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Amgen Receives CHMP Positive Opinions For Two New Treatment Options For Patients With Blood Cancer In Europe

By: Press Release Reporter; Published: September 25, 2015 @ 7:30 am | Comments Disabled

Pivotal Study Demonstrated Kyprolis® (Carfilzomib) in Combination With Standard of Care can Extend Time Patients Live Without Disease Progressing

BLINCYTO® (Blinatumomab) is First Bispecific T cell Engager (BiTE®) Antibody Construct to be Granted Positive CHMP Opinion

{{image}}Thousand Oaks, CA (Press Release) – Amgen (NASDAQ: AMGN) today announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted positive opinions recommending market­ing authori­za­tion for:

Kyprolis® (car­filz­o­mib) in com­bi­na­tion with lena­lido­mide and dex­a­meth­a­sone for the treat­ment of adult patients with multiple myeloma who have received at least one prior ther­apy, and

BLINCYTO® (blina­tumo­mab) as a con­di­tional market­ing authori­za­tion for the treat­ment of adults with Philadelphia chromosome-negative (Ph-) re­lapsed or refractory B-precursor acute lymphoblastic leukemia (ALL).

"We are pleased to receive positive CHMP opinions for Kyprolis and BLINCYTO as this is an im­por­tant step in providing new treat­ment options for patients in Europe with rare forms of cancer," said Sean E. Harper, M.D., exec­u­tive vice pres­i­dent of Research and Development at Amgen. "For patients with multiple myeloma, periods of remission become shorter fol­low­ing each new treat­ment regi­men, underscoring the need for addi­tional treat­ment options. The results of the ASPIRE study dem­onstrate that Kyprolis extended the time patients live without their disease progressing. Addi­tion­ally, there is a critical need for new ther­a­pies for patients with re­lapsed or refractory B-cell pre­cursor ALL."

Kyprolis is a pro­te­a­some inhibitor for use in the treat­ment of patients with re­lapsed multiple myeloma. Pro­tea­somes play an im­por­tant role in cell function and growth by breaking down proteins that are damaged or no longer needed. Kyprolis blocks pro­te­a­somes, which leads to an excessive build-up of proteins within cells. In some cells, Kyprolis can cause cell death, especially in myeloma cells be­cause they are more likely to con­tain a higher amount of ab­nor­mal proteins.

BLINCYTO is the first clin­i­cal val­i­da­tion of the bispecific T cell engager (BiTE®) plat­form, an inno­va­tive ap­proach that can help the body's own immune system fight cancer.

The CHMP positive opinions will now be reviewed by the European Com­mis­sion and if granted, the two prod­ucts will have market­ing authori­za­tion in the 28 member countries of the European Union (EU), as well as Iceland, Lichtenstein and Norway.

About Multiple Myeloma

Multiple myeloma is an incurable blood cancer, char­ac­ter­ized by a recurring pattern of remission and re­lapse. Multiple myeloma is an orphan disease and accounts for approx­i­mately 1 per­cent of all cancers1,2.

About Kyprolis® (car­filz­o­mib)

Kyprolis was granted orphan drug desig­na­tion by the EMA in 2008, and in February 2015, its Marketing Authorization Application (MAA) was granted accelerated assess­ment by the EMA. Kyprolis® (car­filz­o­mib) for Injection was approved as a mono­therapy in the U.S. in July 2012, and in com­bi­na­tion with lena­lido­mide and dex­a­meth­a­sone in July 2015. Kyprolis is also approved in Argentina, Israel, Kuwait, Mexico and Thailand.

Kyprolis is a prod­uct of Onyx Pharma­ceu­ticals, Inc. Onyx Pharma­ceu­ticals is a sub­sid­i­ary of Amgen and holds devel­op­ment and com­mer­cial­iza­tion rights to Kyprolis globally, excluding Japan.

For more in­­for­ma­tion about Kyprolis, visit www.kyprolis.com.

About Kyprolis European Marketing Authorization Application

The MAA was based on data from the Phase 3 ASPIRE (CArfilzomib, Lena­lido­mide, and Dexa­methaSone versus Lena­lido­mide and Dexa­meth­a­sone for the treat­ment of PatIents with Relapsed Multiple MyEloma) trial. The study showed that patients treated with Kyprolis in com­bi­na­tion with lena­lido­mide and dex­a­meth­a­sone (regimen referred to as KRd) had in­­creased median time to progressive disease (PD) or death by 8.7 months com­pared to patients treated with lena­lido­mide and dex­a­meth­a­sone (regimen referred to as Rd) (26.3 months for KRd com­pared to 17.6 months for Rd with HR=0.69; 95 per­cent CI: 0.57-0.83; 1-sided p<0.0001). Discontinuation of treat­ment due to adverse events (AEs) occurred in 15 per­cent of patients in the KRd arm versus 18 per­cent of patients in the Rd arm.

