Daratumumab FDA Application And Review Process Starts

The potential new myeloma therapy daratumumab just got a little closer to being available to U.S. multiple myeloma patients outside of clinical trials.
Johnson and Johnson (NYSE:JNJ) announced today that its Janssen subsidiary has started the process of applying to the U.S. Food and Drug Administration (FDA) to have daratumumab approved as a new treatment for relapsed multiple myeloma.
In particular, Johnson and Johnson has started a rolling submission of a biologics license application to the FDA for daratumumab.
A rolling submission allows Johnson and Jonson to submit completed portions of its application to the FDA on an ongoing basis. The FDA allows this application submission process in special situations where it believes a drug can be of significant benefit to patients who would be treated with it. Normally, the FDA requires companies to submit approval applications that are complete in their entirety at the time of submission.
Daratumumab was granted breakthrough therapy designation by the FDA in 2013 (see related Beacon news). Breakthrough therapy designation is designed to accelerate the development and review process for drugs intended to treat serious or life-threatening illnesses.
Johnson and Johnson has not provided any guidance thus far on how long it expects it will take for the company to complete the submission of daratumumab’s approval application. In addition, because daratumumab has been designated as a breakthrough therapy, it is difficult to predict how long the FDA will take to complete its review of daratumumab’s application, once all of it has been submitted.
That said, The Beacon currently estimates that the entire process will take until sometime during the first quarter of next year – that is, an FDA decision on daratumumab’s application for approval can be expected by March 31, 2016. (This estimated timeline was developed with input from research analyst Mark Schoenebaum and his colleagues at the investment banking advisory firm Evercore ISI.)
Johnson and Johnson is applying to have daratumumab approved as a treatment for patients with multiple myeloma who have received at least three prior lines of therapy, including both a proteasome inhibitor and an immunomodulatory agent, or who are double resistant (refractory) to a proteasome inhibitor and an immunomodulatory agent.
The submission includes data from the so-called Sirius MMY2002 trial, a Phase 2 study of daratumumab that includes multiple myeloma patients who received at least three prior lines of therapy, including both a proteasome inhibitor and an immunomodulatory agent, or who are double refractory to a proteasome inhibitor and an immunomodulatory agent.
The results of that study were presented earlier this week at the annual meeting of the American Society of Clinical Oncology (ASCO). The results show that nearly one third of the trial participants – who had received a median of five prior therapies – responded to single-agent daratumumab. The median time to disease progression was 3.7 months, and the estimated one-year overall survival rate was 65 percent (see related Beacon news).
Because patients in the trial were heavily pretreated, and because they received only single-agent daratumumab, myeloma specialists have been impressed by the efficacy (and safety) that daratumumab demonstrated during the trial.
Safety and efficacy data from another Phase 1/2 study, and safety data from three other clinical trials, also will be included in the daratumumab FDA application.
Daratumumab is a monoclonal antibody that binds to a protein known as CD38, which is commonly found on the surface of myeloma cells. Once bound to a myeloma cell, daratumumab then attacks the cell while also signaling the patient's immune system to act against the cells.
Two other CD38 monoclonal antibodies are also under development as potential myeloma therapies: SAR650984 and MOR202. In addition, elotuzumab, a monoclonal antibody that targets a different protein found on myeloma cells, is also being investigated as a potential myeloma therapy.
Johnson & Johnson is developing daratumumab in collaboration with the Danish biotechnology company Genmab. The drug is currently being tested in a number of multiple myeloma clinical trials, involving both newly diagnosed and relapsed patients.
For more information, please see the Johnson & Johnson and Genmab press releases.
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I am a multiple myeloma patient and would like to find out more about this drug, or be in the trial.
In routine clinical practice, how to define proteasome inhibitor resistant and immunomodulatory agent resistant? Where should we place carfizomib in treatment?
Vorrei saperne di più: Va bene per pazienti recidevari / immunoresistenti? Che requisiti sono richiesti per entrare nel programma? Ed è possibile anche in Italia? Mi sembra di capire che è una terapia alternativa a carfilzomib.
Grazie,
EV
(English translation: I would like to learn more. Is it okay for patients who are relapsed / immunoresistant? What requirements are needed to get into the program? And is it also possible in Italy? I understand that is an alternative therapy to carfilzomib.)
Thank you for the comments, everyone.
Reuben - Our daratumumab topic page will show you all the articles we've published about the drug. For clinical trials in the United States that are open to myeloma patients and which are testing daratumumab, please go to this page at clinicaltrials.gov.
Dr. Ranjith - We suspect there are no hard and fast answers to your question, and it probably would be best to address to one or more myeloma specialists, to give you perspectives to allow you to form your own opinion on them.
Elisabetta - Thus far, daratumumab has been tested primarily in myeloma patients who are relapsed and/or refractory. The drug is not yet approved in any country, however, to be used to treat myeloma patients outside of clinical trials. Although there currently are daratumumab clinical trials in many European countries, including France, Austria, and Germany, we do not see any such trials currently listed as being open in Italy. This page would show daratumumab trials in Italy, if any were in the clinicaltrials.gov database. But there do not currently seem to be any. We suggest you contact the offices of Janssen, the company developing daratumumab, in Italy to double check if any daratumumab trials are open in Italy. This link has their contact information.
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