Details              Category: Small      Molecules              Published on Thursday, 05 November 2020 11:36              Hits: 85        
    Patients treated with Lynparza and bevacizumab lived    without disease progression for a median of 37.2 months vs.    17.7 months with bevacizumab alone  
    One in two women with advanced ovarian cancer has an    HRD-positive tumour  
    LONDON, UK I November 5, 2020 I AstraZeneca    and MSDs Lynparza (olaparib) has been approved in the    European Union (EU) for the 1st-line maintenance treatment with    bevacizumab of patients with homologous recombination deficient    (HRD)-positive advanced ovarian cancer.  
    Ovarian cancer is the fifth most common cause of cancer death    in the EU and the five-year survival rate is approximately 45%,    due partly because women are often diagnosed with advanced    disease (Stage III or IV).1-3  
    The approval by the European Commission was based on a    biomarker subgroup analysis of the PAOLA-1 Phase III trial    which showed Lynparza, in combination with bevacizumab    maintenance treatment, demonstrated a substantial    progression-free survival (PFS) improvement versus bevacizumab    alone for patients with HRD-positive advanced ovarian cancer.    It follows the     recommendation for approval by the Committee for Medicinal    Products for Human Use of the European Medicines Agency in    September 2020.  
    Isabelle Ray-Coquard, principal investigator of the PAOLA-1    Phase III trial and medical oncologist, Centre Lon Brard and    President of the GINECO group, Paris, France, said: For women    with advanced ovarian cancer, the goal of 1st-line treatment is    to delay disease progression for as long as possible with the    intent of achieving long-term remission. Unfortunately, once a    patients cancer recurs, it historically has been incurable.    Lynparza together with bevacizumab has demonstrated an    impressive median progression-free survival benefit of more    than three years and is poised to become the standard of care    for eligible patients with HRD-positive tumours in the EU.  
    Dave Fredrickson, Executive Vice President, Oncology Business    Unit, said: Half of all newly diagnosed patients with advanced    ovarian cancer have HRD-positive tumours. Women treated with    Lynparza in combination with bevacizumab in the    PAOLA-1 Phase III trial lived progression free for a median of    more than three years, showing that HRD testing should be an    essential component of clinical diagnosis. HRD status can help    physicians select a personalised 1st-line treatment regimen for    patients to substantially delay relapse in this devastating    disease.  
    Roy Baynes, Senior Vice President and Head of Global Clinical    Development, Chief Medical Officer, MSD Research Laboratories,    said: Biomarker testing has rapidly enhanced our understanding    of how PARP inhibition can help target this disease. The EU    approval reinforces that HRD-positive tumours represent a    distinct subset of advanced ovarian cancer and HRD testing is    critical for women in this setting.  
    The PAOLA-1 Phase III trial showed    thatLynparza,in combination with    bevacizumab maintenance treatment, reduced the risk of disease    progression or death by 67% (based on a hazard ratio of 0.33;    95% confidence interval 0.25-0.45). The addition    ofLynparzaimproved PFS to a median of 37.2    months versus 17.7 with bevacizumab alone in patients with    HRD-positive advanced ovarian cancer. The data from the PAOLA-1    trial was published inThe    New England Journal of Medicinein 2019.  
    Further results recently presented at the European Society for    Medical Oncology Virtual Congress 2020 showed a statistically    significant improvement in the key secondary endpoint of the    time to second disease progression (PFS2). Lynparza    with bevacizumab provided benefit beyond first disease    progression, improving PFS2 to a median of 50.3 months versus    35.3 with bevacizumab alone.  
    The full EU indication is for Lynparza in combination    with bevacizumab for the maintenance treatment of adult    patients with advanced (FIGO Stages III and IV) high-grade    epithelial ovarian, fallopian tube or primary peritoneal cancer    who are in response (complete or partial) following completion    of 1st-line platinum-based chemotherapy in combination with    bevacizumab and whose cancer is associated with HRD positive    status defined by either a breast cancer susceptibility gene    1/2 (BRCA1/2) mutation and/or genomic instability.  
