FDA Advisory Committee Unanimously Recommends Approval of Genentech’s Subcutaneous Rituximab for Certain
Blood Cancers
– The FDA has set an action date of June 26 to make a final decision on approval –
Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced that the U.S. Food and Drug
Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) voted unanimously (11 to 0) that the benefit-risk of
rituximab/hyaluronidase for subcutaneous (under the skin) injection was favorable for the treatment of certain blood cancers, which
include: previously untreated follicular lymphoma, previously untreated diffuse large B-cell lymphoma (DLBCL), relapsed or
refractory low grade or follicular lymphoma, and previously untreated and relapsed or refractory chronic lymphocytic leukemia
(CLL). This new co-formulation includes the same monoclonal antibody as intravenous Rituxan® (rituximab) and
hyaluronidase, a molecule that helps to deliver medicine under the skin. The FDA is expected to make a decision on approval by June
26, 2017.
“Subcutaneous rituximab can be administered in five to seven minutes compared to an hour and a half or more for intravenous
Rituxan,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “The significant reduction in
administration time could especially benefit people with blood cancer who may receive years of treatment, and we are pleased the
committee unanimously supported this new co-formulation.”
This co-formulation has been available in the European Union since 2014 where it is known as the subcutaneous (SC) formulation
of MabThera® (rituximab) and is approved in approximately 50 other countries worldwide. In the United States, Rituxan is
currently approved as an intravenous formulation for the treatment of people with previously untreated follicular lymphoma,
previously untreated DLBCL, relapsed or refractory low grade or follicular lymphoma, and previously untreated and relapsed or
refractory CLL. Intravenous Rituxan will continue to be available to patients if subcutaneous rituximab is approved. The
committee’s vote does not affect intravenous Rituxan’s approved uses in the United States or in other countries.
The ODAC recommendation was based on a review of results from a clinical development program comprising five studies that
together represented more than 2,000 people across key blood cancers for which intravenous Rituxan is approved. Because the
monoclonal antibody in subcutaneous rituximab and intravenous Rituxan is the same, it was possible to utilize clinical studies that
linked the safety and efficacy profile of the subcutaneous co-formulation to the well-established profile of intravenous Rituxan.
The studies demonstrated that subcutaneous administration of the co-formulation resulted in non-inferior levels of rituximab in the
blood (pharmacokinetics) and consistent clinical efficacy and safety outcomes compared to intravenous Rituxan. The clinical program
also assessed patient preferences for subcutaneous rituximab and healthcare provider opinions. The studies were the following:
- SparkThera (NCT00930514): Phase Ib maintenance study in previously untreated or relapsed follicular
lymphoma
- SABRINA (NCT01200758): Phase III induction and maintenance study in previously untreated follicular
lymphoma
- SAWYER (NCT01292603): Phase Ib study in previously untreated CLL
- MabEase (NCT01649856): Phase III study in previously untreated DLBCL
- PrefMab (NCT01724021): Phase III patient preference study in previously untreated follicular lymphoma
and DLBCL
Data from these studies were included in the company’s Biologics License Application for subcutaneous rituximab submitted to the
FDA.
About Rituxan
Rituxan is a monoclonal antibody designed to attach to CD20, a protein found on certain types of B-cells. It is thought to work
by attacking targeted cells together with the body's immune system. Rituxan was discovered by Biogen and is part of a collaboration
between Genentech and Biogen in the United States. Since its initial approval in 1997, Rituxan has been used to treat more than 4.4
million people with blood cancers.
About Subcutaneous Rituximab
Subcutaneous rituximab is investigational in the United States. It is a co-formulation of the same monoclonal antibody as
intravenous Rituxan and recombinant human hyaluronidase (rHuPH20), a technology licensed from Halozyme Therapeutics, Inc.
Hyaluronidase is an FDA-approved molecule that facilitates the delivery of a relatively large volume of medicine under the skin.
The subcutaneous co-formulation can be administered in five to seven minutes, compared to 1.5 to four hours for intravenous
Rituxan.
About Genentech In Hematology
For more than 20 years, Genentech has been developing medicines with the goal to redefine treatment in hematology. Today, we’re
investing more than ever in our effort to bring innovative treatment options to people with diseases of the blood. In addition to
approved medicines, Genentech’s pipeline of investigational hematology medicines includes an anti-CD79b antibody drug conjugate
(polatuzumab vedotin/RG7596) and a small molecule antagonist of MDM2 (idasanutlin/RG7388). Genentech’s dedication to developing
novel medicines for blood diseases expands beyond oncology, with the development of the investigational hemophilia A treatment
emicizumab. For more information visit http://www.gene.com/hematology.
