia (any 2%; severe
<1%), and injection site reactions (<1%). Dehydration and pyrexia were
also reported
Post-Marketing Experience with ABRAXANE and other Paclitaxel
Formulations
-
Severe hypersensitivity reactions have also been reported with ABRAXANE
-
During postmarketing surveillance, reports of congestive heart failure
and left ventricular dysfunction were observed, primarily among
individuals with underlying cardiac history or prior exposure to
cardiotoxic drugs like anthracyclines
-
There have been reports of extravasation of ABRAXANE. Given the
possibility of extravasation, it is advisable to monitor closely the
ABRAXANE infusion site for possible infiltration during drug
administration
DRUG INTERACTIONS:
-
No drug interaction studies have been conducted with ABRAXANE
-
Caution should be exercised when administering ABRAXANE concomitantly
with medicines known to inhibit or induce either CYP2C8 or CYP3A4
USE IN SPECIFIC POPULATIONS
Nursing Mothers:
-
It is not known whether paclitaxel is excreted in human milk
-
Because many drugs are excreted in human milk and because of the
potential for serious adverse reactions in nursing infants, a decision
should be made to discontinue nursing or to discontinue the drug,
taking into account the importance of the drug to the mother
Pediatric:
-
The safety and efficacy of ABRAXANE in pediatric patients have not
been evaluated
Geriatric:
-
No toxicities occurred notably more frequently among patients ≥ 65
years of age who received ABRAXANE
Renal Impairment:
-
The use of ABRAXANE has not been studied in patients with renal
impairment
-
Patients were excluded for baseline serum bilirubin >1.5 mg/dL or
baseline serum creatinine > 2 mg/dL
DOSAGE AND ADMINISTRATION
-
Dose adjustment is recommended for patients with moderate and severe
hepatic impairment and patients who experience severe neutropenia or
severe sensory neuropathy during treatment with ABRAXANE
Please see full Prescribing Information, including Boxed WARNING,
CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS, and ADVERSE REACTIONS.
About Melanoma
Melanoma is a form of skin cancer characterized by the uncontrolled
growth of pigment-producing cells (melanocytes) located in the skin.
When melanoma is diagnosed early, it is generally a curable disease.
However, when it spreads to other parts of the body, it is the deadliest
and most aggressive form of skin cancer. A person with metastatic
melanoma typically has on average a short life expectancy that is
measured in months. According to the World Health Organization,
approximately 132,000 new cases of melanoma are diagnosed each year
globally. The incidence of melanoma has increased ten-fold over the past
50 years, and has steadily increased since the 1970s. The American
Cancer Society estimates there will be more than 76,000 new cases of
melanoma and nearly 9,200 melanoma deaths this year in the United States.
About Celgene International Sàrl
Celgene International Sàrl, located in Boudry, in the Canton of
Neuchâtel, Switzerland, is a wholly owned subsidiary and international
headquarters of Celgene Corporation. Celgene Corporation, headquartered
in Summit, New Jersey, is an integrated global pharmaceutical company
engaged primarily in the discovery, development and commercialization of
innovative therapies for the treatment of cancer and inflammatory
diseases through gene and protein regulation. For more information,
please visit the Company's website at www.celgene.com.
Forward-Looking Statements
This press release contains forward-looking statements, which are
generally statements that are not historical facts. Forward-looking
statements can be identified by the words "expects," "anticipates,"
"believes," "intends," "estimates," "plans," "will," “outlook” and
similar expressions. Forward-looking statements are based on
management’s current plans, estimates, assumptions and projections, and
speak only as of the date they are made. We undertake no obligation to
update any forward-looking statement in light of new information or
future events, except as otherwise required by law. Forward-looking
statements involve inherent risks and uncertainties, most of which are
difficult to predict and are generally beyond our control. Actual
results or outcomes may differ materially from those implied by the
forward-looking statements as a result of the impact of a number of
factors, many of which are discussed in more detail in our Annual Report
on Form 10-K and our other reports filed with the Securities and
Exchange Commission.
