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Lu S, Qin S, Zhou Z, Chen J, Gu K, Sun P, Pan Y, Yu G, Ma K, Shi J, Sun Y, Yang L, Chen P, Liu A, He J. Bevacizumab biosimilar candidate TAB008 compared to Avastin ® in patients with locally advanced, metastatic EGFR wild-type non-squamous non-small cell lung cancer: a randomized, double-blind, multicenter study. J Cancer Res Clin Oncol 2023; 149:5907-5914. [PMID: 36595042 DOI: 10.1007/s00432-022-04563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Bevacizumab (Avastin®) is a monoclonal antibody targeting the vascular endothelial growth factor (VEGF). Used alone or in combination with chemotherapy and/or immunotherapy, Avastin® has shown promising efficacy in many cancers. This study compared the efficacy and safety of TAB008 with Avastin® sourced from the EU (bevacizumab-EU), in patients with non-squamous non-small cell lung cancer (nsNSCLC). METHOD In this randomized, double-blind, multicenter, phase III similarity study, treatment naïve for metastatic lung cancer., EGFR wild-type, locally advanced, metastatic, or recurrent non-squamous, non-small cell, lung cancer (nsNSCLC) patients were enrolled and randomized (1:1) into TAB008 or Avastin® groups. Patients received TAB008 or Avastin® 15 mg/kg intravenously plus paclitaxel/carboplatin for 4-6 cycles followed by TAB008 or Avastin® 7.5 mg/kg until disease progression, unacceptable toxicity or death. The primary endpoint compared the objective response rate (ORR) within 6 cycles as read by an independent radiological review committee (IRRC). Secondary endpoints compared disease control rate (DCR) Within 6 cycles, duration of response (DoR), progression-free survival (PFS), a year overall survival rate (OSR), overall survival (OS), safety, immunogenicity, and steady-state pharmacokinetics. RESULTS A total of 549 nsNSCLC patients were enrolled (277 in TAB008 group and 272 in Avastin® group). In the full analysis set, ORRs were 55.957% for TAB008 and 55.720% for Avastin®, and the ORR ratio was 1 (90% CI 0.89-1.14), well within the predefined equivalence margin of 0.75-1.33. No significant differences were found in DCR within 6 cycles (95.703% vs 95.367%, p = 0.8536), DoR (8.17 vs 7.3 months, p = 0.3526), PFS (9.10 vs. 7.97 months, p = 0.9457), 1 year overall survival rate (66.2% vs 68%, p = 0.6793), or OS (20.4 vs 17.6 months, p = 0.6549). Serious adverse events (SAEs) occurred in 37.55% (104/277) of patients in the TAB008 group and 34.32% (93/271) in the Avastin® group. Anti-drug antibodies were reported in 3 of 277 (1.08%) TAB008 patients, and 5 of 271 (1.85%) Avastin® patients, neutralizing antibody (Nab) was positive in 1 patient on Avastin®, which became negative upon follow-up. The steady-state trough concentrations (Cssmin) were 106.13 μg/mL in TAB008 group and 96.03 μg/mL in Avastin® groups, with the treatment group ratio of LS geometric means fully contained within the bioequivalence limits of 80.00-125.00% (90% CI was 101.74-120.05%). CONCLUSIONS TAB008 is similar to Avastin® in terms of efficacy, safety, and pharmacokinetic parameters, with comparable immunogenicity. TRIAL REGISTRATION ClinicalTrials.gov number; NCT05427305.
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Affiliation(s)
- S Lu
- Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - S Qin
- Cancer Center, Nanjing Jinling Hospital, Nanjing, China.
| | - Z Zhou
- Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - J Chen
- Oncology, Hunan Cancer Hospital, Changsha, China
| | - K Gu
- Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - P Sun
- Oncology, Yantai Yuhuangding Hospital, Yantai, China
| | - Y Pan
- Oncology, Anhui Provincial Hospital, Hefei, China
| | - G Yu
- Oncology, Weifang People's Hospital, Weifang, China
| | - K Ma
- Oncology, Jilin University First Hospital, Jilin, China
| | - J Shi
- Oncology, Linyi Cancer Hospital, Linyi, China
| | - Y Sun
- Oncology, Jinan Central Hospital, Jinan, China
| | - L Yang
- Cancer Center, Nanjing Jinling Hospital, Nanjing, China
| | - P Chen
- Oncology, Yancheng First People's Hospital, Yancheng, China
| | - A Liu
- Oncology, Nanchang University Second Affiliated Hospital, Nanchang, China
| | - J He
- Statistics, The Second Military Medical University, Shanghai, China
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Na H, Kwon SH, Son KH, Baek Y, Kim J, Lee EK. Comparative Safety Profiles of Oncology Biosimilars: A Systematic Review and Network Meta-analysis. BioDrugs 2023; 37:205-218. [PMID: 36729329 DOI: 10.1007/s40259-023-00576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND It is crucial that the safety profiles of biosimilars are similar to those of the original biologics. A better understanding of biosimilars and their relative safety and immunogenicity profiles are required for healthcare providers to prescribe them to patients with life-threatening cancer diseases who receive chemotherapies with potentially serious adverse events (AEs). OBJECTIVES The purpose of this study was to collate and analyze currently available safety and immunogenicity outcomes of biosimilars used in oncology and compare their safety information with those of the original biologics. METHODS The MEDLINE and Cochrane Library databases were searched as at 28 February 2022. Four anti-cancer biosimilar molecules were considered: bevacizumab, trastuzumab, rituximab, and (peg)filgrastim. Through a systematic review, we selected the randomized controlled trials (RCTs) comparing safety outcomes between the biosimilars and original biologics of the four molecules. As safety outcomes, various treatment-emergent adverse events (TEAEs) were collated, such as any TEAE, serious AE, and TEAE higher than grade 3. A risk ratio (RR) per category of TEAE was estimated through a meta-analysis. A network meta-analysis (NMA) was also conducted to compare the safety among the biosimilar brands for TEAEs over 25% with higher variability in addition to the serious AE cases. RESULTS Forty-nine RCTs were identified. The results from the meta-analysis showed that the safety and immunogenicity profiles of all four biosimilar molecules are comparable with that of the original biologics at the TEAE level without statistically significant differences, except for diarrhea for (peg)filgrastim. The incidence of diarrhea with (peg)filgrastim was less than that with the original biologic (RR 0.66, 95% confidence interval 0.50-0.89). The NMA results showed similar safety profiles among the biosimilar brands for all four biosimilar molecules, except for the serious adverse event of a trastuzumab biosimilar (RR 0.296, 95% credible interval 0.109-0.840). CONCLUSION The meta-analysis and NMA for all four biosimilars showed that the safety and immunogenicity profiles of biosimilar products in oncology are generally comparable with that of the original biologics at the TEAE level. However, additional evidence needs to be collected since several TEAEs of specific biosimilars were out of the equivalent range. The results of this study provide comparative safety information and a better understanding of oncology biosimilars for healthcare providers to prescribe them to patients.
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Affiliation(s)
- HyeJung Na
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea
| | - Sun-Hong Kwon
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea.
| | - Kyung-Hwa Son
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea
| | - Youngsuk Baek
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea
| | - Jiye Kim
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea
| | - Eui-Kyung Lee
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, Republic of Korea.
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Shi Y. Landscape of the clinical development of China innovative anti-lung cancer drugs. CANCER PATHOGENESIS AND THERAPY 2023; 1:67-75. [PMID: 38328605 PMCID: PMC10846302 DOI: 10.1016/j.cpt.2022.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/18/2022] [Accepted: 10/08/2022] [Indexed: 02/09/2024]
Abstract
Even today, lung cancer remains one of the most frequently diagnosed cancers and the leading cause of cancer-related deaths worldwide. Throughout the past decades, remarkable advances have been made in the research and development of anti-lung cancer drugs in China. Since the first registered Chinese clinical trial on May 2, 2006, many potent anti-lung cancer drugs have been developed and approved by the China Food and Drug Administration and the National Medical Product Administration of China. Among them, the most advance were observed in the development of targeted agents and immunotherapeutic agents such as epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) icotinib, aumolertinib, and furmonertinib, anaplastic lymphoma kinase (ALK)-TKI ensartinib, programmed cell death-1 (PD-1) monoclonal antibodies (mAbs) camrelizumab, sintilimab, and tislelizumab, and programmed cell death-ligand 1 (PD-L1) mAb sugemalimab, which have made huge breakthrough in recent years. Some other investigational innovative drug also demonstrated promising efficacy and acceptable safety profiles. Results from clinical studies on these China innovative drugs have led to changes in clinical practice guidelines and considerably improved the outcomes for patients with lung cancer. Thus, in this review, we aim to provide further insight into the clinical development and achievement of China innovative anti-lung cancer drugs.