Rituxan Indications
Rituxan® (rituximab) injection, for intravenous use, is indicated for the treatment of patients with:
- Low-grade or follicular CD20-positive non-Hodgkin’s lymphoma as a single-agent therapy in patients
whose disease recurred or did not respond to initial treatment
- Follicular CD20-positive non-Hodgkin’s lymphoma as an initial treatment with chemotherapy, and in
patients whose initial treatment was successful, as a single-agent follow-up therapy
- Low-grade CD20-positive non-Hodgkin’s lymphoma as a single-agent follow-up therapy for patients who
did not progress on initial treatment with CVP chemotherapy
- CD20-positive diffuse large B-cell non-Hodgkin’s lymphoma as an initial treatment in combination with
CHOP chemotherapy
- CD20-positive chronic lymphocytic leukemia in combination with FC chemotherapy as an initial
treatment or as a treatment after disease has recurred
People with serious infections should not receive Rituxan.
It is not known if Rituxan is safe or effective in children.
Important Safety Information:
Patients must tell their doctor right away about any side effects they experience. Rituxan can cause serious side effects that
can lead to death, including:
- Infusion Reactions: may occur during or within 24 hours of the infusion. The patient’s doctor
should give the patient medicines before their treatment. Symptoms can include hives, rash, itching, facial or oral swelling,
sudden cough, shortness of breath, difficulty breathing, weakness, dizziness, feeling faint, racing heart or chest pain.
- Severe Skin and Mouth Reactions: symptoms can include painful sores, ulcers, or blisters on
the skin, lips or mouth; peeling skin; rash; or pustules.
- Hepatitis B Virus (HBV) Reactivation: may cause serious liver problems including liver failure
and death. If patients have had hepatitis B or are carriers of HBV, receiving Rituxan could cause the virus to become an active
infection again. Patients should not receive Rituxan if they have active HBV liver disease. The patient’s doctor will do blood
tests to check for HBV infection prior to treatment and will monitor the patient during and for several months following their
treatment.
- Progressive Multifocal Leukoencephalopathy (PML): a rare, serious brain infection that can
lead to severe disability and death and for which there is no known prevention, treatment or cure. Symptoms can include
difficulty thinking, loss of balance, changes in speech or walking, weakness on one side of the body or blurred or lost
vision.
What are the additional possible serious side effects of Rituxan?
Patients must tell their doctor right away about any side effects they experience. Rituxan can cause serious side effects that
can lead to death, including:
- Tumor Lysis Syndrome (TLS): may cause kidney failure and the need for dialysis treatment,
abnormal heart rhythm and can lead to death. The patient’s doctor may give the patient medicines before their treatment to help
prevent TLS.
- Serious Infections: can happen during and after treatment and can lead to death. These
infections may be bacterial, fungal or viral. Symptoms can include fever; cold or flu symptoms; earache or headache; pain during
urination; white patches in the mouth or throat; cuts or scrapes that are red, warm, swollen or painful.
- Heart Problems: symptoms can include chest pain and irregular heartbeats that may require
treatment. The patient’s doctor may need to stop their treatment.
- Kidney Problems: the patient’s doctor should do blood tests to check how well the patient’s
kidneys are working.
- Stomach and Serious Bowel Problems: can include blockage or tears in the bowel that can lead
to death. Stomach area pain during treatment can be a symptom.
- Low Blood Cell Counts: the patient’s blood cell counts may be monitored during treatment.
The most common side effects of Rituxan are infusion reactions, chills, infections, body aches, tiredness and low white blood
cells.
Patients must tell their doctor if they are pregnant, plan to become pregnant or are breastfeeding. It is not known if Rituxan
may harm the patient’s unborn baby or pass into the patient’s breast milk. Women should use birth control while using Rituxan and
for 12 months after treatment.
Patients must tell their doctor about any side effect that bothers them or that does not go away.
These are not all of the possible side effects of Rituxan. For more information, patients should ask their doctor or
pharmacist.
Report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch . Report side effects to Genentech at (888) 835-2555.
Please visit http://www.Rituxan.com for the Rituxan full Prescribing Information, including Boxed WARNINGS and Medication
Guide, for additional Important Safety Information.
About Genentech
Founded 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and
commercializes medicines to treat patients with serious or life-threatening medical conditions. The company, a member of the Roche
Group, has headquarters in South San Francisco, California. For additional information about the company, please visit http://www.gene.com.
for Genentech
Media Contact:
Holli Kolkey, 650-922-1269
Advocacy Contact:
Angela Wilson, 202-423-2739
Investor Contacts:
Neera Dahiya Ravindran, M.D., 650-491-5281
Karl Mahler, 011 41 61 687 8503
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