AstraZeneca’s thyroid cancer drug gets CHMP nod

pharmafile | November 21, 2011 | News story | Sales and Marketing AstraZeneca, CHMP, Caprelsa, vandetanib 

AstraZeneca’s thyroid cancer pill Caprelsa has taken a step closer to European approval after being recommended by the CHMP.

Caprelsa (vandetanib) has received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) for the treatment of aggressive and symptomatic medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.

The European Commission will make the final decision as to whether the drug will be approved, and its verdict is expected in the next few months.

Advanced MTC is a rare cancer with a poor prognosis, and currently there are no approved therapies in Europe for this advanced stage of the disease.

But there was one snag: the drug may not be as beneficial in patients without, or are not known to have, a particular mutation – the Rearranged during Transfection (RET) mutation.

Around a quarter of all MTC cases are genetic in nature and caused by the mutation in the RET proto-oncogene.

AstraZeneca said that its clinical data shows that patients benefit from treatment with the drug regardless of their RET status but, in line with CHMP’s requirements, the firm said it would conduct a further study to confirm the benefits in patients who are RET-negative.

A pharmacovigilance plan for Caprelsa will be implemented as part of the marketing authorisation, the CHMP said, given its high number of common adverse events.

Caprelsa was first approved by the FDA and launched in April this year, making $4 million for AZ in the drug’s first two quarters and is expected to bring in $112 million a year by 2016, according to analysts.

This is a much lower prediction than the blockbuster figures touted last year when the drug was also being investigated for non-small cell lung cancer. The drug however failed to succeed in clinical trials involving this patient population.

For MTC however it has performed well in late-stage trials, and showed statistically significant improvements versus placebo, including six months additional progression-free survival.

Caprelsa is a once-daily oral treatment that uses two distinctive mechanisms of action: blocking the blood supply to the tumour by slowing the vascular endothelial growth factor receptor pathway and reducing the growth and survival of the tumour through epidermal growth factor receptor and RET pathways.

There are four types of thyroid cancer: papillary and follicular are the most common with anaplastic and medullary being less common.

Medullary thyroid occurs in around 3-5% of all thyroid cancers. It differs from papillary and follicular types as it does not arise from the thyroid cells themselves, but rather from the specialised C-cells that are in between the thyroid cells.

These C-cells are found mostly in the upper and middle parts of the thyroid and produce a substance called calcitonin that can serve as a marker for the progression of MTC.

Ben Adams

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