On Friday, July 9th, the Oncologic Drugs Advisory Committee (ODAC), suggested that necitumumab (Lilly), a monoclonal antibody.
On Friday, July 9th, the Oncologic Drugs Advisory Committee (ODAC), suggested that necitumumab (Lilly), a monoclonal antibody, shows promise in the first-line treatment of locally advanced or metastatic squamous non-small cell lung cancer (NSCLC) in combination with gemcitabine and cisplatin.
Necitumumab is a monoclonal antibody that binds to the extracellular domain of the human epidermal growth factor receptor (EGFR) and blocks interaction between EGFR and its ligands. As noted by the makers of necitumumab, EGFR expression is high in NSCLC tumors, and is found in more than 95% of squamous NSCLC.
The Committee did not vote on whether necitumumab should be approved; however, most members of the committee noted that it had a favorable risk-benefit profile despite safety concerns, which included the appearance of more sudden and unexplained deaths in patients who were taking the drug.
In the pivotal study, SQUIRE, there was a 1.6-month improvement in median overall survival, and a 0.2-month improvement in median progression-free survival with the addition of necitumumab to gemcitabine and cisplatin (Neci + GC) when compared to the gemcitabine-cisplatin (GC) regimen. Median overall survival was 11.5 months for Neci + GC, compared with 9.9 months for GC alone, and the median progression-free survival was 5.7 months, compared with 5.5 months.
ODAC chair Deborah K. Armstrong, MD, professor of oncology at the Johns Hopkins University in Baltimore, Maryland noted, “I think the survival benefit is modest, but real.”
Several patient advocates who spoke during the public portion of the meeting urged the panel to support approval of necitumumab, noting that there are few options for treatment of squamous NSCLC.
Squamous tumors make up about a third of all lung cancers, and are primarily due to heavy tobacco use, but not always. The majority of patients with the squamous form present with locally advanced or metastatic disease, stated the FDA. Five-year survival is less than 5%, according to the Agency.
A decision regarding the approval of necitumumab is expected later in 2015.
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