Pfizer Inc. today announced that the European Medicines Agency (EMA) has
validated for review the Marketing Authorization Application (MAA) for
IBRANCE® (palbociclib) in combination with endocrine therapy
for the treatment of hormone receptor-positive, human epidermal growth
factor receptor 2-negative (HR+/HER2-) advanced or metastatic breast
cancer. With this validation, the Pfizer application is complete and the
EMA will now begin the review procedure.
“The MAA for IBRANCE is based on the results from the PALOMA-1 and
PALOMA-3 trials, which demonstrated significant clinical benefit for
women with HR+/HER2- advanced or metastatic breast cancer,” said Dr.
Mace Rothenberg, senior vice president of Clinical Development and
Medical Affairs and chief medical officer for Pfizer Oncology. “The
acceptance of our application for review by the EMA represents a
significant step towards potentially bringing IBRANCE to women with
metastatic breast cancer in Europe, and Pfizer looks forward to working
with the EMA on the review procedure.”
The submission is based on the final results of the PALOMA-1 and
PALOMA-3 trials in metastatic breast cancer. Both trials demonstrated
that IBRANCE in combination with an endocrine therapy improved
progression-free survival (PFS) compared to endocrine therapy alone.
The Phase 3 PALOMA-3 study evaluated IBRANCE in combination with
fulvestrant compared to a standard of care, fulvestrant, plus placebo in
women with HR+/HER2- metastatic breast cancer whose disease had
progressed during or after endocrine therapy. The results were presented
as a late-breaker at the 51st Annual Meeting of the American
Society of Clinical Oncology (ASCO) and published in The New
England Journal of Medicine in June 2015. The Phase 2 PALOMA-1 study
evaluated IBRANCE in combination with letrozole compared to letrozole
alone in postmenopausal women with estrogen receptor-positive
(ER+)/HER2- locally advanced or metastatic breast cancer who had not
received previous systemic treatment for their advanced disease. Results
were presented in an oral presentation at the American Association of
Cancer Research (AACR) Annual Meeting and published in The Lancet
Oncology in 2014.
About IBRANCE® (palbociclib)
IBRANCE is an oral, first-in-class inhibitor of cyclin-dependent kinases
(CDKs) 4 and 6.1 CDKs 4 and 6 are key regulators of the cell
cycle that trigger cellular progression.2,3
In the European Union, IBRANCE is an investigational agent and has not
been approved.
IBRANCE was approved by the U.S. Food and Drug Administration (FDA) in
February 2015 for use in combination with letrozole as a treatment for
postmenopausal women with ER+/HER2- advanced breast cancer as initial
endocrine-based therapy for their metastatic disease.1 The
effectiveness of IBRANCE in these patients is based on a study that
measured PFS.1 Continued approval for this indication may be
contingent upon verification and description of clinical benefit in a
confirmatory trial. IBRANCE has also received regulatory approval in
Albania, Chile and Macau.
IMPORTANT IBRANCE (palbociclib) SAFETY INFORMATION FROM THE U.S.
PRESCRIBING INFORMATION
Neutropenia: Neutropenia is frequently reported with IBRANCE
therapy. In the randomized phase II study, Grade 3 (57%) or 4 (5%)
decreased neutrophil counts were reported in patients receiving IBRANCE
plus letrozole. Febrile neutropenia can occur.
Monitor complete blood count prior to starting IBRANCE and at the
beginning of each cycle, as well as Day 14 of the first two cycles, and
as clinically indicated. For patients who experience Grade 3
neutropenia, consider repeating the complete blood count monitoring 1
week later. Dose interruption, dose reduction, or delay in starting
treatment cycles is recommended for patients who develop Grade 3 or 4
neutropenia.
Infections: Infections have been reported at a higher rate in
patients treated with IBRANCE plus letrozole (55%) compared with
letrozole alone (34%). Grade 3 or 4 infections occurred in 5% of
patients treated with IBRANCE plus letrozole vs no patients treated with
letrozole alone. Monitor patients for signs and symptoms of infection
and treat as medically appropriate.