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Affiliation(s)
- Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
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Chen Z, Wang Y, Yang J, Zhou H, Li G. Real-world use of IBI305, a bevacizumab biosimilar, in a tertiary caner-specialized hospital in China. J Clin Pharm Ther 2022; 47:2274-2278. [PMID: 36418209 DOI: 10.1111/jcpt.13809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/07/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE To investigate and describe the real-world use of IBI305, a biosimilar of bevacizumab, across all approved indications in the first 12 months since its entry in National cancer center of China. METHODS A retrospective, observational study was carried out to describe the demographic and patient characteristics and treatment patterns of the adult patients who received IBI305 from December 2020 to December 2021. RESULTS AND DISCUSSION Among 259 cases, 186 patients were non-small cell lung cancer (NSCLC), 86 patients were metastatic colorectal cancer (mCRC), five patients were hepatocellular carcinoma (HCC). More than half of the patients initiated IBI305 were bevacizumab-naive. In patients with NSCLC and mCRC, more than 40% of them received IBI305 as first-line therapy. Among pre-exposed patients, the majority of them were switched from reference product (RP) or other biosimilars to IBI305 within 28 days. WHAT IS NEW AND CONCLUSION Early evidence from real world data suggests rapid clinical adoption of IBI305 in all approved tumour types.
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Affiliation(s)
- Zhe Chen
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanting Wang
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Yang
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyan Zhou
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guohui Li
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Liang X, Liu Q, Yao W, Zhu S. Encouraging efficacy of a comprehensive therapy consisting of sintilimab, bevacizumab biosimilar IBI305, hypo-fractionated intensity-modulated radiotherapy, and oxaliplatin for a maxillary metastasis from hepatocellular carcinoma: A case report and literature review. Front Oncol 2022; 12:941454. [PMID: 36505782 PMCID: PMC9727184 DOI: 10.3389/fonc.2022.941454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Oro-maxillo-facial metastasis from hepatocellular carcinoma (HCC) is very rare, and reports on treating maxillary metastasis from HCC are unavailable. Anti-angiogenesis therapy combined with immunotherapy represented by programmed cell death 1 (PD-1) or its ligand (PD-L1) inhibitor has become the standard treatment of advanced HCC. However, integrating chemoradiotherapy into immunotherapy-bevacizumab combination therapy has not been reported. Here, we presented a Chinese woman with maxillary metastasis from HCC who achieved a nearly complete response (CR) to a quadruple treatment scheme consisting of a PD-1 monoclonal antibody (sintilimab), bevacizumab biosimilar IBI305, hypo-fractionated intensity-modulated radiotherapy (hfIMRT), and concurrent oxaliplatin. This comprehensive treatment is an innovative and effective therapy for advanced HCC.
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Affiliation(s)
- Xuexia Liang
- Department of Cancer Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,Guangdong Provincial Key Laboratory of Biomedical Imaging, Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,*Correspondence: Xuexia Liang,
| | - Qiaodan Liu
- Department of Cancer Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wei Yao
- Department of Cancer Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shuqin Zhu
- Department of Pathology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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6
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Yang L, Liu M, Cao X, Li N, Zheng B, Deng J, Cai H. Efficacy and safety of adding bevacizumab biosimilar or original drug to platinum-based chemotherapy as first-line treatment in patients with advanced NSCLC: a systematic review and meta-analysis. Ther Adv Med Oncol 2022; 14:17588359221130501. [PMID: 36312816 PMCID: PMC9597053 DOI: 10.1177/17588359221130501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The role of bevacizumab combined with paclitaxel and carboplatin in the first-line treatment of advanced non-squamous non-small-cell lung cancer (NSCLC) has been supported by a large number of data. However, whether bevacizumab biosimilars have the same efficacy and safety as the original drug is still controversial. This meta-analysis was designed to evaluate whether bevacizumab biosimilars have the same clinical efficacy and safety as the original drug in patients with advanced non-squamous NSCLC. Methods Electronic databases (PubMed, Embase, Cochrane, CNKI, Wanfang, and VIP) and the ClinicalTrail.gov website were extensively searched using relevant search criteria. We included phase III randomized controlled trials (RCTs) to compare the efficacy and safety of marketed biosimilars and Avastin in the first-line treatment of patients with advanced NSCLC. The risk of bias of the included studies was assessed using the RoB 2 assessment scale, and the RevMan 5.4 statistical software was used for meta-analysis. Results A total of 6360 patients were included in 11 RCTs. There was no statistical difference between the experimental group and the control group in terms of effectiveness [objective response rate (at week 18), disease control rate (at week 18), median duration of response, median progression-free survival, median overall survival (OS), and OS after 12 months]. In terms of safety [treatment-emergent adverse events (grade ⩾3) and treatment-related adverse events (grade ⩾3)], there was also no significant difference between biosimilars and Avastin. Conclusions The efficacy and safety of bevacizumab biosimilars in the treatment of advanced non-squamous NSCLC are highly similar to those of the original drug combined with paclitaxel and carboplatin, respectively.
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Affiliation(s)
| | | | - Xueqiong Cao
- Fujian Medical University Union Hospital,
Fuzhou, China,Fujian Medical University, Fuzhou, China
| | - Na Li
- Fujian Medical University Union Hospital,
Fuzhou, China,Fujian Medical University, Fuzhou, China
| | - Bin Zheng
- Fujian Medical University Union Hospital,
Fuzhou, China,Fujian Medical University, Fuzhou, China
| | - Jianhao Deng
- The Second Hospital of Longyan, Longyan,
Fujian, China
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7
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Meng X, Chen Y, Xing L, Liu X, Zhao K, Jiang L, Zhang L, Zhou C, Yu J. PD-1 inhibitor plus chemotherapy versus bevacizumab plus chemotherapy in patients with advanced non-squamous non-small-cell lung cancer: a pooled analysis of three randomised trials. BMJ Open Respir Res 2022. [PMCID: PMC9472163 DOI: 10.1136/bmjresp-2022-001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background To date, none of randomised trials aim to compare the efficacy of programmed death 1 (PD-1) inhibitor plus chemotherapy and bevacizumab plus chemotherapy as first-line treatment for non-squamous non-small-cell lung cancer (NSCLC). This analysis pooled prospective data to compare the survival benefits of the two regimens for advanced NSCLC without targetable genetic mutations. Methods Data were pooled from three randomised phase III clinical trials: NCT03607539, NCT03134872 and NCT02954172. 466 patients received PD-1 inhibitor (200 mg) plus pemetrexed (500 mg/m²) and platinum (cisplatin 75 mg/m2 or carboplatin area under the curve (AUC) 5 mg/mL/min), while 432 patients received bevacizumab (15 mg/kg) plus paclitaxel (175 mg/m2) and carboplatin (AUC 6 mg/mL/min). Propensity score matching in a 1:1 ratio was performed to balance baseline characteristics of the two arms. The endpoints of this analysis were progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). Results In total, 375 patients in each arm were matched. With a median follow-up of 23 months (IQR 21–26), results showed that median PFS was significantly prolonged in the PD-1 inhibitor arm than in the bevacizumab arm (10.1 vs 7.4 months; HR 0.62, 95% CI 0.52 to 0.73, p<0.001). Improved OS was also demonstrated in the PD-1 inhibitor arm (27.9 vs 20.2 months; HR 0.75 95% CI 0.61 to 0.91, p=0.004). ORR in the PD-1 inhibitor arm was 56.8%, while that in the bevacizumab arm was 45.1%. However, exploratory subgroup analysis indicated that median PFS and median OS of the two arms were comparable in patients with negative programmed death ligand 1 expression or in patients aged ≥65 years old. Conclusions PD-1 inhibitor plus chemotherapy was associated with significant survival benefits compared with bevacizumab plus chemotherapy in patients with advanced non-squamous NSCLC, which provides evidence support to guide clinical practice. Nonetheless, the comparative survival outcomes in several subgroups indicated that bevacizumab plus chemotherapy still mattered.
