European Medicines Company Validates Bristol Myers Squibb’s Software for CAR T Cell Remedy Breyanzi in Relapsed or Refractory Giant B-cell Lymphoma After First-Line Remedy

European Medicines Agency Validates Bristol Myers Squibb’s Application for CAR T Cell Therapy Breyanzi in Relapsed or Refractory Large B-cell Lymphoma After First-Line Therapy

PRINCETON, N.J.–()–Bristol Myers Squibb (NYSE: BMY) in the present day introduced that the European Medicines Company (EMA) has validated its kind II variation software for extension of the indication for Breyanzi (lisocabtagene maraleucel) to deal with grownup sufferers with diffuse massive B-cell lymphoma (DLBCL), excessive grade B-cell lymphoma (HGBCL), main mediastinal massive B-cell lymphoma (PMBCL) and follicular lymphoma grade 3B (FL3B), who’re refractory or have relapsed inside 12 months of preliminary remedy and are candidates for haematopoietic stem cell transplant (HSCT). Validation of the appliance confirms the submission is full and begins the EMA’s centralized assessment process.

“Charges of relapsed or refractory massive B-cell lymphoma after first-line remedy are very excessive and few sufferers are in a position to profit from stem cell transplant, which has been the second-line customary of look after almost 30 years,” mentioned Anne Kerber, senior vice chairman, Cell Remedy Growth, Bristol Myers Squibb. “We look ahead to working with the European Medicines Company with the aim of creating Breyanzi as a brand new second-line customary of look after folks dwelling with relapsed or refractory massive B-cell lymphoma and, in the end, bringing the healing potential of cell remedy to extra sufferers.”

The sort II variation is supported by information from the pivotal Section 3 TRANSFORM examine evaluating Breyanzi as a second-line therapy in adults with relapsed or refractory LBCL in comparison with the usual of care consisting of salvage chemotherapy adopted by high-dose chemotherapy plus HSCT. Within the examine, Breyanzi considerably improved event-free survival (EFS) in comparison with customary of care, the examine’s main endpoint, and demonstrated clinically significant and statistically important enhancements in full response charges and progression-free survival in comparison with customary of care. Breyanzi exhibited a well-established security profile with very low charges of extreme cytokine launch syndrome (CRS) and neurologic occasions, and no new security alerts had been noticed on this second-line setting, in line with the security profile noticed with Breyanzi within the third-line plus setting.

LBCL is an aggressive blood most cancers and the commonest kind of non-Hodgkin lymphoma. Roughly 40% of sufferers could have illness that’s refractory to or relapses after first-line therapy. Excessive-dose chemotherapy adopted by autologous stem cell transplant has been the mainstay of care within the second-line setting and traditionally has been the one potential for treatment after failure of first-line therapy. Whereas an estimated 50% of sufferers with main refractory or relapsed illness are thought of candidates for a stem cell transplant, solely about 25% of those sufferers are in a position to obtain stem cell transplant.

A supplemental Biologics License Software for Breyanzi for the therapy of relapsed or refractory LBCL after failure of first-line remedy is at the moment beneath Precedence Evaluation with the U.S. Meals and Drug Administration (FDA), with an assigned Prescription Drug Person Charge Act (PDUFA) aim date of June 24, 2022. A New Drug Software for Breyanzi for the second-line therapy of sufferers with relapsed or refractory LBCL can be beneath assessment with Japan’s Ministry of Well being, Labour and Welfare.

Breyanzi, a differentiated CD-19 directed CAR T cell remedy, is at the moment authorised within the European Union for the therapy of grownup sufferers with relapsed or refractory (R/R) diffuse DLBCL, main mediastinal massive B-cell lymphoma PMBCL, and FL3B after two or extra traces of systemic remedy. Breyanzi will not be authorised in any area for the second-line therapy of LBCL.