About ASPIRE

The inter­na­tional, ran­dom­ized Phase 3 ASPIRE trial eval­u­ated Kyprolis in com­bi­na­tion with lena­lido­mide and dex­a­meth­a­sone, versus lena­lido­mide and dex­a­meth­a­sone alone, in patients with re­lapsed multiple myeloma fol­low­ing treat­ment with one to three prior regi­mens. The pri­mary end­point of the trial was pro­gres­sion-free survival (PFS), defined as the time from ran­domization to disease pro­gres­sion or death due to any cause, whichever is earlier. The study showed that patients treated with Kyprolis in com­bi­na­tion with lena­lido­mide and low-dose dex­a­meth­a­sone had in­­creased median time to PD or death by 8.7 months com­pared to patients treated with lena­lido­mide and dex­a­meth­a­sone (26.3 months for KRd com­pared to 17.6 months for Rd with HR=0.69; 95 per­cent CI: 0.57-0.83; 1-sided p<0.0001). Secondary end­points in­cluded over­all survival (OS), over­all response rate (ORR), duration of response (DOR), disease control rate, health-related quality of life (HR-QoL) and safety. Patients were ran­dom­ized to receive Kyprolis (20 mg/m2 on days 1 and 2 of cycle one only, escalating to 27 mg/m2 sub­se­quently), in addi­tion to a standard dosing schedule of lena­lido­mide (25 mg per day for 21 days on, 7 days off) and dex­a­meth­a­sone (40 mg per week in 4 week cycles), versus lena­lido­mide and dex­a­meth­a­sone alone. In the Kyprolis arm, patients were given a 10 minute infusion on days 1, 2, 8, 9, 15 and 16. Kyprolis was omitted on days 8 and 9 during cycles 13-18 and not admin­istered beyond 18 cycles. The study ran­dom­ized 792 patients at sites in North America, Europe and Israel.

While the data for median OS are not yet mature based on the prespecified statistical boundary at the interim (1-sided p-value of smaller than 0.0051), the analysis showed a trend in favor of KRd com­pared with Rd (HR=0.79; 95 per­cent CI: 0.63-0.99; one-sided p=0.018, two-sided p=0.04). Patients con­tinue to be mon­i­tored for OS. The ORR was 87.1 per­cent with KRd and 66.7 per­cent with Rd. Median DOR was 28.6 months for patients receiving KRd (95 per­cent CI, 24.9 to 31.3 months) and 21.2 months for patients receiving Rd (95 per­cent CI, 16.7 to 25.8 months). In the KRd and Rd groups, 32 per­cent versus 9 per­cent of patients achieved a com­plete response or higher (stringent com­plete response [sCR] or com­plete response [CR]), a mea­sure­ment indicating depth of response.

The rate of deaths due to AEs within 30 days of the last dose was bal­anced be­tween the KRd arm and the Rd arm. The most common causes of death not due to PD occurring in patients in the KRd arm com­pared to the Rd arm in­cluded cardiac disorders (3 per­cent versus 2 per­cent), in­fec­tion (2 per­cent versus 3 per­cent), renal (0 per­cent versus less than 1 per­cent) and other AEs (2 per­cent versus 3 per­cent). Serious AEs were re­ported in 60 per­cent of the patients in the KRd arm and 54 per­cent of the patients in the Rd arm. The most common serious AEs re­ported in the KRd arm com­pared to the Rd arm were pneu­monia (14 per­cent versus 11 per­cent), res­pira­tory tract in­fec­tion (4 per­cent versus 2 per­cent), pyrexia (4 per­cent versus 2 per­cent) and pul­mo­nary embolism (3 per­cent versus 2 per­cent). Discontinuation of treat­ment due to AEs occurred in 15 per­cent of patients in the KRd arm versus 18 per­cent of patients in the Rd arm. AEs leading to dis­con­tinu­a­tion of Kyprolis occurred in 12 per­cent of patients and the most common events in­cluded pneu­monia (1 per­cent), myo­cardial infarction (1 per­cent) and upper res­pira­tory tract in­fec­tion (1 per­cent).

The ASPIRE data were presented at the 56th Annual Meeting of the American Society of Hematology and published in The New England Journal of Medicine in December 2014.3

About Acute Lymphoblastic Leukemia (ALL)

It is esti­mated that there are close to 600 adults with Ph- re­lapsed or refractory B-precursor ALL in France, Germany, Italy, Spain, and the U.K.4

About BLINCYTO® (blina­tumo­mab)

BLINCYTO is a bispecific CD19-directed CD3 T cell engager (BiTE®) anti­body con­struct that binds spe­cif­i­cally to CD19 expressed on the surface of cells of B-lineage origin and CD3 expressed on the surface of T cells.

