First experience of the use of a generic of plerixafor in peripheral blood stem cell mobilization in multiple myeloma and lymphoma patients

Mobilization failure in patients is a major therapeutic concern which makes subsequent ASCT impossible. A new growth factor called Plerixafor (Mozobil®) developed by the pharmaceutical industry (Sanofi-aventis, France), is a chemoreceptor antagonist, CXCR4 type, which disrupts the interaction of SDFI and CXCR4, thereby enhancing the effect of G-CSF mobilization and is especially indicated for mobilization failure. Currently, there is a generic of plerixafor developed by the pharmaceutical industry (Hetero Drugs Ltd, India). The brand name of this medicine is Mozifor®. The objective of this study was to evaluate if generic plerixafor has the same efficacy and safety as originator plerixafor when used with G-CSF in the mobilization of PBSCs for autologous ASCT in multiple myeloma (MM) and lymphoma failure patients. The 32 patients received plerixafor were divided in two groups. The first group concerns the 11 consecutive patients prospectively received generic plerixafor (Mozifor®) in the period between January to July 2020. These were compared with a retrospective control cohort (second group n = 21) who had been treated between 2009 and 2019 with originator plerixafor (Mozobil®). For the Mozifor® group, the mean CD34+ was 4.54x10⁶/kg(1.56-6.79), the median time to achieve an absolute neutrophil count >0.5 G/L was 13 days (range: 8-21). The median time to self-sustained platelet count >20 G/L was 15 days (range: 8-24). For the Mozobil® group, the mean CD34+ was 3.1x10⁶/kg (0.56-8.91) (p=0.86), the median time to achieve an absolute neutrophil count >0.5 G/L was 10 days (range 7-23). The median time to self-sustained platelet count >20 G/L was 13 days (range: 7-29). Our study showed that the generic of plerixafor was practically identical to that of the originator (Mozobil®) with no significant difference (p = 0.52). This study demonstrates the safety and feasibility of mobilization PBSC with generic plerixafor in ASCT in MM and lymphoma. Although these outcomes are encouraging, prospective comparison with other traditional auto-HCT regimens used for patients with MM and lymphoma is warranted.

A survey of pharmacists' knowledge and views of biosimilars in Quebec and France

OBJECTIVE

The objective of this study was to survey pharmacists' knowledge and views of biosimilars in Quebec and France.

METHODS

An online and anonymous survey was conducted. The survey was divided into two parts including: (1) ten multiple choice questions on main characteristics that distinguish biosimilars from generic drugs; (2) fifteen statements on biosimilars key issues (interchangeability, immunogenicity risk management…). Pharmacists were asked to indicate their level of agreement to these statements using a 5-item Likert scale. A descriptive statistical analysis of the results was performed.

RESULTS

A total of 229 pharmacists answered the survey (141 in Quebec and 88 in France). Pharmacists know the main differences between generic drugs and biosimilars. Viewpoints of pharmacists on biosimilars key issues are alike: nomenclature of biosimilars is essential to avoid confusions with the reference drug; the creation of a list of biosimilar and interchangeable biologic drugs is necessary; responsibilities for immunogenicity risk management should be shared between pharmacists and physicians. However, viewpoints vary regarding the patient informed consent for biologic drugs substitution.

CONCLUSION

Knowledge and views of pharmacists about biosimilars in Quebec and in France are alike. Pharmacists should be knowledgeable about the particularities and key issues of biosimilars because they will play a key role for their introduction in clinical practice. They should be aware of the evolution of the legal framework of biosimilars to ensure their safe and optimal use.