Phase 3 Trial Provides Confirmatory Evidence for IBRANCE in the
First-Line Setting and Will Support Global Regulatory Submissions
Pfizer Inc. (NYSE:PFE) today announced positive top-line results from
the Phase 3 PALOMA-2 trial for IBRANCE® (palbociclib), an
oral, first-in-class inhibitor of cyclin-dependent kinases (CDKs) 4 and
6.1 The study met its primary endpoint by demonstrating an
improvement in progression-free survival (PFS) for the combination of
IBRANCE plus letrozole compared with letrozole plus placebo in
post-menopausal women with estrogen receptor-positive, human epidermal
growth factor receptor 2-negative (ER+, HER2-) advanced or metastatic
breast cancer who had not received previous systemic treatment for their
advanced disease. The PALOMA-2 trial provides confirmatory evidence for
IBRANCE in combination with letrozole in the first-line setting, which
was first studied in the Phase 2 PALOMA-1 trial. These data will support
additional planned global regulatory submissions and a request for
conversion of the accelerated approval for IBRANCE to regular approval
in the U.S. Detailed efficacy and safety results from PALOMA-2 will be
submitted for presentation at the American Society of Clinical Oncology
(ASCO) 2016 Annual Meeting.
“PALOMA-2 represents the third randomized study to demonstrate the
benefit of IBRANCE when added to hormonal therapy in the management of
women with ER+, HER2- advanced breast cancer. IBRANCE remains the only
CDK 4/6 inhibitor with Phase 3 data in this disease,” said Dr. Mace
Rothenberg, MD, chief medical officer, Pfizer Oncology & senior vice
president, Global Product Development, Oncology. “These results provide
confirmatory evidence for PALOMA-1 and will be used to support
regulatory submissions around the world, including a request for
conversion of IBRANCE from accelerated to full approval in the United
States. We look forward to sharing the detailed results of PALOMA-2 with
the oncology community and advancing our discussions with regulatory
authorities.”
The adverse events observed with IBRANCE in combination with letrozole
in PALOMA-2 were generally consistent with the known safety profile for
IBRANCE across the different patient populations and lines of therapy in
the clinical development program to date. The warnings and precautions
of IBRANCE include neutropenia, pulmonary embolism and embryo-fetal
toxicity.1 For more information, please see Important Safety
Information for IBRANCE below.1
Since its introduction in February 2015, more than 25,000 women have
been prescribed IBRANCE by more than 6,000 prescribers in the U.S.
Based on the results of PALOMA-1, IBRANCE first was approved by the U.S.
Food and Drug Administration (FDA) in February 2015 for the treatment of
postmenopausal women with ER+, HER2- advanced breast cancer in
combination with letrozole as initial endocrine-based therapy for their
metastatic disease.1 The indication in combination with
letrozole was approved under accelerated approval based on PFS. As
stated at the time of the approval, continued approval for this
indication may be contingent upon verification and description of
clinical benefit in PALOMA-2, which the FDA identified as the
confirmatory trial.1 Pfizer will work with the FDA to submit
the results of PALOMA-2 to support conversion of the accelerated
approval for IBRANCE to regular approval in the U.S.
As previously announced in February 2016, IBRANCE also is approved in
the U.S. for the treatment of hormone receptor-positive (HR+),
HER2-advanced or metastatic breast cancer in combination with
fulvestrant in women with disease progression following endocrine
therapy based on results from the Phase 3 PALOMA-3 study.1
IBRANCE also is approved in eight countries outside of the U.S., and
Pfizer will work with additional global regulatory authorities to review
the PALOMA-2 data. As previously disclosed in August 2015, Pfizer has
filed a Marketing Authorization Application (MAA) with the European
Medicines Agency (EMA) for IBRANCE in combination with endocrine therapy
for the treatment of HR+, HER2- advanced or metastatic breast cancer.
The MAA was based on the results from the PALOMA-1 and PALOMA-3 trials.
Pfizer will work with the EMA to submit the PALOMA-2 results as
additional supporting data for the ongoing review of the MAA.
About the PALOMA Trials
Pfizer has worked closely with investigators and international breast
cancer experts to establish a robust development program for IBRANCE in
HR+, HER2- breast cancer across stages and treatment settings.
