Janssen Applys to EMA to Expand Use of Imbruvica

Janssen-Cilag International NV announced on Tuesday the submission of a Type II variation application to the European Medicines Agency (EMA) seeking to broaden the existing marketing authorisation for Imbruvica (ibrutinib) to include previously untreated patients with chronic lymphocytic leukaemia (CLL).

Imbruvica is co-developed by Cilag GmbH International, a member of the Janssen Pharmaceutical Companies, and Pharmacyclics LLC, an AbbVie company. Janssen affiliates market Imbruvica in EMEA (Europe, Middle East and Africa) as well as the rest of the world, except for the United States, where Janssen Biotech, Inc. and Pharmacyclics LLC co-market it.

The filing is based on data from the randomised, multi-centre, open-label Phase 3 Resonatetm-2 (PCYC-1115) clinical trial assessing the use of Imbruvica versus chlorambucil in patients with treatment-naïve CLL or small lymphocytic lymphoma (SLL) aged 65 years or older.

According to JNJ, the Resonate-2 trial, which was sponsored by Pharmacyclics LLC, enrolled 269 patients in the U.S., EU and other regions. Patients were randomised to receive either Imbruvica 420 mg orally, once daily until progression or toxicity, or chlorambucil 0.5 to 0.8 mg/kg on days 1 and 15 of each 28-day cycle for up to 12 cycles. At the time of the final analysis the primary endpoint was met, with Imbruvica shown to be superior to chlorambucil in terms of progression-free survival (PFS). In addition, Imbruvica demonstrated significant improvements in key secondary efficacy endpoints, including overall survival (OS), overall response rate (ORR) and in haematologic function, JNJ said. It added that the safety findings were consistent with previous studies.

On 14 September 2015, Janssen announced that a supplemental New Drug Application (sNDA) was filed with the U.S. Food and Drug Administration for treatment-naïve patients with CLL based on these data.1

“This submission to expand the use of IMBRUVICA for patients with treatment-naïve CLL is a significant step forward in transforming the treatment journey for these patients,” said Jane Griffiths, Company Group Chairman, Janssen Europe, Middle East and Africa.

“Our ongoing efforts to further investigate IMBRUVICA in additional populations is part of our commitment to improving outcomes for patients with difficult to manage cancers.”

According to JNJ, Imbruvica (ibrutinib) is a first-in-class Bruton’s tyrosine kinase (BTK) inhibitor, which works by forming a strong covalent bond with BTK to block the transmission of cell survival signals within the malignant B cells. By blocking this BTK protein, IMBRUVICA helps kill and reduce the number of cancer cells. It also slows down the worsening of the cancer.

Imbruvica is currently approved in Europe for the treatment of adult patients with relapsed or refractory mantle cell lymphoma (MCL); adult patients with chronic lymphocytic leukaemia (CLL) who have received at least one prior therapy, or in first line patients with CLL in the presence of 17p deletion or TP53 mutation in patients unsuitable for chemo-immunotherapy.

Also, it is approved in Europe in adult patients with Waldenström’s macroglobulinemia (WM) who have received at least one prior therapy, or in first line treatment for patients unsuitable for chemo-immunotherapy