Ceritinib (3) – Zykadia®

Non-small cell lung carcinoma (NSCLC), ALK+, first-line

Characteristics

Start date 01.08.2017 – Marketing authorisation: 23.06.2017
Resolution 01.02.2018
INN Ceritinib
Brand name Zykadia®
Pharm. company Novartis Pharma GmbH
G-BA Procedure ID D-296
ATC code L01ED02 ALK inhibitors (L01ED)
ICD-10 codes (AIS) C34.0Malignant neoplasm of carina, C34.1Malignant neoplasm of upper lobe, bronchus or lung, C34.2Malignant neoplasm of middle lobe, bronchus or lung, C34.3Malignant neoplasm of lower lobe, bronchus or lung, C34.8Malignant neoplasm of overlapping sites of bronchus and lung, C34.9Malignant neoplasm of unspecified part of bronchus or lung
Alpha-ID codes (AIS) I111155Carcinoma of the upper lobe bronchus, I116693Non-small cell lung cancer, I24595Carcinoma of the main bronchus, I30015Lung carcinoma of the middle lobe, I30021Lung carcinoma of the lower lobe, I30022Malignant neoplasm of the bronchi and lungs, overlapping several sub-areas
DDD 0.45 g O
Therapeutic area Oncological diseases Non-small-cell lung carcinoma (NSCLC)
Reason for procedure New therapeutic indication
Specialty ACT change

Therapeutic indication of the resolution

Zykadia as monotherapy is indicated for the first-line treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC).

Subpopulation Indication Comparator
Adult patients for first-line treatment of advanced, anaplastic lymphoma kinase (ALK)-positive, non-small cell lung cancer (NSCLC). Crizotinib

Studies and Results

No. of studies
(best subpopulation)
1 (ASCEND-4)
Study design
(best subpopulation)
H2H vs. non-ACT + ITC (Bucher)
Meta analysis
(best subpopulation)
no
ACT change 20.06.2017 – Zulassungsänderung nach positive Opinion (EMA)

  • Clinical trials
    • The ASCEND-4 trial is the registration trial for ceritinib in this therapeutic indication. It is the only randomised, actively controlled, open-label trial (RCT) with ceritinib in this therapeutic indication.
    • The ASCEND-4 trial enrolled previously untreated adult patients with ALK-positive NSCLC at a locally advanced or metastatic stage (stage IIIB or IV). Patients received either treatment with ceritinib or with platinum-based combination chemotherapy comprising cisplatin in combination with pemetrexed or carboplatin in combination with pemetrexed.
    • With regard to crizotinib in comparison with this bridging comparator, the pharmaceutical manufacturer identifies the two studies PROFILE 1014 and PROFILE 1029.
    • These studies were all randomised, actively controlled, open-label trials. The studies included previously untreated adult patients with ALK-positive NSCLC at a locally advanced or metastatic stage.

a) Adult patients for first-line treatment of advanced, anaplastic lymphoma kinase (ALK)-positive, non-small cell lung cancer (NSCLC)

  • For first-line treatment of patients with advanced, anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), an additional benefit over the appropriate comparator therapy is not proven.
  • In the absence of available RCTs, the pharmaceutical manufacturer identified three studies relevant to an indirect comparison of ceritinib and crizotinib.
  • The studies identified by the pharmaceutical manufacturer – ASCEND-4, PROFILE 1014 and PROFILE 1029, identified by the pharmaceutical company, are not suitable for an indirect comparison due to the lack of comparability of the bridging comparator, and therefore cannot be used to draw conclusions regarding the additional benefit of ceritinib compared with the appropriate comparator therapy.
  • As there are no relevant data available overall for assessing the additional benefit of ceritinib, the additional benefit is not proven.
  • Overall assessment / Conclusion
    • Due to differences in the bridging comparator, the studies ASCEND-4, PROFILE 1014 and PROFILE 1029 identified by the pharmaceutical manufacturer are not suitable for an indirect comparison.
    • As there are no relevant data available overall to assess the additional benefit of ceritinib, the additional benefit is not proven.

Courtesy translation only, please refer to the German original.

Associated procedures

Ceritinib (3) Zykadia® Novartis Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, first-line 430–850 100% additional benefit not proven
Ceritinib (2) Zykadia® Novartis Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, pre-treated with crizotinib 200–1,310 81% Hint for considerable additional benefit
Ceritinib (1) Zykadia® Novartis Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, pre-treated with crizotinib 0
120–560
100% additional benefit not proven repealed


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