PALOMA-1
-
PALOMA-1 is a randomized (1:1), multi-center, multinational, open
label Phase 2 trial designed to assess PFS in postmenopausal women
with ER+, HER2- advanced breast cancer receiving IBRANCE (125 mg once
daily for three out of four weeks in repeated cycles) in combination
with letrozole versus letrozole alone (2.5 mg once daily on a
continuous regimen) as a first-line treatment. The results from
PALOMA-1 were published online by The Lancet Oncology in
December 2014.
PALOMA-2
-
PALOMA-2 is a randomized (2:1), multicenter, multinational,
double-blind Phase 3 study designed to assess PFS in postmenopausal
women with ER+, HER2- advanced breast cancer receiving IBRANCE (125 mg
orally once daily for three out of four weeks in repeated cycles) in
combination with letrozole (2.5 mg once daily continuously) versus
letrozole plus placebo as a first-line treatment. PALOMA-2 has
more than 200 global sites participating and 666 patients enrolled.
PALOMA-3
-
PALOMA-3 is a randomized (2:1), multicenter, multinational,
double-blind Phase 3 study designed to assess PFS with IBRANCE (125 mg
once daily orally for three out of four weeks in each cycle) in
combination with fulvestrant (500 mg intramuscularly on days 1 and 15
of cycle 1, and then on day 1 of each subsequent 28 day cycle) versus
fulvestrant plus placebo in pre/perimenopausal and postmenopausal
women with HR+, HER2- metastatic breast cancer whose disease has
progressed during or after endocrine therapy. Based on the PALOMA-3
results, a supplemental New Drug Application (sNDA) was reviewed and
approved in February 2016 under the FDA’s Breakthrough Therapy
designation and Priority Review programs to expand the use of IBRANCE
to include use in combination with fulvestrant in women with HR+,
HER2- advanced or metastatic breast cancer with disease progression
following endocrine therapy.1
The full prescribing information for IBRANCE can be found at www.pfizer.com.
Important Safety Information
Neutropenia was the most frequently reported adverse reaction in
Study 1 (PALOMA-1) (75%) and Study 2 (PALOMA-3) (83%). In Study 1, Grade
3 (57%) or 4 (5%) decreased neutrophil counts were reported in patients
receiving IBRANCE plus letrozole. In Study 2, Grade 3 (56%) or Grade 4
(11%) decreased neutrophil counts were reported in patients receiving
IBRANCE plus fulvestrant. Febrile neutropenia has been reported in about
1% of patients exposed to IBRANCE. One death due to neutropenic sepsis
was observed in Study 2. Inform patients to promptly report any fever.
Monitor complete blood count prior to starting IBRANCE, at the beginning
of each cycle, on Day 14 of first 2 cycles, and as clinically indicated.
Dose interruption, dose reduction, or delay in starting treatment cycles
is recommended for patients who develop Grade 3 or 4 neutropenia.
Pulmonary embolism (PE) has been reported at a higher rate in
patients treated with IBRANCE plus letrozole in Study 1 (5%) and in
patients treated with IBRANCE plus fulvestrant in Study 2 (1%) compared
with no cases in patients treated either with letrozole alone or
fulvestrant plus placebo. Monitor for signs and symptoms of PE and treat
as medically appropriate.
Based on the mechanism of action, IBRANCE can cause fetal harm.
Advise females of reproductive potential to use effective contraception
during IBRANCE treatment and for at least 3 weeks after the last dose.
IBRANCE may impair fertility in males and has the potential to
cause genotoxicity. Advise male patients with female partners of
reproductive potential to use effective contraception during IBRANCE
treatment and for 3 months after the last dose. Advise females to inform
their healthcare provider of a known or suspected pregnancy. Advise
women not to breastfeed during IBRANCE treatment and for 3 weeks
after the last dose because of the potential for serious adverse
reactions in nursing infants.
The most common adverse reactions (≥10%) of any grade
reported in Study 1 of IBRANCE plus letrozole vs letrozole alone
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 (≥10%) in Study 1 reported at
a higher incidence in the IBRANCE plus letrozole group vs the letrozole
alone group included neutropenia (54% vs 1%) and leukopenia (19% vs 0%).
