On January 30, 2024 HUTCHMED (China) Limited (Nasdaq/AIM:HCM, HKEX:13) ("HUTCHMED") reported that the marketing approval of ELUNATE (fruquintinib) by the Pharmacy and Poisons Board of Hong Kong for the treatment of adult patients with previously treated metastatic colorectal cancer ("CRC") (Press release, Hutchison China MediTech, JAN 30, 2024, View Source [SID1234639707]). ELUNATE is a selective oral inhibitor of vascular endothelial growth factor ("VEGF") receptors -1, -2 and -3, which play a pivotal role in blocking tumor angiogenesis.
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This marks the first medicine to be approved under the new mechanism for registration of new drugs ("1+" mechanism) announced by the Government of the Hong Kong Special Administrative Region ("SAR") in October last year. The mechanism officially commenced on November 1, 2023. It allows drugs which are beneficial for treatment of life-threatening or severely debilitating diseases to apply for registration for use in Hong Kong, if they have supporting local clinical data and recognition from relevant experts, when they have been approved by only one reference drug regulatory authority (instead of two otherwise). HUTCHMED submitted the application based on the approval of ELUNATE from the China National Medical Products Administration ("NMPA") supported with local clinical data. Fruquintinib was also approved by the U.S. Food and Drug Administration ("FDA") in November 2023.
"We have made it a priority to do everything we can to bring the benefits of our innovative medicines to Hong Kong, our Company’s birthplace, and are excited to have our first medicine now approved here," said Dr Karen Atkin, Executive Vice President and Chief Operating Officer of HUTCHMED. "We appreciate the streamlined drug registration process, showing the efficiency and commitment of the Hong Kong government to accelerate patient access to novel therapies. As we advance our pipeline of drug candidates in other cancer types and immunological diseases, we look forward to bringing additional therapies to benefit patients in Hong Kong."
This approval indication is for patients with metastatic CRC who have previously received fluoropyrimidine, oxaliplatin and irinotecan-based chemotherapy, and those who have previously received or are not suitable for receiving anti-VEGF therapy or anti-epidermal growth factor receptor (EGFR) therapy (RAS wild-type).
"CRC is the second most common cancer type in Hong Kong with limited effective treatment options available, especially for previously treated metastatic CRC patients," said Dr Caron Li, Vice President, Oncology and Immunology, Hong Kong and Regional Markets of HUTCHMED. "Fruquintinib, as a third-line treatment administered orally, demonstrated clinically meaningful benefits and a consistent safety profile in global clinical trials. We are honored to be the first through the "1+" mechanism and look forward to bringing this important treatment option to patients in Hong Kong as quickly as possible.
Dr Stephen Chan, an academic and a specialist in Medical Oncology, said, "Cancer remains to be a major challenge for the patients, their families and us as healthcare providers, with a rising trend in incidence over the past decades. The complex nature of cancer has made it particularly arduous for researchers to bring new advancements to the treatment. It is truly encouraging to see homegrown innovations taking on an increasingly active role to address the global unmet medical needs. We are excited to bring such meaningful treatment options to the cancer patients in Hong Kong."
Fruquintinib will be sold and marketed in Hong Kong by HUTCHMED under the brand name ELUNATE. It has been developed and commercialized in mainland China in partnership with Eli Lilly & Company. Takeda has the exclusive worldwide license to fruquintinib outside of mainland China, Hong Kong and Macau. Takeda markets fruquintinib in the United States under the brand name FRUZAQLA. Fruquintinib was added to the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) shortly after FDA approval.
About CRC in Hong Kong
CRC is a cancer that starts in either the colon or rectum. It was the second most common cancer in Hong Kong in 2021, with about 5,900 new patients diagnosed with CRC, and associated with about 2,300 deaths.1 Although early-stage CRC can be surgically resected, metastatic CRC remains an area of high unmet need with poor outcomes and limited treatment options. Some patients with metastatic CRC may benefit from personalized therapeutic strategies based on molecular characteristics; however, most patients have tumors that do not harbor actionable mutations.2,3,4,5,6
About Fruquintinib
Fruquintinib is a selective oral inhibitor of VEGF receptors ("VEGFR") -1, -2 and -3. VEGFR inhibitors play a pivotal role in blocking tumor angiogenesis. Fruquintinib was designed to have enhanced selectivity that limits off-target kinase activity, allowing for high drug exposure, sustained target inhibition, and flexibility for the potential use as part of combination therapy. Fruquintinib has demonstrated a manageable safety profile and is being investigated in combination with other anti-cancer therapies.
About Fruquintinib Approval in China
Fruquintinib was approved for marketing in China in September 2018, where it is co-marketed by HUTCHMED and Lilly under the brand name ELUNATE. It was included in the China National Reimbursement Drug List (NRDL) in January 2020. The approval was based on data from the FRESCO study, a Phase III pivotal registration trial of fruquintinib in 416 patients with metastatic CRC in China, which were published in The Journal of the American Medical Association, JAMA. Since its launch in China, fruquintinib has benefited more than 80,000 colorectal cancer patients as of mid-2023.
About Fruquintinib Approval in the United States
Fruquintinib received approval in the United States in November 2023, where it is marketed by Takeda under the brand name FRUZAQLA. The approval was based on data from two large Phase III trials: the multi-regional FRESCO-2 trial, data from which were published in The Lancet, along with the FRESCO trial conducted in China. The trials investigated fruquintinib plus best supportive care versus placebo plus best supportive care in patients with previously treated mCRC. Both FRESCO and FRESCO-2 met their primary and key secondary efficacy endpoints and showed consistent benefit among a total of 734 patients treated with fruquintinib. Safety profiles were consistent across trials.