The European Commission (EC) has approved an expanded indication for denosumab for the prevention of skeletal-related events in adults with advanced malignancies involving bone.

The indication now covers patients with bone metastases from solid tumours and those with multiple myeloma.

The approval is based on data from the Phase 3 '482 study, the largest international trial ever conducted for the prevention of skeletal-related events in multiple myeloma patients.

"Many patients with multiple myeloma have bone lesions at diagnosis, which can result in serious and devastating complications, including broken bones, the need for surgery or radiation to the bone and spinal cord compression," said David M. Reese, M.D., senior vice president of Translational Sciences and Oncology at Amgen. “Until now, treatment options for the prevention of bone complications were limited to bisphosphonates, which unlike denosumab, are cleared by the kidneys and can be associated with increased renal toxicity. We are pleased with the expanded indication for XGEVA in Europe, underscoring our dedication to advancing care for patients with multiple myeloma.”

In the Phase 3 ‘482 study, XGEVA successfully met the primary endpoint, demonstrating non-inferiority to zoledronic acid in delaying the time to first on-study skeletal-related event in patients with multiple myeloma (HR=0.98, 95 percent CI: 0.85-1.14).

The median time to first on-study skeletal-related event was 22.8 months for denosumab and 24.0 months for zoledronic acid.

The safety profile was consistent with known adverse events of denosumab.

Denosumab is the first fully human monoclonal antibody that binds to and neutralizes RANK ligand (RANKL) – a protein essential for the formation, function and survival of osteoclasts, cells which break down bone – thereby inhibiting osteoclast-mediated bone destruction.

On Jan. 5, 2018, the U.S. Food and Drug Administration approved the supplemental Biologics License Application for denosumab to expand the currently approved indication for the prevention of skeletal-related events in patients with bone metastases from solid tumours to include patients with multiple myeloma.

Additional regulatory applications for denosumab for the prevention of skeletal-related events in patients with multiple myeloma are underway and have been submitted to health authorities worldwide.

Approval from the EC grants a centralized marketing authorization with unified labelling in the 28 countries that are members of the European Union (EU). Norway, Iceland and Liechtenstein, as members of the European Economic Area, will take corresponding decisions on the basis of the decision of the EC.

Source:  Amgen