Hot oncology drugs that may receive approval in 2009

There are a number of interesting cancer drugs in development that may receive approval this year.  Many of them are from biotech rather than pharma and focused on niche indications.

First up is Genzyme's Clolar (clofarabine), which was filed as a supplemental application in the US on November 24th with a request for priority approval in adult acute myeloid leukemia (AML).  Clolar is already approved for use in relapsed and refractory ALL in both the US and EU.  Data in elderly AML was also presented at the recent American Society of Hematology (ASH) meeting, with unprecedented response rates in a notoriously hard to treat group with a poor prognosis.  No doubt that data will be used to support the initial filing in the over 60 yo patients.

Another exciting compound is pralatrexate from Allos Therapeutics, which is being investigated in peripheral T-cell lymphoma (PTCL), a form of Non-Hodgkins Lymphoma (NHL).  It is also being tested in other cancers including cutaneous T-cell lymphoma (CTCL), NHL, non-small cell lung cancer (NSCLC) and transitory clear cell carcinomas of the bladder.  Pralatrexate has received orphan drug designation and fast track designation in the U.S. for the treatment of patients with T-cell lymphoma and orphan medicinal product designation in Europe for the treatment of PTCL. There are currently no FDA-approved agents for patients with PTCL, either in the first-line or relapsed or refractory setting. Filing is expected in the first half of 2009 in the US, with possible approval within six months, if
successful.

Both PTCL and CTCL are relatively uncommon and yet several companies are fighting a tight battle to gain early entrance to the markets and also for efficacy data.  Another drug being developed in this area is romidepsin from Gloucester Pharmaceuticals.  Post ASH, it looks as if Allos may have the advantage in PTCL and Gloucester in CTCL.  The two drugs have very different mechanisms of actions, which makes it more interesting.  Romidepsin is an HDAC inhibitor, while pralatrexate is an anti-folate compound.

Novartis' Afinitor (everlimus, RAD001) has already been submitted to the FDA for approval in renal cell cancer.  The initial indication is expected to be in patients who have failed Pfizer's Sutent or Bayer's Nexavar, but may well turn out to be the treatment of choice given the proof of concept shown by another mTor inhibitor in that cancer, Torisel from Wyeth.  Incidently, if the Wy-Pfi merger goes ahead, the company may be forced to choose from either Sutent or Torisel, given the overlap in the cancer type.

Last November, Ortho Biotech submitted a BLA for trabectedin when administered in combination with Doxil (doxorubicin HCl liposome injection) for the treatment of women with relapsed ovarian cancer (ROC). If approved, trabectedin combined with Doxil will provide a new, non-platinum treatment option for these patients in the United States.

Meanwhile, GSK are seeking an NDA for their PDGF inhibitor, pazopanib in for renal cell cancer in the US and EU, and a BLA in both the US and Europe for Arzerra (ofatumumab), a CD20 monoclonal antibody in co-development with Genmab for relapsed, refractory CLL. 

December was a busy month for submissions as Amgen also submitted a BLA denosumab, an investigational RANK Ligand inhibitor. The indications for which Amgen is seeking FDA approval are treatment and prevention of postmenopausal osteoporosis (PMO) in women, and treatment and prevention of bone loss in patients undergoing hormone ablation for either prostate or breast cancer. The BLA submission contained data from six Phase 3 trials involving more than 11,000 patients.

All in all, many of these agents may receive fast track or priority designation from the FDA, so we may well see several new cancer drugs on the market for a wide range of tumours by the year end.  It's a fascinating time in the oncology arena and there may be other cancer drugs that I've missed.  If so, please add them in the comments so we can track them.

 

Comments

[rose woodward]

Dear Sally,

You say in todays blog about drugs for renal cancer -

"The initial indication ( for Afinitor) is expected to be in patients who have failed Pfizer's Sutent or Bayer's Nexavar,"

I wonder could I just put a patient perspective on your use of words.....could I suggest the insertion of the words " been" & "by" into this sentence.....

The initial indication ( for Afinitor) is expected to be in patients who have been failed by Pfizer's Sutent or Bayer's Nexavar,

It may seem a small thing but it is important distinction to cancer patients ; it is the drug which has failed the patient because, for whatever reason, it did not get the anticipated response rather than the patient who has failed the drug?

Thanks so much for the blog - I find your insights really valuable.

Rose Woodward

The Fight for Life Campaign - Cancer Patients, Survivors & Carers helping each other.
www.kidneycancersupportnetwork.co.uk

[Jonathan Richman]

Sally, since you asked for comments on Twitter, I figured I'd give my two cents. I agree with Rose here. The wording is subtle but makes a big difference. I used to do marketing for oncology products (mainly breast cancer) and we corrected anyone who said "the patient failed on x" for the very reasons Rose points out.

We didn't use the "failed by" terminology here as recommended by Rose, as I think this gives the drugs a bit too much personification. Rather, something like "indicated where Sutent failed" was/is the way to go.

[MaverickNY]

Rose, good point indeed and the subtle difference is one I should have remembered from my marketing days and hearing Oncologists scolded by patients. My apologies.

Perhaps 'failed by' would be a little strong though, as sometimes it is the side effects that one patient finds intolerable but another does not.

The wording could have been a little more sensitive though, I agree.

[MaverickNY]

Thanks, Jon. That's a good compromise and one that would work for me... the drug failed to work not the patient.

Right now, I'm recalling the look of utter horror on a Hematologists face after he made the same mistake I did :(

[Antibody]

Thanks for share.