Nineteen presentations and publications featuring data from three
Bristol-Myers Squibb medicines, alone and in combination, across four
hematologic malignancies
First disclosure of results from a Phase 2 trial supports safety
and efficacy of
Empliciti (elotuzumab) plus pomalidomide
and low-dose dexamethasone in relapsed/refractory (R/R) multiple myeloma
Updates from
Opdivo (nivolumab) plus ADCETRIS® (brentuximab
vedotin) combination include first disclosure of data in R/R primary
mediastinal large B-cell lymphoma, and an oral presentation in children,
adolescents and young adults with standard-risk R/R classical Hodgkin
lymphoma
PRINCETON, N.J.--(BUSINESS WIRE)--
Bristol-Myers
Squibb Company (NYSE:BMY) today announced that 19 data presentations
and publications, including two oral presentations, from
Company-sponsored studies and collaborations evaluating Opdivo (nivolumab),
Sprycel (dasatinib) and Empliciti (elotuzumab) will be
featured at the 60th American Society of Hematology (ASH)
Annual Meeting in San Diego, Calif., from December 1-4.
“Our presence at ASH, in Immuno-Oncology and beyond, underscores the
breadth of our oncology portfolio, which is designed to deliver a wide
range of possible treatment options to patients,” said Joseph E. Eid,
M.D., senior vice president and head, Medical, Bristol-Myers Squibb.
“These data reiterate the potential of our medicines for patients with
blood cancers, from patients with rare malignancies, like primary
mediastinal large B-cell lymphoma, to those with unique and oftentimes
unmet needs, like children and young adults with relapsed/refractory
classical Hodgkin lymphoma.”
Featured data include:
Multiple Myeloma
-
New Phase 2 data from CA204-142, a single-arm study conducted in the
United States, evaluating Empliciti plus pomalidomide and
low-dose dexamethasone (EPd) in patients with multiple myeloma who
were relapsed, refractory or intolerant to lenalidomide, who received
one to two prior therapies and whose disease progressed during or
after their last therapy. Safety and efficacy data from CA204-142
(Abstract #1991) will be featured on Saturday, December 1, from
6:15-8:15 PM PST.
Classical Hodgkin and Non-Hodgkin Lymphoma
-
Primary safety and efficacy results from the Phase 1/2 CheckMate -436
study, evaluating Opdivo and ADCETRIS (brentuximab vedotin) in
patients with relapsed/refractory (R/R) primary mediastinal large
B-cell lymphoma. The results, including objective and complete
response (CR) rates, from CheckMate -436 (Abstract #1691) will be
featured in the presentation on Saturday, December 1, from 6:15-8:15
PM PST.
-
Updated data from the Phase 1/2 trial evaluating Opdivo and
ADCETRIS in adult patients with R/R classical Hodgkin lymphoma (cHL),
including results from the RNA sequencing analyses of tumor biopsies
from study participants prior to the start of treatment. These
analyses were designed to determine whether tumor characteristics are
associated with response to treatment. These data (Abstract #2837)
will be featured on Sunday, December 2, from 6-8 PM PST.
-
First results from the Phase 2 CheckMate -744 study, the first
risk-stratified, response-adapted study of Opdivo and ADCETRIS,
followed by ADCETRIS and bendamustine for suboptimal response, in
children, adolescents and young adults with R/R cHL, prior to
autologous stem cell transplantation (ASCT). These data (Abstract
#927) will be featured in an oral presentation on Monday, December 3,
at 5 PM PST.
Additional data include:
Note: All times listed are in Pacific Standard Time
Multiple Myeloma
-
Quality-of-life Outcomes in Patients With Relapsed/Refractory
Multiple Myeloma Treated With Elotuzumab Plus Pomalidomide and
Dexamethasone: Results from the Phase 2 Randomized ELOQUENT-3 Study
Author:
Weisel
Abstract: #2288
Poster Session: 903. Outcomes
Research—Non-Malignant Hematology: Poster I
Saturday, December 1,
6:15-8:15 PM, Hall GH
-
Elotuzumab plus Pomalidomide/Dexamethasone for the Treatment of
Relapsed/Refractory Multiple Myeloma: Japanese Subanalysis of the
Randomized Phase 2 ELOQUENT-3 Study
Author: Hori
Abstract:
#3260
Poster Session: 653. Myeloma: Therapy, excluding
Transplantation: Poster II
Sunday, December 2, 6-8 PM, Hall GH
-
Treatment Sequencing in Patients With Relapsed/Refractory Multiple
Myeloma After Daratumumab Treatment: Real-World Findings From a Pooled
Data Analysis of PREAMBLE and the McKesson Electronic Medical Record
Database
Author: Vii
Abstract: #3284
Poster
Session: 653. Myeloma: Therapy, excluding Transplantation: Poster II
Sunday,
December 2, 6-8 PM, Hall GH
-
Survival in Patients With Relapsed/Refractory Multiple Myeloma:
Outcomes After 4 Years of the Ongoing Multinational Observational
PREAMBLE Study
Author: Cook
Abstract: #3285
Poster
Discussion Session: 653. Myeloma: Therapy, excluding Transplantation:
Poster II
Sunday, December 2, 6-8 PM, Hall GH
Classical Hodgkin and Non-Hodgkin Lymphoma
-
Phase 1/2 Study of Brentuximab Vedotin in Combination with
Nivolumab in Patients with Relapsed or Refractory Classic Hodgkin
Lymphoma: Part 3 (Concurrent Dosing) Results and Updated
Progression-Free Survival Results for Parts 1 and 2 (Staggered Dosing)
Author:
Advani
Abstract: #1635
Poster Session: 624. Hodgkin Lymphoma
and T/NK Cell Lymphoma—Clinical Studies: Poster I
Saturday,
December 1, 6:15-8:15 PM, Hall GH
-
Nivolumab Treatment Beyond Investigator-Assessed Progression:
Extended Follow-Up in Patients With Relapsed/Refractory Classical
Hodgkin Lymphoma From the Phase 2 CheckMate 205 Study
Author:
Cohen
Abstract: #2932
Poster Session: 624. Hodgkin Lymphoma
and T/NK Cell Lymphoma—Clinical Studies: Poster II
Sunday,
December 2, 6-8 PM, Hall GH
-
Nivolumab for Relapsed or Refractory Classical Hodgkin Lymphoma
(cHL) After Autologous Hematopoietic Cell Transplantation (auto-HCT):
Extended Follow-Up of the Phase 2 Single-Arm CheckMate 205 Study
Author:
Armand
Abstract: #2897
Poster Session: 624. Hodgkin Lymphoma
and T/NK Cell Lymphoma—Clinical Studies: Poster II
Sunday,
December 2, 6-8 PM, Hall GH
Leukemia
-
Dosing Patterns of Dasatinib Use in SIMPLICITY, an Observational
Study in Chronic Phase Chronic Myeloid Leukemia (CP-CML) Patients
(pts) in Routine Clinical Practice
Author: Cortes
Abstract:
#1730
Poster Session: 632. Chronic Myeloid Leukemia: Therapy:
Poster I
Saturday, December 1, 6:15-8:15 PM, Hall GH
-
The Impact of Chronic Myeloid Leukemia Therapy Management on the
Oncology Care Model
Author: Jabbour
Abstract: #2265
Poster
Discussion Session: 902. Health Services Research—Malignant Diseases:
Poster I
Saturday, December 1, 6:15-8:15 PM, Hall GH
-
Realized and Projected Cost Savings from the Introduction of
Generic Imatinib, with Minimal Additional Savings to Payers Through
Formulary Management
Author: Bloudek
Abstract: #3533
Poster
Session: 902. Health Services Research—Malignant Diseases: Poster II
Sunday,
December 2, 6-8 PM, Hall GH
-
Dasatinib Versus Imatinib in Patients (Pts) With Chronic Myeloid
Leukemia in Chronic Phase (CML-CP) Who Have Not Achieved an Optimal
