First and only immunostimulatory antibody approved in the European Union for multiple myeloma
Accelerated assessment and approval based on long-term data from ELOQUENT-2, which evaluated Empliciti in combination with Revlimid® (lenalidomide) and dexamethasone (Rd)
ELOQUENT-2 demonstrated the Empliciti combination delivered a 53% relative improvement in progression-free survival vs. Rd alone at three years (23% vs. 15%)
Bristol-Myers
Squibb Company (NYSE:BMY) and AbbVie (NYSE:ABBV) announced today
that the European Commission has approved Empliciti™ (elotuzumab)
for the treatment of multiple myeloma as combination therapy with
Revlimid® (lenalidomide) and dexamethasone in patients who
have received at least one prior therapy. Empliciti is now the
first and only immunostimulatory antibody approved for multiple myeloma
in the European Union (EU).
The approval is based on data from the randomized, open-label, Phase 3
ELOQUENT-2 study, which evaluated Empliciti in combination with
lenalidomide and dexamethasone (ERd) versus lenalidomide and
dexamethasone (Rd) alone. The co-primary endpoints of this study,
progression-free survival (PFS) as assessed by hazard ratio (HR) and
overall response rate (ORR), were achieved, with extended follow-up data
showing a 53% relative improvement in PFS rate at three years (23%
versus 15%). Additionally, a pre-specified interim analysis for overall
survival (OS) found a positive trend favoring the Empliciti
combination versus Rd alone (HR=0.77 [95% CI: 0.61, 0.97, p=0.0257]),
though at the time of the interim analysis, the OS endpoint had not
reached the pre-determined threshold for statistical significance.
Patients will continue to be followed for survival, and the final
analysis is pending. Empliciti with lenalidomide and
dexamethasone is associated with the following Warnings and Precautions:
infusion reactions, infections, second primary malignancies,
hepatotoxicity, interference with determination of complete response,
pregnancy/females and males of reproductive potential, and adverse
reactions. Please see detailed Important Safety Information below.
“At Bristol-Myers Squibb, we are committed to delivering pioneering
medicines with the goal of revolutionizing the way cancer is treated for
patients who inspire our work each and every day,” said Emmanuel
Blin, senior vice president and head of Commercialization, Policy
and Operations, Bristol-Myers Squibb. “With the approval of Empliciti in
the EU, we are proud to extend our Immuno-Oncology science to multiple
myeloma patients in Europe who have received at least one prior therapy.”
In ELOQUENT-2, Empliciti was evaluated in patients who had
received one to three prior therapies. The study demonstrated that the
ERd regimen resulted in a 32% reduction in the risk of disease
progression or death compared to Rd alone (HR=0.68 [97.61% CI: 0.55,
0.85, p=0.0001]). The ERd regimen also showed a 21% relative
improvement in PFS rate at one year (68% versus 56%) and a 50% relative
improvement in PFS rate at two years (39% versus 26%) compared to Rd
alone. The ERd regimen demonstrated a significant improvement in ORR of
78.5% (95% CI: 73.6-82.9; p=0.0002) versus 65.5% in the Rd arm
(95% CI: 60.1-70.7). The extended follow-up analysis also showed ERd had
a median delay of one year in the time to next treatment compared to Rd
alone: 33.35 months (95% CI: 26.15, 40.21) versus 21.22 months (95% CI:
18.07, 23.20) (HR=0.62 [95% CI: 0.50, 0.77]). These data were initially
reported at the 57th American Society of Hematology Annual
Meeting in December 2015.
The most common adverse reactions (all grades) in ERd and Rd (>10%),
respectively, were diarrhea (59.2%, 49.3%), pyrexia (43.0%, 27.7%),
fatigue (40.0%, 34.7%), cough (33.2%, 20.3%), nasopharyngitis (29.5%,
27.7%), upper respiratory tract infection (25.2%, 22.7%), lymphopenia
(17.6%, 13.6%), headache (17.2%, 9.6%), pneumonia (15.6%, 12.9%) and
herpes zoster (10.0%, 5.7%).
“Today’s decision of the European Commission is excellent news for
relapsed and refractory multiple myeloma patients,” said Sarper Diler,
President of Myeloma Patients Europe. “Multiple myeloma has had a
difficult-to-treat history, and at Myeloma Patients Europe, we are
committed to ensuring these patients living in any European country are
able to access new, innovative medicines, like Empliciti.”
“Empliciti represents an important new treatment option for
patients with multiple myeloma and healthcare providers who are treating
this cancer in Europe,” said Michael Severino, M.D., executive vice
president of research and development and chief scientific officer,
AbbVie. “AbbVie is proud to be part of the team that developed Empliciti
and pleased to be partnering with Bristol-Myers Squibb to bring this new
therapy to previously treated multiple myeloma patients.”
About ELOQUENT-2
ELOQUENT-2 (CA204-004) is a Phase 3, open-label, randomized study
evaluating Empliciti in combination with Rd versus Rd alone in
patients with relapsed or refractory multiple myeloma. The trial
randomized 646 patients who had received one to three prior therapies.