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Affiliation(s)
- Xiangjiao Meng
- Shandong University Cancer Center, Jinan, Shandong, China
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yu Chen
- Shandong University Cancer Center, Jinan, Shandong, China
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Ligang Xing
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xinchao Liu
- Shandong University Cancer Center, Jinan, Shandong, China
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Kaikai Zhao
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Liyang Jiang
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Caicun Zhou
- Department of Medical Oncology, Tongji University, Shanghai, China
| | - Jinming Yu
- Shandong University Cancer Center, Jinan, Shandong, China
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Research Unit of Radiation Oncology, Chinese Academy of Medical Sciences, Jinan, Shandong, China
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Xu X, Zhang S, Xu T, Zhan M, Chen C, Zhang C. Efficacy and Safety of Bevacizumab Biosimilars Compared With Reference Biologics in Advanced Non-small Cell Lung Cancer or Metastatic Colorectal Cancer Patients: A Network Meta-Analysis. Front Pharmacol 2022; 13:880090. [PMID: 35865968 PMCID: PMC9294356 DOI: 10.3389/fphar.2022.880090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Bevacizumab biosimilars are slowly making their way into cancer treatment, but the data on their efficacy and safety in cancer patients are still poor. We systematically summarized the current evidence for the efficacy and safety of bevacizumab biosimilars in patients with advanced non-small cell lung cancer (NSCLC) or metastatic colorectal cancer (CRC). Methods: This review searched CNKI, VIP, PubMed, Medline (Ovid), Embase, and Cochrane Library (Ovid) for randomized controlled trials of bevacizumab biosimilars treated in adults with advanced NSCLC or metastatic CRC. A pairwise meta-analysis and a Bayesian network meta-analysis based on the random-effect model were performed to summarize the evidence. We rated the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation framework. Results: Ten eligible trials with a total of 5526 patients were included. Seven trials (n = 4581) were for the NSCLC population, while three trials (n = 945) were for patients with CRC. According to the pairwise meta-analysis, the efficacy (objective response rate: risk ratio (RR) 0.98 [0.92–1.04], p = 0.45; progression-free survival: hazard ratio (HR) 1.01 [0.92–1.10], p = 0.85; and overall survival: HR 1.06 [0.94–1.19], p = 0.35) and safety (incidence of grade 3–5 adverse events: odds ratio (OR) 1.03 [0.91–1.16], p = 0.65) of bevacizumab biosimilars performed no significant difference with reference biologics in patients with NSCLC as well as metastatic CRC patients (objective response rate: RR 0.97 [0.87–1.09], p = 0.60; overall survival: HR 0.94 [0.70–1.25], p = 0.66; incidence of grade 3–5 adverse events: OR 0.78 [0.59–1.02], p = 0.73). Network estimates displayed 7 types of bevacizumab biosimilars in the medication regime of NSCLC patients who had no significant difference among each other in terms of efficacy and safety. The certainty of the evidence was assessed as low to moderate. Three types of biosimilars were found to be clinically equivalent to each other in the patients with CRC, which were evaluated with very low to moderate certainty. Conclusion: In patients with advanced NSCLC or metastatic CRC, the efficacy and safety of bevacizumab biosimilars were found to be comparable with those of reference biologics and each other.
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Affiliation(s)
- Xinyi Xu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan Unversity, Chengdu, China
| | - Shengzhao Zhang
- Deparment of Pharmacy, Karamay Centeral Hospital, Karamay, China
| | - Ting Xu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan Unversity, Chengdu, China
- *Correspondence: Ting Xu,
| | - Mei Zhan
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Chen
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan Unversity, Chengdu, China
| | - Chenyu Zhang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- West China School of Pharmacy, Sichuan Unversity, Chengdu, China
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Lu S, Wu L, Jian H, Chen Y, Wang Q, Fang J, Wang Z, Hu Y, Sun M, Han L, Miao L, Ding C, Cui J, Li B, Pan Y, Li X, Ye F, Liu A, Wang K, Cang S, Zhou H, Sun X, Ferry D, Lin Y, Wang S, Zhang W, Zhang C. Sintilimab plus bevacizumab biosimilar IBI305 and chemotherapy for patients with EGFR-mutated non-squamous non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitor therapy (ORIENT-31): first interim results from a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol 2022; 23:1167-1179. [DOI: 10.1016/s1470-2045(22)00382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/16/2022]
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Abstract
Biosimilars play an important role in reducing the burden on patients and increasing the market competition. Biosimilar monoclonal antibodies are currently one of the hotspots of research and development in China with policies support. With the continuous improvement of policies, the enthusiasm for the research and development of biosimilars has increased year by year. The policy requirements in different periods have different degrees of impact on the patent applications of pharmaceutical companies. This review introduces the biosimilar monoclonal antibodies market status and approval process in China, analyzes the patents in this field, and helps pharmaceutical companies protect their intellectual property rights.
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Affiliation(s)
- Jia-Wei Liu
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Yu-Huan Yang
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Nan Wu
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ji-Fu Wei
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
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Luo X, Liu Q, Zhou Z, Yi L, Peng L, Wan X, Zeng X, Tan C, Li S. Cost-Effectiveness of Bevacizumab Biosimilar LY01008 Combined With Chemotherapy as First-Line Treatment for Chinese Patients With Advanced or Recurrent Nonsquamous Non-Small Cell Lung Cancer. Front Pharmacol 2022; 13:832215. [PMID: 35517823 PMCID: PMC9062292 DOI: 10.3389/fphar.2022.832215] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/10/2022] [Indexed: 01/15/2023] Open
Abstract
Objective: To investigate whether LY01008, a locally developed bevacizumab biosimilar agent, is appropriate for widespread use among Chinese advanced or recurrent nonsquamous non-small cell lung cancer (NSCLC) patients, our current study was designed to evaluate the cost-effectiveness of first-line LY01008 combined with platinum-doublet chemotherapy versus chemotherapy alone from the perspective of the Chinese healthcare system. Material and Methods: This economic evaluation designed a Markov model to compare the healthcare cost and quality-adjusted life-year (QALY) of first-line LY01008 combined with chemotherapy versus first-line chemotherapy. Transition probabilities, including disease progression, survival, and adverse event (AE)-related discontinuation of first-line treatment, were estimated using data from the clinical trials. Costs and health utilities were derived from local databases, hospitals, and published literature. Our base case analysis and scenario analysis focused on the cost-effectiveness of chemotherapy combined with a clinical trial dosage (15 mg/kg every 3-week cycle) and a real-world dosage (7.5 mg/kg every 3-week cycle) of LY01008, respectively. Results: In the base case analysis, first-line LY01008 combined with chemotherapy was associated with an increase of 0.48 QALYs in effectiveness and an increase of CNY 189,988 (US$ 26,240) in healthcare costs compared with first-line chemotherapy, resulting an incremental cost-effectiveness ratio (ICER) of CNY 375,425 (US$ 54,430)/QALY. In the scenario analysis, first-line LY01008 combined with chemotherapy was associated with a mean healthcare cost of CNY 265,060 (US$ 38,429), resulting an ICER of CNY 221,579 (US$ 32,125/QALY) between first-line LY01008 combined with chemotherapy versus first-line chemotherapy. The parameters that determine the cost of LY01008 have the greatest impact on the cost-effectiveness results. Conclusion: From the perspective of the Chinese healthcare system, first-line LY01008 at a real-world dosage combined with chemotherapy is likely to represent a cost-effective strategy compared with first-line chemotherapy alone for Chinese advanced or recurrent nonsquamous NSCLC patients.