Response to 3 Months of Imatinib Therapy: DASCERN
Author:
Cortes
Abstract: #788
Oral Abstract Session: 632. Chronic
Myeloid Leukemia: Therapy: TFR Failure, Resistance, and New Drug
Development
Monday, December 3, 2:45-4:15 PM, Room 6E
-
Updated 18 Month Results from DASFREE: A Study Evaluating Dasatinib
Discontinuation in Patients (Pts) with Chronic Myeloid Leukemia in
Chronic Phase (CML-CP) and Deep Molecular Response (DMR)
Author:
Shah
Abstract: #4253
Poster Session: 632. Chronic Myeloid
Leukemia: Therapy: Poster III
Monday, December 3, 6-8 PM, Hall GH
-
Cardiovascular Hospitalization in Patients Treated with Dasatinib
or Nilotinib in SIMPLICITY, an Observational Study of Chronic-Phase
Chronic Myeloid Leukemia (CP-CML) Patients in Routine Clinical Practice
Author:
Mauro
Abstract: #4258
Poster Session: 632. Chronic Myeloid
Leukemia: Therapy: Poster III
Monday, December 3, 6-8 PM, Hall GH
-
Prevalence of Comorbidities Relevant to the Choice of
Second-Generation (2-G) Tyrosine Kinase Inhibitor (TKI) for the
Treatment of Chronic Myeloid Leukemia (CML) in the United States Using
Real-World Claims Databases
Author: Jabbour
Abstract:
#4265
Poster Session: 632. Chronic Myeloid Leukemia: Therapy:
Poster III
Monday, December 3, 6-8 PM, Hall GH
Bristol-Myers Squibb: Advancing Oncology
Research
At Bristol-Myers Squibb, patients are at the center of everything we do.
Our vision is to increase quality, long-term survival for patients with
cancer. Through a unique multidisciplinary approach powered by
translational science, we harness our deep scientific experience in
oncology and Immuno-Oncology (I-O) research, to identify novel
treatments tailored to individual patient needs. Our researchers are
developing a diverse, purposefully built pipeline designed to target
different immune system pathways and address the complex and specific
interactions between the tumor, its microenvironment and immune system.
We source innovation internally and in collaboration with academia,
government, advocacy groups and biotechnology companies, to help make
the promise of transformational medicines, like I-O, a reality for
patients.
About Opdivo
Opdivo is a programmed death-1 (PD-1) immune checkpoint inhibitor
that is designed to uniquely harness the body’s own immune system to
help restore anti-tumor immune response. By harnessing the body’s own
immune system to fight cancer, Opdivo has become an
important treatment option across multiple cancers.
Opdivo’s leading global development program is based on
Bristol-Myers Squibb’s scientific expertise in the field of
Immuno-Oncology, and includes a broad range of clinical trials across
all phases, including Phase 3, in a variety of tumor types. To date, the Opdivo clinical
development program has enrolled more than 25,000 patients. The Opdivo trials
have contributed to gaining a deeper understanding of the potential role
of biomarkers in patient care, particularly regarding how patients may
benefit from Opdivo across the continuum of PD-L1 expression.
In July 2014, Opdivo was the first PD-1 immune checkpoint
inhibitor to receive regulatory approval anywhere in the world. Opdivo is
currently approved in more than 65 countries, including the United
States, the European Union, Japan and China. In October 2015, the
Company’s Opdivo and Yervoy combination
regimen was the first Immuno-Oncology combination to receive regulatory
approval for the treatment of metastatic melanoma and is currently
approved in more than 50 countries, including the United States and the
European Union.
U.S. FDA-APPROVED INDICATIONS FOR OPDIVO
OPDIVO® (nivolumab) as a single agent is indicated for the
treatment of patients with BRAF V600 mutation-positive unresectable or
metastatic melanoma. This indication is approved under accelerated
approval based on progression-free survival. Continued approval for this
indication may be contingent upon verification and description of
clinical benefit in the confirmatory trials.
OPDIVO® (nivolumab) as a single agent is indicated for the
treatment of patients with BRAF V600 wild-type unresectable or
metastatic melanoma.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with metastatic non-small cell lung cancer (NSCLC) with
progression on or after platinum-based chemotherapy. Patients with EGFR
or ALK genomic tumor aberrations should have disease progression on
FDA-approved therapy for these aberrations prior to receiving OPDIVO.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with metastatic small cell lung cancer (SCLC) with progression
after platinum-based chemotherapy and at least one other line of
therapy. This indication is approved under accelerated approval based on
overall response rate and duration of response. Continued approval for
this indication may be contingent upon verification and description of
clinical benefit in confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with advanced renal cell carcinoma (RCC) who have received
prior anti-angiogenic therapy.
OPDIVO® (nivolumab) is indicated for the treatment of adult
patients with classical Hodgkin lymphoma (cHL) that has relapsed or
progressed after autologous hematopoietic stem cell transplantation
(HSCT) and brentuximab vedotin or after 3 or more lines of systemic
therapy that includes autologous HSCT. This indication is approved under
accelerated approval based on overall response rate. Continued approval
for this indication may be contingent upon verification and description
of clinical benefit in confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with recurrent or metastatic squamous cell carcinoma of the
head and neck (SCCHN) with disease progression on or after
platinum-based therapy.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with locally advanced or metastatic urothelial carcinoma who
have disease progression during or following platinum-containing
chemotherapy or have disease progression within 12 months of neoadjuvant
or adjuvant treatment with platinum-containing chemotherapy. This
indication is approved under accelerated approval based on tumor
response rate and duration of response. Continued approval for this
indication may be contingent upon verification and description of
clinical benefit in confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of adult
and pediatric (12 years and older) patients with microsatellite
instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic
colorectal cancer (CRC) that has progressed following treatment with a
fluoropyrimidine, oxaliplatin, and irinotecan. This indication is
approved under accelerated approval based on overall response rate and
duration of response. Continued approval for this indication may be
contingent upon verification and description of clinical benefit in
confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of
patients with hepatocellular carcinoma (HCC) who have been previously
treated with sorafenib. This indication is approved under accelerated
approval based on tumor response rate and durability of response.