TRANSFORM (NCT03575351) is a pivotal, world, randomized, multicenter Section 3 trial evaluating Breyanzi in comparison with the present customary of care (platinum-based salvage chemotherapy adopted by high-dose chemotherapy and HSCT in sufferers responding to salvage chemotherapy) in sufferers with massive B-cell lymphoma that was main refractory or relapsed inside 12 months after CD20-antibody and anthracycline containing first-line remedy. Sufferers had been randomized to obtain Breyanzi or customary of care salvage remedy, together with rituximab plus dexamethasone, high-dose cytarabine, and cisplatin (R-DHAP), rituximab plus ifosfamide, carboplatin and etoposide (R-ICE), or rituximab plus gemcitabine, dexamethasone and cisplatin (R-GDP) per the investigators’ alternative earlier than continuing to high-dose chemotherapy (HDCT) and hematopoietic stem cell transplant (HSCT). The first endpoint of the examine was event-free survival, outlined as time from randomization to dying from any trigger, progressive illness, failure to attain full response or partial response, or begin of latest antineoplastic remedy as a consequence of efficacy issues, whichever happens first. Full response fee was a key secondary endpoint. Different efficacy endpoints included progression-free survival, total survival, total response fee and period of response.

About Breyanzi

Breyanzi is a CD-19 directed chimeric antigen receptor (CAR) T cell remedy, administered as an outlined composition to scale back variability of the CD8 and CD4 element dose. Breyanzi has a 4-1BB costimulatory area which reinforces the enlargement and persistence of the CAR T cells. Breyanzi is authorised by the U.S. Meals and Drug Administration for the therapy of grownup sufferers with relapsed or refractory LBCL after two or extra traces of systemic remedy, together with diffuse massive B-cell lymphoma (DLBCL) not in any other case specified (together with DLBCL arising from indolent lymphoma), high-grade B-cell lymphoma, main mediastinal massive B-cell lymphoma, and follicular lymphoma grade 3B.

Breyanzi can be authorised within the European Union, Switzerland, Japan and Canada for relapsed and refractory LBCL after two or extra traces of systemic remedy. Bristol Myers Squibb’s medical growth program for Breyanzi contains medical research in earlier traces of therapy for sufferers with relapsed or refractory LBCL and different varieties of lymphomas and leukemia. For extra info, go to

U.S. Vital Security Info


  • Cytokine Launch Syndrome (CRS), together with deadly or life-threatening reactions, occurred in sufferers receiving BREYANZI. Don’t administer BREYANZI to sufferers with energetic an infection or inflammatory problems. Deal with extreme or life-threatening CRS with tocilizumab with or with out corticosteroids.
  • Neurologic toxicities, together with deadly or life-threatening reactions, occurred in sufferers receiving BREYANZI, together with concurrently with CRS, after CRS decision or within the absence of CRS. Monitor for neurologic occasions after therapy with BREYANZI. Present supportive care and/or corticosteroids as wanted.
  • BREYANZI is obtainable solely via a restricted program beneath a Danger Analysis and Mitigation Technique (REMS) referred to as the BREYANZI REMS.

Cytokine Launch Syndrome (CRS)

CRS, together with deadly or life-threatening reactions, occurred following therapy with BREYANZI. CRS occurred in 46% (122/268) of sufferers receiving BREYANZI, together with ≥ Grade 3 (Lee grading system) CRS in 4% (11/268) of sufferers. One affected person had deadly CRS and a couple of had ongoing CRS at time of dying. The median time to onset was 5 days (vary: 1 to fifteen days). CRS resolved in 119 of 122 sufferers (98%) with a median period of 5 days (vary: 1 to 17 days). Median period of CRS was 5 days (vary 1 to 30 days) in all sufferers, together with those that died or had CRS ongoing at time of dying.

Amongst sufferers with CRS, the commonest manifestations of CRS embrace fever (93%), hypotension (49%), tachycardia (39%), chills (28%), and hypoxia (21%). Critical occasions which may be related to CRS embrace cardiac arrhythmias (together with atrial fibrillation and ventricular tachycardia), cardiac arrest, cardiac failure, diffuse alveolar injury, renal insufficiency, capillary leak syndrome, hypotension, hypoxia, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS).

Be sure that 2 doses of tocilizumab can be found previous to infusion of BREYANZI.

Sixty-one of 268 (23%) sufferers acquired tocilizumab and/or a corticosteroid for CRS after infusion of BREYANZI. Twenty-seven (10%) sufferers acquired tocilizumab solely, 25 (9%) acquired tocilizumab and a corticosteroid, and 9 (3%) acquired corticosteroids solely.

