The China Center for Drug Evaluation, National Medical Products Administration Has Recommended Breakthrough Therapy Designation for ciltacabtagene autoleucel (cilta-cel, LCAR-B38M CAR-T Cells), an Investigational BCMA CAR-T Cell Therapy
First investigational product being recommended for Breakthrough Therapy Designation in
The BTD for cilta-cel (LCAR-B38M CAR-T cells) is based on the ongoing Phase 2 CARTIFAN-1 study being conducted in
The BTD procedure is part of the recently revised Drug Registration Regulation which went into effect on
In
“Breakthrough designation recommendation by the China CDE of NMPA represents an important regulatory milestone in the continued development of cilta-cel in multiple myeloma patients in China,” said
Previously, the following regulatory designations have been granted to Janssen for cilta-cel:
-
In
July 2020 , theKorea Ministry of Food and Drug Safety granted orphan drug designation.3 -
In
June 2020 , theJapan Ministry of Health, Labor and Welfare granted orphan drug designation.4 -
In
February 2020 , theEuropean Commission granted orphan designation.5 -
In
December 2019 , theU.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation.6 -
In
April 2019 , theEuropean Medicines Agency granted Janssen a PRIME (PRIority MEdicines) designation.7 -
In
February 2019 , the FDA granted Janssen orphan drug designation for the treatment of multiple myeloma.8
About the Clinical Development Program
CARTIFAN-1
The Phase 2 CARTIFAN-1 confirmatory trial (MMY2002, NCT03758417, CTR20181007) is being conducted in
CARTITUDE-1
Cilta-cel (JNJ-4528) is currently being investigated in the Phase 1b/2 CARTITUDE-1 (MMY2001, NCT03548207) pivotal study conducted in US and
CARTITUDE-2
The global, multi-cohort Phase 2 CARTITUDE-2 (MMY2003, NCT04133636) study, cilta-cel (JNJ-4528) is actively recruiting patients with multiple myeloma in various clinical settings. This study is being conducted to evaluate the overall minimal residual disease (MRD) negative rate of participants who receive JNJ-4528 to further explore efficacy and safety in earlier patient populations.11
CARTITUDE-4
The global, Phase 3 CARTITUDE-4 (MMY3002, NCT04181827) study, cilta-cel (JNJ-4528) is actively recruiting patients with multiple myeloma who have received 1-3 prior lines of therapy including a PI and IMiD and are refractory to lenalidomide. The study is being conducted to evaluate the efficacy of JNJ-4528 compared to standard therapies7 including daratumumab, pomalidomide and low-dose dexamethasone (DPd) or pomalidomide, bortezomib and low-dose dexamethasone (PVd).12
LEGEND-2
LEGEND-2 (NCT03090659) is an ongoing, Phase 1, single-arm, open-label, first-in-human, study of 74 patients being conducted at four participating hospitals in
About Multiple Myeloma
Multiple myeloma is an incurable blood cancer that starts in the bone marrow and is characterized by an excessive proliferation of plasma cells.14
Although treatment may result in remission, unfortunately, patients will most likely relapse as there is currently no cure.15 Refractory multiple myeloma is when a patient’s disease is non-responsive or progresses within 60 days of their last therapy.16,17 Relapsed myeloma is when the disease has returned after a period of initial, partial or complete remission and does not meet the definition of being refractory.18 While some patients with multiple myeloma have no symptoms at all, most patients are diagnosed due to symptoms that can include bone problems, low blood counts, calcium elevation, kidney problems or infections.19 Patients who relapse after treatment with standard therapies, including protease inhibitors and immunomodulatory agents, have poor prognoses and few treatment options available.20
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Cautions Concerning Forward-Looking Statements
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References
- China Drug Registration Regulation: http://www.gov.cn/gongbao/content/2020/content_5512563.htm
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Proposed Breakthrough Therapy Type Announcement: http://www.cde.org.cn/news.do?method=changePage&pageName=service&frameStr=26. Accessed
August 2020 -
Korea Ministry of Food and Drug Safety . https://www.mfds.go.kr/brd/m_76/view.do?seq=14749. AccessedAugust 2020 . -
Japan Ministry of Health, Labor and Welfare . https://www.mhlw.go.jp/hourei/doc/tsuchi/T200629I0030.pdf. AccessedAugust 2020 . -
European Medicines Agency . Public summary of opinion on orphan designation. Available at: https://www.ema.europa.eu/en/documents/orphan-designation/eu/3/20/2252-public-summary-positive-opinion-orphan-designation-autologous-human-t-cells-genetically_en.pdf. AccessedAugust 2020 . -
Legendbiotech.com.
U.S. Food and Drug Administration Grants Breakthrough Therapy Designation for JNJ-68284528, an Investigational BCMA CAR-T Cell Therapy. Available at: https://www.legendbiotech.com/pdf/JNJ4528_Breakthrough_Therapy_Designation_Release.pdf. AccessedAugust 2020 . -
Legendbiotech.com. European Medicines Agency Grants Janssen PRIME Designation for JNJ-68284528 (LCAR-B38M), an Investigational BCMA CAR-T Therapy Discovered by
Legend Biotech . Available at: https://www.legendbiotech.com/pdf/Legend_LCAR_PRIME_Designation_Press%20Release_4-1-2019.pdf. AccessedAugust 2020 . -
Accessdata.fda.gov.
U.S. Food & Drug Administration . Available at: https://www.accessdata.fda.gov/scripts/opdlisting/oopd/detailedIndex.cfm?cfgridkey=20186721. AccessedAugust 2020 . -
CARTIFAN-1 (NCT03758417). Available: https://clinicaltrials.gov/ct2/show/NCT03758417. Accessed
August 2020 . -
CARTITUDE-1 (NCT03548207). Available: https://clinicaltrials.gov/ct2/show/NCT03548207. Accessed
August 2020 . -
CARTITUDE-2 (NCT04133636). Available: https://clinicaltrials.gov/ct2/show/NCT04133636. Accessed
August 2020 . -
CARTITUDE-4 (NCT041818270. Available: https://clinicaltrials.gov/ct2/show/NCT04181827. Accessed
August 2020 . -
LEGEND-2 (NCT03090659). Available: https://clinicaltrials.gov/ct2/show/NCT03090659. Accessed
August 2020 . -
American Society of Clinical Oncology . Multiple myeloma: introduction. Available at: https://www.cancer.net/cancer-types/multiple-myeloma/introduction. AccessedAugust 2020 - Abdi J, Chen G, Chang H, et al. Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms. Oncotarget. 2013;4:2186–2207.
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National Cancer Institute . NCI dictionary of cancer terms: refractory. Available: https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=350245. AccessedAugust 2020 . - Richardson P, Mitsiades C, Schlossman R, et al. The treatment of relapsed and refractory multiple myeloma. Hematology Am Soc Hematol Educ Program. 2007:317-23.
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National Cancer Institute . NCI dictionary of cancer terms: relapsed. Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=45866. AccessedAugust 2020 . -
American Cancer Society . Multiple myeloma: early detection, diagnosis and staging. Available at: https://www.cancer.org/content/dam/CRC/PDF/Public/8740.00.pdf. AccessedAugust 2020 . - Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia. 2012;26:149-57.
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