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Affiliation(s)
- Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiao Liu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Lidan Yi
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Liubao Peng
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaohui Zeng
- Department of Nuclear Medicine, PET Image Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sini Li
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
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12
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Peng Y, Zeng X, Peng L, Liu Q, Yi L, Luo X, Li S, Wang L, Qin S, Wan X, Tan C. Sintilimab Plus Bevacizumab Biosimilar Versus Sorafenib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Cost-Effectiveness Analysis. Front Pharmacol 2022; 13:778505. [PMID: 35222020 PMCID: PMC8864224 DOI: 10.3389/fphar.2022.778505] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: The ORIENT-32 clinical trial revealed that sintilimab plus bevacizumab biosimilar significantly improved the median progression-free survival and median overall survival (OS) compared with sorafenib. This analysis evaluated the cost-effectiveness of sintilimab plus bevacizumab biosimilar as a first-line treatment for unresectable hepatocellular carcinoma from the Chinese perspective of healthcare system. Materials and methods: A Markov model with three mutual health states was constructed to evaluate the economic outcome of sintilimab plus bevacizumab biosimilar. The model cycle was 21 days, and the simulation time horizon was a lifetime. The output parameters of the model were the total cost, life-year (LY), quality-adjusted LY (QALY), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses were conducted to assess the robustness of the results. Results: The base-case results found that sintilimab plus bevacizumab biosimilar provided an improvement of 1.27 QALYs and 1.84 LYs compared with sorafenib, and the ICER was $23,352/QALY. The hazard ratio for OS had the greatest influence on the ICER. The probability of sintilimab plus bevacizumab biosimilar was 85% at willingness-to-pay thresholds of $30,552/QALY. Conclusion: The findings of this analysis suggested that sintilimab plus bevacizumab biosimilar was a cost-effective first-line therapy for patients with unresectable hepatocellular carcinoma.
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Affiliation(s)
- Ye Peng
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaohui Zeng
- PET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Liubao Peng
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiao Liu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lidan Yi
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sini Li
- Xiangya School of Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Liting Wang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
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13
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Wan R, Dong X, Chen Q, Yu Y, Yang S, Zhang X, Zhang G, Pan Y, Sun S, Zhou C, Hong W, Zhao H, Yang L, Huang L, Wu R, Zang A, Ma R, Wu L, Lv D, Fu X, Han J, Li W, Duan J, Wang K, Jiang O, Chen Y, Guo Z, Gao H, Wen J, Wang S, Zhao E, Li G, Yue L, Liang L, Zeng A, Wang X, Zhu Y, Pan H, Dai Z, Feng W, Zhao G, Lin C, Li C, Li N, Bao Y, Li Y, Su Y, Zhao M, Fang H, Zhu Y, Zhang Y, Ding L, Wang Y, Yuan X, Wang J. Efficacy and safety of MIL60 compared with bevacizumab in advanced or recurrent non-squamous non-small cell lung cancer: a phase 3 randomized, double-blind study. EClinicalMedicine 2021; 42:101187. [PMID: 34841235 PMCID: PMC8606331 DOI: 10.1016/j.eclinm.2021.101187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND We compared the efficacy, safety, and immunogenicity of MIL60 with reference bevacizumab as first-line treatment in patients with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC) in this phase 3, randomized, double-blind study. METHODS Patients with untreated advanced or recurrent NSCLC were randomized (1:1 ratio) to receive either MIL60 or bevacizumab in combination with paclitaxel/carboplatin. Patients with non-progressive disease continued maintenance single-agent MIL60 until disease progression, or intolerable toxicity. The primary endpoint was the 12-week objective response rates (ORR12) by independent review committee (IRC) using RECIST 1.1. Bioequivalence was established if the ORR ratio located between 0.75 and 1/0.75. The trial was registered with clinicaltrials.gov (NCT03196986). FINDINGS Between Aug 23, 2017, and May 8, 2019, 517 patients were randomly assigned to MIL60 group (n=257) and bevacizumab group (n=260). In the full analysis set (FAS) population including all randomized and evaluable patients who received at least one dose of MIL60 or bevacizumab, the ORR12 in MIL60 group and bevacizumab group were 48.6% and 43.1%, respectively. The ORR ratio of these two groups were 1.14 (90% CI 0.97-1.33), which fell within the pre-specified equivalence boundaries (0.75-1/0.75). The median DOR was 5.7 months (95% CI 4.5-6.2) for MIL60 and 5.6 months (95% CI 4.3-6.4) for bevacizumab. No significant difference was noted in median PFS (7.2 vs. 8.1 months; HR 1.01, 95% CI 0.78-1.30, p=0.9606) and OS (19.3 vs. 16.3 months; HR 0.81, 95% CI 0.64-1.02, p=0.0755). Safety and tolerability profiles were similar between the two groups. No patient detected positive for Anti-drug antibody (ADA). INTERPRETATION The efficacy, safety and immunogenicity of MIL60 were similar with bevacizumab, providing an alternative treatment option for advanced or recurrent non-squamous NSCLC. FUNDING This study was sponsored by Betta Pharmaceutical Co., Ltd.
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Affiliation(s)
- Rui Wan
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaorong Dong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qun Chen
- Medical Oncology, Fuzhou pulmonary Hospital of Fujian, Fuzhou, China
| | - Yan Yu
- Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Shujun Yang
- Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaochun Zhang
- Cancer Precision Medicine Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guojun Zhang
- Respiratory Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yueyin Pan
- Department of Oncology Chemotherapy, the First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, China
| | - Sanyuan Sun
- Oncology, Xuzhou Central Hospital, Xuzhou, China
| | - Chengzhi Zhou
- Pulonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Hong
- Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Hui Zhao
- Respiratory, The Second Hospital of Anhui Medical University, Hefei, China
| | - Lei Yang
- Department of Respiratory Oncology, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Linian Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Rong Wu
- Department of Internal Oncology II, Shengjing Hospital of China Medical University, Liaoning, China
| | - Aimin Zang
- Internal Medicine-Oncology, Affiliated Hospital of Hebei, Baoding, China
| | - Rui Ma
- Medical Oncology Department of Thoracic Cancer (II), Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Lin Wu
- Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China
| | - Dongqing Lv
- Respiratory, Taizhou Hospital of Zhejiang Province, Taizhou, China
| | - Xiuhua Fu
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Jianguo Han
- Oncology, Chifeng Municipal Hospital, Chifeng, China
| | - Wenxin Li
- Oncology, Inner Mongolia People's Hospital, Hohhot, China
| | - Jianchun Duan
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kai Wang
- Respiratory, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Ou Jiang
- Department of Oncology, The Second People's Hospital of Neijiang, Neijiang, China
| | - Yinglan Chen
- Medical Oncology, Jiangxi Province Cancer Hospital, Nanchang, China
| | - Zhongliang Guo
- Department of Respiratory Medicine, Shanghai East Hospital, Shanghai, China
| | - Hongjun Gao
- Department of pulmonary oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Juyi Wen
- Department of Radiation Oncology, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Shubin Wang
- Medical Oncology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Enfeng Zhao
- Three and Four Departments of Radiotherapy and Chemotherapy, Cangzhou Hospital of Integrated Traditional Chinese and Western of Hebei Province, Cangzhou, China
| | - Gaofeng Li
- Thoracic surgery, Yunnan Cancer Hospital, Kunming, China
| | - Lu Yue
- Oncology, Qingdao Municipal Hospital, Qingdao, China
