China NMPA Approves PARP Inhibitor Pamiparib for Patients with Previously Treated Advanced Ovarian Cancer

On May 10, 2021

BeiGene, Ltd. a global biotechnology company focused on developing and commercializing innovative medicines worldwide, announced that its PARP inhibitor pamiparib has received conditional approval from the China National Medical Products Administration (NMPA) for the treatment of patients with germline BRCA (gBRCA) mutation-associated recurrent advanced ovarian, fallopian tube, or primary peritoneal cancer who have been treated with two or more lines of chemotherapy. The new drug application was previously granted priority review by the Center for Drug Evaluation (CDE) in July 2020. BeiGene is preparing to launch pamiparib this month.

“Today’s NMPA approval makes pamiparib the third BeiGene internally discovered and developed medicine to receive marketing authorization, an incredible company milestone validating our scientific innovations,” commented Xiaobin Wu, Ph.D., President, Chief Operating Officer, and General Manager of China at BeiGene. “With a broad commercial portfolio of seven medicines covering 15 indications across hematological malignancies and solid tumors in China, our science-based commercial team is well-positioned to serve patients in need. BeiGene will continue working to advance our broad, diverse pipeline and executing on our mission of expanding access to and improving affordability of impactful treatments for patients worldwide.”

“We are thrilled that pamiparib is the first PARP inhibitor approved in China for patients with both platinum-sensitive and platinum-resistant relapsed ovarian cancer. Pamiparib was uniquely designed to reduce drug resistance and sustain anti-tumor response, and as reported at last year’s ESMO, this selective PARP inhibitor demonstrated high response rates and was generally well tolerated among patients,” said Yong (Ben) Ben, M.D., Chief Medical Officer, Immuno-Oncology at BeiGene. “We appreciate the patients and investigators who participated in this trial, and hope that pamiparib will become an important treatment option for patients in China with recurrent ovarian cancer. In addition, we are evaluating pamiparib in several other trials and indications, including as a maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer in an ongoing Phase 3 trial.”

“Disease recurrence is common among patients with advanced ovarian cancer and, due to the limited efficacy and unacceptable toxicity of chemotherapy, PARP inhibitors have become established treatment options in later lines of therapy. The encouraging pivotal Phase 2 data demonstrated that pamiparib can provide clinically meaningful and durable responses for patients who are sensitive or resistant to platinum-based chemotherapy. We believe that the approval of pamiparib will bring a new hope for these patients and their loved ones,” commented Xiaohua Wu, M.D., Ph.D., Professor and Chair of Gynecologic Oncology Department at Fudan University Shanghai Cancer Center and lead investigator for the trial.

The NMPA conditional approval of pamiparib for the treatment of patients with advanced ovarian, fallopian tube, or primary peritoneal cancer is based on clinical results from a pivotal Phase 2 portion of the Phase 1/2 trial (NCT03333915). A total of 113 patients in China with high-grade, non-mucinous, epithelial ovarian cancer (including fallopian or primary peritoneal cancer), harboring gBRCA mutations, following at least two prior lines of standard chemotherapy, were enrolled in the pivotal Phase 2 portion of the trial, including 90 patients with advanced platinum-sensitive ovarian cancer (PSOC), and 23 patients with advanced platinum-resistant ovarian cancer (PROC).

Clinical efficacy data in the pamiparib label in China, as assessed by independent review committee (IRC) per RECIST v1.1, were based on 101 patients evaluable for efficacy analysis, including 82 patients with PSOC and 19 patients with PROC. For patients with PSOC, with a median follow-up time of 17.0 months, the objective response rate (ORR) was 68.3% (95% CI: 57.1, 78.1) and the median duration of response (DoR) was 13.8 months (95% CI: 10.97, 20.73); for patients with PROC, the median follow-up time was 11.6 months, the ORR was 31.6% (95% CI: 12.6, 56.6) and the median DoR was 11.1 months (95% CI: 4.21, 16.59).

The safety profile of pamiparib in the label in China was based on 317 patients who received pamiparib as a monotherapy in three clinical trials. The most common adverse reactions (≥10%) were anemia, nausea, leukopenia, neutropenia, vomiting, fatigue, thrombocytopenia, decreased appetite, diarrhea, abdominal pain, aspartate aminotransferase (AST) increased, alanine aminotransferase (ALT) increased, blood bilirubin increased, and lymphopenia. Grade ≥3 adverse reactions occurred in 55.8% of patients, with the most common (≥1%) being anemia, neutropenia, leukopenia, thrombocytopenia, lymphopenia, vomiting, fatigue, diarrhea, nausea, and AST increased. Serious adverse reactions occurred in 21.5% of patients, with the most common (≥1%) being anemia and leukopenia.

The most common adverse reactions reported from the pivotal Phase 2 trial in the label in China (≥10%) were anemia, leukopenia, nausea, neutropenia, vomiting, thrombocytopenia, decreased appetite, fatigue, abdominal pain, ALT increased, diarrhea, AST increased, lymphopenia, gamma-glutamyltransferase increased, upper respiratory tract infection, blood bilirubin increased, malaise, weight decreased, and dizziness. Grade ≥3 adverse reactions occurred in 71.7% of patients, with the most common (≥1%) being anemia, neutropenia, leukopenia, thrombocytopenia, lymphopenia, vomiting, diarrhea, gamma-glutamyltransferase increased, hypokalemia, abdominal pain, fatigue, upper respiratory tract infection, pancytopenia, and hypertension.

The recommended dose of pamiparib is 60 mg twice daily (BID) taken orally.