Patients were randomized 1:1 to receive either Empliciti 10 mg/kg
in combination with Rd or Rd alone in 4-week cycles until disease
progression or unacceptable toxicity. Baseline patient demographics and
disease characteristics were well balanced between treatment arms and
included a meaningful portion of patients who were ≥ 65 years old, had
high-risk cytogenetics and/or were refractory to the most recent line of
therapy. The minimum follow-up for all study subjects was 24 months. The
co-primary endpoints were PFS, as assessed by hazard ratio, and ORR, as
determined by a blinded Independent Review Committee using the European
Group for Blood and Marrow Transplantation response criteria.
“As multiple myeloma is largely incurable and is often characterized by
a cycle of remission and relapse, there is a critical need for new
therapies for patients that work in unique and innovative ways,” said
Antonio Palumbo, M.D., study investigator and chief of the Myeloma Unit,
Department of Oncology, University of Torino in Torino, Italy. “In
clinical trials, Empliciti in combination with lenalidomide and
dexamethasone delivered a significant benefit in progression-free
survival compared to lenalidomide and dexamethasone alone, which could
make a meaningful difference in the lives of patients struggling with
this serious disease.”
Discontinuation rates due to adverse reactions were similar across the
ERd and Rd arms (8.7%, 12.9%). The most frequent serious adverse
reactions (Grade 3-4) in ERd and Rd were lymphopenia (12.7%, 7.4%),
pneumonia (10.5%, 8.1%), fatigue (6.4%, 6.2%), diarrhea (3.7%, 3.1%) and
deep vein thrombosis (3.5%, 1.7%). The most common adverse reactions in
ERd and Rd (>20%), respectively, were diarrhea (59.2%, 49.3%), pyrexia
(43.0%, 27.7%), fatigue (40.0%, 34.7%), cough (33.2%, 20.3%),
nasopharyngitis (29.5%, 27.7%) and upper respiratory tract infection
(25.2%, 22.7%).
Infusion reactions occurred in 10% of patients treated with ERd; these
adverse reactions were Grade 3 or lower (Grade 3, 1%; Grade 4, 0%). In
the trial, 1% of patients discontinued due to infusion reactions, and 5%
of patients required interruption of the administration of Empliciti
for a median of 25 minutes.
About Multiple Myeloma
Multiple myeloma is a hematologic, or blood, cancer that develops in the
bone marrow. It occurs when a plasma cell, a type of cell in the soft
center of bone marrow, becomes cancerous and multiplies uncontrollably.
Common symptoms of multiple myeloma include bone pain, fatigue, kidney
impairment and infections.
Despite advances in multiple myeloma treatment over the last decade,
less than half of patients survive for five or more years after
diagnosis. Patients often experience a cycle of remission and relapse,
and once a patient first relapses, their prognosis worsens with
progressively faster relapses through each subsequent line of therapy.
It is estimated that annually, more than 114,200 new cases of multiple
myeloma are diagnosed, and more than 80,000 people die from the disease
globally.
Bristol-Myers Squibb & Immuno-Oncology:
Advancing Oncology Research
At Bristol-Myers Squibb, we have a vision for the future of cancer care
that is focused on Immuno-Oncology, now considered a major treatment
modality alongside surgery, radiation and chemotherapy for certain types
of cancer.
We have a comprehensive clinical portfolio of investigational and
approved Immuno-Oncology agents, many of which were discovered and
developed by our scientists. We pioneered the research leading to the
first regulatory approval for the combination of two Immuno-Oncology
agents and continue to study the role of combinations in cancer.
Our collaboration with academia, as well as small and large biotech
companies, is responsible for researching the potential Immuno-Oncology
and non-Immuno-Oncology combinations, with the goal of providing new
treatment options in clinical practice.
At Bristol-Myers Squibb, we are committed to changing survival
expectations in hard-to-treat cancers and the way patients live with
cancer.
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 in combination with lenalidomide and dexamethasone is
approved in the United States, and the safety and efficacy of Empliciti
is being evaluated by other health authorities.
Bristol-Myers Squibb and AbbVie are co-developing Empliciti, with
Bristol-Myers Squibb solely responsible for commercial activities.
U.S. INDICATION
EMPLICITI™ (elotuzumab) is indicated in combination with lenalidomide
and dexamethasone for the treatment of patients with multiple myeloma
who have received one to three prior therapies.
U.S. IMPORTANT SAFETY INFORMATION
Infusion Reactions
-
EMPLICITI can cause infusion reactions. Common symptoms include 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. 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 infusing with EMPLICITI.
Infections
-
In a clinical trial of patients with multiple myeloma (N=635),
infections were reported in 81.4% of patients in the EMPLICITI with
lenalidomide/dexamethasone arm (ERd) and 74.4% in the
lenalidomide/dexamethasone arm (Rd). Grade 3-4 infections were 28%
(ERd) and 24.3% (Rd). Opportunistic infections were reported in 22%
(ERd) and 12.9% (Rd). Fungal infections were 9.7% (ERd) and 5.4% (Rd).