| | - Li Liang
- Oncology, Peking University Third Hospital, Beijing, China
| | - Aiping Zeng
- Department of Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoshan Wang
- Oncology, Sichuan Provincial People's Hospital, Chengdu, China
| | - Yuxi Zhu
- Department of Oncology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hongming Pan
- Oncology Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhaoxia Dai
- Department of Thoracic Medical Oncology II, The Second Hospital of Dalian Medical University, Dalian, China
| | - Weineng Feng
- Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, China
| | - Guofang Zhao
- Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, China
| | - Chuan Lin
- Oncology, Yibin Second People's Hospital, Yibin, China
| | - Chong Li
- Department of Respiratory Medicine, The First People's Hospital of Changzhou, Changzhou, China
| | - Na Li
- Department of Oncology, Suining Central Hospital, Suining, China
| | - Yangyi Bao
- Department of Oncology, The First People's Hospital of Hefei, Hefei, China
| | - Yinyin Li
- First Department of Oncology, Shenyang Chest Hospital, Shenyang, China
| | - Yanjun Su
- Department of Pulmonary Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Min Zhao
- Oncology, Hebei Chest Hospital, Shijiazhuang, China
| | - Haohui Fang
- Respiratory, Anhui Chest Hospital, Hefei, China
| | - Yulong Zhu
- Department of Respiratory, Hospital of Traditional Chinese Medicine of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yu Zhang
- Respiratory, Nanjing Chest Hospital, Nanjing, China
| | - Lieming Ding
- Betta pharmaceuticals Co., Ltd., Hangzhou, China
| | - Yang Wang
- Betta pharmaceuticals Co., Ltd., Hangzhou, China
| | - Xiaobin Yuan
- Betta pharmaceuticals Co., Ltd., Hangzhou, China
| | - Jie Wang
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Corresponding Author: Jie Wang, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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14
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Socinski MA, Waller CF, Idris T, Bondarenko I, Luft A, Beckmann K, Vishweswaramurthy A, Loganathan S, Donnelly C, Hummel MA, Shapiro R, Woods M, Rao A, Nayak VG, Ranganna G, Barve A. Phase III double-blind study comparing the efficacy and safety of proposed biosimilar MYL-1402O and reference bevacizumab in stage IV non-small-cell lung cancer. Ther Adv Med Oncol 2021; 13:17588359211045845. [PMID: 34819997 PMCID: PMC8606731 DOI: 10.1177/17588359211045845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/25/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose: This phase III study compared the efficacy and safety of proposed biosimilar MYL-1402O with reference bevacizumab (BEV), as first-line treatment for patients with stage IV non-squamous non-small-cell lung cancer. Patients and methods: Patients were randomly assigned (1:1) to receive MYL-1402O or bevacizumab with carboplatin-paclitaxel up to 18 weeks (6 cycles), followed by up to 24 weeks (8 cycles) of bevacizumab monotherapy. The primary objective was comparison of overall response rate (ORR), based on independently reviewed best tumor responses as assessed during the first 18 weeks. ORR was analyzed per US Food and Drug Administration (ratio of ORR) and European Medicines Agency (difference in ORRs) requirements for equivalence evaluation. Secondary end points included progression-free survival, disease control rate, duration of response, overall survival, safety, and immunogenicity over a period of 42 weeks, and pharmacokinetics (up to 18 weeks). Results: A total of 671 patients were included in the intent-to-treat population. The ratio of ORR was 0.96 [confidence interval (CI) 0.83, 1.12] and the difference in ORR was −1.6 (CI −9.0, 5.9) between treatment arms; CIs were within the predefined equivalence margins. Overall, the incidence of treatment-emergent adverse events and serious adverse events was comparable. Treatment-emergent anti-drug antibody (ADA) positivity was transient, with no notable differences between treatment arms (6.5% versus 4.8% ADA positivity rate in MYL-1402O versus BEV, respectively). The incidence of neutralizing antibody post-baseline was lower in the MYL-1402O arm (0.6%) compared to the bevacizumab arm (2.5%). Conclusions: MYL-1402O is therapeutically equivalent to bevacizumab, based on the ORR analyses, with comparable secondary endpoints. Trial Registry Information EU Clinical Trials Register, Registration # EudraCT no. 2015-005141-32https://www.clinicaltrialsregister.eu/ctr-search/search?query=2015-005141-32 Plain language summary Previous studies established bioequivalence of the proposed bevacizumab biosimilar MYL-1402O to reference bevacizumab. In this randomized, double-blind, phase III trial, MYL-1402O (n = 337) demonstrated comparable efficacy to bevacizumab (n = 334) in treating advanced non-squamous non-small-cell lung cancer per Food and Drug Administration and European Medicines Agency requirements for equivalence; the ratio of objective response rate (ORR) was 0.96 [90% confidence interval (CI) 0.83, 1.12] and the difference in ORR (MYL-1402O:bevacizumab) was −1.6 (95% CI −9.0, 5.9). Median progression-free survival at 42 weeks was comparable: 7.6 (7.0, 9.5) with MYL-1402O versus 9.0 (7.2, 9.7) months (p = 0.0906) with bevacizumab, by independent review. Treatment-emergent adverse events leading to death (2.4% vs 1.5%), serious adverse events (17.6% vs 16.7%), and antidrug antibodies (6.5% vs 4.8%), were comparable in the MYL-1402O vs bevacizumab arms, respectively. The incidence of neutralizing antibody post-baseline was lower with MYL-1402O (0.6%) than with bevacizumab (2.5%). These findings confirm therapeutic equivalence of MYL-1402O to bevacizumab, providing opportunities for improving access to bevacizumab.
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Affiliation(s)
- Mark A Socinski
- AdventHealth Cancer Institute, 2501 North Orange Avenue, Suite 289, Orlando, FL 32803, USA
| | - Cornelius F Waller
- Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg, Freiburg, Germany
| | | | - Igor Bondarenko
- Dnipropetrovsk Medical Academy, Dnipropetrovsk Oblast, Ukraine
| | - Alexander Luft
- Leningrad Regional Clinical Hospital, St. Petersburg, Russian Federation
| | - Katrin Beckmann
- Mylan Healthcare GmbH (A Viatris Company), Hannover, Germany
| | | | | | | | | | | | | | - Anita Rao
- Biocon Research Ltd., Bangalore, India
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15
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Goyal P, Vats B, Subbarao M, Honnappa CG, Kabadi P, Rohil S, Bera A, Mehta GR, Pai H, Adhikari L, Tagore R, Sharma S, Venkatachala R, Nair P, Annegowda S, Sahu A, Trivedi S, Shastri N, Gokhale Y, Thomas R, Thakur A, Mohan D, Rao K U, Melarkode R, Ullanat R. Analytical similarity assessment of MYL-1402O to reference Bevacizumab. Expert Opin Biol Ther 2021; 22:271-298. [PMID: 34465264 DOI: 10.1080/14712598.2021.1973426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bevacizumab (BEV) is a recombinant humanized monoclonal immunoglobulin G1 antibody that binds to vascular endothelial growth factor (VEGF)-A and acts as an antiangiogenic agent. It is approved for treatment of many cancer indications, including metastatic colorectal cancer and nonsquamous non-small cell lung cancer. RESEARCH DESIGN AND METHODS The analytical similarity of the BEV biosimilar MYL-1402O to reference BEV sourced from the European Union and United States was assessed using physicochemical and functional tests to support the clinical development of MYL-1402O. Assessment of physicochemical and analytical similarity showed that MYL-1402O has the same amino acid sequence and similar posttranslational modification profile as the reference BEV products. RESULTS The functional and biologic activity of MYL-1402O assessed using inhibition of VEGF-induced cell proliferation in human umbilical vein endothelial cells, inhibition of VEGF-induced VEGF receptor 2 phosphorylation, and fragment antigen and fragment crystallizable receptor binding, was comparable to reference BEV products. CONCLUSIONS The totality of the data assessment confirms the high degree of similarity of MYL-1402O to reference BEV with respect to physicochemical and in vitro functional properties. The product quality data presented here, along with data from phase 1 clinical studies, demonstrate the similarity of MYL-1402O to reference BEV products, supporting further clinical development of this BEV biosimilar.
