The FDA’s Oncologic Drugs Advisory Committee (ODAC) met on the afternoon of July 13th to discuss Biologics License Application (BLA) 761074 for Mylan’s biosimilar to Genentech Inc.’s Herceptin (trastuzumab), MYL-1401O. MYL-1401O’s proposed indications include: Adjuvant treatment of HER2 overexpressing node positive or node negative (ER/PR negative or with one high risk feature) breast cancer; in combination with paclitaxel for first-line treatment of HER2-overexpressing metastatic breast cancer; as a single agent for treatment of HER2-overexpressing breast cancer in patients who have received one or more chemotherapy regimens for metastatic disease; and in combination with cisplatin and capecitabine or 5-fluorouracil, for the treatment of patients with HER2 overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma who have not received prior treatment for metastatic disease.
MYL-1401O is a humanized monoclonal antibody, which targets Human Epidermal Growth Factor Receptor 2 (HER2). This inhibits proliferation of tumor cells and activates antibody-dependent cell-mediated cytotoxicity, which activate tumor cell lysis, leading to the destruction of cancerous cells. The sponsor presented their analytical, non-clinical, and clinical data package, which demonstrated high similarity of MYL-1401O to the reference product. The sponsor concluded that the totality of evidence supports both the overall biosimilarity of MYL-1401O to the reference product, and extrapolation to all indications currently held by the reference product.
The FDA was supportive of the sponsor’s product, which was reflected in their presentation. The FDA concluded that extrapolation to all indications is supported by both the scientific understanding of the mechanism of action (MOA) and biosimilarity of MYL-1401O to the reference product. The FDA posed three discussion questions, which preceded the vote. The discussion focused on whether there was enough available evidence to support licensure of MYL-1401O for all approved indications of the reference product. The committee was largely in support, concluding that the analytical, pharmacological, and non-clinical evidence demonstrated biosimilarity and that there were no clinically meaningful differences between MYL-1401O and the US reference product. The vote, which asked members whether approval of MYL-1401O was appropriate for all indications, resulted in a 16-0 positive outcome.
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