BiTE® anti­body con­structs are a type of immuno­therapy being in­ves­ti­gated for fighting cancer by helping the body's immune system to detect and target malignant cells. The modified anti­bodies are designed to engage two dif­fer­en­t targets simultaneously, thereby juxtaposing T cells (a type of white blood cell capable of killing other cells perceived as threats) to cancer cells. BiTE® anti­body con­structs help place the T cells within reach of the targeted cell, with the intent of allow­ing T cells to inject toxins and trigger the cancer cell to die (apoptosis). BiTE® anti­body con­structs are cur­rently being in­ves­ti­gated for their poten­tial to treat a wide variety of cancers.

BLINCYTO was granted breakthrough ther­apy and priority review desig­na­tions by the U.S. Food and Drug Admin­istra­tion, and is now approved in the U.S. for the treat­ment of Ph- re­lapsed or refractory B-cell pre­cursor ALL. This in­di­ca­tion is approved under accelerated approval. Continued approval for this in­di­ca­tion may be contingent upon veri­fi­ca­tion of clin­i­cal benefit in sub­se­quent trials.

About BLINCYTO European Conditional Marketing Authorization Application

The CHMP recommended granting BLINCYTO a con­di­tional market­ing authori­za­tion for the treat­ment of adults with Ph- re­lapsed or refractory B-precursor ALL.

Conditional license requires the license to be renewed every year and it will be converted to full standard license once post-licensing commitments have been fulfilled. Amgen ex­pec­ts a de­ci­sion on the con­di­tional MAA from the European Com­mis­sion in the coming months.

The BLINCYTO con­di­tional market­ing authori­za­tion appli­ca­tion is based on results of the '211 and '206 trials. In the '211 study:

  • 42.9 per­cent of evaluable patients receiving BLINCYTO achieved complete remission or complete remission with partial hematological recovery (CR/CRh*).
  • 17 per­cent of patients underwent allogeneic hematopoietic stem cell transplantation (HSCT) in CR/CRh* induced with BLINCYTO
  • 82.2 per­cent of those who achieved CR/CRh* achieved deep molecular remission, or minimal residual disease (MRD) response, a measure of eradication of residual disease at the molecular level.

The most serious adverse reac­tions in­cluded: in­fec­tions (31.7 per­cent), neurologic events (16.4 per­cent), neu­tro­penia/febrile neu­tro­penia (15.3 per­cent), cytokine release syn­drome (0.5 per­cent) and tumor lysis syn­drome (0.5 per­cent).

About Study '211

Study '211 eval­u­ated blina­tumo­mab in an open-label, multi­center, single-arm Phase 2 study. Eligible patients were at least 18 years of age with Ph- re­lapsed or refractory B-precursor ALL. Relapsed or refractory was defined as re­lapsed with a first remission duration of less than or equal to 12 months in first salvage, or re­lapsed or refractory after the first salvage, or re­lapsed within 12 months of allo­geneic hema­to­poietic stem cell trans­plan­ta­tion (HSCT), and greater than or equal to 10 per­cent blasts in bone marrow. The pri­mary end­point was the CR/CRh* rate within two cycles of blina­tumo­mab. Of the 189 patients eval­u­ated in the trial, 42.9 per­cent (81/189; 95 per­cent CI, 35.7 – 50.2) achieved CR or CRh* within two cycles of treat­ment with blina­tumo­mab with the majority of responses (79 per­cent [64/81]) occurring within the first cycle of treat­ment. In a prespecified exploratory analysis, 82.2 per­cent (60/73) of MRD evaluable patients with CR/CRh* also had a MRD response. The most common adverse reac­tions (greater than 20 per­cent) were infusion-related reac­tions (67.2 per­cent), in­fec­tions (63 per­cent), pyrexia (59.8 per­cent), headache (34.4 per­cent), febrile neu­tro­penia (28 per­cent), periph­eral edema (25.9 per­cent), nausea (24.3 per­cent), hypokalemia (23.8 per­cent), con­sti­pa­tion (20.6 per­cent) and anemia (20.1 per­cent). The most serious adverse reac­tions that occurred during blina­tumo­mab treat­ment in­cluded: in­fec­tions (31.7 per­cent), neurologic events (16.4 per­cent), neu­tro­penia/febrile neu­tro­penia (15.3 per­cent), cytokine release syn­drome (0.5 per­cent) and tumor lysis syn­drome (0.5 per­cent).

