- Dostarlimab-gxly plus chemotherapy is the only immuno-oncology
combination to show statistically significant and clinically
meaningful overall survival (OS) in the overall population
- 31% reduction in risk of death and 16.4-month improvement in
median OS observed with dostarlimab-gxly plus chemotherapy versus
chemotherapy in the overall population
- 37% reduction in risk of disease progression or death and
6-month improvement in median progression-free survival observed
with the addition of Zejula (niraparib) to dostarlimab-gxly
maintenance following dostarlimab-gxly plus chemotherapy versus
chemotherapy in MMRp/MSS population where treatment options are
still needed
GSK plc (LSE/NYSE: GSK) today announced statistically
significant and clinically meaningful overall survival (OS) results
from Part 1 and progression-free survival (PFS) results from Part 2
of the RUBY/ENGOT-EN6/GOG3031/NSGO phase III trial in adult
patients with primary advanced or recurrent endometrial cancer.
These data were presented today in a late-breaking plenary session
at the Society of Gynecologic Oncology 2024 Annual Meeting on
Women’s Cancer (March 16-18).
The goal of the RUBY phase III trial program is to evaluate
which patients with primary advanced or recurrent endometrial
cancer could potentially benefit from treatment with Jemperli
(dostarlimab-gxly) plus chemotherapy, with or without the addition
of Zejula (niraparib) maintenance. Part 1 of the RUBY phase III
trial is investigating dostarlimab-gxly plus standard-of-care
chemotherapy (carboplatin-paclitaxel) followed by dostarlimab-gxly
compared to chemotherapy plus placebo followed by placebo. Part 2
of the RUBY phase III trial is evaluating dostarlimab-gxly plus
standard-of-care chemotherapy, followed by dostarlimab-gxly plus
niraparib as maintenance therapy compared to chemotherapy plus
placebo followed by placebo. The safety and tolerability profiles
of dostarlimab-gxly plus carboplatin-paclitaxel and
dostarlimab-gxly plus carboplatin-paclitaxel followed by
dostarlimab-glxy plus niraparib were generally consistent with the
known safety profiles of the individual medicines.
Previous data showed a statistically significant and clinically
meaningful improvement in PFS with Jemperli plus chemotherapy
versus chemotherapy alone in frontline mismatch repair deficient
(dMMR)/microsatellite instability-high (MSI-H) primary advanced or
recurrent endometrial cancer. These data led to regulatory
approvals for this patient population in the US, EU and certain
other countries. Data presented today show additional potential
benefit of dostarlimab-gxly plus chemotherapy, with or without the
addition of niraparib, in the overall population of patients with
primary advanced or recurrent endometrial cancer, including
patients with mismatch repair proficient (MMRp)/microsatellite
stable (MSS) tumors, for which there are currently no approved
immuno-therapy-based regimens.
Hesham Abdullah, Senior Vice President, Global Head Oncology,
R&D, GSK said: “The positive data presented today further
show how dostarlimab-gxly-based regimens could benefit a broader
set of patients with endometrial cancer. The results we’ve seen to
date comprise the growing body of evidence supporting the role of
dostarlimab-gxly as the backbone of our immuno-oncology development
program. Our goal is to continue to identify ways to use
dostarlimab-gxly alone and in combination with other therapies to
help improve outcomes for patients with limited treatment
options.”
RUBY Part 1: a statistically significant and clinically
meaningful improvement in OS was observed for dostarlimab-gxly plus
chemotherapy versus placebo plus chemotherapy, meeting a primary
endpoint of the study.
Dostarlimab-gxly plus chemotherapy versus chemotherapy alone
showed:
In the overall population:
- a statistically significant reduction in the risk of death by
31% (Hazard Ratio [HR]: 0.69; [95% CI: 0.539–0.890])
- a clinically meaningful improvement of 16.4 months in median OS
(44.6 months vs 28.2 months)
In a prespecified exploratory analysis of the MMRp/MSS
population:
- a clinically meaningful trend in reduced risk of death by 21%
(HR: 0.79; [95% CI: 0.602–1.044])
- a clinically meaningful improvement of seven months in median
OS (34.0 months vs 27.0 months)
Full OS summaries are shown below.
dostarlimab-gxly +
carboplatin-paclitaxel
placebo +
carboplatin-paclitaxel
Overall population, Number (N)
245
249
OS, HR (95% CI)
0.69 (0.539–0.890)
P-value1
0.002
OS, median (95% CI), mo.
