Avastin’s Breast Cancer Claim: Will FDA’s Hamburg Take A Middle Road?
FDA Commissioner Margaret Hamburg faces a decision on the future of Avastin’s (bevacizumab) first-line metastatic breast cancer claim that may not be so cut and dried as the Oncologic Drugs Advisory Committee’s unanimous vote favoring the indication’s withdrawal suggests.
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Under questioning from FDA’s Richard Pazdur, VP Sandra Horning says company would be willing to withdraw pertuzumab’s neoadjuvant indication if results from ongoing adjuvant study are “clearly negative”; advisory committee members say they expect sponsor to bow out more gracefully than it did in the fight over bevacizumab’s breast cancer claim.
If all drugs cleared for accelerated approval succeed in their confirmatory studies, then FDA is being overly conservative in its use of the expedited approval pathway, FDA Office of Hematology and Oncology Products Director Richard Pazdur says at the AACR annual meeting.
Pertuzumab’s approval came almost a year after FDA and Genentech battled over the future of bevacizumab’s breast cancer claim at an unprecedented public hearing. While both oncologic agents were approved on the basis of a median progression-free survival benefit exceeding five months, the regulatory similarities end there.