MedPath

Umbralisib

Generic Name
Umbralisib
Drug Type
Small Molecule
Chemical Formula
C31H24F3N5O3
CAS Number
1532533-67-7
Unique Ingredient Identifier
38073MQB2A
Background

Marginal zone lymphoma is a rare, slowly progressing type of non-Hodgkin lymphoma initially treated with rituximab (an anti-CD20 drug), either alone or in combination with chemotherapy. Unfortunately, many patients experience a relapse or develop resistance to these drugs. Treatment options then become limited, and alternate treatments for the lymphoma are required to control disease progression. Follicular lymphoma is also treated with rituximab and other chemotherapeutic agents, but may show similar progression.

On February 5, 2021, the Food and Drug Administration granted accelerated approval to umbralisib, a kinase inhibitor for PI3K-delta and casein kinase CK1-epsilon, based on promising results from clinical trials. It was marketed as Ukoniq by TG Therapeutics and has been approved for the treatment of relapsing and refractory marginal cell lymphoma and follicular lymphoma in adults. Umbralisib inhibits casein kinase, a primary regulator of protein translation, kinase-1ε, distinguishing it from other lymphoma treatments. While it initially offered a promising therapy for patients experiencing relapsing or refractory disease, umbralisib was withdrawn from the market due to safety concerns as the drug was associated with a possible increased risk of death outweighing the benefits.

Indication

Umbralisib does not have any approved therapeutic indications.

Breyanzi Receives Positive CHMP Opinion for Follicular Lymphoma Treatment in EU

• The CHMP has recommended Breyanzi for treating relapsed or refractory follicular lymphoma (FL) in adults after two or more prior systemic therapies. • The recommendation is based on the Phase 2 TRANSCEND FL study, which showed a 97.1% overall response rate and a 94.2% complete response rate. • Breyanzi demonstrated rapid and durable responses, with 75.7% of patients in response at 18 months, and a consistent safety profile in clinical trials. • The European Commission will review the CHMP recommendation, with a final decision expected within approximately two months.

FDA Clarifies Confirmatory Trial Requirements for Accelerated Drug Approvals

• The FDA issued draft guidance clarifying requirements for confirmatory trials needed to verify clinical benefit of drugs receiving accelerated approval. • The guidance emphasizes early consultation with the FDA on trial design and the need for sponsors to commit sufficient resources for timely trial completion. • The FDA intends to require confirmatory trials to be underway before granting accelerated approval, except in limited circumstances. • The guidance also details procedures for expedited withdrawal of approval if confirmatory trials fail or other issues arise, ensuring accountability.

FDA's Accelerated Approval Pathway Faces Scrutiny as Some Drugs are Withdrawn

• Several drugs approved under the FDA's accelerated approval pathway have been withdrawn from the market due to safety concerns or failure to confirm clinical benefit. • Pfizer pulled Oxbryta, a sickle cell disease therapy, after new data showed a higher risk of deaths and complications in treated patients. • Biogen and Eisai discontinued Aduhelm, an Alzheimer's drug, after a controversial approval and inauspicious rollout, focusing instead on Leqembi. • The FDA is now requiring confirmatory trials to be underway before granting accelerated approval to address delays and ensure clinical outcomes.
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