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Polatuzumab Vedotin Shows Superior Efficacy in First-Line DLBCL Treatment and Confirms Long-Term Benefits in Relapsed Disease

  • The phase 3 POLARIX trial demonstrated that polatuzumab vedotin plus R-CHP (pola-R-CHP) significantly improved progression-free survival compared to standard R-CHOP in previously untreated DLBCL patients, reducing the risk of disease progression by 27%.
  • Long-term follow-up data from the GO29365 study confirmed durable disease control with polatuzumab vedotin plus bendamustine and rituximab in relapsed/refractory DLBCL, with 25% of patients achieving ongoing responses lasting over 2 years.
  • Both studies showed manageable safety profiles for polatuzumab vedotin combinations, with peripheral neuropathy rates comparable to standard regimens and no new safety signals identified with extended follow-up.

FDA Approves Insightec's Exablate Neuro for Advanced Parkinson's Disease Treatment

  • The FDA has approved Insightec's Exablate Neuro focused ultrasound system for treating advanced Parkinson's disease patients with mobility, rigidity, or dyskinesia symptoms through incisionless pallidotomy.
  • The treatment uses focused ultrasound waves to precisely target and ablate the globus pallidus without requiring brain implants or surgical incisions, reducing infection risk compared to invasive surgery.
  • This approval expands the device's indications beyond essential tremor and tremor-dominant Parkinson's disease, with 37 medical centers in the US currently using the technology.
  • Parkinson's disease affects an estimated one million patients in the United States, with the new approval providing a less invasive surgical option when medications are not well tolerated.

Real-World Evidence Increasingly Influences FDA Drug Approvals, Study Finds

  • A systematic review of FDA approval documents from 2019-2021 found that 85% of new drug and biologic approvals incorporated real-world evidence (RWE) in some form, with the proportion increasing from 75% in 2019 to 96% in the first half of 2021.
  • Among 88 approvals that included RWE studies intended to support safety or effectiveness, 74% influenced FDA's benefit-risk assessment, with 9% serving as substantial or primary evidence and 65% providing supportive evidence.
  • FDA's documented feedback on RWE studies highlighted common issues including methodological problems, sample size concerns, and omission of patient-level data, emphasizing the importance of fit-for-purpose data selection and rigorous study design.

FDA Approves Breakthrough Twice-Yearly HIV Prevention Drug Lenacapavir with Nearly 100% Efficacy

  • The FDA has approved lenacapavir, a breakthrough preventative treatment for HIV that offers nearly 100 percent protection from the virus and could change the course of the AIDS epidemic.
  • The new drug represents a significant advancement in HIV prevention with its twice-yearly dosing schedule, potentially improving patient adherence compared to daily prevention medications.
  • Despite the promising therapeutic breakthrough, deep cuts to health initiatives could hinder the rollout of this potentially game-changing HIV prevention treatment.

FDA Approves Zanubrutinib for Waldenström's Macroglobulinemia Treatment

  • The FDA has approved zanubrutinib (Brukinsa) for treating adult patients with Waldenström's macroglobulinemia, marking the second therapy specifically approved for this rare lymphoma.
  • The approval was based on the phase 3 ASPEN trial comparing zanubrutinib to ibrutinib, showing a higher very good partial response rate of 28% versus 19% respectively.
  • Zanubrutinib demonstrated improved tolerability compared to the first-generation BTK inhibitor ibrutinib across several clinically important side effects.
  • The drug is administered orally at either 160 mg twice daily or 320 mg once daily, offering patients a convenient single-agent treatment option.

UK Approves First COVID-19 Monoclonal Antibody Treatment as AstraZeneca Reports 77% Efficacy in Prevention Trial

  • The UK's MHRA approved Ronapreve, the first monoclonal antibody therapy specifically designed to treat and prevent COVID-19, developed by Regeneron and Roche.
  • The treatment combines two monoclonal antibodies administered by injection or infusion, working by binding to the virus and preventing respiratory system entry.
  • AstraZeneca simultaneously announced that its AZD7442 antibody combination reduced COVID-19 symptom risk by 77% in a trial of 5,172 participants, with over three-quarters having comorbidities affecting vaccine response.
  • Both treatments represent significant advances for vulnerable populations who may not respond adequately to COVID-19 vaccines alone.

FDA Approves Aduhelm: First Disease-Modifying Alzheimer's Treatment in Nearly Two Decades

  • The FDA granted accelerated approval to Biogen's aducanumab (Aduhelm) as the first disease-modifying Alzheimer's treatment in nearly two decades, despite divided expert opinions on its clinical efficacy.
  • Aduhelm, priced at $56,000 annually, works by reducing amyloid plaques in the brain and will require monthly intravenous infusions with comprehensive clinical and MRI monitoring for potential adverse effects.
  • As part of the accelerated approval, Biogen must conduct a Phase 4 confirmatory trial, while experts view this approval as a potential catalyst for developing more effective Alzheimer's treatments targeting multiple pathways.

FDA Approves Monjuvi in Combination with Lenalidomide for Relapsed/Refractory DLBCL

  • The FDA has approved Monjuvi (tafasitamab-cxix) in combination with lenalidomide as the first second-line treatment for adult patients with relapsed or refractory diffuse large B-cell lymphoma who are not eligible for autologous stem cell transplant.
  • The approval was based on the Phase 2 L-MIND study, which demonstrated a 55% overall response rate with a 37% complete response rate and median duration of response of 21.7 months.
  • Approximately 10,000 patients are diagnosed annually in the United States with relapsed or refractory DLBCL who are not eligible for stem cell transplant, representing a significant unmet medical need.
  • Monjuvi is a humanized CD19-targeting monoclonal antibody that received accelerated approval and will be co-commercialized by MorphoSys and Incyte in the United States.

Pertuzumab Regimen Shows Modest Survival Benefit in HER2-Positive Early Breast Cancer

• The APHINITY trial's 6-year analysis reveals that adjuvant pertuzumab with trastuzumab plus chemotherapy improved overall survival by 0.9% in HER2-positive early breast cancer patients, though not reaching statistical significance.
• Patients with node-positive disease showed the most significant benefit from the pertuzumab regimen, with a 4.5% absolute improvement in invasive disease-free survival at 6 years compared to placebo.
• The pertuzumab combination maintained a favorable cardiac safety profile with severe cardiac events occurring in less than 1% of patients, supporting its continued use in high-risk HER2-positive early breast cancer.

European Regulators Approve Lenacapavir, First Twice-Yearly HIV Prevention Injection

  • The European Medicines Agency's advisory committee issued a positive opinion on lenacapavir for pre-exposure prophylaxis, marking the final regulatory hurdle before formal approval by the European Commission.
  • Lenacapavir demonstrated 100% efficacy in preventing HIV transmission during clinical trials, offering a twice-yearly injection alternative to daily prevention pills.
  • The approval comes as HIV cases rose 11.8% in Europe in 2023, with over 24,700 new diagnoses across the EU, Iceland, Liechtenstein, and Norway.
  • Gilead Sciences has committed to making generic versions available in 120 low-income countries, though concerns remain about equitable global access.

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