44.6 (32.6–NR)
28.2 (22.1–35.6)
dMMR/MSI-H population2, N
53
65
OS, HR (95% CI)
0.32 (0.166–0.629)
OS, median3 (95% CI), mo.
NR (NR–NR)
31.4 (20.3–NR)
MMRp/MSS2, N
192
184
OS, HR (95% CI)
0.79 (0.602–1.044)
OS, median (95% CI), mo.
34.0 (28.6–NR)
27.0 (21.5–35.6)
1 One-sided p-value based on stratified
log-rank test. 2 Exploratory analyses of OS in dMMR/MSI-H and OS in
MMRp/MSS populations were pre-specified with no planned hypothesis
testing. 3 Although the median OS was not reached, at 30 months the
estimated reduction in the risk of death was 82.8% for patients who
received dostarlimab plus chemotherapy vs. 54.1% for patients who
received chemotherapy alone.
Matthew Powell, MD, Division of Gynecologic Oncology,
Washington University School of Medicine, and US principal
investigator of the RUBY trial said: “RUBY Part 1 is the first
clinical trial to show a statistically significant and clinically
meaningful improvement in overall survival for an immuno-oncology
therapy in combination with chemotherapy in the overall population
of patients with primary advanced or recurrent endometrial cancer.
As a clinician, I celebrate the results of the RUBY Part 1 trial
presented today, which show how dostarlimab-gxly added to
chemotherapy could potentially benefit a broader set of patients
with this type of cancer.”
In RUBY Part 1, grade 3 or higher and serious treatment-emergent
adverse events (AEs) were approximately 12% higher in the
dostarlimab-gxly plus carboplatin-paclitaxel arm (treatment arm)
compared with the placebo plus carboplatin-paclitaxel arm (control
arm). The nature and types of immune-related AEs in the
dostarlimab-gxly plus chemotherapy safety profile were consistent
with the mechanism of action of dostarlimab-gxly and similar to
those reported for other PD-(L)1 inhibitors. In the trial, 40.7% of
participants in the treatment arm and 16.3% of participants in the
control arm had immune-related AEs assessed by the investigator as
related to dostarlimab-gxly or placebo, respectively.
Discontinuation of dostarlimab-gxly or placebo due to a
treatment-emergent AE occurred in 19.1% of patients in the
treatment arm and 8.1% of patients in the control arm.
GSK expects US Food and Drug Administration regulatory
submission acceptance based on RUBY Part 1 data for an expanded
indication in the overall population in the first half of this
year.
RUBY Part 2: addition of niraparib to dostarlimab-gxly in
maintenance setting significantly improved PFS in first-line
primary advanced or recurrent endometrial cancer compared to
chemotherapy alone, meeting the primary endpoint of the
trial.
Dostarlimab-gxly plus chemotherapy followed by dostarlimab-gxly
plus niraparib compared to placebo plus chemotherapy followed by
placebo showed:
In the overall population:
- a statistically significant reduction in the risk of disease
progression or death by 40% (HR: 0.60 [95% CI: 0.43–0.82])
- a clinically meaningful improvement of 6.2 months in median PFS
(14.5 months vs 8.3 months)
In the MMRp/MSS population:
- a statistically significant reduction in the risk of disease
progression or death by 37% (HR: 0.63 [95% CI: 0.44–0.91])
- a clinically meaningful improvement of 6.0 months in median PFS
(14.3 months vs 8.3 months)
Dr Mansoor Raza Mirza, Chief Oncologist, Copenhagen
University Hospital, Denmark, and RUBY principal investigator
said: “In RUBY Part 2, we observed that the use of
dostarlimab-gxly in combination with niraparib in the maintenance
therapy setting further improved progression-free survival versus
placebo for patients with primary advanced or recurrent endometrial
cancer. These findings are particularly important for patients who
have MMRp/MSS tumors as the data help build on the initial benefit
observed with an immuno-oncology plus chemotherapy regimen,
reflecting the potential for the addition of niraparib maintenance
to address unmet medical need for these patients.”