About Study '206

Study '206 eval­u­ated the safety and efficacy of blina­tumo­mab in an open-label, multi­center, dose-escalation Phase 2 study of 36 patients, who were at least 18 years of age with B-precursor ALL re­lapsed after at least induction and consolidation or having refractory disease with greater than 5 per­cent blasts in bone marrow, had an Eastern Cooperative Oncology Group (ECOG) per­for­mance status of at most 2, had a life ex­pec­tancy of at least 12 weeks, and who did not have au­tol­o­gous HSCT within six weeks prior to start of treat­ment, allo­geneic HSCT within three months prior to start of treat­ment, or pre­vi­ous treat­ment with blina­tumo­mab.
The CR/CRh* rate was 69.4 per­cent (25/36) with 15 patients achieving CR (41.7 per­cent; 95 per­cent CI, 25.5 per­cent - 59.2 per­cent), and 10 patients achieving CRh* (27.8 per­cent; 95 per­cent CI, 14.2 per­cent - 45.2 per­cent). Of the patients with hema­to­logic CR, 88 per­cent (22/25) also had MRD responses. The median duration of remission was 8.9 months, and the median re­lapse-free survival (RFS) was 7.6 months. The median OS was 9.8 months. Overall safety results from this study were con­sis­tent with the known blina­tumo­mab safety profile.

Kyprolis U.S. Product Safety Information

Important Safety Information Regarding Kyprolis (car­filz­o­mib) for Injection U.S. Indication

This safety in­­for­ma­tion is specific to the current U.S. approved indi­ca­tion

Cardiac Toxicities
New onset or worsening of pre-existing cardiac failure (e.g., congestive heart failure, pul­mo­nary edema, and de­creased ejection fraction), restrictive car­dio­my­op­athy, myo­cardial ischemia, and myo­cardial infarction in­clud­ing fatalities have occurred fol­low­ing admin­istra­tion of Kyprolis. Death due to cardiac arrest has occurred within a day of Kyprolis admin­istra­tion.

Withhold Kyprolis for Grade 3 or 4 cardiac adverse events until re­cov­ery, and con­sider whether to restart Kyprolis based on a benefit / risk assess­ment.

Adequate hydration is required prior to each dose in Cycle 1. Monitor all patients for evi­dence of volume overload, especially patients at risk for cardiac failure. Adjust total fluid intake as clin­i­cally appro­pri­ate in patients with base­line cardiac failure or who are at risk for cardiac failure.Patients ≥ 75 years, the risk of cardiac failure is in­­creased. Patients with New York Heart Association Class III and IV heart failure, recent myo­cardial infarction, and conduction ab­nor­mal­i­ties may be at greater risk for cardiac com­pli­ca­tions.

Acute Renal Failure
Cases of acute renal failure and renal insufficiency adverse events (renal im­pair­ment, acute renal failure, and renal failure) have occurred in patients receiving Kyprolis. Acute renal failure was re­ported more frequently in patients with ad­vanced re­lapsed and refractory multiple myeloma who received Kyprolis mono­therapy. This risk was greater in patients with a base­line reduced esti­mated creatinine clearance. Monitor renal function with regular mea­sure­ment of the serum creatinine and/or esti­mated creatinine clearance. Reduce or withhold dose as appro­pri­ate.

Tumor Lysis Syndrome
Cases of Tumor Lysis Syndrome (TLS), in­clud­ing fatal out­comes, have occurred in patients receiving Kyprolis. Patients with multiple myeloma and a high tumor burden should be con­sidered at greater risk for TLS. Adequate hydration is required prior to each dose in Cycle 1, and in sub­se­quent cycles as needed. Consider uric acid lowering drugs in patients at risk for TLS. Monitor for evi­dence of TLS during treat­ment and man­age promptly. Withhold Kyprolis until TLS is resolved.

Pulmonary Toxicity
Acute Respiratory Distress Syndrome (ARDS), acute res­pira­tory failure, and acute diffuse in­fil­tra­tive pul­mo­nary disease such as pneu­monitis and interstitial lung disease have occurred in patients receiving Kyprolis. Some events have been fatal. In the event of drug-induced pul­mo­nary toxicity, dis­con­tinue Kyprolis.

Pulmonary Hypertension
Pulmonary arterial hyper­tension (PAH) was re­ported in patients treated with Kyprolis. Evaluate with cardiac imaging and/or other tests as indicated. Withhold Kyprolis for PAH until resolved or returned to base­line and con­sider whether to restart Kyprolis based on a benefit / risk assess­ment.

Dyspnea
Dyspnea was re­ported in patients treated with Kyprolis. Evaluate dyspnea to exclude car­dio­pul­mo­nary con­di­tions in­clud­ing cardiac failure and pul­mo­nary syn­dromes. Stop Kyprolis for Grade 3 or 4 dyspnea until resolved or returned to base­line. Consider whether to restart Kyprolis based on a benefit / risk assess­ment.

Hypertension
Hypertension, in­clud­ing hypertensive crisis and hypertensive emergency, has been observed with Kyprolis. Some of these events have been fatal. Monitor blood pressure regularly in all patients. If hyper­tension cannot be adequately controlled, withhold Kyprolis and eval­u­ate. Consider whether to restart Kyprolis based on a benefit / risk assess­ment.

Venous Thrombosis
Venous thrombo­embolic events (in­clud­ing deep venous thrombosis and pul­mo­nary embolism) have been observed with Kyprolis. Thrombo­pro­phy­laxis is recommended and should be based on an assess­ment of the patient's under­lying risks, treat­ment regi­men, and clin­i­cal status.

Infusion Reactions
Infusion reac­tions, in­clud­ing life-threatening reac­tions, have occurred in patients receiving Kyprolis. Symp­toms in­clude fever, chills, arthralgia, myalgia, facial flushing, facial edema, vomiting, weakness, shortness of breath, hypo­­tension, syncope, chest tightness, or angina. These reac­tions can occur immedi­ately fol­low­ing or up to 24 hours after admin­istra­tion of Kyprolis. Pre­medi­cate with dex­a­meth­a­sone to reduce the incidence and severity of infusion reac­tions. Inform patients of the risk and of symp­toms of an infusion reac­tion and to con­tact a physician im­medi­ately if they occur.

Thrombocytopenia
Kyprolis causes thrombo­cytopenia with re­cov­ery to base­line platelet count usually by the start of the next cycle. Thrombocytopenia was re­ported in patients receiving Kyprolis. Monitor platelet counts frequently during treat­ment with Kyprolis. Reduce or withhold dose as appro­pri­ate.

Hepatic Toxicity and Hepatic Failure
Cases of hepatic failure, in­clud­ing fatal cases, have been re­ported during treat­ment with Kyprolis. Kyprolis can cause in­­creased serum transaminases. Monitor liver enzymes regularly. Reduce or withhold dose as appro­pri­ate.

Thrombotic Thrombocytopenic Purpura /Hemolytic Uremic Syndrome (TTP/HUS)
Cases of TTP/HUS in­clud­ing fatal out­come have occurred in patients receiving Kyprolis. Monitor for signs and symp­toms of TTP/HUS. Discontinue Kyprolis if diag­nosis is sus­pected. If the diag­nosis of TTP/HUS is excluded, Kyprolis may be restarted. The safety of reinitiating Kyprolis ther­apy in patients pre­vi­ously experiencing TTP/HUS is not known.

Posterior Reversible Encephalopathy Syndrome (PRES)
Cases of PRES have occurred in patients receiving Kyprolis. PRES was formerly known as Reversible Posterior Leukoencephalopathy Syndrome. Consider a neuro-radiological imaging (MRI) for onset of visual or neurological symp­toms. Discontinue Kyprolis if PRES is sus­pected and eval­u­ate. The safety of reinitiating Kyprolis ther­apy in patients pre­vi­ously experiencing PRES is not known.

Embryo-fetal Toxicity
Kyprolis can cause fetal harm when admin­istered to a pregnant woman based on its mech­a­nism of action and findings in animals.

Females of reproductive poten­tial should be advised to avoid becoming pregnant while being treated with Kyprolis and the poten­tial hazard to the fetus if Kyprolis is used during pregnancy.

ADVERSE REACTIONS

The most common adverse events occurring in at least 20% of patients treated with Kyprolis in mono­therapy trials: anemia, fatigue, thrombo­cytopenia, nausea, pyrexia, de­creased platelets, dyspnea, diarrhea, de­creased lym­pho­cyte, headache, de­creased hemoglobin, cough, edema periph­eral.

The most common adverse events occurring in at least 20% of patients treated with Kyprolis in the com­bi­na­tion ther­apy trial: de­creased lym­pho­cytes, de­creased absolute neu­tro­phil count, de­creased phosphorus, anemia, neu­tro­penia, de­creased total white blood cell count, de­creased platelets, diarrhea, fatigue, thrombo­cytopenia, pyrexia, muscle spasm, cough, upper res­pira­tory tract in­fec­tion, de­creased hemoglobin, hypokalemia.

Full U.S. pre­scrib­ing in­­for­ma­tion is avail­able at www.kyprolis.com.

