Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals, Inc. announced that The New England Journal of Medicine published results of a Phase 3 trial demonstrating that Nexavar(R) (sorafenib) tablets decreased the absolute risk of death by 31 percent in patients with unresectable hepatocellular carcinoma (HCC), or liver cancer, versus patients who received placebo. This represents a 44 percent improvement in median overall survival for patients treated with Nexavar.
Based on the strength of these data, Nexavar was approved for HCC by the European Agency for the Evaluation of Medicinal Products (EMEA) and by the U.S. Food and Drug Administration (FDA) in October and November 2007, respectively.
"Despite advances in the management of many other cancers, liver cancer has remained a treatment challenge, due to a lack of systemic therapies to extend life and limited opportunity for surgical intervention," said Dr. Josep M. Llovet, co-principal investigator of the study and professor of research, Barcelona Clinic Liver Cancer (BCLC) Group, IDIBAPS, Liver Unit, Hospital Clinic Barcelona; director of research, HCC Program, associate professor of Medicine, Mount Sinai School of Medicine, New York. "This landmark study reflects a new systemic standard of care using Nexavar in the first-line management of liver cancer."
"The number of lives lost to liver cancer continues to increase globally, due to the prevalence of hepatitis B and C infections," said Jordi Bruix, co-principal investigator and director of the Barcelona Clinic Liver Cancer (BCLC) Group; senior consultant, Liver Unit, Hospital Clinic of Barcelona. "We are encouraged that there is a new treatment option available for liver cancer that has clearly demonstrated a survival benefit in this patient population."
The international Phase 3 double-blind, placebo-controlled Sorafenib HCC Assessment Randomized Protocol (SHARP) trial evaluated 602 liver cancer patients who had no prior systemic therapy. The primary endpoints of the study included overall survival and time to symptomatic progression in patients administered Nexavar versus those who received placebo. Secondary endpoints included time to progression, disease control rate and safety.
Results were first presented at the American Society of Clinical Oncology in June 2007.
Median overall survival was 10.7 months for patients who received Nexavar compared to 7.9 months for patients who received placebo (HR=0.69; p=0.0006). There was no difference in time to symptomatic progression between patient groups, based on a patient-reported assessment questionnaire.
Median time to tumor progression was 5.5 months with Nexavar versus 2.8 months with placebo (HR=0.58; p=<0.001). The most common drug-related grade 3/4 events in patients receiving Nexavar were diarrhea and hand-foot-skin reaction. No indication of imbalances was observed with regard to serious adverse events between the Nexavar and placebo-treated groups.
"Hepatocellular cancer is the second type of cancer where Nexavar has demonstrated a meaningful clinical benefit," said Dimitris Voliotis, MD, vice president, Nexavar Clinical Development, Bayer HealthCare Pharmaceuticals. "We are pleased that Nexavar is now available to patients suffering from liver cancer in the U.S. and Europe and we continue to work with worldwide regulatory authorities to secure approvals in other regions."
Hepatocellular carcinoma is the most common form of liver cancer and is responsible for about 90 percent of the primary malignant liver tumors in adults. Liver cancer is the sixth most common cancer in the world and the third leading cause of cancer-related deaths globally. More than 600,000 cases of liver cancer are diagnosed worldwide each year (more than 400,000 in China, South Korea, Japan and Taiwan, 54,000 in the European Union, and 15,000 in the United States) and the incidence is increasing. In 2002, approximately 600,000 people died of liver cancer including approximately 370,000 in China, South Korea and Japan, 57,000 in the European Union, and 13,000 in the United States. (1,2)
In addition, chronic hepatitis B (HBV) and C (HCV) viral infections are the leading causes of primary liver cancer worldwide. In the Asia-Pacific region, more than eight percent of the general population is infected with HBV and between two and four percent is infected with HCV. (3,4)
Nexavar's Differentiated Mechanism
Nexavar targets both the tumor cell and tumor vasculature. In preclinical studies, Nexavar has been shown to target members of two classes of kinases known to be involved in both cell proliferation (growth) and angiogenesis (blood supply) -- two important processes that enable cancer growth. These kinases included Raf kinase, VEGFR-1, VEGFR-2, VEGFR-3, PDGFR-B, KIT, FLT-3 and RET. Preclinical models have also demonstrated that Raf/MEK/ERK has a role in HCC; therefore blocking signaling through Raf-1 may offer therapeutic benefits in HCC.
Nexavar is currently approved in more than 40 countries for liver cancer and in more than 70 countries for the treatment of patients with advanced kidney cancer. Nexavar is also being evaluated by the companies, international study groups, government agencies and individual investigators as a single agent or combination treatment in a wide range of cancers, including metastatic melanoma, lung cancer, breast cancer and as an adjuvant therapy for kidney cancer.
Copyright 2008, Hospital Business Week via NewsRx.com