In RUBY Part 2, grade 3 or higher and serious treatment-emergent
AEs were approximately 36% and 24% higher, respectively, in the
dostarlimab-gxly plus chemotherapy followed by dostarlimab-gxly
plus niraparib arm (treatment arm) compared with the placebo plus
chemotherapy followed by placebo arm (control arm). In the trial,
36.6% of participants in the treatment arm and 6.3% of participants
in the control arm had immune-related AEs assessed by the
investigator as related to dostarlimab-gxly or placebo,
respectively. No cases of myelodysplastic syndrome/acute myeloid
leukemia were reported; other secondary primary malignancies
occurred in 1 patient each in both treatment arms. Discontinuation
of dostarlimab-gxly or placebo due to a TEAE occurred in 24.1% of
patients in the treatment arm and 5.2% of patients in the control
arm. Discontinuation of niraparib or placebo due to a
treatment-emergent AE occurred in 15.7% of patients in the
treatment arm and 4.2% of patients in the control arm.
About endometrial cancer Endometrial cancer is found in
the inner lining of the uterus, known as the endometrium.
Endometrial cancer is the most common gynecologic cancer in
developed countries, with approximately 417,000 new cases reported
each year worldwide1, and incidence rates are expected to rise by
almost 40% between 2020 and 2040.2,3 Approximately 15-20% of
patients with endometrial cancer will be diagnosed with advanced
disease at the time of diagnosis.4
About RUBY RUBY is a two-part global, randomized,
double-blind, multicenter phase III trial of patients with primary
advanced or recurrent endometrial cancer. Part 1 is evaluating
dostarlimab-gxly plus carboplatin-paclitaxel followed by
dostarlimab-gxly versus carboplatin-paclitaxel plus placebo
followed by placebo. Part 2 is evaluating dostarlimab-gxly plus
carboplatin-paclitaxel followed by dostarlimab-gxly plus niraparib
versus placebo plus carboplatin-paclitaxel followed by placebo.
In Part 1, the dual-primary endpoints are investigator-assessed
PFS based on the Response Evaluation Criteria in Solid Tumors v1.1
and OS. The statistical analysis plan included pre-specified
analyses of PFS in the dMMR/MSI-H and overall populations and OS in
the overall population. Pre-specified exploratory analyses of PFS
and OS in the MMRp/MSS population and OS in the dMMR/MSI-H
populations were also performed. RUBY Part 1 included a broad
population, including histologies often excluded from clinical
trials and had approximately 10% of patients with carcinosarcoma
and 20% with serous carcinoma.
In Part 2, the primary endpoint is investigator-assessed PFS in
the overall population, followed by PFS in the MMRp/MSS population,
and OS in the overall population is a key secondary endpoint.
Additional secondary endpoints in Part 1 and Part 2 include PFS per
blinded independent central review, PFS2, overall response rate,
duration of response, disease control rate, patient-reported
outcomes, and safety and tolerability.
RUBY is part of an international collaboration between the
European Network of Gynaecological Oncological Trial groups
(ENGOT), a research network of the European Society of
Gynaecological Oncology (ESGO) that consists of 22 trial groups
from 31 European countries that perform cooperative clinical
trials, and the GOG Foundation, a non-profit organization dedicated
to transforming the standard of care in gynecologic oncology.
About Jemperli (dostarlimab-gxly) Jemperli is a
programmed death receptor-1 (PD-1)-blocking antibody that binds to
the PD-1 receptor and blocks its interaction with the PD-1 ligands
PD-L1 and PD-L2.5
Jemperli was discovered by AnaptysBio, Inc. and licensed to
TESARO, Inc., under a collaboration and exclusive license agreement
signed in March 2014. Under this agreement, GSK is responsible for
the ongoing research, development, commercialization, and
manufacturing of Jemperli, and cobolimab (GSK4069889), a TIM-3
antagonist.
