Combination Therapy of REVLIMID/Rituximab Achieved 64% Response Rate, in Patients Who Had Received Prior Treatments, Including RituximabBOUDRY, Switzerland, Dec 07, 2009 (BUSINESS WIRE) -- Celgene International Sàrl (NASDAQ:CELG) announced that data
evaluating combination therapy with REVLIMID (lenalidomide) and
rituximab in patients with relapsed chronic lymphocytic leukaemia (CLL)
were presented during the 51st American Society of Hematology
annual meeting in New Orleans, LA. The phase II study conducted at MD
Anderson Cancer Center demonstrated a 64 percent overall response after
12 cycles, including the observation of complete responses.
In this study, 14 of 22 patients (64%) achieved a response after 12
treatment cycles. 71% of patients over the age of 65 achieved a response
after six cycles. These patients represent a typical CLL patient
demographic. 92 % of patients in the study had received prior
fludarabine, cyclophosphamide, and rituximab or an equivalent regimen.
In addition, there was a 67% response observed in patients with the poor
prognostic factor, 17p deletion. For all patients, a 95% overall
survival rate was reported after 12 treatment cycles.
Compared with data presented for REVLIMID alone, there was no increase
in toxicity and tumour flare was less frequent and less severe with this
combination. The most common Grade 3 or 4 treatment-related adverse
events observed per cycle were: neutropaenia (31%) and fatigue (27%).
Two patients developed tumour lysis syndrome.
About Chronic Lymphocytic Leukaemia
CLL is the most
prevalent of the one of the four main types of leukaemia. CLL is a
malignant process arising in a single cell (lymphocyte). Over time, the
CLL cells multiply and displace normal lymphocytes in the blood, bone
marrow, lymph nodes nodes and spleen, resulting in an inability to fight
infection by making normal antibody responses. There is no cure for CLL.
About REVLIMID(R)
REVLIMID is an IMiDs(R) compound. REVLIMID and other
IMiDs continue to be evaluated in over 100 clinical trials. The IMiDs
pipeline is covered by a comprehensive intellectual property estate of
issued and pending patent applications in the US, EU and other regions,
including composition-of- matter and use patents.
REVLIMID is approved in combination with dexamethasone for the treatment
of patients with multiple myeloma who have received at least one prior
therapy in nearly 50 countries, encompassing Europe, the Americas, the
Middle-East and Asia, and in combination with dexamethasone for the
treatment of patients whose disease has progressed after one therapy in
Australia and New Zealand.
REVLIMID is also approved in the United States, Canada and several Latin
American countries, as well as Malaysia and Israel, for
transfusion-dependent anaemia due to low- or intermediate-1-risk MDS
associated with a deletion 5q cytogenetic abnormality with or without
additional cytogenetic abnormalities. Marketing Authorization
Applications are currently being evaluated in a number of other
countries.
Important Safety Information
REVLIMID(R) (lenalidomide) in combination with dexamethasone is indicated
for the treatment of multiple myeloma patients who have received at
least one prior therapy.
REVLIMID(R) (lenalidomide) is indicated for patients with
transfusion-dependent anaemia due to Low- or Intermediate-1-risk
myelodysplastic syndromes (MDS) associated with a deletion 5q
cytogenetic abnormality with or without additional cytogenetic
abnormalities.
WARNINGS:
1. POTENTIAL FOR HUMAN BIRTH DEFECTS.
LENALIDOMIDE IS AN ANALOGUE OF THALIDOMIDE. THALIDOMIDE IS A KNOWN
HUMAN TERATOGEN THAT CAUSES SEVERE LIFE-THREATENING HUMAN BIRTH DEFECTS.
IF LENALIDOMIDE IS TAKEN DURING PREGNANCY, IT MAY CAUSE BIRTH DEFECTS OR
DEATH TO AN UNBORN BABY. FEMALES SHOULD BE ADVISED TO AVOID PREGNANCY
WHILE TAKING REVLIMID(R) (lenalidomide).
Special Prescribing Requirements
BECAUSE OF THIS POTENTIAL TOXICITY AND TO AVOID FETAL EXPOSURE TO
REVLIMID(R) (lenalidomide), REVLIMID(R) (lenalidomide)
IS ONLY AVAILABLE UNDER A SPECIAL RESTRICTED DISTRIBUTION PROGRAM. THIS
PROGRAM IS CALLED "RevAssist(R)". UNDER THIS
PROGRAM, ONLY PRESCRIBERS AND PHARMACISTS REGISTERED WITH THE PROGRAM
CAN PRESCRIBE AND DISPENSE THE PRODUCT. IN ADDITION, REVLIMID(R)
(lenalidomide) MUST ONLY BE DISPENSED TO PATIENTS WHO ARE
REGISTERED AND MEET ALL THE CONDITIONS OF THE RevAssist(R)
PROGRAM.
