FDA grants priority review for venetoclax new drug application

• Venetoclax, an investigational medicine, is a potential new way of treating the most common adult leukaemia

Roche (SIX: RO, ROG; OTCQX: RHHBY) announced today that the US Food and Drug Administration (FDA) has accepted the New Drug Application (NDA) and granted Priority Review for venetoclax for the treatment of people with chronic lymphocytic leukaemia (CLL) who have received at least one prior therapy, including those with 17p deletion. Venetoclax is a small molecule inhibitor of the BCL-2 protein being developed in partnership with AbbVie, and was granted Breakthrough Therapy Designation by the FDA in April 2015 for the treatment of people with previously treated (relapsed or refractory) CLL with 17p deletion.

“Venetoclax is a potential new way to treat this difficult type of chronic lymphocytic leukaemia,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “We look forward to working with AbbVie and health authorities to bring this first-of-its-kind medicine to people who need more options.”

A Priority Review designation is granted to medicines that the FDA has determined to have the potential to provide significant improvements in the treatment, prevention or diagnosis of a disease. Breakthrough Therapy Designation is designed to expedite the development and review of medicines intended to treat serious or life-threatening diseases and to help ensure people have access to them through FDA approval as soon as possible.

A Marketing Authorization Application (MAA) has been validated by the European Medicines Agency (EMA).

About Study M13-982

The NDA for venetoclax is based in part on data from the pivotal Phase II M13-982 study. M13-982 (NCT01889186) is a Phase II, open-label, single arm, multicentre study evaluating the efficacy and safety of venetoclax in patients with relapsed, refractory or previously untreated chronic lymphocytic leukaemia (CLL) with 17p deletion. The study included 107 patients with relapsed or refractory disease, and all but one had 17p deletion. Additionally, about 50 patients with relapsed, refractory or previously untreated disease have been enrolled in the safety expansion cohort. The primary endpoint of the study is overall response rate (ORR) as determined by an independent review committee (IRC), and secondary endpoints include complete response (CR), partial response (PR), duration of response (DOR), progression-free survival (PFS) and overall survival (OS). The level of minimal residual disease (MRD) in peripheral blood and/or bone marrow was assessed in a subset of patients.

Results from the study were recently presented at the 57th American Society of Hematology (ASH) Annual Meeting showing:

• The study met its primary endpoint, with an ORR of 79.4 percent among the 107 patients with relapsed or refractory disease receiving venetoclax, as assessed by IRC. In addition, 7.5 percent of patients achieved a complete response with or without complete recovery of blood counts in the bone marrow (CR/CRi).
• Forty-five patients had an assessment for MRD in the blood. Of these, 18 patients achieved MRD-negativity, meaning no cancer could be detected using a specific test. Ten of these 18 patients also had bone marrow assessments and six were MRD-negative.
• At one year, 84.7 percent of all responses and 94.4 percent of MRD-negative responses were maintained. The one-year PFS and OS rates were 72 percent and 86.7 percent, respectively.
• The most common serious adverse events were fever (7 percent), low red blood cell count as a result of immune response (7 percent), pneumonia (6 percent) and low white blood cell count with fever (5 percent). The most common Grade 3-4 adverse events were low white blood cell count (40 percent), low red blood cell count (18 percent) and low platelet count (15 percent). Grade 3 or higher infection occurred in 20 percent of patients. Laboratory tumour lysis syndrome was reported in five patients; none had clinical consequences.

About Chronic Lymphocytic Leukaemia (CLL)

CLL is a slow-growing cancer of the blood and bone marrow that is generally considered incurable and is one of the most common adult leukaemias worldwide.ⁱ,ⁱⁱ In certain cases of CLL, a part of chromosome 17 is lost and along with it an important gene that controls apoptosis called p53.ⁱⁱⁱ The 17p deletion is found in 3 to 10 percent of previously untreated cases and approximately 30 to 50 percent of relapsed or refractory cases.^iv

About Venetoclax (RG7601, GDC-0199/ABT-199)

Venetoclax is an investigational small molecule designed to selectively bind and inhibit the BCL-2 protein, which plays an important role in a process called apoptosis (programmed cell death). It is believed that blocking BCL-2 may restore the signalling system that tells cells, including cancer cells, to self-destruct. The BCL-2 protein is linked to the development of resistance in certain blood cancers and is expressed in chronic lymphocytic leukaemia (CLL) and non-Hodgkin’s lymphoma (NHL). In collaboration with AbbVie, venetoclax is being evaluated in a robust development program as a single agent or in combination with other medicines. There are ongoing Phase II and III studies for venetoclax in CLL, and Phase I and II studies are also ongoing in several other blood cancers, including indolent NHL, diffuse large B-cell lymphoma (DLBCL), acute myeloid leukaemia (AML) and multiple myeloma (MM).

About Roche in haematology

For more than 20 years, Roche has been developing medicines that redefine treatment in haematology. 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 MabThera^Ⓡ/Rituxan^Ⓡ (rituximab) and Gazyva^Ⓡ/Gazyvaro^Ⓡ (obinutuzumab), Roche’s pipeline of investigational haematology medicines includes an anti-PDL1 antibody (atezolizumab/MPDL3280A), an anti-CD79b antibody drug conjugate (polatuzumab vedotin/RG7596), a small molecule antagonist of MDM2 (idasanutlin/RG7388) and in collaboration with AbbVie, a small molecule BCL-2 inhibitor (venetoclax/RG7601/GDC-0199/ABT-199). Roche’s dedication to developing novel molecules in haematology expands beyond oncology, with the development of the investigational haemophilia A treatment emicizumab (ACE910).

About Roche

Headquartered in Basel, Switzerland, Roche is a leader in research-focused healthcare with combined strengths in pharmaceuticals and diagnostics. Roche is the world’s largest biotech company, with truly differentiated medicines in oncology, immunology, infectious diseases, ophthalmology and neuroscience. Roche is also the world leader in in vitro diagnostics and tissue-based cancer diagnostics, and a frontrunner in diabetes management. Roche’s personalised healthcare strategy aims at providing medicines and diagnostics that enable tangible improvements in the health, quality of life and survival of patients. Founded in 1896, Roche has been making important contributions to global health for more than a century. Twenty-nine medicines developed by Roche are included in the World Health Organization Model Lists of Essential Medicines, among them life-saving antibiotics, antimalarials and chemotherapy.

In 2014, the Roche Group employed 88,500 people worldwide, invested 8.9 billion Swiss francs in R&D and posted sales of 47.5 billion Swiss francs. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. For more information, please visit www.roche.com.

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References
i Leukemia & Lymphoma Society, “Chronic Lymphocytic Leukemia.” http://www.lls.org/sites/default/files/file_assets/cll.pdf
ii Leukemia & Lymphoma Society, “Chronic Lymphocytic Leukemia.” http://www.lls.org/leukemia/chronic-lymphocytic-leukemia
iii Selner, L. et al. (2013) “What Do We Do with Chronic Lymphocytic Leukemia with 17p Deletion?” Curr Hemetol Malig Rep. 8(1):81-90.
iv Schnaiter, A. et al. (2013) “17p Deletion in Chronic Lymphocytic Leukemia: Risk Stratification and Therapeutic Approach.” Hematol Oncol Clin N Am 27 (2013) 289–301