Continued approval for this indication may be contingent upon
verification and description of clinical benefit in the confirmatory
trials.
OPDIVO® (nivolumab) is indicated for the adjuvant treatment
of patients with melanoma with involvement of lymph nodes or metastatic
disease who have undergone complete resection.
IMPORTANT SAFETY INFORMATION
Immune-Mediated Pneumonitis
OPDIVO can cause immune-mediated pneumonitis. Fatal cases have been
reported. Monitor patients for signs with radiographic imaging and for
symptoms of pneumonitis. Administer corticosteroids for Grade 2 or more
severe pneumonitis. Permanently discontinue for Grade 3 or 4 and
withhold until resolution for Grade 2. In patients receiving OPDIVO
monotherapy, fatal cases of immune-mediated pneumonitis have occurred.
Immune-mediated pneumonitis occurred in 3.1% (61/1994) of patients.
In Checkmate 205 and 039, pneumonitis, including interstitial lung
disease, occurred in 6.0% (16/266) of patients receiving OPDIVO.
Immune-mediated pneumonitis occurred in 4.9% (13/266) of patients
receiving OPDIVO: Grade 3 (n=1) and Grade 2 (n=12).
Immune-Mediated Colitis
OPDIVO can cause immune-mediated colitis. Monitor patients for signs and
symptoms of colitis. Administer corticosteroids for Grade 2 (of more
than 5 days duration), 3, or 4 colitis. Withhold OPDIVO monotherapy for
Grade 2 or 3 and permanently discontinue for Grade 4 or recurrent
colitis upon re-initiation of OPDIVO. In patients receiving OPDIVO
monotherapy, immune-mediated colitis occurred in 2.9% (58/1994) of
patients.
Immune-Mediated Hepatitis
OPDIVO can cause immune-mediated hepatitis. Monitor patients for
abnormal liver tests prior to and periodically during treatment.
Administer corticosteroids for Grade 2 or greater transaminase
elevations. Withhold OPDIVO for Grade 2 and permanently discontinue
OPDIVO for Grade 3 or 4. For patients with HCC, withhold OPDIVO and
administer corticosteroids if AST/ALT is within normal limits at
baseline and increases to >3 and up to 5 times the upper limit of normal
(ULN), if AST/ALT is >1 and up to 3 times ULN at baseline and increases
to >5 and up to 10 times the ULN, and if AST/ALT is >3 and up to 5 times
ULN at baseline and increases to >8 and up to 10 times the ULN.
Permanently discontinue OPDIVO and administer corticosteroids if AST or
ALT increases to >10 times the ULN or total bilirubin increases >3 times
the ULN. In patients receiving OPDIVO monotherapy, immune-mediated
hepatitis occurred in 1.8% (35/1994) of patients.
In Checkmate 040, immune-mediated hepatitis requiring systemic
corticosteroids occurred in 5% (8/154) of patients receiving OPDIVO.
Immune-Mediated Endocrinopathies
OPDIVO can cause immune-mediated hypophysitis, immune-mediated adrenal
insufficiency, autoimmune thyroid disorders, and Type 1 diabetes
mellitus. Monitor patients for signs and symptoms of hypophysitis, signs
and symptoms of adrenal insufficiency, thyroid function prior to and
periodically during treatment, and hyperglycemia. Administer hormone
replacement as clinically indicated and corticosteroids for Grade 2 or
greater hypophysitis. Withhold for Grade 2 or 3 and permanently
discontinue for Grade 4 hypophysitis. Administer corticosteroids for
Grade 3 or 4 adrenal insufficiency. Withhold for Grade 2 and permanently
discontinue for Grade 3 or 4 adrenal insufficiency. Administer
hormone-replacement therapy for hypothyroidism. Initiate medical
management for control of hyperthyroidism. Withhold OPDIVO for Grade 3
and permanently discontinue for Grade 4 hyperglycemia.
In patients receiving OPDIVO monotherapy, hypophysitis occurred in 0.6%
(12/1994) of patients. In patients receiving OPDIVO monotherapy, adrenal
insufficiency occurred in 1% (20/1994) of patients. In patients
receiving OPDIVO monotherapy, hypothyroidism or thyroiditis resulting in
hypothyroidism occurred in 9% (171/1994) of patients. Hyperthyroidism
occurred in 2.7% (54/1994) of patients receiving OPDIVO monotherapy. In
patients receiving OPDIVO monotherapy, diabetes occurred in 0.9%
(17/1994) of patients.
Immune-Mediated Nephritis and Renal Dysfunction
OPDIVO can cause immune-mediated nephritis. Monitor patients for
elevated serum creatinine prior to and periodically during treatment.
Administer corticosteroids for Grades 2-4 increased serum creatinine.
Withhold OPDIVO for Grade 2 or 3 and permanently discontinue for Grade 4
increased serum creatinine. In patients receiving OPDIVO monotherapy,
immune-mediated nephritis and renal dysfunction occurred in 1.2%
(23/1994) of patients.
Immune-Mediated Skin Adverse Reactions
OPDIVO can cause immune-mediated rash, including Stevens-Johnson
syndrome (SJS) and toxic epidermal necrolysis (TEN), some cases with
fatal outcome. Administer corticosteroids for Grade 3 or 4 rash.
Withhold for Grade 3 and permanently discontinue for Grade 4 rash. For
symptoms or signs of SJS or TEN, withhold OPDIVO and refer the patient
for specialized care for assessment and treatment; if confirmed,
permanently discontinue. In patients receiving OPDIVO monotherapy,
immune-mediated rash occurred in 9% (171/1994) of patients.
Immune-Mediated Encephalitis
OPDIVO can cause immune-mediated encephalitis. Evaluation of patients
with neurologic symptoms may include, but not be limited to,
consultation with a neurologist, brain MRI, and lumbar puncture.
Withhold OPDIVO in patients with new-onset moderate to severe neurologic
signs or symptoms and evaluate to rule out other causes. If other
etiologies are ruled out, administer corticosteroids and permanently
discontinue OPDIVO for immune-mediated encephalitis. In patients
receiving OPDIVO monotherapy, encephalitis occurred in 0.2% (3/1994) of
patients. Fatal limbic encephalitis occurred in one patient after 7.2
months of exposure despite discontinuation of OPDIVO and administration
of corticosteroids.
Other Immune-Mediated Adverse Reactions
Based on the severity of the adverse reaction, permanently discontinue
or withhold OPDIVO, administer high-dose corticosteroids, and, if
appropriate, initiate hormone-replacement therapy. Across clinical
trials of OPDIVO, the following clinically significant immune-mediated
adverse reactions, some with fatal outcome, occurred in <1.0% of
patients receiving OPDIVO: myocarditis, rhabdomyolysis, myositis,
uveitis, iritis, pancreatitis, facial and abducens nerve paresis,
demyelination, polymyalgia rheumatica, autoimmune neuropathy,
Guillain-Barré syndrome, hypopituitarism, systemic inflammatory response
syndrome, gastritis, duodenitis, sarcoidosis, histiocytic necrotizing
lymphadenitis (Kikuchi lymphadenitis), motor dysfunction, vasculitis,
aplastic anemia, pericarditis, and myasthenic syndrome.