2. HEMATOLOGIC TOXICITY (NEUTROPENIA
AND THROMBOCYTOPENIA).
THIS DRUG IS ASSOCIATED WITH SIGNIFICANT NEUTROPENIA AND
THROMBOCYTOPENIA.EIGHTY PERCENT OF PATIENTS WITH DEL 5q
MYELODYSPLASTIC SYNDROMES HAD TO HAVE A DOSE DELAY/REDUCTION DURING THE
MAJOR STUDY. THIRTY-FOUR PERCENT OF PATIENTS HAD TO HAVE A SECOND DOSE
DELAY/REDUCTION. GRADE 3 OR 4 HEMATOLOGIC TOXICITY WAS SEEN IN 80% OF
PATIENTS ENROLLED IN THE STUDY. PATIENTS ON THERAPY FOR DEL 5q
MYELODYSPLASTIC SYNDROMES SHOULD HAVE THEIR COMPLETE BLOOD COUNTS
MONITORED WEEKLY FOR THE FIRST 8 WEEKS OF THERAPY AND AT LEAST MONTHLY
THEREAFTER. PATIENTS MAY REQUIRE DOSE INTERRUPTION AND/OR REDUCTION.
PATIENTS MAY REQUIRE USE OF BLOOD PRODUCT SUPPORT AND/OR GROWTH FACTORS.
(SEE DOSAGE AND ADMINISTRATION)
3. DEEP VENOUS THROMBOSIS AND
PULMONARY EMBOLISM.
THIS DRUG HAS DEMONSTRATED A SIGNIFICANTLY INCREASED RISK OF DEEP
VENOUS THROMBOSIS (DVT) AND PULMONARY EMBOLISM (PE) IN PATIENTS WITH
MULTIPLE MYELOMA WHO WERE TREATED WITH REVLIMID(R)
(lenalidomide) COMBINATION THERAPY. PATIENTS AND PHYSICIANS ARE ADVISED
TO BE OBSERVANT FOR THE SIGNS AND SYMPTOMS OF THROMBOEMBOLISM. PATIENTS
SHOULD BE INSTRUCTED TO SEEK MEDICAL CARE IF THEY DEVELOP SYMPTOMS SUCH
AS SHORTNESS OF BREATH, CHEST PAIN, OR ARM OR LEG SWELLING. IT IS NOT
KNOWN WHETHER PROPHYLACTIC ANTICOAGULATION OR ANTIPLATELET THERAPY
PRESCRIBED IN CONJUNCTION WITH REVLIMID(R)
(lenalidomide) MAY LESSEN THE POTENTIAL FOR VENOUS THROMBOEMBOLIC
EVENTS. THE DECISION TO TAKE PROPHYLACTIC MEASURES SHOULD BE DONE
CAREFULLY AFTER AN ASSESSMENT OF AN INDIVIDUAL PATIENT'S UNDERLYING RISK
FACTORS.
You can get the information about REVLIMID(R)
(lenalidomide) and the RevAssist(R) program on
the Internet at www.REVLIMID.com
or by calling the manufacturer's toll-free number at 1-888-423-5436.
Additional Warnings: Haematologic Toxicity
Multiple Myeloma
In the pooled multiple myeloma studies, Grade 3 and 4 haematologic
toxicities were more frequent in patients treated with the combination
of REVLIMID(R) (lenalidomide) and dexamethasone than in patients treated
with dexamethasone alone. Patients on therapy should have their complete
blood counts monitored every 2 weeks for the first 12 weeks and then
monthly thereafter. Patients may require dose interruption and/or dose
reduction.
Contraindications:
Hypersensitivity: REVLIMID(R)
(lenalidomide) is contraindicated in any patients who have demonstrated
hypersensitivity to the drug or its components.
Precautions:
Renal impairment: Since lenalidomide is primarily excreted unchanged by
the kidney, adjustments to the starting dose of REVLIMID(R) (lenalidomide)
are recommended to provide appropriate drug exposure in patients with
moderate or severe (CLcr < 60 mL/min) renal impairment and in patients
on dialysis. Because elderly patients are more likely to have decreased
renal function, care should be taken in dose selection, and it would be
prudent to monitor renal function.
