Efficacy and safety of RGB-02, a pegfilgrastim biosimilar to prevent chemotherapy-induced neutropenia: results of a randomized, double-blind phase III clinical study vs. reference pegfilgrastim in patients with breast cancer receiving chemotherapy.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
06 Feb 2019
Historique:
received: 15 01 2018
accepted: 29 01 2019
entrez: 8 2 2019
pubmed: 8 2 2019
medline: 31 8 2019
Statut: epublish

Résumé

Treatment with recombinant human granulocyte-colony stimulating factor (G-CSF) is accepted standard for prevention of chemotherapy-induced neutropenia. RGB-02 (Gedeon Richter) is a proposed biosimilar to pegylated G-CSF (Neulasta®, Amgen) with sustained release properties. This is a randomized, comparative, double-blind, multicenter study to evaluate efficacy and safety of RGB-02 in breast cancer patients receiving cytotoxic regimen. Two hundred thirty-nine women presenting with breast cancer were randomized to RGB-02 (n = 121) and the reference product (n = 118). All patients received up to 6 cycles of docetaxel/doxorubicin chemotherapy combination and a once-per-cycle injection of a fixed 6 mg dose of pegfilgrastim. Primary endpoint was the duration of severe neutropenia (ANC < 0.5 × 10 The mean duration of severe neutropenia in Cycle 1 was 1.7 (RGB-02) and 1.6 days (reference), with a difference (LS Mean) of 0.1 days (95% CI -0.2, 0.4). Equivalence could be established as the CI for the difference in LS Mean lay entirely within the pre-defined range of ±1 day. This positive result was supported by the analysis of secondary endpoints, which also revealed no clinical meaningful differences. Safety profiles were comparable between groups. No neutralizing antibodies against pegfilgrastim were identified. Treatment equivalence in reducing the duration of chemotherapy induced neutropenia between RGB-02 and Neulasta® could be demonstrated. Similar efficacy and safety profiles of the once-per-cycle administration of RGB-02 and the pegfilgrastim reference were demonstrated. The trial was registered prospectively, prior to study initiation. EudraCT number ( 2013-003166-14 ). The date of registration was 12 July, 2013.

Sections du résumé

BACKGROUND BACKGROUND
Treatment with recombinant human granulocyte-colony stimulating factor (G-CSF) is accepted standard for prevention of chemotherapy-induced neutropenia. RGB-02 (Gedeon Richter) is a proposed biosimilar to pegylated G-CSF (Neulasta®, Amgen) with sustained release properties. This is a randomized, comparative, double-blind, multicenter study to evaluate efficacy and safety of RGB-02 in breast cancer patients receiving cytotoxic regimen.
METHODS METHODS
Two hundred thirty-nine women presenting with breast cancer were randomized to RGB-02 (n = 121) and the reference product (n = 118). All patients received up to 6 cycles of docetaxel/doxorubicin chemotherapy combination and a once-per-cycle injection of a fixed 6 mg dose of pegfilgrastim. Primary endpoint was the duration of severe neutropenia (ANC < 0.5 × 10
RESULTS RESULTS
The mean duration of severe neutropenia in Cycle 1 was 1.7 (RGB-02) and 1.6 days (reference), with a difference (LS Mean) of 0.1 days (95% CI -0.2, 0.4). Equivalence could be established as the CI for the difference in LS Mean lay entirely within the pre-defined range of ±1 day. This positive result was supported by the analysis of secondary endpoints, which also revealed no clinical meaningful differences. Safety profiles were comparable between groups. No neutralizing antibodies against pegfilgrastim were identified.
CONCLUSIONS CONCLUSIONS
Treatment equivalence in reducing the duration of chemotherapy induced neutropenia between RGB-02 and Neulasta® could be demonstrated. Similar efficacy and safety profiles of the once-per-cycle administration of RGB-02 and the pegfilgrastim reference were demonstrated.
TRIAL REGISTRATION BACKGROUND
The trial was registered prospectively, prior to study initiation. EudraCT number ( 2013-003166-14 ). The date of registration was 12 July, 2013.