If uveitis occurs in combination with other immune-mediated adverse
reactions, consider a Vogt-Koyanagi-Harada-like syndrome, which has been
observed in patients receiving OPDIVO and may require treatment with
systemic steroids to reduce the risk of permanent vision loss.
Infusion Reactions
OPDIVO can cause severe infusion reactions, which have been reported in
<1.0% of patients in clinical trials. Discontinue OPDIVO in patients
with Grade 3 or 4 infusion reactions. Interrupt or slow the rate of
infusion in patients with Grade 1 or 2. In patients receiving OPDIVO
monotherapy as a 60-minute infusion, infusion-related reactions occurred
in 6.4% (127/1994) of patients. In a separate study in which patients
received OPDIVO monotherapy as a 60-minute infusion or a 30-minute
infusion, infusion-related reactions occurred in 2.2% (8/368) and 2.7%
(10/369) of patients, respectively. Additionally, 0.5% (2/368) and 1.4%
(5/369) of patients, respectively, experienced adverse reactions within
48 hours of infusion that led to dose delay, permanent discontinuation
or withholding of OPDIVO.
Complications of Allogeneic HSCT after OPDIVO
Complications, including fatal events, occurred in patients who received
allogeneic HSCT after OPDIVO. Outcomes were evaluated in 17 patients
from Checkmate 205 and 039, who underwent allogeneic HSCT after
discontinuing OPDIVO (15 with reduced-intensity conditioning, 2 with
myeloablative conditioning). Thirty-five percent (6/17) of patients died
from complications of allogeneic HSCT after OPDIVO. Five deaths occurred
in the setting of severe or refractory GVHD. Grade 3 or higher acute
GVHD was reported in 29% (5/17) of patients. Hyperacute GVHD was
reported in 20% (n=2) of patients. A steroid-requiring febrile syndrome,
without an identified infectious cause, was reported in 35% (n=6) of
patients. Two cases of encephalitis were reported: Grade 3 (n=1)
lymphocytic encephalitis without an identified infectious cause, and
Grade 3 (n=1) suspected viral encephalitis. Hepatic veno-occlusive
disease (VOD) occurred in one patient, who received reduced-intensity
conditioned allogeneic HSCT and died of GVHD and multi-organ failure.
Other cases of hepatic VOD after reduced-intensity conditioned
allogeneic HSCT have also been reported in patients with lymphoma who
received a PD-1 receptor blocking antibody before transplantation. Cases
of fatal hyperacute GVHD have also been reported. These complications
may occur despite intervening therapy between PD-1 blockade and
allogeneic HSCT.
Follow patients closely for early evidence of transplant-related
complications such as hyperacute GVHD, severe (Grade 3 to 4) acute GVHD,
steroid-requiring febrile syndrome, hepatic VOD, and other
immune-mediated adverse reactions, and intervene promptly.
Embryo-Fetal Toxicity
Based on its mechanism of action, OPDIVO can cause fetal harm when
administered to a pregnant woman. Advise pregnant women of the potential
risk to a fetus. Advise females of reproductive potential to use
effective contraception during treatment with an OPDIVO-containing
regimen and for at least 5 months after the last dose of OPDIVO.
Lactation
It is not known whether OPDIVO is present in human milk. Because many
drugs, including antibodies, are excreted in human milk and because of
the potential for serious adverse reactions in nursing infants from an
OPDIVO-containing regimen, advise women to discontinue breastfeeding
during treatment.
Serious Adverse Reactions
In Checkmate 037, serious adverse reactions occurred in 41% of patients
receiving OPDIVO (n=268). Grade 3 and 4 adverse reactions occurred in
42% of patients receiving OPDIVO. The most frequent Grade 3 and 4
adverse drug reactions reported in 2% to <5% of patients receiving
OPDIVO were abdominal pain, hyponatremia, increased aspartate
aminotransferase, and increased lipase. In Checkmate 066, serious
adverse reactions occurred in 36% of patients receiving OPDIVO (n=206).
Grade 3 and 4 adverse reactions occurred in 41% of patients receiving
OPDIVO. The most frequent Grade 3 and 4 adverse reactions reported in
≥2% of patients receiving OPDIVO were gamma-glutamyltransferase increase
(3.9%) and diarrhea (3.4%). In Checkmate 017 and 057, serious adverse
reactions occurred in 46% of patients receiving OPDIVO (n=418). The most
frequent serious adverse reactions reported in ≥2% of patients receiving
OPDIVO were pneumonia, pulmonary embolism, dyspnea, pyrexia, pleural
effusion, pneumonitis, and respiratory failure. In Checkmate 032,
serious adverse reactions occurred in 45% of patients receiving OPDIVO
(n=245). The most frequent serious adverse reactions reported in at
least 2% of patients receiving OPDIVO were pneumonia, dyspnea,
pneumonitis, pleural effusion, and dehydration. In Checkmate 025,
serious adverse reactions occurred in 47% of patients receiving OPDIVO
(n=406). The most frequent serious adverse reactions reported in ≥2% of
patients were acute kidney injury, pleural effusion, pneumonia,
diarrhea, and hypercalcemia. In Checkmate 205 and 039, adverse reactions
leading to discontinuation occurred in 7% and dose delays due to adverse
reactions occurred in 34% of patients (n=266). Serious adverse reactions
occurred in 26% of patients. The most frequent serious adverse reactions
reported in ≥1% of patients were pneumonia, infusion-related reaction,
pyrexia, colitis or diarrhea, pleural effusion, pneumonitis, and rash.
Eleven patients died from causes other than disease progression: 3 from
adverse reactions within 30 days of the last OPDIVO dose, 2 from
infection 8 to 9 months after completing OPDIVO, and 6 from
complications of allogeneic HSCT. In Checkmate 141, serious adverse
reactions occurred in 49% of patients receiving OPDIVO (n=236). The most
frequent serious adverse reactions reported in ≥2% of patients receiving
OPDIVO were pneumonia, dyspnea, respiratory failure, respiratory tract
infection, and sepsis. In Checkmate 275, serious adverse reactions
occurred in 54% of patients receiving OPDIVO (n=270). The most frequent
serious adverse reactions reported in ≥2% of patients receiving OPDIVO
were urinary tract infection, sepsis, diarrhea, small intestine
obstruction, and general physical health deterioration. In Checkmate
040, serious adverse reactions occurred in 49% of patients (n=154). The
most frequent serious adverse reactions reported in ≥2% of patients were
pyrexia, ascites, back pain, general physical health deterioration,
abdominal pain, and pneumonia. In Checkmate 238, Grade 3 or 4 adverse
reactions occurred in 25% of OPDIVO-treated patients (n=452). The most
frequent Grade 3 and 4 adverse reactions reported in ≥2% of
OPDIVO-treated patients were diarrhea and increased lipase and amylase.
Serious adverse reactions occurred in 18% of OPDIVO-treated patients.
Common Adverse Reactions
In Checkmate 037, the most common adverse reaction (≥20%) reported with
OPDIVO (n=268) was rash (21%). In Checkmate 066, the most common adverse
reactions (≥20%) reported with OPDIVO (n=206) vs dacarbazine (n=205)
were fatigue (49% vs 39%), musculoskeletal pain (32% vs 25%), rash (28%
vs 12%), and pruritus (23% vs 12%). In Checkmate 017 and 057, the most
common adverse reactions (≥20%) in patients receiving OPDIVO (n=418)
were fatigue, musculoskeletal pain, cough, dyspnea, and decreased
appetite. In Checkmate 032, the most common adverse reactions (≥20%) in
patients receiving OPDIVO (n=245) were fatigue (45%), decreased appetite
(27%), musculoskeletal pain (25%), dyspnea (22%), nausea (22%), diarrhea
(21%), constipation (20%), and cough (20%). In Checkmate 025, the most
common adverse reactions (≥20%) reported in patients receiving OPDIVO
(n=406) vs everolimus (n=397) were fatigue (56% vs 57%), cough (34% vs
38%), nausea (28% vs 29%), rash (28% vs 36%), dyspnea (27% vs 31%),
diarrhea (25% vs 32%), constipation (23% vs 18%), decreased appetite
(23% vs 30%), back pain (21% vs 16%), and arthralgia (20% vs 14%). In
Checkmate 205 and 039, the most common adverse reactions (≥20%) reported
in patients receiving OPDIVO (n=266) were upper respiratory tract
infection (44%), fatigue (39%), cough (36%), diarrhea (33%), pyrexia
(29%), musculoskeletal pain (26%), rash (24%), nausea (20%), and
pruritus (20%). In Checkmate 141, the most common adverse reactions
(≥10%) in patients receiving OPDIVO (n=236) were cough and dyspnea at a
higher incidence than investigator’s choice. In Checkmate 275, the most
common adverse reactions (≥20%) reported in patients receiving OPDIVO
(n=270) were fatigue (46%), musculoskeletal pain (30%), nausea (22%),
and decreased appetite (22%). In Checkmate 142 in MSI-H/dMMR mCRC
patients receiving OPDIVO as a single agent, the most common adverse
reactions (≥20%) were fatigue (54%), diarrhea (43%), abdominal pain
(34%), nausea (34%), vomiting (28%), musculoskeletal pain (28%), cough
(26%), pyrexia (24%), rash (23%), constipation (20%), and upper
respiratory tract infection (20%). In Checkmate 040, the most common
adverse reactions (≥20%) in patients receiving OPDIVO (n=154) were
fatigue (38%), musculoskeletal pain (36%), abdominal pain (34%),
pruritus (27%), diarrhea (27%), rash (26%), cough (23%), and decreased
appetite (22%). In Checkmate 238, the most common adverse reactions
(≥20%) reported in OPDIVO-treated patients (n=452) vs ipilimumab-treated
patients (n=453) were fatigue (57% vs 55%), diarrhea (37% vs 55%), rash
(35% vs 47%), musculoskeletal pain (32% vs 27%), pruritus (28% vs 37%),
headache (23% vs 31%), nausea (23% vs 28%), upper respiratory infection
(22% vs 15%), and abdominal pain (21% vs 23%). The most common
immune-mediated adverse reactions were rash (16%), diarrhea/colitis
(6%), and hepatitis (3%).
Please see U.S. Full Prescribing Information for OPDIVO
About Empliciti
Empliciti is an immunostimulatory antibody that specifically
targets Signaling Lymphocyte Activation Molecule Family member 7
(SLAMF7), a cell-surface glycoprotein. SLAMF7 is expressed on myeloma
cells independent of cytogenetic abnormalities. SLAMF7 also is expressed
on Natural Killer cells, plasma cells and at lower levels on specific
immune cell subsets of differentiated cells within the hematopoietic
lineage.
Empliciti has a dual mechanism-of-action. It directly activates
the immune system through Natural Killer cells via the SLAMF7 pathway. Empliciti also
targets SLAMF7 on myeloma cells, tagging these malignant cells for
Natural Killer cell-mediated destruction via antibody-dependent cellular
toxicity.
Empliciti was initially approved by the FDA in 2015 in
combination with lenalidomide and dexamethasone for the treatment of
patients with multiple myeloma who have received one to three prior
therapies.
Bristol-Myers Squibb and AbbVie are co-developing Empliciti,
with Bristol-Myers Squibb solely responsible for commercial activities.
U.S. FDA-APPROVED INDICATIONS FOR EMPLICITI
EMPLICITI® (elotuzumab) is indicated in combination with
lenalidomide and dexamethasone for the treatment of adult patients with
multiple myeloma who have received one to three prior therapies.
EMPLICITI is indicated in combination with pomalidomide and
dexamethasone for the treatment of adult patients with multiple myeloma
who have received at least two prior therapies including lenalidomide
and a proteasome inhibitor.
EMPLICITI is available for injection for intravenous use in 300 mg and
400 mg vials.
IMPORTANT SAFETY INFORMATION
Infusion Reactions
-
Infusion reactions were reported in 10% of patients treated with
EMPLICITI in the ELOQUENT-2 trial [EMPLICITI + lenalidomide +
dexamethasone (ERd) vs lenalidomide + dexamethasone (Rd)] and 3.3% in
the ELOQUENT-3 trial [EMPLICITI + pomalidomide + dexamethasone (EPd)
vs pomalidomide + dexamethasone (Pd)].
-
In the ELOQUENT-2 trial, all infusion reactions were Grade 3 or lower,
with Grade 3 infusion reactions occurring in 1% of patients. The most
common symptoms included fever, chills, and hypertension. Bradycardia
and hypotension also developed during infusions. In the trial, 5% of
patients required interruption of the administration of EMPLICITI for
a median of 25 minutes due to infusion reactions, and 1% of patients
discontinued due to infusion reactions. Of the patients who
experienced an infusion reaction, 70% (23/33) had them during the
first dose.
-
In the ELOQUENT-3 trial, the only infusion reaction symptom was chest
discomfort (2%), which was Grade 1. All the patients who experienced
an infusion reaction had them during the first treatment cycle.
-
If a Grade 2 or higher infusion reaction occurs, interrupt the
EMPLICITI infusion and institute appropriate medical and supportive
measures. If the infusion reaction recurs, stop the EMPLICITI infusion
and do not restart it on that day. Severe infusion reactions may
require permanent discontinuation of EMPLICITI therapy and emergency
treatment.
-
Premedicate with dexamethasone, H1 blocker, H2 blocker, and
acetaminophen prior to EMPLICITI infusion.