Nursing mothers: It is not known whether REVLIMID(R) (lenalidomide) is
excreted in human milk. Because of the potential for adverse reactions
in nursing infants, a decision should be made whether to discontinue
nursing or the drug, taking into account the importance of the drug to
the mother.
Adverse Reactions:
Multiple Myeloma
In the REVLIMID(R) (lenalidomide)/dexamethasone treatment group, 151
patients (45%) underwent at least one dose interruption with or without
a dose reduction of REVLIMID(R) (lenalidomide) compared to 21% in the
placebo/dexamethasone treatment group. Of these patients who had one
dose interruption with or without a dose reduction, 50% in the REVLIMID(R)
(lenalidomide)/dexamethasone treatment group underwent at least one
additional dose interruption with or without a dose reduction compared
to 21% in the placebo/dexamethasone treatment group. Most adverse events
and Grade 3/4 adverse events were more frequent in MM patients who
received the combination of REVLIMID(R) (lenalidomide)/dexamethasone
compared to placebo/dexamethasone.
Other adverse events reported in multiple myeloma patients (REVLIMID(R)
(lenalidomide)/dexamethasone vs dexamethasone/placebo): constipation
(39% vs 19%), fatigue (38% vs 37%), insomnia (32% vs 37%), muscle cramp
(30% vs 21%), diarrhea (29% vs 25%), neutropenia (28% vs 5%), anemia
(24% vs 17%), asthenia (23% vs 25%), pyrexia (23% vs 19%), nausea (22%
vs 19%), headache (21% vs 21%), peripheral edema (21% vs 19%), dizziness
(21% vs 15%), dyspnea (20% vs 15%), tremor (20% vs 7%), decreased weight
(18% vs 14%), thrombocytopenia (17% vs 10%), rash (16% vs 8%), back pain
(15% vs 14%), hyperglycemia (15% vs 14%), and muscle weakness (15% vs
15%).
Myelodysplastic Syndromes
Thrombocytopenia (61.5%; 91/148) and neutropenia (58.8%; 87/148) were
the most frequently reported adverse events observed in the del 5q MDS
population. Other adverse reactions reported in del 5q MDS patients
(REVLIMID(R) (lenalidomide)): diarrhea (49%), pruritus (42%), rash (36%),
fatigue (31%), constipation (24%), nausea (24%), nasopharyngitis (23%),
arthralgia (22%), pyrexia (21%), back pain (21%), peripheral edema
(20%), cough (20%), dizziness (20%), headache (20%), muscle cramp (18%),
dyspnea (17%), and pharyngitis (16%).
Dosage and Administration:
Dosing is continued or modified
based upon clinical and laboratory findings. Dosing modifications are
recommended to manage Grade 3 or 4 neutropenia or thrombocytopenia or
other Grade 3 or 4 toxicity judged to be related to REVLIMID(R)
(lenalidomide). For other Grade 3 or 4 toxicities judged to be related
to REVLIMID(R)(lenalidomide), hold treatment and restart at next lower
dose level when toxicity has resolved to less than or equal to Grade 2.
Please see full Prescribing Information, including Boxed WARNINGS,
CONTRAINDICATIONS, PRECAUTIONS, and ADVERSE REACTIONS.
About Celgene International Sàrl
Celgene International Sàrl,
located in Boudry, in the Canton of Neuchâtel, Switzerland, is a wholly
owned subsidiary and international headquarters of Celgene Corporation.
Celgene Corporation, headquartered in Summit, New Jersey, is an
integrated global pharmaceutical company engaged primarily in the
discovery, development and commercialisation of innovative therapies for
the treatment of cancer and inflammatory diseases through gene and
protein regulation. For more information, please visit the Company's
website at www.celgene.com.
This release contains certain forward-looking statements which
involve known and unknown risks, delays, uncertainties and other factors
not under the Company's control. The Company's actual results,
performance, or achievements could be materially different from those
projected by these forward-looking statements.The factors that
could cause actual results, performance, or achievements to differ from
the forward-looking statements are discussed in the Company's filings
with the Securities and Exchange Commission, such as the Company's Form
10-K, 10-Q and 8-K reports.Given these risks and uncertainties,
you are cautioned not to place undue reliance on the forward-looking
statements.

SOURCE: Celgene International
Celgene International Sàrl
Kevin Loth
Director of External Relations
+41 32 729 86 21