BLINCYTO U.S. Product Safety Information

Important Safety Information Regarding BLINCYTO® (blina­tumo­mab) U.S. Indication
This safety in­­for­ma­tion is specific to the current U.S. approved indi­ca­tion.

WARNING: CYTOKINE RELEASE SYNDROME and NEUROLOGICAL TOXICITIES

  • Cytokine Release Syndrome (CRS), which may be life-threatening or fatal, occurred in patients receiving BLINCYTO®. Interrupt or discontinue BLINCYTO® as recommended.
  • Neurological toxicities, which may be severe, life-threatening or fatal, occurred in patients receiving BLINCYTO®. Interrupt or discontinue BLINCYTO® as recommended.

Contraindications

BLINCYTO® is con­tra­in­di­cated in patients with a known hypersensitivity to blina­tumo­mab or to any component of the prod­uct formulation.

Warnings and Precautions

Cytokine Release Syndrome (CRS): Life-threatening or fatal CRS occurred in patients receiving BLINCYTO®. Infusion reac­tions have occurred and may be clin­i­cally indistinguishable from mani­fest­a­tions of CRS. Closely mon­i­tor patients for signs and symp­toms of serious events such as pyrexia, headache, nausea, asthenia, hypo­­tension, in­­creased alanine amino­trans­ferase (ALT), in­­creased aspartate amino­trans­ferase (AST), in­­creased total bilirubin (TBILI), disseminated intravascular coagulation (DIC), capillary leak syn­drome (CLS), and hemophagocytic lymphohistiocytosis/macrophage activation syn­drome (HLH/MAS). Inter­rupt or dis­con­tinue BLINCYTO® as outlined in the Prescribing Information (PI).

Neurological Toxicities: Approximately 50% of patients receiving BLINCYTO® in clin­i­cal trials ex­peri­enced neurological toxicities. Severe, life-threatening, or fatal neurological toxicities occurred in approx­i­mately 15% of patients, in­clud­ing encephalopathy, convulsions, speech disorders, disturbances in consciousness, con­fu­sion and disorientation, and coordination and bal­ance disorders. The median time to onset of any neurological toxicity was 7 days. Monitor patients for signs or symp­toms and in­ter­rupt or dis­con­tinue BLINCYTO® as outlined in the PI.

Infections: Approximately 25% of patients receiving BLINCYTO® experienced serious in­fec­tions, some of which were life-threatening or fatal. Administer pro­phy­lactic antibiotics and employ surveillance testing as appro­pri­ate during treat­ment. Monitor patients for signs or symp­toms of in­fec­tion and treat appro­pri­ately, in­clud­ing in­ter­ruption or dis­con­tinu­a­tion of BLINCYTO® as needed.

Tumor Lysis Syndrome (TLS): Life-threatening or fatal TLS has been observed. Preventive measures, in­clud­ing pretreatment nontoxic cytoreduction and on treat­ment hydration, should be used during BLINCYTO® treatment. Monitor patients for signs and symp­toms of TLS and in­ter­rupt or dis­con­tinue BLINCYTO® as needed to man­age these events.

Neutropenia and Febrile Neutropenia, in­clud­ing life-threatening cases, have been observed. Monitor appro­pri­ate laboratory parameters during BLINCYTO® infusion and in­ter­rupt BLINCYTO® if prolonged neu­tro­penia occurs.

Effects on Ability to Drive and Use Machines: Due to the possibility of neurological events, in­clud­ing seizures, patients receiving BLINCYTO® are at risk for loss of consciousness, and should be advised against driving and engaging in hazardous occupations or activities such as operating heavy or poten­tially dan­ger­ous machinery while BLINCYTO® is being admin­istered.

Elevated Liver Enzymes: Transient elevations in liver enzymes have been asso­ci­ated with BLINCYTO® treat­ment. The majority of these events were observed in the setting of CRS. The median time to onset was 15 days. Grade 3 or greater elevations in liver enzymes occurred in 6% of patients outside the setting of CRS and resulted in treat­ment dis­con­tinu­a­tion in less than 1% of patients. Monitor ALT, AST, gamma-glutamyl transferase (GGT), and TBILI prior to the start of and during BLINCYTO® treatment. BLINCYTO® treatment should be in­ter­rupted if transaminases rise to > 5 times the upper limit of normal (ULN) or if TBILI rises to > 3 times ULN.

Leukoencephalopathy: Although the clin­i­cal sig­nif­i­cance is unknown, cranial magnetic resonance imaging (MRI) changes showing leukoencephalopathy have been observed in patients receiving BLINCYTO®, especially in patients pre­vi­ously treated with cranial irradiation and anti-leukemic chemo­ther­apy. Preparation and admin­istra­tion errors have occurred with BLINCYTO® treatment. Follow instructions for preparation (in­clud­ing admixing) and admin­istra­tion in the PI strictly to minimize medication errors (in­clud­ing underdose and overdose).