Indications and Important Safety Information for JEMPERLI
(dostarlimab-gxly)
- JEMPERLI, in combination with carboplatin and paclitaxel,
followed by JEMPERLI as a single agent, is indicated for the
treatment of adult patients with primary advanced or recurrent
endometrial cancer (EC) that is mismatch repair deficient (dMMR),
as determined by an FDA-approved test, or microsatellite
instability-high (MSI-H).
- JEMPERLI, as a single agent, is indicated for the treatment of
adult patients with dMMR recurrent or advanced:
- EC, as determined by an FDA-approved test, that has progressed
on or following prior treatment with a platinum-containing regimen
in any setting and are not candidates for curative surgery or
radiation, or
- solid tumors, as determined by an FDA-approved test, that have
progressed on or following prior treatment and who have no
satisfactory alternative treatment options. This indication is
approved under accelerated approval based on tumor response rate
and durability of response. Continued approval for this indication
may be contingent upon verification and description of clinical
benefit in a confirmatory trial(s).
Important Safety Information
Severe and Fatal Immune-Mediated Adverse Reactions
- Immune-mediated adverse reactions, which can be severe or
fatal, can occur in any organ system or tissue and can occur at any
time during or after treatment with a PD-1/PD-L1–blocking antibody,
including JEMPERLI.
- Monitor closely for signs and symptoms of immune-mediated
adverse reactions. Evaluate liver enzymes, creatinine, and thyroid
function tests at baseline and periodically during treatment. For
suspected immune-mediated adverse reactions, initiate appropriate
workup to exclude alternative etiologies, including infection.
Institute medical management promptly, including specialty
consultation as appropriate.
- Based on the severity of the adverse reaction, withhold or
permanently discontinue JEMPERLI. In general, if JEMPERLI requires
interruption or discontinuation, administer systemic
corticosteroids (1 to 2 mg/kg/day prednisone or equivalent) until
improvement to ≤Grade 1. Upon improvement to ≤Grade 1, initiate
corticosteroid taper and continue to taper over at least 1 month.
Consider administration of other systemic immunosuppressants in
patients whose immune-mediated adverse reaction is not controlled
with corticosteroids.
Immune-Mediated Pneumonitis
- JEMPERLI can cause immune-mediated pneumonitis, which can be
fatal. In patients treated with other PD-1/PD-L1–blocking
antibodies, the incidence of pneumonitis is higher in patients who
have received prior thoracic radiation. Pneumonitis occurred in
2.3% (14/605) of patients, including Grade 2 (1.3%), Grade 3
(0.8%), and Grade 4 (0.2%) pneumonitis.
Immune-Mediated Colitis
- Colitis occurred in 1.3% (8/605) of patients, including Grade 2
(0.7%) and Grade 3 (0.7%) adverse reactions. Cytomegalovirus
infection/reactivation have occurred in patients with
corticosteroid-refractory immune-mediated colitis. In such cases,
consider repeating infectious workup to exclude alternative
etiologies.
Immune-Mediated Hepatitis
- JEMPERLI can cause immune-mediated hepatitis, which can be
fatal. Grade 3 hepatitis occurred in 0.5% (3/605) of patients.
Immune-Mediated Endocrinopathies
- Adrenal Insufficiency
- Adrenal insufficiency occurred in 1.2% (7/605) of patients,
including Grade 2 (0.5%) and Grade 3 (0.7%). For Grade 2 or higher
adrenal insufficiency, initiate symptomatic treatment per
institutional guidelines, including hormone replacement as
clinically indicated. Withhold or permanently discontinue JEMPERLI
depending on severity.
- Hypophysitis
- JEMPERLI can cause immune-mediated hypophysitis. Grade 3
hypophysitis occurred in 0.4% (1/241) of patients receiving
JEMPERLI in combination with carboplatin and paclitaxel. Grade 2
hypophysitis occurred in 0.2% (1/605) of patients receiving
JEMPERLI as a single agent. Initiate hormone replacement as
clinically indicated. Withhold or permanently discontinue JEMPERLI
depending on severity.