Identifiants

pubmed: 30727980
doi: 10.1186/s12885-019-5329-6
pii: 10.1186/s12885-019-5329-6
pmc: PMC6364429
doi:

Substances chimiques

Biosimilar Pharmaceuticals 0
Hematologic Agents 0
Docetaxel 15H5577CQD
pegfilgrastim 3A58010674
Polyethylene Glycols 3WJQ0SDW1A
Doxorubicin 80168379AG
Filgrastim PVI5M0M1GW

Types de publication

Clinical Trial, Phase III Comparative Study Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

122

Références

J Clin Oncol. 2002 Feb 1;20(3):727-31
pubmed: 11821454
Ann Oncol. 2002 Jun;13(6):903-9
pubmed: 12123336
Ann Oncol. 2003 Jan;14(1):29-35
pubmed: 12488289
J Clin Oncol. 2003 Feb 1;21(3):514-9
pubmed: 12560443
Anticancer Drugs. 2003 Apr;14(4):259-64
pubmed: 12679729
Pharmacotherapy. 2003 Aug;23(8 Pt 2):9S-14S
pubmed: 12921217
Pharmacotherapy. 2003 Aug;23(8 Pt 2):15S-19S
pubmed: 12921218
Semin Oncol. 2003 Aug;30(4 Suppl 13):24-30
pubmed: 14508717
J Immunol Methods. 2004 Jun;289(1-2):1-16
pubmed: 15251407
J Clin Oncol. 2005 Feb 20;23(6):1178-84
pubmed: 15718314
J Clin Oncol. 2006 Jul 1;24(19):3187-205
pubmed: 16682719
Eur J Cancer. 2006 Oct;42(15):2433-53
pubmed: 16750358
J Clin Pharmacol. 2008 Sep;48(9):1025-31
pubmed: 18524995
J Pharm Biomed Anal. 2008 Dec 15;48(5):1267-81
pubmed: 18993008
Ann Oncol. 2010 May;21 Suppl 5:v252-6
pubmed: 20555092
Eur J Cancer. 2011 Jan;47(1):8-32
pubmed: 21095116
Ann Oncol. 2011 Sep;22 Suppl 6:vi12-24
pubmed: 21908498
Cochrane Database Syst Rev. 2012 Oct 17;10:CD007913
pubmed: 23076939
Support Care Cancer. 2015 Feb;23(2):525-45
pubmed: 25284721
Support Care Cancer. 2015 Nov;23(11):3131-40
pubmed: 25821144
J Oncol Pharm Pract. 2016 Oct;22(5):702-16
pubmed: 26769697
Clin Lung Cancer. 2016 Mar;17(2):119-27
pubmed: 26781346
Future Oncol. 2016 Jun;12(11):1359-67
pubmed: 27020170
Oncologist. 2016 Jul;21(7):789-94
pubmed: 27091420

Auteurs

Zsuzsanna Kahan (Z)

Department of Oncotherapy, University of Szeged, Korányi Fasor 12, Szeged, 6720, Hungary.

Daniela Grecea (D)

Institutul Oncologic Prof. Dr. I. Chiricuta, Republicii Bulevardul 34-36, 400015, Cluj-Napoca, Romania.

Martin Smakal (M)

Nemocnice Horovice, K nemocnici 1106, 268 01, Horovice, Czech Republic.

Sergei Tjulandin (S)

Russian Cancer Research Center of the Russian Academy of Medical Sciences, Kashirskoye Shosse 24, Moscow, Russia, 115478.

Igor Bondarenko (I)

Department of Oncology and Medical Radiology, Dnipropetrovsk Medical Academy, Vernadsky str. 9, Dnipropetrovsk, 49044, Ukraine.

Luca Perjesi (L)

Gedeon Richter Plc, Budapest, Hungary; Gyömröi út 19-21, Budapest, 1103, Hungary.

Andras Illes (A)

Gedeon Richter Plc, Budapest, Hungary; Gyömröi út 19-21, Budapest, 1103, Hungary. andras.illes@richter.hu.

Karoly Horvat-Karajz (K)

Gedeon Richter Plc, Budapest, Hungary; Gyömröi út 19-21, Budapest, 1103, Hungary.

Ildiko Aradi (I)

Gedeon Richter Plc, Budapest, Hungary; Gyömröi út 19-21, Budapest, 1103, Hungary.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH