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UNITUXIN
Proper Name
Dinutuximab
Indication
Unituxin is a GD2-binding monoclonal antibody indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy.
Description

Unituxin (dinutuximab) is a chimeric monoclonal antibody composed of murine variable heavy and light chain regions and the human constant region for the heavy chain IgG1 and light chain kappa. Unituxin binds to the glycolipid disialoganglioside (GD2). Dinutuximab is produced in the murine myeloma cell line, SP2/0.

Manufacturing Platform

PARAMETER

DATA

Manufacturer

United Therapeutics Corp.

Indication

Unituxin is a GD2-binding monoclonal antibody indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy.

Cell Substrate

Glycosylated chimeric IgG1 human/mouse monoclonal antibody (mAb)

Manufacturing platform

The upstream process consists of the thawing of a cell bank vial, cell expansion in a series of flasks, production in a bioreactor and recovery of the active substance. The active substance is purified with a series of chromatography, viral inactivation and filtration and ultra-/diafiltration steps.

Dose in vial/final container

17.5 mg/5 mL (3.5 mg/mL) in a single-use vial

Dose to patient

17.5 mg/m2 /day as a diluted intravenous infusion over 10 to 20 hours for 4 consecutive days for up to 5 cycles

 CLINICAL TRIALS:

NCT

TRIAL PHASE

NO OF PATIENTS ENROLLED

STUDY TITLE

COUNTRIES

Clinical studies of ch14.18 in patients with Neuroblastoma

NCT03098030

2, 3

483

Dinutuximab and Irinotecan Versus Irinotecan to Treat Subjects with Relapsed or Refractory Small Cell Lung Cancer

United States, India, Australia, Bulgaria, Italy, Canada, France, Georgia, Hong Kong, Poland, Taiwan, Romania, Korea, Republic of, Lithuania, Malaysia, Philippines, Russian Federation, Spain, Slovakia, Ukraine, Thailand, Hungary, United Kingdom

NCT00026312

3

1449

Isotretinoin with or without Dinutuximab, Aldesleukin, and Sargramostim Following Stem Cell Transplant in Treating Patients with Neuroblastoma

United States, Puerto Rico, Australia, New Zealand, Canada

NCT01041638

3

105

Monoclonal Antibody Ch14.18, Sargramostim, Aldesleukin, and Isotretinoin After Autologous Stem Cell Transplant in Treating Patients with Neuroblastoma

United States

NCT01418495

-

12

Pharmacokinetics of Ch14.18 in Younger Patients with High-Risk Neuroblastoma

United States

NCT01767194

2

73

Irinotecan Hydrochloride and Temozolomide with Temsirolimus or Dinutuximab in Treating Younger Patients with Refractory or Relapsed Neuroblastoma          

United States, Puerto Rico, Australia, New Zealand, Canada

NCT01711554

1

27

Lenalidomide and Dinutuximab with or without Isotretinoin in Treating Younger Patients with Refractory or Recurrent Neuroblastoma          

United States, Canada

NCT01592045

1, 2

28

ch14.18 Pharmacokinetic Study in High-risk Neuroblastoma

United States

Key Regulatory Milestones

US Approval

March 10, 2015

EU Approval

August 14, 2015 (withdrawn)

Health Canada Approval

November 28, 2018

TGA

March 17, 2020

(as Dinutuximab beta)

Advisory Committee

This BLA for this new active moiety, first-in-class molecule was not referred for review to the Oncologic Drugs Advisory Committee (ODAC) for several reasons: the safety profile of dinutuximab is acceptable for the treatment of high-risk neuroblastoma, the evaluation of the safety data when used in the treatment of high-risk neuroblastoma did not raise significant safety or efficacy issues that were unexpected for a drug in this population, and the composition of the committee is predominantly adult oncologists who do not treat this disease. Instead, FDA sought advice from two pediatric oncologists and a patient representative as Special Government Employees, who concurred that substantial evidence of effectiveness had been demonstrated and the risk/benefit assessment was favorable in this life-threatening disease with no satisfactory alternative therapies.

Advanced Facts