viernes, 20 de octubre de 2017

Drug Approvals and Databases > Drug Trials Snapshot: VERZENIO

Drug Approvals and Databases > Drug Trials Snapshot: VERZENIO







A new  DRUG TRIALS SNAPSHOT is now available. 
VERZENIO is a drug for treatment of a specific form of breast cancer called hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. 
VERZENIO is used in combination with fulvestrant (another drug used to treat breast cancer) when the breast cancer worsened after hormonal therapy.
VERZENIO is taken alone when the breast cancer worsened after hormonal therapy and chemotherapy.
See more Drug Trials Snapshots  or contact us with questions at Snapshots@fda.hhs.gov.


Drug Trials Snapshot: VERZENIO


HOW TO USE THIS SNAPSHOT
The information provided in Snapshots highlights who participated in the clinical trials that supported the FDA approval of this drug, and whether there were differences among sex, race and age groups. The “MORE INFO” bar shows more detailed, technical content for each section. The Snapshot is intended as one tool for consumers to use when discussing the risks and benefits of the drugs.
 
LIMITATIONS OF THIS SNAPSHOT:
Do not rely on Snapshots to make decisions regarding medical care. Always speak to your health provider about the risks and benefits of a drug. Refer to the VERZENIO Package Insert for complete information.

VERZENIO (abemaciclib)

(ver-ZEN-ee-oh) 
Eli Lilly and Company 
Approval date:September 28, 2017

DRUG TRIALS SNAPSHOT SUMMARY:

What is the drug for?

VERZENIO is a drug for treatment of a specific form of breast cancer called hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. 
VERZENIO is used in combination with fulvestrant (another drug used to treat breast cancer) when the breast cancer worsened after hormonal therapy. 
VERZENIO is taken alone when the breast cancer worsened after hormonal therapy and chemotherapy.
 

How is this drug used?

VERZENIO tablet of 150 mg is taken twice daily in combination with fulvestrant . VERZENIO tablet of 200 mg is taken twice daily when used alone.

What are the benefits of this drug?

The first trial measured the length of time tumors did not grow after treatment (progression-free survival). The progression-free survival for patients taking VERZENIO with fulvestrant was about 16 months compared to 9 months for patients taking a placebo with fulvestrant. 
The second trial measured the percent of patients whose tumors completely or partially shrank after treatment (objective response rate). In the trial, approximately 20 percent of patients taking VERZENIO experienced complete or partial shrinkage of their tumors that lasted about 9 months.

Were there any differences in how well the drug worked in clinical trials among sex, race and age?


  • Sex:  The trial included only women therefore sex differences cannot be determined.
  • Race:  The majority of patients were white. The number of patients in other races was limited; therefore, differences in response among races could not be determined.
  • Age:  VERZENIO worked similarly in patients above and below 65 years of age.

What are the possible side effects?

VERZENIO may cause serious side effects, including severe diarrhea, low white blood cell counts (neutropenia), liver damage and blood clots in veins and lungs.
The most common side effects include diarrhea, nausea, abdominal pain, infections, tiredness, low blood counts, decreased appetite, vomiting, and headache.

Were there any differences in side effects among sex, race and age?

  • Sex:  The trial included only women therefore sex differences cannot be determined.
  • Race: The majority of patients were white. The number of patients in other races was limited; therefore, differences in side effects among races could not be determined.
  • Age:  The incidence of overall side effects was similar in patients above and below 65 years of age.

Who participated in the clinical trials?

The FDA approved VERZENIO based on evidence from two clinical trials that enrolled women with HR-positive, HER2-negative advanced breast cancer.
Patients in Trial 1 (NCT02107703) had an advanced  breast cancer that progresed  after hormone therapy. The trial was conducted at 145 sites in North America, Europe and Asia.
Patients in Trial  2 (NCT 02102490) had an advanced  breast cancer that progresed  after hormone  and chemo therapy . The trial was conducted at 35 sites in US and Europe.
Figures 1a and 1b summarizes how many women were in the clinical trials.
Figure 1a. Baseline Demographics by Sex-Trial 1
Pie chart summarizing  669 women (100%) who participated in the clinical trial 1.
Figure 1b. Baseline Demographics by Sex-Trial 2
Pie chart summarizing  132 women (100%) who participated in the clinical trial 2.
FDA Review
Figures 2a and 2b and Table 1 summarize patients by race in the clinical trials.
Figure 2a. Baseline Demographics by Race-Trial 1
Pie chart summarizing the percentage of patients by race in the clinical trial 1. In total, 373 White (56%), 214 Asian (32%), 14 Black or African Americans (2%) 26 American Indian or Alaska Native (4%) and 42 Other (6%), participated in the clinical trial.
Figure 2b. Baseline Demographics by Race-Trial 2
Pie chart summarizing the percentage of patients by race in the clinical trial 2. In total, 112 White (85%), 2 Asian (1%), 6 Black or African Americans (5%) and 12 patients with missing race data (9%) participated in the clinical trial.
Table 1. Demographics by Race (Trials 1 and 2)
RaceTrial 1Trial 2
Number of PatientsPercentageNumber of PatientsPercentage
White3735611285
Asian2143221
Black or African American14265
American Indian or Alaska Native26400
Multiple2less than 100
Missing*406129
FDA Review


 
Figure 3a. Baseline Demographics by Age-Trial 1
Pie chart summarizing how many individuals of certain age groups were in the clinical trial 1. In total, 424 patients were younger than 65 years (63%), 174 were 65-74 years old (26%), and  71  patients were  75 years and older (11 %).
Figure 3b. Baseline Demographics by Age-Trial 2
Pie chart summarizing how many individuals of certain age groups were in the clinical trial 2. In total, 90 patients were younger than 65 years (68%), 32 were 65-74 years old (24%), and  10  patients were  75 years and older (8 %).

FDA Review

How were the trials designed?

There were two trials that evaluated benefits and side effects of VERZENIO in patients with advanced HR-positive, HER2-negative breast cancer. Each trial was designed differently.
In the first trial, patients had breast cancer that had progressed after treatment with hormone therapy and had not received chemotherapy once the cancer had metastasized. Patients received, at random, either VERZENIO in combination with fulvestrant or placebo in combination with fulvestrant.  The treatment continued until the disease progressed or the side effects became too toxic. Neither the patients nor the health care providers knew which treatment was being given until the trial was completed. 
The trial  measured the length of time tumors did not grow after treatment (progression-free survival).
In the second trial patients had breast cancer that had progressed after treatment with hormone therapy and also  have received chemotherapy after the cancer metastasized. All patients received  VERZENIO. The treatment continued until the disease progressed or the side effects became too toxic.
The trial measured the percent of patients whose tumors completely or partially shrank after treatment (objective response rate).
 

GLOSSARY

CLINICAL TRIAL: Voluntary research studies conducted in people and designed to answer specific questions about the safety or effectiveness of drugs, vaccines, other therapies, or new ways of using existing treatments.
COMPARATOR: A previously available treatment or placebo used in clinical trials that is compared to the actual drug being tested.
EFFICACY: How well the drug achieves the desired response when it is taken as described in a controlled clinical setting, such as during a clinical trial.
PLACEBO: An inactive substance or “sugar pill” that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
SUBGROUP: A subset of the population studied in a clinical trial. Demographic subsets include sex, race, and age groups.

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