    Lynparzain combination with bevacizumab    isapproved    in the USand in several other countries as a 1st-line    maintenance treatment for patients with HRD-positive advanced    ovarian cancer and is currently under regulatory review in    other countries around the world.  
    Financial considerations  
    Following this approval for Lynparza in the EU,    AstraZeneca will receive a regulatory milestone payment from    MSD of $25m, anticipated to be booked as collaboration revenue    during the fourth quarter of 2020.  
    Ovarian cancer  
    In 2018, there were nearly 68,000 new cases of ovarian cancer    diagnosed in the EU and around 45,000    deaths.3Approximately 50% of ovarian    cancers are HRD-positive including BRCA1/2    mutation.4,5Approximately 15% of ovarian    cancers have a BRCA1/2 mutation.6 The primary    aim of 1st-line treatment is to delay disease progression for    as long as possible with the intent to achieve long-term    remission.7-9  
    Homologous recombination deficiency  
    HRD, which defines a subgroup of ovarian cancer, encompasses a    wide range of genetic abnormalities, including BRCA mutations    and beyond. As with BRCA gene mutations, HRD interferes with    normal cell DNA repair mechanisms and confers sensitivity to    PARP inhibitors including Lynparza.10  
    PAOLA-1  
    PAOLA-1 is a double-blinded Phase III trial testing the    efficacy and safety ofLynparzaadded to    standard-of-care bevacizumab versus bevacizumab alone, as a    1st-line maintenance treatment for newly diagnosed advanced    FIGO Stage III-IV high-grade serous or endometroid ovarian,    fallopian tube, or peritoneal cancer patients who had a    complete or partial response to 1st-line treatment with    platinum-based chemotherapy and bevacizumab.AstraZeneca    and MSD     announced in August 2019 that the trial met its primary    endpoint of PFS in the overall trial population.  
    Lynparza  
    Lynparza (olaparib) is a first-in-class PARP inhibitor    and the first targeted treatment to block DNA damage response    (DDR) in cells/tumours harbouring a deficiency in homologous    recombination repair (HRR), such as mutations in BRCA1 and/or    BRCA2. Inhibition of PARP with Lynparza leads to the    trapping of PARP bound to DNA single-strand breaks, stalling of    replication forks, their collapse and the generation of DNA    double-strand breaks and cancer cell death. Lynparza    is being tested in a range of PARP-dependent tumour types with    defects and dependencies in the DDR pathway.  
    Lynparza is currently approved in a number of    countries, including those in the EU, for the maintenance    treatment of platinum-sensitive relapsed ovarian cancer. It is    approved in the US, the EU, Japan, China, and several other    countries as 1st-line maintenance treatment of BRCA-mutated    advanced ovarian cancer following response to platinum-based    chemotherapy. It is also approved in the US as a 1st-line    maintenance treatment with bevacizumab for patients with    HRD-positive advanced ovarian cancer (BRCAm and/or genomic    instability). Lynparza is approved in the US, Japan,    and a number of other countries for germline BRCA-mutated,    HER2-negative, metastatic breast cancer, previously treated    with chemotherapy; in the EU, this includes locally advanced    breast cancer. It is also approved in the US, the EU and    several other countries for the treatment of germline BRCAm    metastatic pancreatic cancer. Lynparza is approved in    the US for homologous recombination repair (HRR) gene-mutated    metastatic castration-resistant prostate cancer (BRCAm and    other HRR gene mutations). Regulatory reviews are underway in    several countries for ovarian, breast, pancreatic and prostate    cancers.  
    Lynparza, which is being jointly developed and    commercialised by AstraZeneca and MSD, has been used to treat    over 30,000 patients worldwide. Lynparza has the    broadest and most advanced clinical trial development programme    of any PARP inhibitor, and AstraZeneca and MSD are working    together to understand how it may affect multiple    PARP-dependent tumours as a monotherapy and in combination    across multiple cancer types. Lynparza is the    foundation of AstraZeneca's industry-leading portfolio of    potential new medicines targeting DDR mechanisms in cancer    cells.  
