Syringe
The US Food and Drug Administration (FDA) approved a new, subcutaneous (SC) formulation of rituximab with hyaluronidase human (Rituxan Hycela™).
The new formulation includes the same monoclonal antibody as intravenous rituximab, but is combined with an enzyme that helps to deliver rituximab under the skin.
The new treatment reduces administration time from 1.5 hours or more for intravenous rituximab to 5 to 7 minutes for the subcutaneous injection.
It is approved for use in adults with previously untreated and relapsed or refractory follicular lymphoma (FL), previously untreated diffuse large B-cell lymphoma (DLBCL), and previously untreated and previously treated chronic lymphocytic leukemia (CLL).
“[P]eople with 3 of the most common blood cancers now have a new treatment option which provides efficacy comparable with intravenous Rituxan and can be delivered under the skin in minutes instead of hours through IV infusion,” said Sandra Horning, MD, chief medical officer of Genentech.
Rituxan Hycela is manufactured by Genentech, Inc, a member of the Roche Group, and jointly marketed by Biogen and Genentech USA, Inc.
“People who benefit from Rituxan may receive years of repeated treatments for their blood cancer, so an option that reduces the administration time can be important,” she noted.
The FDA based its decision on results from 4 clinical studies:
- SABRINA (NCT01200758): Phase 3 combination study with chemotherapy and maintenance study in previously untreated FL
- SAWYER (NCT01292603): Phase 1b study in previously untreated CLL
- MabEase (NCT01649856): Phase 3 study in previously untreated DLBCL
- PrefMab (NCT01724021): Phase 3 patient preference study in previously untreated FL and DLBCL
This last study showed that 77% of patients preferred subcutaneous over intravenous administration, primarily because it reduced administration time.
Together, these trials represented nearly 2,000 people and demonstrated that subcutaneous administration of rituximab/hyaluronidase resulted in non-inferior levels of rituximab in the blood compared to intravenous rituximab.
And the subcutaneous formulation also demonstrated comparable clinical efficacy outcomes to the intravenous formulation.
Patients must have had at least 1 full dose of intravenous rituximab without severe adverse reactions before receiving the subcutaneous injection. There is a higher risk of certain severe adverse reactions during the first infusion.
The safety profile of rituximab/hyaluronidase is also comparable to intravenous rituximab, except for cutaneous reactions.
The most common (≥20%) adverse reactions observed with rituximab/hyaluronidase were:
- In FL, infections, neutropenia, nausea, constipation, cough, and fatigue.
- In DLBCL, infections, neutropenia, alopecia, nausea, and anemia.
- In CLL, infections, neutropenia, nausea, thrombocytopenia, pyrexia, vomiting, and erythema at the injection site.
Rituxan Hycela will be available in the US within 1 to 2 weeks, according to the manufacturer. Intravenous rituximab will continue to be available.
A subcutaneous formulation of rituximab (MabThera) had previously been approved for use in European markets by the European Commission.
For further information on the new US formulation, see the full prescribing information.
