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Saturday, September 6, 2014

英國NICE 對 Halaven (賀樂維/ Eribulin) 持保留態度 !!! 捷克 OK !

NICE final "no" to Halaven UK NEWS | APRIL 03, 2012 5  LYNNE TAYLOR In final guidance issued today, the National Institute for Health and Clinical Excellence (NICE) has rejected the use of Eisai's Halaven (eribulin) in locally-advanced or metatastic breast cancer which has progressed after at least two chemotherapeutic regimens for advanced disease. Evidence presented to NICE's independent advisory committee indicated that the drug may help some patients live for a little longer, but it also caused more undesirable side effects than other, already-available treatments, and the panel also felt that its effects on health-related quality of life had not been adequately assessed, said NICE's executive director, Sir Andrew Dillon. Hatfield, UK, 6 January 2014 – Halaven® (eribulin) has received reimbursement approval in the Czech Republic as a highly innovative drug for patients with metastatic breast cancer, effective from the 1 January 2014. Eribulin is the first, single-agent chemotherapy to demonstrate a prolonged overall survival in patients with heavily pre-treated advanced breast cancer, compared to other single agent chemotherapies.[1]  "The reimbursement of eribulin in the Czech Republic is an important step forward for women with metastatic breast cancer," says Professor MUDr. Bohuslav Melichar, PhD, the Scientific Secretary of the Czech Society for Oncology. "These patients urgently need new treatment options and in particular, therapies which have demonstrated an overall survival benefit in heavily pre-treated patients. The advent of eribulin will be welcomed by patients and doctors across the country."  Breast cancer is the most common cancer in Czech women and accounts for nearly 25% of all newly diagnosed malignancies in the female population.[2] More than 6,400 people are diagnosed with breast cancer each year in the Czech Republic[3] and metastatic disease will develop in approximately 30% of cases.  "Metastatic breast cancer continues to affect many women across Europe. We are pleased that the Czech health authorities recognise the innovative drug status and clinical value eribulin may offer to women with locally advanced or metastatic breast cancer," commented MUDr, Miloš Živanský, Medical Director of CEE in Eisai. "The reimbursement in the Czech Republic underscores the potential importance of this treatment and Eisai will work closely with local health authorities to ensure that women in the Czech Republic have rapid access to a treatment that has a proven overall survival benefit."  Eribulin received European Commission approval on 17 March 2011 based on the results of the pivotal Phase III EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Treatment of Physician's Choice (TPC) Versus Eribulin E7389) study. Eribulin is now available in 50 countries worldwide.  In the EMBRACE study population (n=762), eribulin was shown to prolong overall survival in heavily pre-treated patients with metastatic breast cancer by 2.5 months compared to patients receiving Treatment of Physicians Choice (TPC), representing a mix of real-life treatment choices (eribulin 13.1 months vs. TPC 10.6 months, HR 0.81 (95% CI 0.66, 0.99) p=0.041).[4] Updated data confirmed that patients treated with eribulin survived a median of 2.7 months longer than patients who received treatment of physician's choice (overall survival of 13.2 months versus 10.5 months, respectively, HR 0.81 (95% CI 0.067, 0.96), nominal p=0.014).4 A pre-planned analysis of patients from Region 1 of the study (North America/Western Europe/Australia) showed a significant overall survival benefit of eribulin over TPC of 3.0 months (p=0.009).4  The most commonly reported adverse reactions among patients treated with eribulin were asthenia (fatigue), neutropenia, alopecia (hair loss), peripheral neuropathy (numbness and tingling in arms and legs), nausea and constipation.4  Eisai is committed to developing and delivering highly beneficial new treatments to help improve the lives of people with cancer. Built on scientific expertise, Eisai is supported by a global capability to conduct discovery and preclinical research, and develop small molecules, therapeutic vaccines, and biologic and supportive care agents for cancer across multiple indications. 

Halaven® (eribulin)  Eribulin is a non-taxane, microtubule dynamics inhibitor indicated for the treatment of patients with breast cancer who have previously received at least two chemotherapeutic regimens for metastatic disease and whose prior therapy should have included an anthracycline and a taxane. Eribulin belongs to a class of antineoplastic agents, the halichondrins, which are natural products, isolated from the marine sponge Halichondria okadai. It is believed to work by inhibiting the growth phase of microtubule dynamics without affecting the shortening phase and sequesters tubulin into non-productive aggregates. 

Global Phase III Clinical Study 305 (EMBRACE)4  EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Treatment of Physician's Choice (TPC) Versus Eribulin E7389) was an open-label, randomised, global, multi-centre, parallel two-arm study designed to compare overall survival in patients treated with eribulin versus a Treatment of Physician's Choice (TPC) arm. TPC was defined as any single-agent chemotherapy, hormonal treatment or biologic therapy approved for the treatment of cancer; or palliative treatment or radiotherapy administered according to local practice. The study included 762 patients with metastatic breast cancer who previously had been treated with at least two and a maximum of five prior chemotherapies, including an anthracycline and a taxane. The vast majority (96%) of patients in the TPC arm received chemotherapy.  In the total Phase III EMBRACE study population, eribulin was shown to prolong median overall survival in heavily pre-treated patients with metastatic breast cancer compared to patients receiving TPC by 2.7 months (13.2 vs 10.5 HR 0.81 (95% CI 0.067, 0.96) nominal p=0.014). A pre-planned analysis of patients from Region 1 of the study (North America/Western Europe/Australia) showed a significant median overall survival benefit of eribulin over TPC of 3.0 months (nominal p=0.031).  The most commonly reported adverse reactions among patients treated with eribulin in the EMBRACE study were fatigue (asthenia), a decrease in infection-fighting white blood cells (neutropaenia), hair loss (alopecia), numbness and tingling in arms and legs (peripheral neuropathy), nausea and constipation. Peripheral neuropathy was the most common adverse event leading to discontinuation from eribulin, occurring in less than 5% of the patients involved in the EMBRACE trial. Neutropaenia only led to eribulin discontinuation for 0.6% patients. Death due to serious side effects, discontinuation and dose interruptions to treatment were lower in the eribulin arm of the trial compared with the TPC arm. 

Metastatic Breast Cancer Over 300,000 women are diagnosed with breast cancer in Europe every year, of whom about one third subsequently develop metastatic disease.[5],[6] Metastatic disease is an advanced stage of the disease that occurs when cancer spreads beyond the breast to other parts of the body. 

About Eisai Eisai is one of the world's leading research and development (R&D) based pharmaceutical companies and we define our corporate mission as "giving first thought to patients and their families and to increasing the benefits health care provides," which we call human health care (hhc).  Eisai concentrates its R&D activities in three key areas: 

 Oncology including: anticancer therapies; tumour regression, tumour suppression, antibodies, etc.

 Neuroscience, including: Alzheimer's disease, epilepsy, pain and weight loss

 Vascular/Immunological reaction including: thrombocytopenia, rheumatoid arthritis, psoriasis, inflammatory bowel disease 

With operations in the U.S., Asia, Europe and its domestic home market of Japan, Eisai employs more than 10,000 people worldwide. From its EMEA Knowledge Centre in Hatfield, UK, Eisai has recently expanded its business operations to include Europe, the Middle East, Africa, Russia and Oceania (EMEA). Eisai EMEA has sales and marketing operations in over 20 markets, including the United Kingdom, France, Germany, Italy, Spain, Switzerland, Sweden, Ireland, Austria, Denmark, Finland, Norway, Portugal, Czech Republic, Slovakia, the Netherlands, Belgium, Luxembourg, Russia and the Middle East.

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