Doc logic
39 minutes ago
exwannabe,
There is nothing obvious about what has happened with FDA and NWBO other than FDA obviously interfering with the powering of the trial by allowing the treatment arm to be fully enrolled after the halt but not the SOC/placebo arm. That is a self implicating clear case of interference which must be for a positive reason for the trial outcome because nothing negative was disclosed by NWBO or FDA which would have been required to explain this action for negative reasons. There are some things that make much more sense than stating that OS change to the primary endpoint was rejected which is an exaggerated assumption.
FDA will not tell NWBO that a change of OS to a primary endpoint is being rejected until a formal review of the change in a BLA submission describing the need for the change along the exceptions pathway to adequate and well controlled studies is made. On the other hand, it was basically incumbent upon FDA, because of their interference by insistence upon crossover, reduction in powering of the trial and the orphan status of L, to work with NWBO to provide input along the way as to how they would proceed forward with determining what adequate measures might be considered regarding the blinded data they had to work with. With this in mind the SAP was most likely submitted basically with pre submission commentary that would have been sufficient along with the help from Dr Duffy with determining final presentation of same for consideration. There was no negative feedback within a 30 day period from being submitted which means it was accepted.. not approved.. but accepted as potentially approvable based on how the data is presented with conclusions drawn utilizing the actual measures chosen for a marketing submission.
No marketing submission has been made yet so the much more likely scenario vs rejection of OS as the new primary endpoint is that there was concern about the artisan method being limiting for any consideration of L as SOC for GBM, rGBM and potentially for lower grade gliomas.
FDA likely suggested that NWBO seek approval for L when they could quickly be able to provide it as standard of care for at least GBM and rGBM and have a more closed system in place to alleviate more safety concern related to the more open artisan method.
If someone in FDA had been hinting, as you suggest, that another trial would be needed ahead of a marketing application that would likely be due to big pharma influence. That influence might now be potentially traced back through discovery in the market maker trial especially since FDA intervened and could be considered suspect with regard to how the clinicaltrials.gov site was dealt with that led to what seems to be market maker interference with price discovery. I don’t think FDA would want themselves exposed like that so I doubt they went in that direction. On the other hand it would be hard to move L towards standard of care when sufficient production of product is not available due to the limitations created by artisan methodology and safety concerns from a more open process could also be raised. This is especially true when considering that Flaskworks was being worked on and big pharma could be seen as possible expansion partners during ramp up. This seems like a much more likely strategy for FDA to deal with, is something NWBO has hinted at with the concept of franchises and at least Merck and Walgreens have connections to or commented about prior to some non specified product, vaccine related cryo capacity buildout; ). Then again it could just be FDA breaking the rules by giving NWBO their decision with regard to OS being moved to the primary endpoint in the L Phase 3 trial before a formal process for determining if the exceptions process for adequate and well controlled studies was properly followed by NWBO and their efforts to create appropriate measures to determine treatment effect were fully adjudicated; ). Best wishes.
Horseb4CarT
3 hours ago
If it looks like a duck, and walks like a duck, and quacks like a duck, then it's most likely a duck,.... exit stage right
DCVAX L is most likely a duck..... I mean following in the (waddling) footsteps of the other 90% of the treatments that have been approved after appearing in the CHM meeting minutes, as you infer!!!!
Didah didah didah that's all folks!!!
Lykiri
3 hours ago
gallium-68 (68Ga) gozetotide (a medicine for diagnostic use only to allow the imaging of prostate cancer). This medicine had its first CHM meeting on 4/25/24. It goes by the name Illuccix, and is owned by Telix Pharmaceuticals. It has been languishing in the process for a long time – this is the poor drug that had to wait a full year for its first meeting. Also, it is the one drug out of the 24 I looked at that publicly mentioned receiving its RFI. One single drug, out of 24. So next time someone tries to tell you it's unusual for a company not to PR updates, know that they are just making that up. And if you are one of the people here clamoring all day every day about the company's "unusual" or "suspicious" strategy regarding communications about this process, know that you are wrong, and everyone here knows you are wrong.