- Thyroid Disorders
- Grade 2 thyroiditis occurred in 0.5% (3/605) of patients. Grade
2 hypothyroidism occurred in 12% (28/241) of patients receiving
JEMPERLI in combination with carboplatin and paclitaxel. Grade 2
hypothyroidism occurred in 8% (46/605) of patients receiving
JEMPERLI as a single agent. Hyperthyroidism occurred in 3.3%
(8/241) of patients receiving JEMPERLI in combination with
carboplatin and paclitaxel, including Grade 2 (2.9%) and Grade 3
(0.4%). Hyperthyroidism occurred in 2.3% (14/605) of patients
receiving JEMPERLI as a single agent, including Grade 2 (2.1%) and
Grade 3 (0.2%). Initiate thyroid hormone replacement or medical
management of hyperthyroidism as clinically indicated. Withhold or
permanently discontinue JEMPERLI depending on severity.
- Type 1 Diabetes Mellitus, Which Can Present with Diabetic
Ketoacidosis
- JEMPERLI can cause type 1 diabetes mellitus, which can present
with diabetic ketoacidosis. Grade 3 type 1 diabetes mellitus
occurred in 0.4% (1/241) of patients receiving JEMPERLI in
combination with carboplatin and paclitaxel. Grade 3 type 1
diabetes mellitus occurred in 0.2% (1/605) of patients receiving
JEMPERLI as a single agent. Monitor patients for hyperglycemia or
other signs and symptoms of diabetes. Initiate treatment with
insulin as clinically indicated. Withhold or permanently
discontinue JEMPERLI depending on severity.
Immune-Mediated Nephritis with Renal Dysfunction
- JEMPERLI can cause immune-mediated nephritis, which can be
fatal. Grade 2 nephritis, including tubulointerstitial nephritis,
occurred in 0.5% (3/605) of patients.
Immune-Mediated Dermatologic Adverse Reactions
- JEMPERLI can cause immune-mediated rash or dermatitis. Bullous
and exfoliative dermatitis, including Stevens-Johnson syndrome
(SJS), toxic epidermal necrolysis (TEN), and drug rash with
eosinophilia and systemic symptoms (DRESS), have occurred with
PD-1/PD-L1–blocking antibodies. Topical emollients and/or topical
corticosteroids may be adequate to treat mild to moderate
non-bullous/exfoliative rashes. Withhold or permanently discontinue
JEMPERLI depending on severity.
Other Immune-Mediated Adverse Reactions
- The following clinically significant immune-mediated adverse
reactions occurred in <1% of the 605 patients treated with
JEMPERLI or were reported with the use of other PD-1/PD-L1–blocking
antibodies. Severe or fatal cases have been reported for some of
these adverse reactions.
- Nervous System: Meningitis, encephalitis, myelitis and
demyelination, myasthenic syndrome/myasthenia gravis,
Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy
- Cardiac/Vascular: Myocarditis, pericarditis, vasculitis
- Ocular: Uveitis, iritis, other ocular inflammatory toxicities.
Some cases can be associated with retinal detachment. Various
grades of visual impairment to include blindness can occur
- Gastrointestinal: Pancreatitis, including increases in serum
amylase and lipase levels, gastritis, duodenitis
- Musculoskeletal and Connective Tissue: Myositis/polymyositis,
rhabdomyolysis and associated sequelae including renal failure,
arthritis, polymyalgia rheumatica
- Endocrine: Hypoparathyroidism
- Other (Hematologic/Immune): Autoimmune hemolytic anemia,
aplastic anemia, hemophagocytic lymphohistiocytosis, systemic
inflammatory response syndrome, histiocytic necrotizing
lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune
thrombocytopenia, solid organ transplant rejection, other
transplant (including corneal graft) rejection
Infusion-Related Reactions
- Severe or life-threatening infusion-related reactions have been
reported with PD-1/PD-L1–blocking antibodies. Severe
infusion-related reactions (Grade 3) occurred in 0.2% (1/605) of
patients receiving JEMPERLI. Monitor patients for signs and
symptoms of infusion-related reactions. Interrupt or slow the rate
of infusion or permanently discontinue JEMPERLI based on severity
of reaction.