    The AstraZeneca and MSD strategic oncology    collaboration  
    In July 2017, AstraZeneca and Merck & Co., Inc.,    Kenilworth, NJ, US, known as MSD outside the US and Canada,    announced a global strategic oncology collaboration to    co-develop and co-commercialise Lynparza, the worlds    first PARP inhibitor, and Koselugo (selumetinib), a    mitogen-activated protein kinase (MEK) inhibitor, for multiple    cancer types. Working together, the companies will develop    Lynparza and Koselugo in combination with    other potential new medicines and as monotherapies.    Independently, the companies will develop Lynparza and    Koselugo in combination with their respective PD-L1    and PD-1 medicines.  
    AstraZeneca in oncology  
    AstraZeneca has a deep-rooted heritage in oncology and offers a    quickly growing portfolio ofnew    medicines that has the potential to transform patients lives    and the Companys future. With seven new medicines launched    between 2014 and 2020, and a broad    pipelineof small molecules and biologics    in development, the Company is committed to advance oncology as    a key growth driver for AstraZeneca focused on lung, ovarian,    breast and blood cancers.  
    By harnessing the power of four scientific platforms     Immuno-Oncology, Tumour Drivers and Resistance, DNA Damage    Response and Antibody Drug Conjugates  and by championing the    development of personalised combinations, AstraZeneca has the    vision to redefine cancer treatment and, one day, eliminate    cancer as a cause of death.  
    AstraZeneca  
    AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, science-led    biopharmaceutical company that focuses on the discovery,    development and commercialisation of prescription medicines,    primarily for the treatment of diseases in three therapy areas    - Oncology, Cardiovascular, Renal & Metabolism, and    Respiratory & Immunology. Based in Cambridge, UK,    AstraZeneca operates in over 100 countries and its innovative    medicines are used by millions of patients worldwide. Please    visit astrazeneca.com    and follow the Company on Twitter @AstraZeneca.  
    References  
    1. EuroHealth. (2018). Ovarian Cancer: The Silent Killer.    Available at: https://eurohealth.ie/policy-brief-women-and-ovarian-cancer-in-the-eu-2018/    [Accessed October 2020].  
    2. ECIS. (2020).Estimates of cancer incidence and mortality in    2020, for all cancer sites. Available here [Accessed    October 2020].  
    3. The World Health Organization. IARC. Globocan. (2018).    Available at: http://gco.iarc.fr/ [Accessed October 2020].  
    4. Moschetta et al. (2016). BRCA somatic mutations and    epigenetic BRCA modifications in serous ovarian cancer. Annals    of Oncology, 27(8), pp.1449-1455.  
    5. Bonadio et al. (2018). Homologous recombination deficiency    in ovarian cancer: a review of its epidemiology and management.    Clinics, 73(Suppl 1): e450s.  
    6. Ramus. (2009). The Contribution of BRCA1 and BRCA2 to    Ovarian Cancer. Molecular Oncology, 3(2), pp.138150.  
    7. Raja et al. (2012). Optimal first-line treatment in ovarian    cancer. Annals on Oncology. 23 Suppl 10, x118-127.  
    8. NHS Choices, Ovarian Cancer Available at: https://www.nhs.uk/conditions/ovarian-cancer/treatment/    [Accessed October 2020].  
    9. Ledermann et al. (2013). Newly diagnosed and relapsed    epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines    for diagnosis, treatment and follow-up. Annals of Oncology, 24,    pp.vi24-vi32.  
    10. Moore, K. (2018). Maintenance Olaparib in Patients with    Newly Diagnosed Advanced Ovarian Cancer. New England Journal of    Medicine, 379(26), pp.2495-2505.  
    SOURCE: AstraZeneca  
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Lynparza approved in the EU as 1st-line maintenance treatment with bevacizumab for HRD-positive advanced ovarian cancer | Small Molecules | News...