Adverse Reactions

The most commonly re­ported adverse reac­tions (≥ 20%) in clin­i­cal trials were pyrexia (62%), headache (36%), periph­eral edema (25%), febrile neu­tro­penia (25%), nausea (25%), hypokalemia (23%), rash (21%), tremor (20%), diarrhea (20%) and con­sti­pa­tion (20%). Serious adverse reac­tions were re­ported in 65% of patients. The most common serious adverse reac­tions (≥ 2%) in­cluded febrile neu­tro­penia, pyrexia, pneu­monia, sepsis, neu­tro­penia, device-related in­fec­tion, tremor, encephalopathy, in­fec­tion, overdose, con­fu­sion, Staphylococcal bacteremia, and headache.

U.S. Dosage and Admin­istra­tion Guidelines

BLINCYTO® is admin­istered as a continuous in­tra­venous infusion at a constant flow rate using an infusion pump which should be pro­grammable, lockable, non-elastomeric, and have an alarm. It is very im­por­tant that the instructions for preparation (in­clud­ing admixing) and admin­istra­tion provided in the full Prescribing Information are strictly followed to minimize medication errors (in­clud­ing underdose and overdose). Please see full U.S. Prescribing Information and medication guide for BLINCYTO at www.BLINCYTO.com.

About Amgen

Amgen is committed to unlocking the poten­tial of biology for patients suffering from serious illnesses by discovering, devel­op­ing, manu­fac­tur­ing and delivering inno­va­tive human thera­peutics. This ap­proach begins by using tools like ad­vanced human genetics to unravel the complexities of disease and under­stand the fundamentals of human biology.

Amgen focuses on areas of high unmet medical need and leverages its biologics manu­fac­tur­ing expertise to strive for solu­tions that im­prove health out­comes and dramatically im­prove people's lives. A bio­technology pioneer since 1980, Amgen has grown to be one of the world's leading independent bio­technology com­panies, has reached millions of patients around the world and is devel­op­ing a pipe­line of medicines with break­away poten­tial.

For more in­­for­ma­tion, visit www.amgen.com and follow us on www.twitter.com/amgen.

Forward-Looking Statements

This news release con­tains forward-looking state­ments that are based on the current ex­pec­ta­tions and beliefs of Amgen Inc. and its sub­sid­i­aries (Amgen or us) and are subject to a number of risks, un­cer­tain­ties and assump­tions that could cause actual results to differ ma­teri­ally from those described. All state­ments, other than state­ments of historical fact, are state­ments that could be deemed forward-looking state­ments, in­clud­ing esti­mates of revenues, operating margins, capital ex­pen­di­tures, cash, other financial metrics, ex­pec­ted legal, arbitration, political, regu­la­tory or clin­i­cal results or practices, customer and prescriber patterns or practices, reim­burse­ment activities and out­comes and other such esti­mates and results. Forward-looking state­ments involve sig­nif­i­cant risks and un­cer­tain­ties, in­clud­ing those discussed below and more fully described in the Securities and Exchange Com­mis­sion (SEC) re­ports filed by Amgen Inc., in­clud­ing Amgen Inc.'s most recent annual re­port on Form 10-K and any sub­se­quent periodic re­ports on Form 10-Q and Form 8-K. Please refer to Amgen Inc.'s most recent Forms 10-K, 10-Q and 8-K for addi­tional in­­for­ma­tion on the un­cer­tain­ties and risk factors related to our business. Unless other­wise noted, Amgen is providing this in­­for­ma­tion as of Sept. 25, 2015, and expressly disclaims any duty to update in­­for­ma­tion con­tained in this news release.

