Axicabtagen-Ciloleucel (4) – Yescarta®

Follicular lymphoma, after ≥ 3 prior therapies

Characteristics

Start date 01.07.2023 – Marketing authorisation: 21.06.2022
Resolution 21.12.2023
Limitation date 01.07.2024 limitation repealed
INN Axicabtagen-Ciloleucel
Brand name Yescarta®
Pharm. company Gilead Sciences GmbH
G-BA Procedure ID D-889
ATC code L01XL03 OTHER ANTINEOPLASTIC AGENTS (L01X)
ICD-10 codes (AIS) C82.0Follicular lymphoma grade I, C82.1Follicular lymphoma grade II, C82.2Follicular lymphoma grade III, unspecified, C82.3Follicular lymphoma grade IIIa, C82.4Follicular lymphoma grade IIIb, C82.7, C82.9Follicular lymphoma, unspecified
Alpha-ID codes (AIS) I116042Follicular lymphoma grade 1, I116043Follicular lymphoma grade 2, I116044Follicular lymphoma grade 3, I116045Follicular lymphoma grade 3a, I116046Follicular lymphoma grade 3b, I116049Other types of follicular lymphoma, I17968Follicular lymphoma
ORPHAcodes (AIS) 545Follicular lymphoma grade 1, 545Follicular lymphoma grade 2, 545Follicular lymphoma grade 3, 545Follicular lymphoma grade 3a, 545Follicular lymphoma grade 3b, 545Other types of follicular lymphoma, 545Follicular lymphoma
Therapeutic area Oncological diseases Follicular lymphoma (FL) Orphan (turnover limit)
Reason for procedure New therapeutic indication – Orphan turnover exceeded
Regulatory status ATMP (CAR-T)
Specialty Bundling

Therapeutic indication of the resolution

Yescarta is used to treat adult patients with relapsed or refractory (r/r) follicular lymphoma (FL) after three or more systemic therapies

Subpopulation Indication Comparator
Adults with relapsed or refractory follicular lymphoma after three or more systemic therapies systemic therapies Patient-individualised therapy with selection of: - Bendamustine + obinutuzumab followed by obinutuzumab maintenance therapy in accordance with the marketing authorisation, - Lenalidomide + rituximab, - Rituximab monotherapy, - mosunetuzumab, - tisagenlecleucel taking into account the previous therapy, the course of the disease and the patient's general condition.

Studies and Results

No. of studies
(best subpopulation)
1 (ZUMA-5)
Study design
(best subpopulation)
Single-arm + historical comparison
Meta analysis
(best subpopulation)
no

  • Clinical trials
    • The ZUMA-5 trial is an ongoing, single-arm, multicentre Phase II trial investigating the efficacy and safety of axicabtagen-ciloleucel in adult patients with indolent B-cell lymphoma, with the histological subtype restricted to grade 1, 2 or 3a follicular lymphoma or marginal zone lymphoma (according to the 2016 WHO classification).
    • The SCHOLAR-5 study is a retrospective, multicentre study based on electronic health records, involving patients with relapsed or refractory indolent non-Hodgkin’s lymphoma.

Adults with relapsed or refractory follicular lymphoma following three or more courses of systemic therapy

  • An additional benefit is not proven.
  • Consequently, there are no suitable data available to enable an assessment of the additional benefit, which is why an additional benefit of axicabtagen-ciloleucel in patients with relapsed or refractory follicular lymphoma following three or more systemic therapies is not proven.
  • Overall assessment
    • The comparison presented of individual arms from the ZUMA-5 and SCHOLAR-5 studies is not suitable for benefit assessment of axicabtagen-ciloleucel, particularly due to the questionable structural equivalence between the treatment arms and the lack of systematic identification of potential confounders.

Courtesy translation only, please refer to the German original.

Associated procedures

Axicabtagen-Ciloleucel (7) Yescarta® Gilead Sciences GmbH Oncological diseases Diffuse large B-cell lymphoma, highly malignant B-cell lymphoma, after 1 prior therapy, relapse within 12 months or refractory 800–1,130 100% Hint for minor additional benefit Orphan (turnover limit)
Axicabtagen-Ciloleucel (4) Yescarta® Gilead Sciences GmbH Oncological diseases Follicular lymphoma, after ≥ 3 prior therapies 60–270 100% additional benefit not proven Orphan (turnover limit)
Axicabtagen-Ciloleucel (6) Yescarta® Gilead Sciences GmbH Oncological diseases Diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma, after at least 2 prior therapies 680–1,200 100% additional benefit not proven Orphan (turnover limit)
Axicabtagen-Ciloleucel (5) Yescarta® Gilead Sciences GmbH Oncological diseases Diffuse large B-cell lymphoma, highly malignant B-cell lymphoma, after 1 prior therapy, relapse within 12 months or refractory 800–1,130
1,600–2,260
50% Hint for non-quantifiable additional benefit Orphan (turnover limit) repealed subpopulations
Axicabtagen-Ciloleucel (3) Yescarta® Gilead Sciences GmbH Oncological diseases Diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma, after at least 2 prior therapies 0
455–729
100% Hint for non-quantifiable additional benefit Orphan repealed
Axicabtagen-Ciloleucel (2) Yescarta® Kite, a Gilead Company Oncological diseases Primary mediastinal large B-cell lymphoma (PMBCL) 0
5–9
100% non-quantifiable additional benefit Orphan repealed
Axicabtagen-Ciloleucel (1) Yescarta® Kite, a Gilead Company Oncological diseases Diffuse large B-cell lymphoma (DLBCL) 0
440–700
100% non-quantifiable additional benefit Orphan repealed


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