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Affiliation(s)
- Parag Goyal
- Biologics R&D, Viatris Inc, Canonsburg, PA, USA
| | | | - Malini Subbarao
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | | | - Pradeep Kabadi
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Sheija Rohil
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Arnab Bera
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | | | - Harish Pai
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Laxmi Adhikari
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | | | | | | | - Pradip Nair
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | | | - Abhilashi Sahu
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Sneha Trivedi
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Namrata Shastri
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Yatika Gokhale
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | - Roshni Thomas
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
| | | | - Deepa Mohan
- Biocon Research Lab, Biocon Biologics Limited, Bengaluru, India
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16
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Shi Y, Lei K, Jia Y, Ni B, He Z, Bi M, Wang X, Shi J, Zhou M, Sun Q, Wang G, Chen D, Shu Y, Liu L, Guo Z, Liu Y, Yang J, Wang K, Xiao K, Wu L, Yi T, Sun D, Kang M, Ma T, Mao Y, Shi J, Tang T, Wang Y, Xing P, Lv D, Liao W, Luo Z, Wang B, Wu X, Zhu X, Han S, Guo Q, Liu R, Lu Z, Zhang J, Fang J, Hu C, Ji Y, Liu G, Lu H, Wu D, Zhang J, Zhu S, Liu Z, Qiu W, Ye F, Yu Y, Zhao Y, Zheng Q, Chen J, Pan Z, Zhang Y, Lian W, Jiang B, Qiu B, Zhang G, Zhang H, Chen Y, Chen Y, Duan H, Li M, Liu S, Ma L, Pan H, Yuan X, Yuan X, Zheng Y, Gao E, Zhao L, Wang S, Wu C. Bevacizumab biosimilar LY01008 compared with bevacizumab (Avastin) as first-line treatment for Chinese patients with unresectable, metastatic, or recurrent non-squamous non-small-cell lung cancer: A multicenter, randomized, double-blinded, phase III trial. Cancer Commun (Lond) 2021; 41:889-903. [PMID: 34184418 PMCID: PMC8441057 DOI: 10.1002/cac2.12179] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/25/2021] [Accepted: 05/31/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated the preclinical pharmacological and toxicological consistency, and clinical pharmacokinetic equivalence of bevacizumab biosimilar LY01008 with reference bevacizumab (Avastin). This randomized controlled trial aimed to compare the efficacy and safety of LY01008 with Avastin in first-line treatment of Chinese patients with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC). METHODS Stage IIIB-IV NSCLC patients with evaluable lesions, good physical status, and adequate organ functions from 67 centers across China were randomized in a ratio of 1:1 to receive LY01008 or Avastin 15 mg/kg intravenously in combination with paclitaxel/carboplatin (combined treatment) for 4-6 cycles, followed by maintenance monotherapy with LY01008 until disease progression, intolerable toxicity, or death. The primary endpoint was objective response rate (ORR) in accordance with Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 confirmed by independent radiological review committees (IRRC). Secondary endpoints included disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety. This study was registered in ClinicalTrials.gov (NCT03533127). RESULTS Between December 15th , 2017, and May 15th , 2019, a total of 649 patients were randomized to the LY01008 (n = 324) or Avastin (n = 325) group. As of September 25th , 2019 for primary endpoint analysis, 589 patients received ORR evaluation, with a median number of combined treatment cycles of 5 (range 1-6) and median duration of treatment of 3.0 (range 0.0-5.1) months. ORR of response-evaluable patients in the LY01008 and Avastin groups were 48.5% and 53.0%, respectively. The stratified ORR ratio was 0.91 (90% CI 0.80-1.04, within the prespecified equivalence margin of 0.75-1.33). Up to May 15th , 2020, with a median follow-up of 13.6 (range 0.8-28.4) months, no notable differences in DCR, median DoR, median PFS, median OS, and 1-year OS rate were observed between the LY01008 and Avastin groups. There were no clinically meaningful differences in safety and immunogenicity across treatment groups. CONCLUSIONS LY01008 demonstrated similarity to Avastin in terms of efficacy and safety in Chinese patients with advanced or recurrent non-squamous NSCLC. LY01008 combined with paclitaxel/carboplatin is expected to become a new treatment option for unresectable, metastatic, or recurrent non-squamous NSCLC patients in the first-line setting.
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Ren Z, Xu J, Bai Y, Xu A, Cang S, Du C, Li Q, Lu Y, Chen Y, Guo Y, Chen Z, Liu B, Jia W, Wu J, Wang J, Shao G, Zhang B, Shan Y, Meng Z, Wu J, Gu S, Yang W, Liu C, Shi X, Gao Z, Yin T, Cui J, Huang M, Xing B, Mao Y, Teng G, Qin Y, Wang J, Xia F, Yin G, Yang Y, Chen M, Wang Y, Zhou H, Fan J. Sintilimab plus a bevacizumab biosimilar (IBI305) versus sorafenib in unresectable hepatocellular carcinoma (ORIENT-32): a randomised, open-label, phase 2-3 study. Lancet Oncol 2021; 22:977-990. [PMID: 34143971 DOI: 10.1016/s1470-2045(21)00252-7] [Citation(s) in RCA: 471] [Impact Index Per Article: 157.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND China has a high burden of hepatocellular carcinoma, and hepatitis B virus (HBV) infection is the main causative factor. Patients with hepatocellular carcinoma have a poor prognosis and a substantial unmet clinical need. The phase 2-3 ORIENT-32 study aimed to assess sintilimab (a PD-1 inhibitor) plus IBI305, a bevacizumab biosimilar, versus sorafenib as a first-line treatment for unresectable HBV-associated hepatocellular carcinoma. METHODS This randomised, open-label, phase 2-3 study was done at 50 clinical sites in China. Patients aged 18 years or older with histologically or cytologically diagnosed or clinically confirmed unresectable or metastatic hepatocellular carcinoma, no previous systemic treatment, and a baseline Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 were eligible for inclusion. In the phase 2 part of the study, patients received intravenous sintilimab (200 mg every 3 weeks) plus intravenous IBI305 (15 mg/kg every 3 weeks). In the phase 3 part, patients were randomly assigned (2:1) to receive either sintilimab plus IBI305 (sintilimab-bevacizumab biosimilar group) or sorafenib (400 mg orally twice daily; sorafenib group), until disease progression or unacceptable toxicity. Randomisation was done using permuted block randomisation, with a block size of six, via an interactive web response system, and stratified by macrovascular invasion or extrahepatic metastasis, baseline α-fetoprotein, and ECOG performance status. The primary endpoint of the phase 2 part of the study was safety, assessed in all patients who received at least one dose of study drug. The co-primary endpoints of the phase 3 part of the study were overall survival and independent radiological review committee (IRRC)-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT03794440. The study is closed to new participants and follow-up is ongoing for long-term outcomes. FINDINGS Between Feb 11, 2019 and Jan 15, 2020, we enrolled 595 patients: 24 were enrolled directly into the phase 2 safety run-in and 571 were randomly assigned to sintilimab-bevacizumab biosimilar (n=380) or sorafenib (n=191). In the phase 2 part of the trial, 24 patients received at least one dose of the study drug, with an objective response rate of 25·0% (95% CI 9·8-46·7). Based on the preliminary safety and activity data of the phase 2 part, in which grade 3 or worse treatment-related adverse events occurred in seven (29%) of 24 patients, the randomised phase 3 part was started. At data cutoff (Aug 15, 2020), the median follow-up was 10·0 months (IQR 8·5-11·7) in the sintilimab-bevacizumab biosimilar group and 10·0 months (8·4-11·7) in the sorafenib group. Patients in the sintilimab-bevacizumab biosimilar group had a significantly longer IRRC-assessed median progression-free survival (4·6 months [95% CI 4·1-5·7]) than did patients in the sorafenib group (2·8 months [2·7-3·2]; stratified hazard ratio [HR] 0·56, 95% CI 0·46-0·70; p<0·0001). In the first interim analysis of overall survival, sintilimab-bevacizumab biosimilar showed a significantly longer overall survival than did sorafenib (median not reached [95% CI not reached-not reached] vs 10·4 months [8·5-not reached]; HR 0·57, 95% CI 0·43-0·75; p<0·0001). The most common grade 3-4 treatment-emergent adverse events were hypertension (55 [14%] of 380 patients in the sintilimab-bevacizumab biosimilar group vs 11 [6%] of 185 patients in the sorafenib group) and palmar-plantar erythrodysaesthesia syndrome (none vs 22 [12%]). 123 (32%) patients in the sintilimab-bevacizumab biosimilar group and 36 (19%) patients in the sorafenib group had serious adverse events. Treatment-related adverse events that led to death occurred in six (2%) patients in the sintilimab-bevacizumab biosimilar group (one patient with abnormal liver function, one patient with both hepatic failure and gastrointestinal haemorrhage, one patient with interstitial lung disease, one patient with both hepatic faliure and hyperkalemia, one patient with upper gastrointestinal haemorrhage, and one patient with intestinal volvulus) and two (1%) patients in the sorafenib group (one patient with gastrointestinal haemorrhage and one patient with death of unknown cause). INTERPRETATION Sintilimab plus IBI305 showed a significant overall survival and progression-free survival benefit versus sorafenib in the first-line setting for Chinese patients with unresectable, HBV-associated hepatocellular carcinoma, with an acceptable safety profile. This combination regimen could provide a novel treatment option for such patients. FUNDING Innovent Biologics. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Zhenggang Ren