Complications of Allogeneic HSCT
- Fatal and other serious complications can occur in patients who
receive allogeneic hematopoietic stem cell transplantation (HSCT)
before or after treatment with a PD-1/PD-L1–blocking antibody,
which may occur despite intervening therapy. Monitor patients
closely for transplant-related complications and intervene
promptly.
Embryo-Fetal Toxicity and Lactation
- Based on its mechanism of action, JEMPERLI can cause fetal
harm. Advise pregnant women of the potential risk to a fetus.
Advise females of reproductive potential to use effective
contraception during treatment with JEMPERLI and for 4 months after
their last dose. Because of the potential for serious adverse
reactions from JEMPERLI in a breastfed child, advise women not to
breastfeed during treatment with JEMPERLI and for 4 months after
their last dose.
Common Adverse Reactions
The most common adverse reactions (≥20%) in patients with
dMMR/MSI-H EC who received JEMPERLI in combination with carboplatin
and paclitaxel were rash, diarrhea, hypothyroidism, and
hypertension. The most common Grade 3 or 4 laboratory abnormalities
(≥10%) were decreased neutrophils, decreased hemoglobin, decreased
white blood cell count, decreased lymphocytes, increased glucose,
decreased sodium, and decreased platelets.
The most common adverse reactions (≥20%) in patients with dMMR
EC who received JEMPERLI as a single agent were fatigue/asthenia,
anemia, nausea, diarrhea, constipation, vomiting, and rash. The
most common Grade 3 or 4 laboratory abnormalities (>2%) were
decreased lymphocytes, decreased sodium, increased alanine
aminotransferase, increased creatinine, decreased neutrophils,
decreased albumin, and increased alkaline phosphatase.
The most common adverse reactions (≥20%) in patients with dMMR
solid tumors who received JEMPERLI as a single agent were
fatigue/asthenia, anemia, diarrhea, and nausea. The most common
Grade 3 or 4 laboratory abnormalities (≥2%) were decreased
lymphocytes, decreased sodium, increased alkaline phosphatase, and
decreased albumin.
Please see the full US Prescribing Information
for JEMPERLI.
About Zejula (niraparib) Zejula is an oral, once-daily
poly(ADP-ribose) polymerase (PARP) inhibitor.
Indication and Important Safety Information for ZEJULA
(niraparib)
ZEJULA (niraparib) tablets 100 mg/200 mg/300 mg are
indicated:
- for first-line maintenance treatment of adult patients with
advanced epithelial ovarian, fallopian tube, or primary peritoneal
cancer who are in a complete or partial response to first-line
platinum-based chemotherapy
- for the maintenance treatment of adult patients with
deleterious or suspected deleterious germline BRCA-mutated
recurrent epithelial ovarian, fallopian tube, or primary peritoneal
cancer who are in a complete or partial response to platinum-based
chemotherapy. Select patients for therapy based on an FDA-approved
companion diagnostic for ZEJULA
Important Safety Information
Myelodysplastic syndrome/acute myeloid leukemia
(MDS/AML), including cases with a fatal outcome, have been reported
in patients who received ZEJULA. In PRIMA, MDS/AML occurred in 6
out of 484 (1.2%) patients treated with ZEJULA, and in 3 out of 244
(1.2%) patients treated with placebo. The duration of therapy with
ZEJULA in patients who developed secondary MDS/cancer
therapy-related AML varied from 3.7 months to 2.5 years. In
NOVA, of patients within the gBRCAmut
cohort, MDS/AML occurred in 10 out of 136 (7%) patients treated
with ZEJULA and in 2 out of 65 (3%) patients treated with placebo.
The duration of therapy with ZEJULA in patients who developed
secondary MDS/cancer therapy-related AML varied from 3.6 months to
5.9 years. All patients who developed secondary MDS/cancer
therapy-related AML had received previous chemotherapy with
platinum agents and/or other DNA-damaging agents, including
radiotherapy. For suspected MDS/AML or prolonged hematological
toxicities, refer the patient to a hematologist for further
evaluation. Discontinue ZEJULA if MDS/AML is confirmed.