Pulmonary embolism (PE): PE has been reported at a higher rate in
patients treated with IBRANCE plus letrozole (5%) compared with no cases
in patients treated with letrozole alone. Monitor patients for signs and
symptoms of PE and treat as medically appropriate.
Pregnancy and lactation: Based on the mechanism of action,
IBRANCE can cause fetal harm. Advise females with reproductive potential
to use effective contraception during therapy with IBRANCE and for at
least 2 weeks after the last dose. Advise females to contact their
healthcare provider if they become pregnant or if pregnancy is suspected
during treatment with IBRANCE. Advise women not to breastfeed while on
IBRANCE therapy because of the potential for serious adverse reactions
in nursing infants from IBRANCE.
Additional hematologic abnormalities: Decreases in hemoglobin
(83% vs 40%), leukocytes (95% vs 26%), lymphocytes (81% vs 35%), and
platelets (61% vs 16%) occurred at a higher rate in patients treated
with IBRANCE plus letrozole vs letrozole alone.
Adverse reactions: The most common all causality adverse
reactions (≥10%) of any grade reported in patients treated with IBRANCE
plus letrozole vs letrozole alone in the phase II study included
neutropenia (75% vs 5%), leukopenia (43% vs 3%), fatigue (41% vs 23%),
anemia (35% vs 7%), upper respiratory infection (31% vs 18%), nausea
(25% vs 13%), stomatitis (25% vs 7%), alopecia (22% vs 3%), diarrhea
(21% vs 10%), thrombocytopenia (17% vs 1%), decreased appetite (16% vs
7%), vomiting (15% vs 4%), asthenia (13% vs 4%), peripheral neuropathy
(13% vs 5%), and epistaxis (11% vs 1%).
Grade 3/4 adverse reactions reported (≥10%) occurring at a higher
incidence in the IBRANCE plus letrozole vs letrozole alone group include
neutropenia (54% vs 1%) and leukopenia (19% vs 0%). The most frequently
reported serious adverse events in patients receiving IBRANCE were
pulmonary embolism (4%) and diarrhea (2%).
General dosing information: The recommended dose of IBRANCE is
125 mg taken orally once daily for 21 days followed by 7 days off
treatment in 28-day cycles. IBRANCE should be taken with food and in
combination with letrozole 2.5 mg once daily continuously.
Patients should be encouraged to take their dose at approximately the
same time each day.
Capsules should be swallowed whole. No capsule should be ingested if it
is broken, cracked, or otherwise not intact. If a patient vomits or
misses a dose, an additional dose should not be taken that day. The next
prescribed dose should be taken at the usual time.
Management of some adverse reactions may require temporary dose
interruption/delay and/or dose reduction, or permanent discontinuation.
Dose modification of IBRANCE is recommended based on individual safety
and tolerability.
Drug interactions: Avoid concurrent use of strong CYP3A
inhibitors. If patients must be administered a strong CYP3A inhibitor,
reduce the IBRANCE dose to 75 mg/day. If the strong inhibitor is
discontinued, increase the IBRANCE dose (after 3-5 half-lives of the
inhibitor) to the dose used prior to the initiation of the strong CYP3A
inhibitor. Grapefruit or grapefruit juice may increase plasma
concentrations of IBRANCE and should be avoided.
Avoid concomitant use of strong and moderate CYP3A inducers. The dose of
the sensitive CYP3A substrates with a narrow therapeutic index may need
to be reduced as IBRANCE may increase their exposure.
Hepatic and renal impairment: IBRANCE has not been studied in
patients with moderate to severe hepatic impairment or in patients with
severe renal impairment (CrCl <30 mL/min).