- Department of Hepatic Oncology, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Jianming Xu
- Digestive Oncology Department, The Fifth Medical Centre of PLA General Hospital, Beijing, China
| | - Yuxian Bai
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin, China
| | - Aibing Xu
- Department of Oncological Internal Medicine, Nantong Tumour Hospital, Nantong, China
| | - Shundong Cang
- Department of Internal Medicine-Oncology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Chengyou Du
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiu Li
- Abdominal Tumour Department, West China Hospital, Sichuan University, Chengdu, China
| | - Yinying Lu
- Treatment and Research Centre for Liver Cancer Department 2, The Fifth Medical Centre of PLA General Hospital, Beijing, China
| | - Yajin Chen
- Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yabing Guo
- Department of Tumours of Liver, Nan Fang Hospital, Guangzhou, China
| | - Zhendong Chen
- Oncology Department, The Second Hospital of Anhui Medical University, Hefei, China
| | - Baorui Liu
- Department of Oncology, Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Weidong Jia
- General Surgery Department, Anhui Provincial Hospital, Hefei, China
| | - Jian Wu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Junye Wang
- Department of Oncology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Guoliang Shao
- Department of Interventional Therapy, Zhejiang Cancer Hospital, Hangzhou, China
| | - Bixiang Zhang
- Department of Hepatobiliary Surgery, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yunfeng Shan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhiqiang Meng
- Department of Traditional Chinese Medicine/Integrative Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Jianbing Wu
- Oncology Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shanzhi Gu
- Radioactive Interventional Department, Hunan Cancer Hospital, Changsha, China
| | - Wei Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Chao Liu
- Department of Pancreaticobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xuetao Shi
- Department of Hepatobiliary Surgery, Shandong Cancer Hospital, Jinan, China
| | - Zhenyuan Gao
- Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Tao Yin
- Department of Hepatobiliary Surgery, Hubei Cancer Hospital, Wuhan, China
| | - Jiuwei Cui
- Oncology Department, Bethune First Hospital of Jilin University, Changchun, China
| | - Ming Huang
- Department of Minimally Invasive Interventional Medicine, Yunnan Cancer Hospital, Kunming, China
| | - Baocai Xing
- Hepatobiliary Pancreatic Surgery 1, Beijing Cancer Hospital, Beijing, China
| | - Yilei Mao
- Live Surgery Ward, Peking Union Medical College Hospital, Beijing, China
| | - Gaojun Teng
- Radiology Department, Zhongda Hospital Southeast University, Nanjing, China
| | - Yanru Qin
- Department of Internal Medicine Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinhai Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Feng Xia
- Department of Hepatobiliary Surgery, The First Hospital Affiliated to AMU (Southwest Hospital), Chongqing, China
| | - Guowen Yin
- Intervention Department, Jiangsu Cancer Hospital, Nanjing, China
| | - Yong Yang
- Department of Medical Science and Strategy Oncology, Innovent Biologics, Suzhou, China
| | - Mingxia Chen
- Department of Biostatistics and Information, Innovent Biologics, Suzhou, China
| | - Yan Wang
- Department of Medical Science and Strategy Oncology, Innovent Biologics, Suzhou, China
| | - Hui Zhou
- Department of Medical Science and Strategy Oncology, Innovent Biologics, Suzhou, China
| | - Jia Fan
- Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China.
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Safdar A, Butt MH, Ahmad A, Zaman M. Progress in oncology biosimilars till 2020: Scrutinizing comparative studies of biosimilar monoclonal antibodies. J Oncol Pharm Pract 2021; 27:1195-1204. [PMID: 34096401 DOI: 10.1177/10781552211016083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stupendous elevation in the healthcare costs has followed with the inception of the current unconventional options of treatment available for cancer patients. There is a dire need of innovative financing approaches to lessen the financial load on healthcare system. Biosimilars are biological drugs consisting of an active ingredient from a reference biological drug that has a great potential of relieving financial load. Strict requirements from regulatory point of view are required as biosimilars are exceedingly similar to but not identical to the reference product. This provides with a certainty that no consequential differences from clinical point of view as compared to the respective biologics exists with regards to efficacy, safety and purity. Safety and effectiveness of biosimilars have been disclosed since more than 10 years of affirmations. However, there is a need to educate the healthcare professionals to abolish potential misconceptions and coalesce biosimilars into regular clinical practice. The present review focuses on providing an overview of regulatory aspects and requirements for biosimilars, the main challenges in the selection and development of biosimilars and the economic impact and financial savings observed in recent studies carried out in different parts of the world. In addition, we have discussed the different successful comparative studies which have been done in different parts of the world to depict the biosimilarity for monoclonal antibodies such as bevacizumab, trastuzumab and rituximab.
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Affiliation(s)
- Aqsa Safdar
- Faculty of Pharmacy, 66901University of Central Punjab, Lahore, Pakistan
| | | | - Abrar Ahmad
- Faculty of Pharmacy, 66901University of Central Punjab, Lahore, Pakistan
| | - Muhammad Zaman
- Faculty of Pharmacy, 66901University of Central Punjab, Lahore, Pakistan
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Zhong Q, Tao Y, Chen H, Zhou Y, Huang L, Han X, Shi Y. The changing landscape of anti-lung cancer drug clinical trials in mainland China from 2005 to 2020. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 11:100151. [PMID: 34327360 PMCID: PMC8315452 DOI: 10.1016/j.lanwpc.2021.100151] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND In recent years, new drug development on lung cancer is in full swing in China. The aim of this study was to overview the changing landscape of anti-lung cancer drug clinical trials in mainland China from 2005 to 2020. METHODS We analysed anti-lung cancer drug clinical trials registered on three websites including the China National Medical Products Administration Centre for Drug Evaluation platform, the Chinese Clinical Trial Registry and ClinicalTrials.gov. FINDINGS A total of 1595 anti-lung cancer drug clinical trials from Jan 1st, 2005 to Dec 31st, 2020 were extracted, which included 630 (39•5%) investigator-initiated trials (IITs), 698 (43•8%) domestic industry-sponsored trials (ISTs), and 267 (16•7%) international ISTs. During the past 16 years, the number of anti-lung cancer clinical trials including IITs and domestic ISTs had a remarkable growth, however, the number of international ISTs increased slowly. The number of principal clinical trial units also increased significantly over time. Of the 1595 trials, the largest growth was observed in phase I trials during 2013-2020, with an average annual growth rate of 38•6%. 278 trials were led by principal investigators (PI) from Guangdong, followed by Beijing (n=273) and Shanghai (n=257). Among the 965 ISTs, clinical trials involving targeted drugs (588, 60•9%) accounted for the largest proportion, followed by immunotherapeutic drugs (284, 29•4%), cytotoxic drugs (75, 7•8%), and traditional Chinese medicine (18, 1•9%). In terms of targeted drugs, EGFR-TKIs remained the most studied drugs (225/588, 38•27%). As for immunotherapy, 125 out of 284 (44•01%) trials involved PD-1 inhibitors, 60 (21•13%) trials involved PD-L1 inhibitors, and seven (2•46%) trials involved CTLA-4 inhibitors. INTERPRETATION In the past 16 years, the development of anti-lung cancer drug clinical trials has achieved much progress in mainland China. The most progress lied in targeted therapy and immunotherapy. FUNDING This work was financially supported in part by China National Major Project for New Drug Innovation (2017ZX09304015) and Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-001).
