Zykadia receives a Priority Review for frontline use in ALK+ metastatic NSCLC

Share on facebook
Share on twitter
Share on linkedin
Share on email
Share on print

Novartis said FDA has accepted the company’s supplemental New Drug Application for filing, and granted Priority Review for the expanded use of Zykadia (ceritinib) as a first-line treatment for patients with metastatic non-small cell lung cancer whose tumors are anaplastic lymphoma kinase-positive as detected by an FDA-approved test.

FDA also granted Breakthrough Therapy designation to Zykadia for the first-line treatment of patients with ALK+ metastatic NSCLC with metastases to the brain.

The sNDA submission for first-line use of Zykadia is based on the primary analysis of ASCEND-4, a global phase III, randomized, open-label, multicenter clinical trial which evaluated safety and efficacy of Zykadia compared to platinum-based chemotherapy, including maintenance, in adult patients with Stage IIIB or IV ALK+ NSCLC.

The study was conducted at 134 clinical trial sites across 28 countries, and randomized across 376 patients.

The study found:

  • Patients treated with first-line Zykadia had a median progression-free survival (PFS) of 16.6 months (95% confidence interval [CI]: 12.6, 27.2), compared to 8.1 months (95% CI: 5.8, 11.1) for patients treated with standard first-line pemetrexed-platinum chemotherapy with pemetrexed maintenance. A 45% risk reduction in PFS was obtained in the Zykadia arm compared to the chemotherapy arm (hazard ratio [HR] = 0.55, [95% CI: 0.42, 0.73; one-sided p value <0.001])1.

  • In a pre-specified analysis of patients receiving Zykadia without brain metastases at screening, patients experienced a median PFS of 26.3 months (95% CI: 15.4, 27.7), compared with 8.3 months (95% CI: 6.0, 13.7) among patients treated with chemotherapy (HR = 0.48 [95% CI: 0.33, 0.69])1.

  • In a pre-specified analysis of patients receiving Zykadia with brain metastases at baseline, the median PFS was 10.7 months (95% CI: 8.1, 16.4) in the Zykadia group versus 6.7 months (95% CI: 4.1, 10.6) in the chemotherapy group (HR = 0.70 [95% CI: 0.44, 1.12])1. Intracranial overall response rate (ORR) (72.7%, [95% CI: 49.8, 89.3]) is consistent with whole body ORR (72.5% [95% CI: 65.5, 78.7]). The most common adverse events (AEs) occurring in more than 25% of Zykadia patients were diarrhea (85% vs. 11% with chemotherapy), nausea (69% vs. 55% with chemotherapy), vomiting (66% vs. 36% with chemotherapy), ALT increase (60% vs. 22% with chemotherapy), AST increase (53% vs. 19% with chemotherapy), gamma-glutamyltransferase increase (37% vs. 10% in chemotherapy), decreased appetite (34% vs. 31% with chemotherapy), blood alkaline phosphate increase (29% vs. 5% with chemotherapy) and fatigue (29% vs. 30% with chemotherapy).

YOU MAY BE INTERESTED IN

Just consider for a minute if this was the first year of running your lab, if you were on the job market as a physician or scientist right now, if you were a resident contemplating a career in cancer research after fellowship, if you were a graduate student or postdoc, if you were an undergraduate or a technician who was looking toward graduate school.
The immune system can be a powerful tool to control cancer. Immune cells within our body detect cancer cells and release payloads that kill them. Transformative science in the last decade has led to the development of therapies that enhance the ability of our immune cells to carry out this function. These therapies, including checkpoint blockade and CAR-T cells, have been lifesaving for many patients that before had untreatable cancer. But, sadly, a majority of patients with advanced solid tumors still succumb to their disease. 

Never miss an issue!

Get alerts for our award-winning coverage in your inbox.

Login