The most frequently reported serious adverse events in patients
receiving IBRANCE plus letrozole were pulmonary embolism (4%) and
diarrhea (2%).
Lab abnormalities occurring in Study 1 (all grades,
IBRANCE plus letrozole vs letrozole alone) were decreased WBC (95% vs
26%), decreased neutrophils (94% vs 17%), decreased lymphocytes (81% vs
35%), decreased hemoglobin (83% vs 40%), and decreased platelets (61% vs
16%).
The most common adverse reactions (≥10%) of any grade reported in Study
2 of IBRANCE plus fulvestrant vs fulvestrant plus placebo included
neutropenia (83% vs 4%), leukopenia (53% vs 5%), infections (47% vs
31%), fatigue (41% vs 29%), nausea (34% vs 28%), anemia (30% vs 13%),
stomatitis (28% vs 13%), headache (26% vs 20%), diarrhea (24% vs 19%),
thrombocytopenia (23% vs 0%), constipation (20% vs 16%), vomiting (19%
vs 15%), alopecia (18% vs 6%), rash (17% vs 6%), decreased appetite (16%
vs 8%), and pyrexia (13% vs 5%).
Grade 3/4 adverse reactions (≥10%) in Study 2 reported at
a higher incidence in the IBRANCE plus fulvestrant group vs the
fulvestrant plus placebo group included neutropenia (66% vs 1%) and
leukopenia (31% vs 2%). The most frequently reported serious adverse
reactions in patients receiving IBRANCE plus fulvestrant were infections
(3%), pyrexia (1%), neutropenia (1%), and pulmonary embolism (1%).
Lab abnormalities occurring in Study 2 (all grades,
IBRANCE plus fulvestrant vs fulvestrant plus placebo) were decreased WBC
(99% vs 26%), decreased neutrophils (96% vs 14%), anemia (78% vs 40%),
and decreased platelets (62% vs 10%).
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 CYP3A inducers. The dose
of sensitive CYP3A substrates with a narrow therapeutic index may
need to be reduced as IBRANCE may increase their exposure.
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 IBRANCE® (palbociclib) 125mg capsules
IBRANCE is an oral inhibitor of CDKs 4 and 6,1 which are key
regulators of the cell cycle that trigger cellular progression.3,4
IBRANCE is indicated for the treatment of HR+, HER2- advanced or
metastatic breast cancer in combination with letrozole as initial
endocrine based therapy in postmenopausal women, or fulvestrant in women
with disease progression following endocrine therapy.1 The
indication in combination with letrozole is approved under accelerated
approval based on progression-free survival (PFS). Continued approval
for this indication may be contingent upon verification and description
of clinical benefit in a confirmatory trial.1
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 healthcare products. Our global portfolio
includes medicines and vaccines as well as many of the world's
best-known consumer healthcare 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. For more information, please visit us at www.pfizer.com.
In addition, to learn more, follow us on Twitter at @Pfizer
and @Pfizer_News,
LinkedIn,
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and like us on Facebook at Facebook.com/Pfizer.
DISCLOSURE NOTICE: The information contained in this release is as of
April 19, 2016. 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), including its potential benefits, that involves
substantial risks and uncertainties that could cause actual results to
differ materially from those expressed or implied by such statements.
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 regulatory authorities will be satisfied
with the design of and results from our clinical studies; whether and
when the accelerated approval for IBRANCE will be converted to regular
approval in the U.S.; whether and when drug applications may be filed in
any additional jurisdictions for IBRANCE for potential HR+/HER2-
metastatic breast cancer indications or in any jurisdictions for any
other potential indications for IBRANCE; whether and when the MAA filed
by Pfizer with the EMA for IBRANCE in combination with endocrine therapy
for the treatment of HR+, HER2- advanced or metastatic breast cancer may
be approved and whether and when any such other applications may
be approved by 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, 2015 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 U.S.
Securities and Exchange Commission and available at www.sec.gov
and www.pfizer.com.
1 IBRANCE® (palbociclib) Prescribing Information.
New York. NY: Pfizer Inc: 2016.
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