Chugai's Alecensa Receives Breakthrough Therapy Designation from FDA

Chugai Pharmaceutical Co., Ltd. (TOKYO:4519) announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation (BTD) for the first-line treatment of ALK positive non-small cell lung cancer (NSCLC) to Alecensa^®, a highly selective ALK inhibitor created by Chugai. Alecensa^® is approved in Japan and in the United States, and filed in Europe by Roche.
“We are pleased that Alecensa has received Breakthrough Therapy
Designation for the second time, which also marks the fourth BTD for
Chugai originated drugs,” said Dr. Yasushi Ito, Chugai’s Senior Vice
President, Head of Project & Lifecycle Management Unit. “This
designation underscores that the medical value of Alecensa is highly
appreciated, and that the drug has great potential to the treatment of
ALK positive NSCLC.”
This designation is based on the J-ALEX study, conducted by Chugai,
which is an open-label, randomized phase III study that compares the
efficacy and safety between Alecensa and crizotinib. The J-ALEX study
enrolled 207 ALK-inhibitor naïve patients with ALK fusion gene
positive advanced or recurrent NSCLC, who had not undergone chemotherapy
or had undergone one chemotherapy regimen. The subjects were allocated
to either the Alecensa arm or the crizotinib arm in a one to one ratio.
The primary endpoint of the J-ALEX study was progression free survival
(PFS) as assessed by a blinded independent review board. The secondary
endpoints included overall survival, objective response rate and safety.
In February 2016, an independent data monitoring committee recommended
to discontinue the J-ALEX study early for benefit based on the results
of the predetermined interim analysis which was examined by the
committee.
The PFS hazard ratio of the Alecensa arm to the crizotinib arm was 0.34,
and Alecensa demonstrated significantly prolonged PFS (99.6826% CI:
0.17-0.70, stratified log-rank p<0.0001). Median PFS was not reached
(95% CI: 20.3-Not reached) in the Alecensa arm while it was 10.2 months
(95%CI: 8.2-12.0) in the crizotinib arm. In the Alecensa arm,
constipation was an adverse event (AE) with >30% frequency, while in the
crizotinib arm nausea, diarrhea, vomiting, visual disturbance,
dysgeusia, constipation, ALT elevation and AST elevation were observed
in >30% patients. Grade 3-4 AEs occurred in 27% of the Alecensa arm and
in 51% of the crizotinib arm, with no treatment-related deaths in both
arms.
This is the fourth Breakthrough Therapy Designation for Chugai
originated drugs following Alecensa (ALK positive, metastatic NSCLC in
patients who have progressed on or those who are intolerant to
crizotinib), Actemra (systemic sclerosis), and emicizumab (prophylactic
treatment for 12 years or older patients with hemophilia A with factor
VIII inhibitors).
Based on Chugai’s business philosophy of “Innovation all for the
patients,” Chugai will collaborate with Roche and Genentech to receive
approval for the early use of Alecensa in a number of countries around
the world.
About Breakthrough Therapy Designation
The Breakthrough
Therapy Designation was adopted as part of the FDA Safety and Innovation
Act (FDASIA) enacted in July 2012 aiming at expediting the development
and review of drugs for the treatment of severe or life-threatening
diseases or symptoms. In order to grant Breakthrough Therapy
Designation, preliminary clinical evidence is required demonstrating
that the drug may have substantial improvement on at least one
clinically significant endpoint over existing therapies. Breakthrough
Therapy Designation includes the features of a Fast Track designation,
with the addition of intensive guidance on efficient drug development as
well organizational commitment from FDA.
About Alecensa
Alecensa is a highly selective ALK inhibitor
discovered by Chugai. It has been reported that 2 to 5 percent of
patients with NSCLC express a chromosomal rearrangement which leads to
fusion of the ALK gene with another gene.¹⁾ ALK kinase
signalling is constantly active in cells with such fusion genes,
resulting in uncontrolled growth of tumor cells and transforming the
cells into tumor cells.^{2, 3)} Alecensa exerts its anti-tumor
effect by selectively inhibiting ALK kinase activity to inhibit tumor
cell proliferation and induce cell death.⁴⁾ In addition,
Alecensa is not recognized by the transporter proteins in the blood
brain barrier that actively pump molecules out of the brain. Alecensa is
active in the central nervous system and has proven activity against
brain metastases.
In Japan, Alecensa is available to patients with “ALK fusion gene
positive unresectable, recurrent/advanced NSCLC” and is marketed by
Chugai. In the US, Alecensa was approved in December 2015 for the
indication of “ALK positive, metastatic NSCLC in patients who have
progressed on or those who are intolerant to crizotinib.” In September
2015, Roche filed the MAA in Europe to the European Medicines Agency for
the approval of “ALK fusion gene positive unresectable,
recurrent/advanced NSCLC.”

About Chugai
Chugai Pharmaceutical is one of Japan’s leading
research-based pharmaceutical companies with strengths in biotechnology
products. Chugai, based in Tokyo, specializes in prescription
pharmaceuticals and is listed on the 1st section of the Tokyo Stock
Exchange. As an important member of the Roche Group, Chugai is actively
involved in R&D activities in Japan and abroad. Specifically, Chugai is
working to develop innovative products which may satisfy the unmet
medical needs, mainly focusing on the oncology area.
In Japan,
Chugai’s research facilities in Gotemba and Kamakura are collaborating
to develop new pharmaceuticals and laboratories in Ukima are conducting
research for technology development for industrial production. Overseas, Chugai
Pharmabody Research based in Singapore is engaged in research
focusing on the generation of novel antibody drugs by utilizing Chugai’s
proprietary innovative antibody engineering technologies. Chugai
Pharma USA and Chugai
Pharma Europe are engaged in clinical development activities in the
United States and Europe.
The consolidated revenue in 2015 of
Chugai totalled 498.8 billion yen and the operating income was 90.7
billion yen (IFRS Core basis).
Additional information is available
on the internet at https://www.chugai-pharm.co.jp/english.