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Affiliation(s)
- Qiaofeng Zhong
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Yunxia Tao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Haizhu Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Yu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Liling Huang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Xiaohong Han
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.41 Damucang Hutong, Xicheng District, Beijing 100032, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
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Qin S, Li J, Bai Y, Shu Y, Li W, Yin X, Cheng Y, Sun G, Deng Y, Zhong H, Li Y, Qian X, Zhang L, Zhang J, Chen K, Kang W. Efficacy, Safety, and Immunogenicity of HLX04 Versus Reference Bevacizumab in Combination with XELOX or mFOLFOX6 as First-Line Treatment for Metastatic Colorectal Cancer: Results of a Randomized, Double-Blind Phase III Study. BioDrugs 2021; 35:445-458. [PMID: 34014555 PMCID: PMC8295119 DOI: 10.1007/s40259-021-00484-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 12/24/2022]
Abstract
Background HLX04 is a proposed biosimilar of bevacizumab. Objective This phase III study aimed to evaluate the efficacy, safety, and
immunogenicity of HLX04 compared with reference bevacizumab in combination with XELOX
or mFOLFOX6 as first-line treatment for recurrent/metastatic colorectal cancer
(CRC). Methods In this double-blind, parallel-group study, patients were randomized 1:1
to receive HLX04 or bevacizumab (7.5 mg/kg every 3 weeks when combined with XELOX; 5
mg/kg every 2 weeks when combined with mFOLFOX6). The primary endpoint was
progression-free survival rate at week 36 (PFSR36w) per
Response Evaluation Criteria in Solid Tumors (RECIST v1.1). Prespecified equivalence
margins of PFSR36w were set as − 11 to 15% (rate difference)
and 0.8 to 1.25 (rate ratio). Secondary endpoints included efficacy, safety,
immunogenicity, and pharmacokinetics. Results A total of 677 patients were randomized (HLX04 n = 340; bevacizumab n = 337)
between April 2018 and April 2020. PFSR36w was 46.4% (95%
confidence interval [CI] 41.1–51.8) with HLX04 and 50.7% (95% CI 45.4–56.1) with
bevacizumab. The rate difference (− 4.2%; 90% CI − 10.6 to 2.1) and rate ratio (0.92;
90% CI 0.80–1.05) both fell within the prespecified equivalence margins. No notable
differences were observed between treatment groups in any efficacy endpoints or their
subgroup analyses. Safety, immunogenicity, and pharmacokinetic profiles were
comparable between the two treatment groups. Conclusions HLX04 demonstrated equivalent efficacy with similar safety and
immunogenicity profiles to reference bevacizumab among patients with
recurrent/metastatic CRC, thus offering an alternative treatment option to
patients. Trial registration Chinadrugtrials.org.cn, CTR20171503 (18 March 2018); ClinicalTrials.gov,
NCT03511963 (30 April 2018). Supplementary Information The online version contains supplementary material available at 10.1007/s40259-021-00484-9. Colorectal cancer (CRC) is the third most common cancer worldwide. Approximately 20%
of patients with CRC have metastases at their first visit. Bevacizumab is a biologic
antibody approved in many countries for the treatment of metastatic CRC. However, high
treatment costs significantly limit patient access to bevacizumab. Therefore, HLX04, a
potential bevacizumab biosimilar, which is almost identical to bevacizumab but less
expensive and more accessible, has been developed. This randomized clinical trial was
designed to evaluate the efficacy (ability of a drug to produce the desired treatment
effects), safety, and immunogenicity (ability of a drug to induce immune response that
would affect its efficacy and safety) of HLX04 compared with the reference bevacizumab
in patients with recurrent/metastatic CRC. Efficacy of the tested drug was evaluated by
comparing the proportion of patients without disease progression or death at week 36
(PFSR36w). Safety was monitored using adverse events and other
clinical evaluations. Immunogenicity was assessed by the incidence of antidrug
antibodies. Of the 677 patients enrolled in the study, 340 received HLX04 and 337
received bevacizumab. Statistical analyses showed that HLX04 was equivalent to
bevacizumab in efficacy evaluations (the difference in PFSR36w
between the two treatment groups fell within the prespecified “equivalence margins”).
Moreover, the two treatments were similar with respect to safety and immunogenicity
evaluations. In summary, patients responded equally well to HLX04 and bevacizumab,
supporting the development of HLX04 as a proposed biosimilar to bevacizumab for patients
with recurrent/metastatic CRC.
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Affiliation(s)
- Shukui Qin
- Department of Oncology, Qinhuai Medical Area, Eastern Theater General Hospital of PLA China, Nanjing, China
| | - Jin Li
- Department of Medical Oncology, Tongji University Shanghai East Hospital, No. 1800 Yuntai Road, Pudong New Area, Shanghai, China.
| | - Yuxian Bai
- Department of Gastroenterology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yongqian Shu
- Department of Oncology, Jiangsu Province Hospital, Nanjing, China
| | - Wei Li
- Department of Oncology, The First Hospital of Jilin University, Changchun, China
| | - Xianli Yin
- Department of Gastroenterology and Urology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ying Cheng
- Department of Internal Medicine, Jilin Cancer Hospital, Changchun, China
| | - Guoping Sun
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital (Guangdong Gastrointestinal Hospital), Sun Yat-sen University, Guangzhou, China
| | - Haijun Zhong
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yunfeng Li
- Department of Colorectal Surgery, Yunnan Cancer Hospital, Kunming, China
| | - Xiaoping Qian
- The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Liangming Zhang
- Department of Medical Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jingdong Zhang
- Medical Oncology Department of Gastrointestinal Tumors, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China
| | - Kehe Chen
- Department of Chemotherapy Division II in Clinical Tumor Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Abstract
Objective To summarize and review the clinical data of Food and Drug Administration (FDA)-approved biosimilars for use in treatment of cancer and the current challenges health care institutions face when implementing a newly approved biosimilar. Data Sources A literature search of the following databases was performed between January 1, 2012, and December 31, 2019: PubMed, Google, and ClinicalTrials.gov. Search terms included the words biosimilar, bevacizumab, rituximab, and/or trastuzumab. Study Selection and Data Extraction Only primary literature on biosimilars with an ongoing or completed phase 3 trial and/or FDA approval were included in the final analysis. Primary literature consisted of peer-reviewed publications, published abstracts, and any results posted on the ClinicalTrials.gov database. Data Synthesis Clinical trials of FDA-approved biosimilars for bevacizumab, rituximab, and trastuzumab showed no significant differences with respect to efficacy, safety, and pharmacokinetics when compared with their reference products. Relevance to Patient Care and Clinical Practice The anticipated growth of biologics in oncology and the recent introduction of biosimilars over the past few years have placed a lot of emphasis on biosimilars as a significant source of cost savings for the health care system. Our article compiles and analyzes existing data on biosimilar efficacy, safety, and financial impact. Conclusions The major concerns of biosimilars revolve around their long-term efficacy and safety. Even with many questions to be answered, biosimilars have the potential for significant cost savings in the US health care system.
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Affiliation(s)
- Dat Ngo
- City of Hope National Medical Center, Duarte, CA, USA
| | - Jason Chen
- City of Hope National Medical Center, Duarte, CA, USA
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Complete response to the combination of sintilimab and IBI305 for a patient with HBV-associated hepatocellular carcinoma with multiple lung metastasis. Dig Liver Dis 2020; 52:794-796. [PMID: 32386943 DOI: 10.1016/j.dld.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022]
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Miao Y, Wang W, Dong Y, Hu J, Wei K, Yang S, Lai X, Tang H. Hypoxia induces tumor cell growth and angiogenesis in non-small cell lung carcinoma via the Akt-PDK1-HIF1α-YKL-40 pathway. Transl Cancer Res 2020; 9:2904-2918. [PMID: 35117647 PMCID: PMC8799056 DOI: 10.21037/tcr.2020.03.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND As one of the most common forms of cancer, non-small cell lung carcinoma (NSCLC), is characterized by oxygen deprivation (hypoxia). The transcription factor hypoxia-inducible factor (HIF)-1α is a major mediator which responds hypoxia and regulates many contributing factors. The various modes of hypoxia regulation are frequently the focus of research studies. With reference to previous published research, we hypothesized that hypoxia promotes the growth and angiogenesis of NSCLC via the Akt-PDK1-HIF1α-YKL-40 pathway, and verified it. METHODS We mainly investigated changes in related factor expression between differently treated CL1-5 cells. We carried out overexpression and underexpression transfection, Western blot, rt-PCR and ELISA, and observed cellular biological behaviors by CCK-8 migration and invasion assay, and tube formation assay. RESULTS A hypoxic environment significantly increased the phosphorylation of Akt and PDK1 in mitochondria. The hypoxia-induced accumulation of p-Akt in mitochondria activated PDK1 phosphorylation, promoted the expression of HIF1α, and the expression of YKL-40. The overexpression of YKL-40 promoted the proliferation, migration, invasion and tubule formation of CL1-5 cells. CONCLUSIONS A hypoxic tumor microenvironment can promote the expansion and angiogenesis of NSCLC cells through the Akt-PDK1-HIF1α-YKL-40 pathway. This may provide a new mechanism and potential interventional target for anti-vascular lung cancer therapy.
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Affiliation(s)
- Yushan Miao
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Wei Wang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Yaping Dong
- The Graduate School of Fujian Medical University, Fuzhou 350122, China
| | - Jiaxun Hu
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Kunchen Wei
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Shuo Yang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Xueli Lai
- Department of Nephrology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Hao Tang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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