13 Jan 2025
MELBOURNE, Australia and INDIANAPOLIS, Jan. 13, 2025 (GLOBE NEWSWIRE) -- Telix Pharmaceuticals Limited (ASX: TLX, Nasdaq: TLX, Telix, the Company) today provides an update on its commercial and operational performance for the quarter ended 31 December 2024 (Q4 2024)
Illuccix® global regulatory submissions: The German Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, or BfArM) is expected to provide its decision on the Company’s EU marketing authorization application on 15 January 2025. In the United Kingdom (UK), the Company has responded to all queries with no substantive issues raised. The UK regulator (the Medicines and Healthcare products Regulatory Agency - MHRA) is experiencing significant administrative delays but an approval decision is expected this month. The Brazilian Health Regulatory Agency (ANVISA) is expected to provide a decision imminently after protracted administrative delays also unrelated to Telix’s marketing authorization application.
https://ir.telixpharma.com/news-releases/news-release-details/telix-exceeds-fy24-guidance-us142m-q4-revenue-0
18 July 2024
Telix is expecting to receive a regulator’s assessment report by the end of July 2024 from the UK Medicines & Healthcare Products Regulatory Agency (MHRA),
22 August 2024
The UK Medicines & Healthcare Products Regulatory Agency
(MHRA) regulator's assessment report has been received with no substantive issues raised. Decisions expected in H2 2024.
HappyLibrarian
3 hours ago
That being said, I don’t know how things work behind the curtain. Maybe if MHRA want to reject, rather than going through a CHM review, they can simply relay to the sponsor that they would recommend withdrawing/resubmitting. Who knows.
If so, any reasonable person who is a shareholder would regard such a recommendation as material to their decision to remain invested, sell or buy more shares
FeMike
4 hours ago
The first thing that comes to mind is that maybe it’s common for applications to be denied prior to the first CHM meeting, in which case they wouldn’t appear in any of the minutes. But who knows, there may be some other explanation.
I appreciate the DD and info here.
Just an fyi for you, this scenario isn’t necessarily possible.
The MHRA isn’t allowed to outright reject an application. If they recommend rejection, it must go through a CHM review first as a matter of procedure. The only way to skip CHM review is with an outright approval.
That being said, I don’t know how things work behind the curtain. Maybe if MHRA want to reject, rather than going through a CHM review, they can simply relay to the sponsor that they would recommend withdrawing/resubmitting. Who knows.
Lykiri
5 hours ago
Fexapotide Triflutate (the submitting company seems to have gone through some kind of bizarre corporate crisis recently which appears to have delayed their application in another jurisdiction, so that may have happened with the MRHA application as well)
July 16, 2024
Nymox Pharmaceutical Corporation (“Nymox”)
The Company's MAA to MHRA in the U.K. is in the active process of responses to questions received from MHRA. Nymox will update later in the cycle when appropriate.
Nymox Pharmaceutical Corporation (“Nymox”) (OTC Markets NYMXF) announced today that its MAA submission to the Danish Medicines Agency (DKMA) has run out of time and in order to continue will be required to extend the MAA application to DKMA by re-submission with a new fee required. As it currently stands the application “does not meet the conditions of the Medicines Act for issuing a marketing authorization.” Although a great number of questions were resolved by the Company, there remain further responses required that will require additional cycle time.
https://www.globenewswire.com/news-release/2024/07/16/2913880/10918/en/Nymox-Required-to-Resubmit-Application-to-DKMA.html
Nymozarfex is the brand name for fexapotide triflutate, a pro-apoptotic protein developed by Nymox Pharmaceutical Corporation for the treatment of benign prostatic hyperplasia (BPH).
