Crizotinib (4) – Xalkori®

Non-small cell lung carcinoma (NSCLC), ROS1+

Characteristics

Start date 01.10.2016 – Marketing authorisation: 25.08.2016
Resolution 16.03.2017
INN Crizotinib
Brand name Xalkori®
Pharm. company Pfizer Pharma GmbH
G-BA Procedure ID D-261
ATC code L01ED01 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 0.5 g O
Therapeutic area Oncological diseases Non-small-cell lung carcinoma (NSCLC)
Reason for procedure New therapeutic indication

Therapeutic indication of the resolution

XALKORI as monotherapy is indicated for the treatment of adults with ROS1-positive advanced non-small cell lung cancer (NSCLC).

Subpopulation Indication Comparator
1) Treatment of ROS1-positive advanced non-small cell lung cancer: non-pretreated patients with ROS1-positive advanced non-small cell lung cancer (NSCLC). Patients with ECOG performance status 0, 1 or 2: (cisplatin in combination with a third-generation cytostatic) or (carboplatin in combination with a third-generation cytostatic), patients with ECOG performance status 2: monotherapy with gemcitabine or vinorelbine.
2a) Treatment of ROS1-positive advanced non-small cell lung cancer: pre-treated patients with ROS1-positive advanced non-small cell lung cancer (NSCLC) who are eligible for treatment with docetaxel or pemetrexed. Docetaxel or pemetrexed
2b) Treatment of ROS1-positive advanced non-small cell lung cancer: pre-treated patients with ROS1-positive advanced non-small cell lung cancer (NSCLC) for whom treatment with docetaxel or pemetrexed is not an option. Best-Supportive-Care

Studies and Results

No. of studies
(best subpopulation)
2 (Bergethon 2012, Gainor 2013)
Study design
(best subpopulation)
Single-arm + no comparison
Meta analysis
(best subpopulation)
no
Reason for dividing into subpopulations (G-BA) Previous treatment, Patient eligibility

  • Clinical trials
    • Both RCTs compare crizotinib with chemotherapy in previously untreated (PROFILE1014) and previously treated (PROFILE1007) patients with ALK-positive advanced NSCLC and have already been assessed for these patients.

1) previously untreated patients with ROS1-positive, advanced non-small cell lung cancer (NSCLC)

  • For previously untreated patients with ROS1-positive, advanced non-small cell lung cancer and previously treated patients with ROS1-positive, advanced non-small cell lung cancer who are eligible for treatment with docetaxel or pemetrexed, an additional benefit over the appropriate comparator therapy is not proven.
  • There are no randomised controlled trials (RCTs) involving patients with ROS1-positive advanced NSCLC that directly compare crizotinib with the appropriate comparator therapy.
  • Overall, there are no data available that would allow an assessment of the additional benefit of crizotinib compared with the appropriate comparator therapy. The additional benefit is not proven.

2a) Previously treated patients with ROS1-positive, advanced non-small cell lung cancer (NSCLC) – patients for whom treatment with docetaxel or pemetrexed is an option

  • For previously untreated patients with ROS1-positive, advanced non-small cell lung cancer and previously treated patients with ROS1-positive, advanced non-small cell lung cancer, for whom treatment with docetaxel or pemetrexed is an option, an additional benefit over the appropriate comparator therapy is not proven.
  • There are no randomised controlled trials (RCTs) involving patients with ROS1-positive advanced NSCLC that directly compare crizotinib with the appropriate comparator therapy.
  • Overall, there are no data available that would allow an assessment of the additional benefit of crizotinib compared with the appropriate comparator therapy. The additional benefit is not proven.

2b) Pre-treated patients with ROS1-positive, advanced non-small cell lung cancer (NSCLC) – patients for whom treatment with docetaxel or pemetrexed is not an option

  • For previously treated patients with ROS1-positive, advanced non-small cell lung cancer for whom treatment with docetaxel or pemetrexed is not an option, an additional benefit is not proven compared with the appropriate comparator therapy.
  • The pharmaceutical manufacturer has not submitted any data on this issue.

Courtesy translation only, please refer to the German original.

Associated procedures

Crizotinib (4) Xalkori® Pfizer Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ROS1+ 210–770 100% additional benefit not proven
Crizotinib (3) Xalkori® Pfizer Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, pre-treated 480 71% Hint for considerable additional benefit
Crizotinib (2) Xalkori® Pfizer Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, first-line 0
300–900
100% Hint for considerable additional benefit repealed
Crizotinib (1) Xalkori® Pfizer Pharma GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), ALK+, pre-treated 0
480
71% Hint for considerable additional benefit repealed


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