Hematologic adverse reactions (thrombocytopenia, anemia,
neutropenia, and/or pancytopenia) have been reported in patients
receiving ZEJULA. The overall incidence of Grade ≥3
thrombocytopenia, anemia, and neutropenia were reported,
respectively, in 39%, 31%, and 21% of patients receiving ZEJULA in
PRIMA and 29%, 25%, and 20% of patients receiving ZEJULA in NOVA.
Discontinuation due to thrombocytopenia, anemia, and neutropenia
occurred, respectively, in 4%, 2%, and 2% of patients in PRIMA and
3%, 1%, and 2% of patients in NOVA. In patients who were
administered a starting dose of ZEJULA based on baseline weight or
platelet count in PRIMA, Grade ≥3 thrombocytopenia, anemia, and
neutropenia were reported, respectively, in 22%, 23%, and 15% of
patients receiving ZEJULA. Discontinuation due to thrombocytopenia,
anemia, and neutropenia occurred, respectively, in 3%, 3%, and 2%
of patients. Do not start ZEJULA until patients have recovered from
hematological toxicity caused by prior chemotherapy (≤Grade 1).
Monitor complete blood counts weekly for the first month, monthly
for the next 11 months, and periodically thereafter. If
hematological toxicities do not resolve within 28 days following
interruption, discontinue ZEJULA, and refer the patient to a
hematologist for further investigations.
Hypertension and hypertensive crisis have been reported
in patients receiving ZEJULA. Grade 3-4 hypertension occurred in 6%
of patients receiving ZEJULA vs 1% of patients receiving placebo in
PRIMA, with no reported discontinuations. Grade 3-4 hypertension
occurred in 9% of patients receiving ZEJULA vs 2% of patients
receiving placebo in NOVA, with discontinuation occurring in <1%
of patients. Monitor blood pressure and heart rate at least weekly
for the first two months, then monthly for the first year, and
periodically thereafter during treatment with ZEJULA. Closely
monitor patients with cardiovascular disorders, especially coronary
insufficiency, cardiac arrhythmias, and hypertension. Manage
hypertension with antihypertensive medications and adjustment of
the ZEJULA dose if necessary.
Posterior reversible encephalopathy syndrome (PRES)
occurred in 0.1% of 2,165 patients treated with ZEJULA in clinical
trials and has also been described in postmarketing reports.
Monitor all patients for signs and symptoms of PRES, which include
seizure, headache, altered mental status, visual disturbance, or
cortical blindness, with or without associated hypertension.
Diagnosis requires confirmation by brain imaging. If suspected,
promptly discontinue ZEJULA and administer appropriate treatment.
The safety of reinitiating ZEJULA is unknown.
Embryo-fetal toxicity and lactation: Based on its
mechanism of action, ZEJULA can cause fetal harm. Advise females of
reproductive potential of the potential risk to a fetus and to use
effective contraception during treatment and for 6 months after
receiving their final dose of ZEJULA. Because of the potential for
serious adverse reactions from ZEJULA in breastfed infants, advise
lactating women not to breastfeed during treatment with ZEJULA and
for 1 month after receiving the last dose.
First-line Maintenance Advanced Ovarian Cancer
Most common adverse reactions (Grades 1-4) in ≥10% of all
patients who received ZEJULA in PRIMA were thrombocytopenia (66%),
anemia (64%), nausea (57%), fatigue (51%), neutropenia (42%),
constipation (40%), musculoskeletal pain (39%), leukopenia (28%),
headache (26%), insomnia (25%), vomiting (22%), dyspnea (22%),
decreased appetite (19%), dizziness (19%), cough (18%),
hypertension (18%), AST/ALT elevation (14%), and acute kidney
injury (12%).
Common lab abnormalities (Grades 1-4) in ≥25% of all patients
who received ZEJULA in PRIMA included: decreased hemoglobin (87%),
decreased platelets (74%), decreased leukocytes (71%), increased
glucose (66%), decreased neutrophils (66%), decreased lymphocytes
(51%), increased alkaline phosphatase (46%), increased creatinine
(40%), decreased magnesium (36%), increased AST (35%), and
increased ALT (29%).
