ASH Clinical News May 2017 NEW | Page 23

CLINICAL NEWS Trials of Vadastuximab Talirine to Resume After FDA Clinical Hold The FDA lifted its clinical hold on early- stage studies of vadastuximab talirine for AML after halting them in early January following four patient deaths. Seattle Genetics Inc., the manufacturer of vadastuximab talirine, said the clinical hold was resolved through a compre- hensive study evaluating more than 300 patients, and amendments were made to the study protocols to further enhance safety. Two early-stage trials will resume, with plans for a mid-stage trial to begin this year. Results from a phase Ib study were presented at the 2016 ASH Annual Meeting and suggested that combining standard 7+3 chemotherapy with vadas- tuximab talirine was safe in patients with newly diagnosed AML. Seventy-six per- cent of patients achieved a response, most of which (60%) were complete remissions. Patients showed no evidence of in- creased toxicity; 30- and 60-day mortality rates were 0 percent and 7 percent, respec- tively; and the rates of hematologic AEs were similar to what would be expected with standard chemotherapy alone, ac- cording to the researchers. Source: Reuters, March 6, 2017. Development of CAR T-Cell Therapy for Acute Lymphocytic Leukemia Shut Down Following Clinical Holds Juno Therapeutics, the manufacturer of the experimental chimeric antigen receptor (CAR) therapy JCAR015 for patients with relapsed acute lymphocytic leukemia, announced that it will discontinue the development of JCAR015. Last year, the FDA placed a clinical hold on phase II trials of JCAR015 follow- ing patient deaths from cerebral edema, but then allowed trials to resume. The manufacturers originally reported that the deaths were related to the addition of fludarabine to the pre-conditioning regimen, and they proposed that the trial continue with cyclophosphamide as a substitution. However, after five patient deaths were reported, the manufacturer said its internal investigation identified multiple factors that increased the risk of severe toxic reactions, including “factors related to the product.” The promising new class of immu- notherapy, which removes T cells from ASHClinicalNews.org a patient’s blood and re-engineers them to more efficiently attack cancer before returning them to the patient, was highly anticipated by health-care professionals and patients alike. Source: Reuters, March 1, 2017. FDA Grants Marketing Authorization for Personal Genetic Risk Tests The FDA has approved marketing for 23andMe Personal Genome Service Genetic Health Risk (GHR) tests, the first direct-to-consumer tests that ana- lyze DNA from users’ saliva samples to calculate their genetic predisposal for the following 10 diseases and conditions: • • • • • • • • • • Parkinson’s disease late-onset Alzheimer’s disease celiac disease alpha-1 antitrypsin deficiency early-onset primary dystonia factor XI deficiency Gaucher disease type 1 glucose-6-Phosphate Dehydrogenase deficiency hereditary hemochromatosis hereditary thrombophilia the test. Data were reviewed through the FDA’s device premarket review pathway, which regulates low- to moderate-risk devices while simultaneously establish- ing criteria (“special controls”) to ensure accuracy, reliability, and clinical relevance in the testing. In 2013, the FDA warned the manu- facturers of the GHR test to discontinue marketing the test kit. The marketing ma- terials stated that the device was intended for use in the diagnosis and prevention of diseases and disorders, but doing so before the FDA had the opportunity to review the statements, the manufacturer was in violation of the Federal Food, Drug, and Cosmetic Act. In response, the manufacturer reconfigured their testing platform and worked with the FDA to design trials that would assess its health- related claims. In a press release announcing the deci- sion, Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiologi- cal Health, noted that “consumers can now have direct access to certain genetic risk information, but it is important that people understand that genetic risk is just one piece of the bigger puzzle, it does not mean they will or won’t ultimately develop a disease.” The FDA cautioned that results from testing should still be monitored by a health-care professional because of the risk associated with the test, including false-positive and false-negative findings. Source: U.S. FDA press release, April 6, 2017. “Consumers can now have direct access to certain genetic risk information, but it is important that people understand that genetic risk is just one piece of the bigger puzzle.” —JEFFREY SHUREN, MD The FDA’s decision was supported by an analysis of peer-reviewed literature estab- lishing a strong link between genetic vari- ants and the 10 conditions included on FDA Clears Device That Touts “Fast and Virtually Painless” Blood Draw The FDA granted 510(k) clearance to TAP, a blood collection device that is placed on the upper arm and collects 100 µL of capillary blood with the press of a button, lasting two to three minutes. Seventh Sense Biosystems, Inc., the manufacturer of TAP, claims that the device is “fast and virtually painless.” The single-use device is attached to the upper arm through vacuum pressure and draws blood through an array of fine needles. The drawn blood is held inter- nally within the device until laboratory analysis of hemoglobin A1c levels. The device uses lithium heparin as its antico- agulant, which the manufacturers noted may limit the range of potential diagnostic testin