About Pfizer Oncology
Pfizer Oncology is committed to the discovery, investigation and
development of innovative treatment options to improve the outlook for
cancer patients worldwide. Our strong pipeline of biologics and small
molecules, one of the most robust in the industry, is studied with
precise focus on identifying and translating the best scientific
breakthroughs into clinical application for patients across a wide range
of cancers. By working collaboratively with academic institutions,
individual researchers, cooperative research groups, governments, and
licensing partners, Pfizer Oncology strives to cure or control cancer
with breakthrough medicines, to deliver the right drug for each patient
at the right time. For more information, please visit www.Pfizer.com.
Pfizer Inc.: Working together for a healthier world®
At Pfizer, we apply science and our global resources to bring therapies
to people that extend and significantly improve their lives. We strive
to set the standard for quality, safety and value in the discovery,
development and manufacture of health care products. Our global
portfolio includes medicines and vaccines as well as many of the world's
best-known consumer health care products. Every day, Pfizer colleagues
work across developed and emerging markets to advance wellness,
prevention, treatments and cures that challenge the most feared diseases
of our time. Consistent with our responsibility as one of the world's
premier innovative biopharmaceutical companies, we collaborate with
health care providers, governments and local communities to support and
expand access to reliable, affordable health care around the world. For
more than 150 years, Pfizer has worked to make a difference for all who
rely on us. To learn more, please visit us at www.pfizer.com.
DISCLOSURE NOTICE: The information contained in this release is as of
August 20, 2015. Pfizer assumes no obligation to update forward-looking
statements contained in this release as the result of new information or
future events or developments.
This release contains forward-looking information about IBRANCE
(palbociclib) that involves substantial risks and uncertainties that
could cause actual results to differ materially from those expressed or
implied by such statements. Forward-looking statements include those
about IBRANCE’s potential benefits and about the MAA for IBRANCE in
Europe for a potential indication for the treatment of women with
HR+/HER2- advanced or metastatic breast cancer in combination with
endocrine therapy. Risks and uncertainties include, among other things,
uncertainties regarding the commercial success of IBRANCE; the
uncertainties inherent in research and development, including further
investigation of the clinical benefit of IBRANCE, the ability to meet
anticipated clinical trial commencement and completion dates and
regulatory submission dates, as well as the possibility of unfavorable
clinical trial results, including unfavorable new clinical data and
additional analyses of existing clinical data; whether the PALOMA-2
Phase 3 trial of IBRANCE will demonstrate a statistically significant
improvement in progression-free survival and whether the other trials of
IBRANCE will meet their primary endpoints; whether regulatory
authorities will be satisfied with the design of and results from our
clinical studies; whether and when drug applications or supplemental
drug applications may be filed with the U.S. Food and Drug
Administration or any other jurisdictions for potential HR+/HER2-
metastatic breast cancer indications for IBRANCE; whether and
when the EMA may approve the MAA and whether and when any other
applications may be approved by other regulatory authorities, which will
depend on the assessment by such regulatory authorities of the
benefit-risk profile suggested by the totality of the efficacy and
safety information submitted; decisions by regulatory authorities
regarding labeling and other matters that could affect the availability
or commercial potential of IBRANCE; and competitive developments.
A further description of risks and uncertainties can be found in
Pfizer’s Annual Report on Form 10-K for the fiscal year ended December
31, 2014 and in its subsequent reports on Form 10-Q, including in the
sections thereof captioned “Risk Factors” and “Forward-Looking
Information and Factors That May Affect Future Results”, as well as in
its subsequent reports on Form 8-K, all of which are filed with the SEC
and available at www.sec.gov
and www.pfizer.com.
1 IBRANCE® (palbociclib) Prescribing Information.
New York. NY: Pfizer Inc: 2015.
2 Weinberg RA. pRb and Control of the Cell Cycle Clock. In:
Weinberg RA, ed. The Biology of Cancer. 2nd ed. New York, NY: Garland
Science; 2014:275-329.
3 Sotillo E, Grana X. Escape from Cellular Quiescence. In:
Enders GH, ed. Cell Cycle Deregulation in Cancer. New York, NY: Humana
Press; 2010:3-22.
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