SUMMARY OF THE COMMISSION ON HUMAN MEDICINES MEETING HELD ON
THURSDAY 30TH AND FRIDAY 31ST MAY 2024
LICENSING
NEW DRUGS (not previously licensed in the United Kingdom)
The Commission considered and advised on:
• a medicine used to treat adult patients with a type of liver disease known as primary
biliary cholangitis (PBC) which can get gradually worse over time and without
treatment may eventually lead to liver failure. It can also reduce itching that is linked
to PBC.
• a medicine used to treat men with an enlarged prostate (benign prostatic
hyperplasia, BPH[)?/b]
https://app.box.com/s/jv487awvqzzsrdql0o34h9gg350ceyd4/file/1722460230204
tunnelvisionofplenty
5 hours ago
I’m not being selective in the medicines I’m looking at; I’m just going off the medicines that appear in the CHM minutes.
The first thing that comes to mind is that maybe it’s common for applications to be denied prior to the first CHM meeting, in which case they wouldn’t appear in any of the minutes. But who knows, there may be some other explanation.
The fact remains that, whatever the reason, 90% of the medicines that appeared in the CHM minutes were approved going back over a year. And now, as of June 2024, DCVax-L has appeared in the minutes. And we are currently in the window when, based on recent trends, other medicines appearing in the minutes have been approved.
Lykiri
6 hours ago
Great work tunnelvisionofplenty.
Avacincaptad pegol, (which appears to have been delayed by the company for some reason – possibly because it was not approved, although when drugs aren't approved I've often seen the NICE status updated to reflect that the drug was completely withdrawn from consideration so that may not be the case here)
NICE has postponed the appraisal of avacincaptad pegol, (also known as Izelvay in Europe) to November 2025 at the request of Astellas, likely to allow the company to gather additional data and submit a more comprehensive and robust dossier. This delay appears to be linked to the withdrawal of the MAA from the EMA in October 2024 due to concerns regarding the effectiveness of the product, as well as the FDA's issuance of a Complete Response Letter (CRL) in November 2024. Izervay was previously granted FDA approval on August 4, 2023, for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).
NICE
17 December 2024
Please note that following on from a request received from the company, the timelines for this appraisal have been revised and the appraisal is now anticipated to begin in late November 2025. These timings are based on a request from the company to reschedule the initial date set by NICE, in order to facilitate a suitably comprehensive and robust submission.
https://www.nice.org.uk/guidance/awaiting-development/gid-ta11511
EMA
Astellas Pharma Europe B.V. withdrew its application for a marketing authorisation of Izelvay, a medicine intended for the treatment of geographic atrophy caused by age-related macular degeneration (AMD).
The company withdrew the application on 24 October 2024.
The application was withdrawn after the European Medicines Agency had evaluated the information from the company and prepared questions for the company. After the Agency had assessed the company’s responses to the last round of questions, there were still some unresolved issues.
In its letter notifying the Agency of the withdrawal of the application, the company stated that it withdrew the application because of the Agency’s concerns about the effectiveness of the medicine.
Active substance - avacincaptad pegol
https://www.ema.europa.eu/en/medicines/human/EPAR/izelvay#overview
FDA
The US Food and Drug Administration (FDA) has accepted the revised supplemental New Drug Application (sNDA) for IZERVAY (avacincaptad pegol intravitreal solution) for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD) on January 6, 2025. This revision was in response to the Agency's November 2024 Complete Response Letter (CRL).1
According to the company’s press release1, the application was refiled following a December 20, 2024, meeting between the FDA and Astellas and has been designated as a Class 1 resubmission, with a 60-day review period. This sets the target action date for February 26, 2025.
The sNDA seeks to add positive 2-year data to the IZERVAY US Prescribing Information based on results from the GATHER2 Phase 3 clinical trial.1
The company noted1 that the impact of this matter on Astellas' financial results for the fiscal year ending March 31, 2025, is expected to be minor.
IZERVAY was approved by the FDA on August 4, 2023, for the treatment of GA secondary to AMD.1
https://www.ophthalmologytimes.com/view/fda-accepts-revised-supplemental-new-drug-application-for-izervay