No forward-looking state­ment can be guar­an­teed and actual results may differ ma­teri­ally from those we project. Discovery or identi­fi­ca­tion of new prod­uct can­di­dates or devel­op­ment of new indi­ca­tions for existing prod­ucts cannot be guar­an­teed and movement from concept to prod­uct is uncertain; consequently, there can be no guar­an­tee that any particular prod­uct can­di­date or devel­op­ment of a new indi­ca­tion for an existing prod­uct will be suc­cess­ful and become a commercial prod­uct. Further, pre­clin­i­cal results do not guar­an­tee safe and effective per­for­mance of prod­uct can­di­dates in humans. The complexity of the human body cannot be perfectly, or sometimes, even adequately modeled by computer or cell cul­ture systems or animal models. The length of time that it takes for us and our partners to com­plete clin­i­cal trials and obtain regu­la­tory approval for prod­uct market­ing has in the past varied and we ex­pec­t similar variability in the future. We develop prod­uct can­di­dates internally and through licensing col­lab­o­rations, part­ner­ships and joint ventures. Product can­di­dates that are derived from rela­tion­ships may be subject to disputes be­tween the parties or may prove to be not as effective or as safe as we may have believed at the time of entering into such rela­tion­ship. Also, we or others could identify safety, side effects or manu­fac­tur­ing problems with our prod­ucts after they are on the market. Our business may be impacted by gov­ern­ment in­ves­ti­ga­tions, litigation and prod­uct liability claims. If we fail to meet the compliance obli­ga­tions in the corporate integrity agree­ment be­tween us and the U.S. gov­ern­ment, we could become subject to sig­nif­i­cant sanctions. We depend on third parties for a sig­nif­i­cant portion of our manu­fac­tur­ing capacity for the supply of certain of our current and future prod­ucts and limits on supply may constrain sales of certain of our current prod­ucts and prod­uct can­di­date devel­op­ment.

In addi­tion, sales of our prod­ucts (in­clud­ing prod­ucts of our wholly-owned sub­sid­i­aries) are affected by the reim­burse­ment policies imposed by third-party payers, in­clud­ing gov­ern­ments, private insurance plans and man­aged care providers and may be affected by regu­la­tory, clin­i­cal and guideline devel­op­ments and domestic and inter­na­tional trends to­ward man­aged care and health­care cost con­tainment as well as U.S. legislation affecting pharma­ceu­tical pricing and reim­burse­ment. Government and others' reg­u­la­tions and reim­burse­ment policies may affect the devel­op­ment, usage and pricing of our prod­ucts. In addi­tion, we compete with other com­pa­nies with respect to some of our marketed prod­ucts as well as for the discovery and devel­op­ment of new prod­ucts. We believe that some of our newer prod­ucts, prod­uct can­di­dates or new indi­ca­tions for existing prod­ucts, may face com­pe­ti­tion when and as they are approved and marketed. Our prod­ucts may compete against prod­ucts that have lower prices, estab­lish­ed reim­burse­ment, superior per­for­mance, are easier to admin­ister, or that are other­wise competitive with our prod­ucts. In addi­tion, while Amgen and its partners routinely obtain patents for their prod­ucts and tech­nology, the protection of our prod­ucts offered by patents and patent appli­ca­tions may be chal­lenged, invalidated or circumvented by our or our partners' com­pet­i­tors and there can be no guar­an­tee of our or our partners' ability to obtain or main­tain patent protection for our prod­ucts or prod­uct can­di­dates. We cannot guar­an­tee that we will be able to produce commercially suc­cess­ful prod­ucts or main­tain the commercial success of our existing prod­ucts. Our stock price may be affected by actual or perceived market oppor­tu­ni­ty, competitive position, and success or failure of our prod­ucts or prod­uct can­di­dates. Further, the discovery of sig­nif­i­cant problems with a prod­uct similar to one of our prod­ucts that implicate an entire class of prod­ucts could have a ma­teri­al adverse effect on sales of the affected prod­ucts and on our business and results of operations. Our efforts to integrate the operations of com­pa­nies we have acquired may not be suc­cess­ful. We may ex­peri­ence dif­fi­culties, delays or unexpected costs and not achieve antic­i­pated benefits and savings from our ongoing restructuring plan. Our business per­for­mance could affect or limit the ability of our Board of Directors to declare a dividend or their ability to pay a dividend or repurchase our common stock.

The scientific in­­for­ma­tion discussed in this news release related to our prod­uct can­di­dates is limited to the European Union. Such prod­uct can­di­dates are not approved by the European Medicines Agency, and no conclusions can or should be drawn re­gard­ing the safety or effectiveness of the prod­uct can­di­dates.

References:

  1. GLOBCAN 2012, Global Prevalence and Incidence, available at http://globocan.iarc.fr/old/summary_table_pop_prev.asp?selection=224900&title=World&sex=0&window=1&sort=0&submit=%C2%A0Execute%C2%A0, accessed on March 9, 2015
  2. Palumbo A and Anderson K, Multiple myeloma, N Engl J Med, 2011;364:1046–60
  3. Stewart KA, Rajkumar VS, Dimopoulos MA, et al. Carfilzomib, Lenalidomide, and Dexamethasone for Relapsed Multiple Myeloma. N Engl J Med. 2015; 372:142-152.
  4. Katz AJ, et al. Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden. Cancer Causes Control. 2015;1-16. Retrieved from: http://link.springer.com/article/10.1007%2Fs10552-015-0657-6.

Source: Amgen.


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