Infections
-
In the ELOQUENT-2 trial (N=635), infections were reported in 81% of
patients in the ERd arm and 74% in the Rd arm. Grade 3-4 infections
were 28% (ERd) and 24% (Rd). Discontinuations due to infections were
3.5% (ERd) and 4.1% (Rd). Fatal infections were 2.5% (ERd) and 2.2%
(Rd). Opportunistic infections were reported in 22% (ERd) and 13%
(Rd). Fungal infections were 10% (ERd) and 5% (Rd). Herpes zoster was
14% (ERd) and 7% (Rd).
-
In the ELOQUENT-3 trial (N=115), infections were reported in 65% of
patients in both the EPd arm and the Pd arm. Grade 3-4 infections were
reported in 13% (EPd) and 22% (Pd). Discontinuations due to infections
were 7% (EPd) and 5% (Pd). Fatal infections were 5% (EPd) and 3.6%
(Pd). Opportunistic infections were reported in 10% (EPd) and 9% (Pd).
Herpes zoster was reported in 5% (EPd) and 1.8% (Pd).
-
Monitor patients for development of infections and treat promptly.
Second Primary Malignancies
-
In the ELOQUENT-2 trial (N=635), invasive second primary malignancies
(SPM) were 9% (ERd) and 6% (Rd). The rate of hematologic malignancies
was the same between ERd and Rd treatment arms (1.6%). Solid tumors
were reported in 3.5% (ERd) and 2.2% (Rd). Skin cancer was reported in
4.4% (ERd) and 2.8% (Rd).
-
In the ELOQUENT-3 trial (N=115), invasive SPMs were 0% (EPd) and 1.8%
(Pd).
-
Monitor patients for the development of SPMs.
Hepatotoxicity
-
In the ELOQUENT-2 trial (N=635), AST/ALT >3X the upper limit, total
bilirubin >2X the upper limit, and alkaline phosphatase <2X the upper
limit were 2.5% (ERd) vs 0.6% (Rd). Of 8 patients experiencing
hepatotoxicity, 2 patients discontinued treatment while 6 patients had
resolution and continued. Monitor liver enzymes periodically. Stop
EMPLICITI upon ≥Grade 3 elevation of liver enzymes. Continuation of
treatment may be considered after return to baseline values.
Interference with Determination of Complete Response
-
EMPLICITI is a humanized IgG kappa monoclonal antibody that can be
detected on both the serum protein electrophoresis and immunofixation
assays used for the clinical monitoring of endogenous M-protein. This
interference can impact the determination of complete response and
possibly relapse from complete response in patients with IgG kappa
myeloma protein.
Pregnancy/Females and Males of Reproductive Potential
-
There are no available data on EMPLICITI use in pregnant women to
inform a drug-associated risk of major birth defects and miscarriage.
-
There is a risk of fetal harm, including severe life-threatening human
birth defects, associated with lenalidomide and pomalidomide, and they
are contraindicated for use in pregnancy. Refer to the respective
product full prescribing information for requirements regarding
contraception and the prohibitions against blood and/or sperm donation
due to presence and transmission in blood and/or semen and for
additional information.
Adverse Reactions
-
ELOQUENT-2 trial:
-
Serious adverse reactions were 65% (ERd) and 57% (Rd). The most
frequent serious adverse reactions in the ERd arm compared to the
Rd arm were: pneumonia (15%, 11%), pyrexia (7%, 5%), respiratory
tract infection (3.1%, 1.3%), anemia (2.8%, 1.9%), pulmonary
embolism (3.1%, 2.5%), and acute renal failure (2.5%, 1.9%).
-
The most common adverse reactions in ERd and Rd, respectively
(≥20%) were fatigue (62%, 52%), diarrhea (47%, 36%), pyrexia (37%,
25%), constipation (36%, 27%), cough (34%, 19%), peripheral
neuropathy (27%, 21%), nasopharyngitis (25%, 19%), upper
respiratory tract infection (23%, 17%), decreased appetite (21%,
13%), and pneumonia (20%, 14%).
-
ELOQUENT-3 trial:
-
Serious adverse reactions were 22% (EPd) and 15% (Pd). The most
frequent serious adverse reactions in the EPd arm compared to the
Pd arm were: pneumonia (13%, 11%) and respiratory tract infection
(7%, 3.6%).
-
The most common adverse reactions in EPd arm (≥20% EPd) and Pd,
respectively, were constipation (22%, 11%) and hyperglycemia (20%,
15%).
Please see the full
Prescribing
Information
.
About Sprycel
Sprycel first received FDA approval in 2006 for the treatment of
adults with Philadelphia chromosome-positive (Ph+) chronic myeloid
leukemia (CML) in chronic phase (CP) who are resistant or intolerant to
prior therapy including imatinib. At that time, Sprycel also
received FDA approval for adults with Ph+ acute lymphoblastic leukemia
(ALL) who are resistant or intolerant to prior therapy. Sprycel is
approved and marketed for these indications in more than 60 countries.
Sprycel is also an FDA-approved treatment for adults with
newly diagnosed Ph+ CML-CP and is approved for this indication in more
than 50 countries.
Both the FDA and the European Commission approved the expansion of Sprycel’s indication
to include pediatric patients with Ph+ CML-CP in November 2017 and July
2018.
U.S. FDA-APPROVED INDICATIONS FOR SPRYCEL
SPRYCEL® (dasatinib) is indicated for the treatment of adults
with:
-
Newly diagnosed Philadelphia chromosome-positive (Ph+) chronic myeloid
leukemia (CML) in chronic phase
-
Chronic, accelerated, or myeloid or lymphoid blast phase Ph+ CML with
resistance or intolerance to prior therapy including imatinib
-
Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+
ALL) with resistance or intolerance to prior therapy
SPRYCEL® is indicated for the treatment of pediatric patients
with:
IMPORTANT SAFETY INFORMATION
Myelosuppression
Treatment with SPRYCEL is associated with severe (NCI CTCAE Grade 3/4)
thrombocytopenia, neutropenia, and anemia, which occur earlier and more
frequently in patients with advanced phase CML or Ph+ ALL than in
patients with chronic phase CML. Myelosuppression was reported in
patients with normal baseline laboratory values as well as in patients
with pre-existing laboratory abnormalities.
-
In patients with chronic phase CML, perform complete blood counts
(CBCs) every 2 weeks for 12 weeks, then every 3 months thereafter, or
as clinically indicated
-
In patients with advanced phase CML or Ph+ ALL, perform CBCs weekly
for the first 2 months and then monthly thereafter, or as clinically
indicated
-
Myelosuppression is generally reversible and usually managed by
withholding SPRYCEL temporarily and/or dose reduction
-
In clinical studies, myelosuppression may have also been managed
by discontinuation of study therapy
-
Hematopoietic growth factor has been used in patients with
resistant myelosuppression
Bleeding-Related Events
SPRYCEL can cause serious and fatal bleeding. In all CML or Ph+ ALL
clinical studies, Grade ≥3 central nervous system (CNS) hemorrhages,
including fatalities, occurred in <1% of patients receiving SPRYCEL. The
incidence of Grade 3/4 hemorrhage, occurred in 5.8% of adult patients
and generally required treatment interruptions and transfusions. The
incidence of Grade 5 hemorrhage occurred in 0.4% of adult patients. The
most frequent site of hemorrhage was gastrointestinal.
-
Most bleeding events in clinical studies were associated with severe
thrombocytopenia
-
In addition to causing thrombocytopenia in human subjects, dasatinib
caused platelet dysfunction in vitro
-
Concomitant medications that inhibit platelet function or
anticoagulants may increase the risk of hemorrhage
Fluid Retention
SPRYCEL may cause fluid retention. After 5 years of follow-up in the
adult randomized newly diagnosed chronic phase CML study (n=258), grade
3/4 fluid retention was reported in 5% of patients, including 3% of
patients with grade 3/4 pleural effusion. In adult patients with newly
diagnosed or imatinib resistant or intolerant chronic phase CML, grade
3/4 fluid retention occurred in 6% of patients treated with SPRYCEL at
the recommended dose (n=548). In adult patients with advanced phase CML
or Ph+ ALL treated with SPRYCEL at the recommended dose (n=304), grade
3/4 fluid retention was reported in 8% of patients, including grade 3/4
pleural effusion reported in 7% of patients. In pediatric patients with
chronic phase CML cases of Grade 1 or 2 fluid retention were reported in
10.3% of patients.
-
Patients who develop symptoms of pleural effusion or other fluid
retention, such as new or worsened dyspnea on exertion or at rest,
pleuritic chest pain, or dry cough should be evaluated promptly with a
chest x-ray or additional diagnostic imaging as appropriate
-
Fluid retention events were typically managed by supportive care
measures that may include diuretics or short courses of steroids
-
Severe pleural effusion may require thoracentesis and oxygen therapy
-
Consider dose reduction or treatment interruption
Cardiovascular Events
SPRYCEL can cause cardiac dysfunction. After 5 years of follow-up in the
randomized newly diagnosed chronic phase CML trial in adults (n=258),
the following cardiac adverse reactions occurred:
-
Cardiac ischemic events (3.9% dasatinib vs 1.6% imatinib), cardiac
related fluid retention (8.5% dasatinib vs 3.9% imatinib), and
conduction system abnormalities, most commonly arrhythmia and
palpitations (7.0% dasatinib vs 5.0% imatinib). Two cases (0.8%) of
peripheral arterial occlusive disease occurred with imatinib and 2
(0.8%) transient ischemic attacks occurred with dasatinib
Monitor patients for signs or symptoms consistent with cardiac
dysfunction and treat appropriately.
Pulmonary Arterial Hypertension (PAH)
SPRYCEL may increase the risk of developing PAH in adult and pediatric
patients, which may occur any time after initiation, including after
more than 1 year of treatment. Manifestations include dyspnea, fatigue,
hypoxia, and fluid retention. PAH may be reversible on discontinuation
of SPRYCEL.
-
Evaluate patients for signs and symptoms of underlying cardiopulmonary
disease prior to initiating SPRYCEL and during treatment. If PAH is
confirmed, SPRYCEL should be permanently discontinued
QT Prolongation
SPRYCEL may increase the risk of prolongation of QTc in patients
including those with hypokalemia or hypomagnesemia, patients with
congenital long QT syndrome, patients taking antiarrhythmic medicines or
other medicinal products that lead to QT prolongation, and cumulative
high-dose anthracycline therapy
-
Correct hypokalemia or hypomagnesemia prior to and during SPRYCEL
administration
Severe Dermatologic Reactions
Cases of severe mucocutaneous dermatologic reactions, including
Stevens-Johnson syndrome and erythema multiforme, have been reported in
patients treated with SPRYCEL.
-
Discontinue permanently in patients who experience a severe
mucocutaneous reaction during treatment if no other etiology can be
identified
Tumor Lysis Syndrome (TLS)
TLS has been reported in patients with resistance to prior imatinib
therapy, primarily in advanced phase disease.
-
Due to potential for TLS, maintain adequate hydration, correct uric
acid levels prior to initiating therapy with SPRYCEL, and monitor
electrolyte levels
-
Patients with advanced stage disease and/or high tumor burden may be
at increased risk and should be monitored more frequently
Embryo-Fetal Toxicity
Based on limited human data, SPRYCEL can cause fetal harm when
administered to a pregnant woman. Hydrops fetalis, fetal leukopenia and
fetal thrombocytopenia have been reported with maternal exposure to
SPRYCEL. Transplacental transfer of dasatinib has been measured in fetal
plasma and amniotic fluid at concentrations comparable to those in
maternal plasma.
-
Advise females of reproductive potential to avoid pregnancy, which may
include the use of effective contraception, during treatment with
SPRYCEL and for 30 days after the final dose
Effects on Growth and Development in Pediatric Patients
In pediatric trials of SPRYCEL in chronic phase CML after at least 2
years of treatment, adverse reactions associated with bone growth and
development were reported in 5 (5.2%) patients, one of which was severe
in intensity (Growth Retardation Grade 3). These 5 cases included cases
of epiphyses delayed fusion, osteopenia, growth retardation, and
gynecomastia. Of these 5 cases, 1 case of osteopenia and 1 case of
gynecomastia resolved during treatment.
Lactation
No data are available regarding the presence of dasatinib in human milk,
the effects of the drug on the breastfed child or the effects of the
drug on milk production. However, dasatinib is present in the milk of
lactating rats.
-
Because of the potential for serious adverse reactions in nursing
children from SPRYCEL, breastfeeding is not recommended during
treatment with SPRYCEL and for 2 weeks after the final dose
Drug Interactions
-
Strong CYP3A4 inhibitors: The coadministration with strong
CYP3A inhibitors may increase dasatinib concentrations. Increased
dasatinib concentrations may increase the risk of toxicity. Avoid
concomitant use of strong CYP3A4 inhibitors. If concomitant
administration of a strong CYP3A4 inhibitor cannot be avoided,
consider a SPRYCEL dose reduction
- Grapefruit juice may increase plasma concentrations of
SPRYCEL and should be avoided
-
Strong CYP3A4 inducers: The coadministration of SPRYCEL
with strong CYP3A inducers may decrease dasatinib concentrations.
Decreased dasatinib concentrations may reduce efficacy. Consider
alternative drugs with less enzyme induction potential. If concomitant
administration of a strong CYP3A4 inducer cannot be avoided, consider
a SPRYCEL dose increase
- St. John’s wort may decrease plasma concentrations of
SPRYCEL and should be avoided
-
Gastric Acid Reducing Agents: The coadministration of
SPRYCEL with a gastric acid reducing agent may decrease the
concentrations of dasatinib. Decreased dasatinib concentrations may
reduce efficacy.
Do not administer H2 antagonists
or proton pump inhibitors with SPRYCEL. Consider the use of antacids
in place of H2 antagonists or proton pump inhibitors.
Administer the antacid at least 2 hours prior to or 2 hours after the
dose of SPRYCEL. Avoid simultaneous administration of SPRYCEL with
antacids.
Adverse Reactions
The safety data reflects exposure to SPRYCEL at all doses tested in
clinical studies (n=2809) including 324 adult patients with newly
diagnosed chronic phase CML, 2388 adult patients with imatinib resistant
or intolerant chronic or advanced phase CML or Ph+ ALL, and 97 pediatric
patients with chronic phase CML.
The median duration of therapy in a total of 2712 SPRYCEL-treated adult
patients was 19.2 months (range 0–93.2 months). Median duration of
therapy in:
-
1618 adult patients with chronic phase CML was 29 months (range 0–92.9
months)
-
Median duration for 324 adult patients in the newly diagnosed
chronic phase CML trial was approximately 60 months
-
1094 adult patients with advanced phase CML or Ph+ ALL was 6.2
months (range 0–93.2 months)
In two non-randomized trials in 97 pediatric patients with chronic phase
CML (51 patients newly diagnosed and 46 patients resistant or intolerant
to previous treatment with imatinib), the median duration of therapy was
51.1 months (range 1.9 to 99.6 months).
In the newly diagnosed adult chronic phase CML trial, after a minimum of
60 months of follow-up, the cumulative discontinuation rate for 258
patients was 39%.
In the overall population of 2712 adult SPRYCEL-treated patients, 88% of
patients experienced adverse reactions at some time and 19% experienced
adverse reactions leading to treatment discontinuation.
Among the 1618 adult SPRYCEL-treated patients with chronic phase CML,
drug-related adverse reactions leading to discontinuation were reported
in 329 (20.3%) patients.
-
In the adult newly diagnosed chronic phase CML trial, drug was
discontinued for adverse reactions in 16% of SPRYCEL-treated patients
with a minimum of 60 months of follow-up
Among the 1094 SPRYCEL-treated patients with advanced phase CML or Ph+
ALL, drug-related adverse reactions leading to discontinuation were
reported in 191 (17.5%) patients.
Among the 97 pediatric subjects, drug-related adverse reactions leading
to discontinuation were reported in 1 patient (1%).
Patients ≥65 years are more likely to experience the commonly reported
adverse reactions of fatigue, pleural effusion, diarrhea, dyspnea,
cough, lower gastrointestinal hemorrhage, and appetite disturbance, and
more likely to experience the less frequently reported adverse reactions
of abdominal distention, dizziness, pericardial effusion, congestive
heart failure, hypertension, pulmonary edema and weight decrease, and
should be monitored closely.
-
In adult newly diagnosed chronic phase CML patients:
-
Drug-related serious adverse reactions (SARs) were reported for
16.7% of patients. Serious adverse reactions reported in ≥5% of
patients included pleural effusion (5%)
-
Grade 3/4 laboratory abnormalities included neutropenia (29%),
thrombocytopenia (22%), anemia (13%), hypophosphatemia (7%),
hypocalcemia (4%), elevated bilirubin (1%), and elevated
creatinine (1%)
-
In adult patients resistant or intolerant to prior imatinib therapy:
-
Drug-related SARs were reported for 26.1% of SPRYCEL-treated
patients treated at the recommended dose of 100 mg once daily in
the randomized dose-optimization trial of patients with chronic
phase CML resistant or intolerant to prior imatinib therapy.
Serious adverse reactions reported in ≥5% of patients included
pleural effusion (10%)
-
Grade 3/4 hematologic laboratory abnormalities in chronic phase
CML patients resistant or intolerant to prior imatinib therapy who
received SPRYCEL 100 mg once daily with a minimum follow up of 60
months included neutropenia (36%), thrombocytopenia (24%), and
anemia (13%). Other grade 3/4 laboratory abnormalities included:
hypophosphatemia (10%), and hypokalemia (2%)
-
Among chronic phase CML patients with resistance or intolerance to
prior imatinib therapy, cumulative grade 3/4 cytopenias were
similar at 2 and 5 years including: neutropenia (36% vs 36%),
thrombocytopenia (23% vs 24%), and anemia (13% vs 13%)
-
Grade 3/4 elevations of transaminases or bilirubin and Grade 3/4
hypocalcemia, hypokalemia, and hypophosphatemia were reported in
patients with all phases of CML
-
Elevations in transaminases or bilirubin were usually managed with
dose reduction or interruption
-
Patients developing Grade 3/4 hypocalcemia during the course of
SPRYCEL therapy often had recovery with oral calcium
supplementation
-
In pediatric subjects with Ph+ CML in chronic phase
-
Drug-related SARs were reported for 14.4% of pediatric patients
-
In the pediatric studies, the rates of laboratory abnormalities
were consistent with the known profile for laboratory parameters
in adults
-
Most common adverse reactions (≥15%) in patients included
myelosuppression, fluid retention events, diarrhea, headache, skin
rash, hemorrhage, dyspnea, fatigue, nausea, and musculoskeletal pain
Please see full Prescribing Information
here
.
About the Bristol-Myers Squibb and Ono
Pharmaceutical Collaboration
In 2011, through a collaboration agreement with Ono Pharmaceutical Co.,
Bristol-Myers Squibb expanded its territorial rights to develop and
commercialize Opdivo globally, except in Japan, South Korea
and Taiwan, where Ono had retained all rights to the compound at the
time. On July 23, 2014, Ono and Bristol-Myers Squibb further expanded
the companies’ strategic collaboration agreement to jointly develop and
commercialize multiple immunotherapies – as single agents and
combination regimens – for patients with cancer in Japan, South Korea
and Taiwan.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information about
Bristol-Myers Squibb, visit us at BMS.com
or follow us on LinkedIn,
Twitter,
YouTube
and Facebook.
Bristol-Myers Squibb Forward-Looking Statement
This press release contains “forward-looking statements” as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. All statements that are not
statements of historical facts are, or may be deemed to be,
forward-looking statements. Such forward-looking statements
are based on current expectations and involve inherent risks and
uncertainties, including factors that could delay, divert or change any
of them, and could cause actual outcomes and results to differ
materially from current expectations. These risks, uncertainties and
other factors include, among others, that products mentioned in this
release may not receive regulatory approval for the indication described
in this release. No forward-looking statement can be
guaranteed. Forward-looking statements in this press release should be
evaluated together with the many uncertainties that affect Bristol-Myers
Squibb’s business, particularly those identified in the cautionary
factors discussion in Bristol-Myers Squibb’s Annual Report on Form 10-K
for the year ended December 31, 2017, as updated by our subsequent
Quarterly Reports on Form 10-Q and Current Reports on Form 8-K. The
forward-looking statements included in this document are made only as of
the date of this document and except as otherwise required by federal
securities law, Bristol-Myers Squibb undertakes no obligation to
publicly update any forward-looking statement, whether as a result of
new information, future events or otherwise.
View source version on businesswire.com:
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elizabeth.renz@bms.com
Investors:
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timothy.power@bms.com
Source: Bristol-Myers Squibb Company