Maintenance Recurrent Germline BRCA-mutated Ovarian
Cancer
Most common adverse reactions (Grades 1-4) in ≥10% of patients
who received ZEJULA in NOVA gBRCAmut Cohort were nausea (77%),
thrombocytopenia (71%), fatigue (61%), anemia (52%), vomiting
(40%), constipation (38%), headache (35%), neutropenia (31%),
decreased appetite (22%), hypertension (21%), insomnia (18%),
dizziness (18%), dyspnea (17%), dyspepsia (17%), back pain (16%),
cough (16%), nasopharyngitis (13%), dry mouth (13%), dysgeusia
(13%), urinary tract infection (11%), rash (10%), and anxiety
(10%).
Common lab abnormalities (Grades 1-4) in ≥25% of patients who
received ZEJULA in NOVA gBRCAmut Cohort included: decrease in
hemoglobin (85%), decrease in platelet count (81%), decrease in
white blood cell count (71%), decrease in absolute neutrophil count
(56%), increase in AST (35%), and increase in ALT (25%).
Please see the US Prescribing Information for
ZEJULA tablets.
GSK in oncology Oncology is an emerging therapeutic area
for GSK where we are committed to maximizing patient survival with
a current focus on hematologic malignancies, gynecologic cancers
and other solid tumors through breakthroughs in immuno-oncology and
tumor-cell targeting therapies.
About GSK GSK is a global biopharma company with a
purpose to unite science, technology, and talent to get ahead of
disease together. Find out more at us.gsk.com.
Cautionary statement regarding forward-looking statements
GSK cautions investors that any forward-looking statements or
projections made by GSK, including those made in this announcement,
are subject to risks and uncertainties that may cause actual
results to differ materially from those projected. Such factors
include, but are not limited to, those described under Item 3.D
“Risk factors” in the company's Annual Report on Form 20-F for
2023.
Registered in England & Wales: No. 3888792
Registered Office: 980 Great West Road Brentford,
Middlesex TW8 9GS
References
- Faizan U, Muppidi V. Uterine Cancer. [Updated 2022 Sep 5]. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
2022 Jan-. Available at:
www.ncbi.nlm.nih.gov/books/NBK562313/.
- Braun MM, et al. Am Fam Physician. 2016;93(6):468-474.
- International Research on Cancer. Global Cancer Observatory.
Cancer Tomorrow. gco.iarc.fr/tomorrow/en/dataviz/. Accessed 13 July
2022.
- CMP: CancerMPact® Patient Metrics Mar-2023, Cerner Enviza.
Available at www.cancermpact.com. Accessed 29 Feb 2024.
- Laken H, Kehry M, Mcneeley P, et al. Identification and
characterization of TSR-042, a novel anti-human PD-1 therapeutic
antibody. European Journal of Cancer. 2016;69, S102.
doi:10.1016/s0959-8049(16)32902-1.
View source
version on businesswire.com: https://www.businesswire.com/news/home/20240315640367/en/
GSK inquiries
Media: Tim Foley +44 (0) 20 8047 5502 (London) Dan Smith +44 (0)
20 8047 5502 (London) Kathleen Quinn +1 202 603 5003 (Washington
DC) Lyndsay Meyer +1 202 302 4595 (Washington DC)
Investor Relations: Nick Stone +44 (0) 7717 618834 (London)
James Dodwell +44 (0) 20 8047 2406 (London) Mick Readey +44 (0)
7990 339653 (London) Josh Williams +44 (0) 7385 415719 (London)
Camilla Campbell +44 (0) 7803 050238 (London) Steph Mountifield +44
(0) 7796 707505 (London) Jeff McLaughlin +1 215 751 7002
(Philadelphia) Frannie DeFranco +1 215 751 4855 (Philadelphia)
Grafico Azioni GSK (NYSE:GSK)
Storico
Da Feb 2025 a Mar 2025
Grafico Azioni GSK (NYSE:GSK)
Storico
Da Mar 2024 a Mar 2025