Herpes zoster was 13.5% (ERd) and 6.9% (Rd). Discontinuations due to
infections were 3.5% (ERd) and 4.1% (Rd). Fatal infections were 2.5%
(ERd) and 2.2% (Rd). Monitor patients for development of infections
and treat promptly.
Second Primary Malignancies
-
In a clinical trial of patients with multiple myeloma (N=635),
invasive second primary malignancies (SPM) were 9.1% (ERd) and 5.7%
(Rd). The rate of hematologic malignancies were 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).
Monitor patients for the development of SPMs.
Hepatotoxicity
-
Elevations in liver enzymes (AST/ALT greater than 3 times the upper
limit, total bilirubin greater than 2 times the upper limit, and
alkaline phosphatase less than 2 times the upper limit) consistent
with hepatotoxicity were 2.5% (ERd) and 0.6% (Rd). Two patients
experiencing hepatotoxicity discontinued treatment; however, 6 out of
8 patients had resolution and continued treatment. Monitor liver
enzymes periodically. Stop EMPLICITI upon Grade 3 or higher elevation
of liver enzymes. After return to baseline values, continuation of
treatment may be considered.
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 studies with EMPLICITI with pregnant women to inform any
drug associated risks.
-
There is a risk of fetal harm, including severe life-threatening human
birth defects associated with lenalidomide and it is contraindicated
for use in pregnancy. Refer to the lenalidomide 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
-
Infusion reactions were reported in approximately 10% of patients
treated with EMPLICITI with lenalidomide and dexamethasone. All
reports of infusion reaction were Grade 3 or lower. Grade 3 infusion
reactions occurred in 1% of patients.
-
Serious adverse reactions were 65.4% (ERd) and 56.5% (Rd). The most
frequent serious adverse reactions in the ERd arm compared to the Rd
arm were: pneumonia (15.4%, 11%), pyrexia (6.9%, 4.7%), 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 (61.6%, 51.7%), diarrhea (46.9%, 36.0%), pyrexia (37.4%,
24.6%), constipation (35.5%, 27.1%), cough (34.3%, 18.9%), peripheral
neuropathy (26.7%, 20.8%), nasopharyngitis (24.5%, 19.2%), upper
respiratory tract infection (22.6%, 17.4%), decreased appetite (20.8%,
12.6%), and pneumonia (20.1%, 14.2%).
Please see the full Prescribing Information for Empliciti.
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.
About AbbVie
AbbVie is a global, research-based biopharmaceutical company formed in
2013 following separation from Abbott Laboratories. The company’s
mission is to use its expertise, dedicated people and unique approach to
innovation to develop and market advanced therapies that address some of
the world’s most complex and serious diseases. Together with its
wholly-owned subsidiary, Pharmacyclics, AbbVie employs more than 28,000
people worldwide and markets medicines in more than 170 countries. For
further information on the company and its people, portfolio and
commitments, please visit www.abbvie.com.
Follow @abbvie on
Twitter or view careers on our Facebook or
LinkedIn page.
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. 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. 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, 2015 in our Quarterly Reports on Form 10-Q and
our Current Reports on Form 8-K. Bristol-Myers Squibb undertakes no
obligation to publicly update any forward-looking statement, whether as
a result of new information, future events or otherwise.
AbbVie Forward-Looking Statements
Some statements in this news release may be forward-looking
statements for purposes of the Private Securities Litigation Reform Act
of 1995. The words “believe,” “expect,” “anticipate,” “project” and
similar expressions, among others, generally identify forward-looking
statements. AbbVie cautions that these forward-looking statements are
subject to risks and uncertainties that may cause actual results to
differ materially from those indicated in the forward-looking
statements. Such risks and uncertainties include, but are not limited
to, challenges to intellectual property, competition from other
products, difficulties inherent in the research and development process,
adverse litigation or government action, and changes to laws and
regulations applicable to our industry. Additional information about the
economic, competitive, governmental, technological and other factors
that may affect AbbVie's operations is set forth in Item 1A, “Risk
Factors,” in AbbVie's 2015 Annual Report on Form 10-K, which has been
filed with the Securities and Exchange Commission. AbbVie undertakes no
obligation to release publicly any revisions to forward-looking
statements as a result of subsequent events or developments, except as
required by law.
Endnotes
Empliciti is a trademark of Bristol-Myers Squibb Company.
Revlimid is a registered trademark of Celgene Corporation. All other
trademarks are property of their respective owners.

Media:Kirby Hosea, 609-419-5071cell: 609-455-7891kirby.hosea@bms.comorInvestors:Ranya Dajani, 609-252-5330ranya.dajani@bms.comorBill Szablewski, 609-252-5894william.szablewski@bms.com