Neurologic Toxicities

Neurologic toxicities that had been deadly or life-threatening, occurred following therapy with BREYANZI. CAR T cell-associated neurologic toxicities occurred in 35% (95/268) of sufferers receiving BREYANZI, together with ≥ Grade 3 in 12% (31/268) of sufferers. Three sufferers had deadly neurologic toxicity and seven had ongoing neurologic toxicity at time of dying. The median time to onset of the primary occasion was 8 days (vary: 1 to 46 days). The onset of all neurologic occasions occurred inside the first 8 weeks following BREYANZI infusion. Neurologic toxicities resolved in 81 of 95 sufferers (85%) with a median period of 12 days (vary: 1 to 87 days). Three of 4 sufferers with ongoing neurologic toxicity at information cutoff had tremor and one topic had encephalopathy. Median period of neurologic toxicity was 15 days (vary: 1 to 785 days) in all sufferers, together with these with ongoing neurologic occasions on the time of dying or at information cutoff.

Seventy-eight (78) of 95 (82%) sufferers with neurologic toxicity skilled CRS. Neurologic toxicity overlapped with CRS in 57 sufferers. The onset of neurologic toxicity was after onset of CRS in 30 sufferers, earlier than CRS onset in 13 sufferers, identical day as CRS onset in 7 sufferers, and identical day as CRS decision in 7 sufferers.

Neurologic toxicity resolved in three sufferers earlier than the onset of CRS. Eighteen sufferers skilled neurologic toxicity after decision of CRS.

The commonest neurologic toxicities included encephalopathy (24%), tremor (14%), aphasia (9%), delirium (7%), headache (7%), dizziness (6%), and ataxia (6%). Critical occasions together with cerebral edema and seizures occurred with BREYANZI. Deadly and severe instances of leukoencephalopathy, some attributable to fludarabine, have occurred in sufferers handled with BREYANZI.

CRS and Neurologic Toxicities Monitoring

Monitor sufferers day by day at a licensed healthcare facility throughout the first week following infusion, for indicators and signs of CRS and neurologic toxicities. Monitor sufferers for indicators and signs of CRS and neurologic toxicities for at the least 4 weeks after infusion; consider and deal with promptly. Counsel sufferers to hunt rapid medical consideration ought to indicators or signs of CRS or neurologic toxicity happen at any time. On the first signal of CRS, institute therapy with supportive care, tocilizumab or tocilizumab and corticosteroids as indicated.


Due to the chance of CRS and neurologic toxicities, BREYANZI is obtainable solely via a restricted program beneath a Danger Analysis and Mitigation Technique (REMS) referred to as the BREYANZI REMS. The required parts of the BREYANZI REMS are:

  • Healthcare services that dispense and administer BREYANZI should be enrolled and adjust to the REMS necessities.
  • Licensed healthcare services will need to have on-site, rapid entry to tocilizumab.
  • Be sure that a minimal of two doses of tocilizumab can be found for every affected person for infusion inside 2 hours after BREYANZI infusion, if wanted for therapy of CRS.
  • Licensed healthcare services should make sure that healthcare suppliers who prescribe, dispense, or administer BREYANZI are skilled on the administration of CRS and neurologic toxicities.

Additional info is obtainable at, or contact Bristol Myers Squibb at 1-888-423-5436.

Hypersensitivity Reactions

Allergic reactions could happen with the infusion of BREYANZI. Critical hypersensitivity reactions, together with anaphylaxis, could also be as a consequence of dimethyl sulfoxide (DMSO).

Critical Infections

Extreme infections, together with life-threatening or deadly infections, have occurred in sufferers after BREYANZI infusion. Infections (all grades) occurred in 45% (121/268) of sufferers. Grade 3 or greater infections occurred in 19% of sufferers. Grade 3 or greater infections with an unspecified pathogen occurred in 16% of sufferers, bacterial infections occurred in 5%, and viral and fungal infections occurred in 1.5% and 0.4% of sufferers, respectively. Monitor sufferers for indicators and signs of an infection earlier than and after BREYANZI administration and deal with appropriately. Administer prophylactic antimicrobials in accordance with customary institutional pointers.

Febrile neutropenia has been noticed in 9% (24/268) of sufferers after BREYANZI infusion and could also be concurrent with CRS. Within the occasion of febrile neutropenia, consider for an infection and handle with broad spectrum antibiotics, fluids, and different supportive care as medically indicated.

Keep away from administration of BREYANZI in sufferers with clinically important energetic systemic infections.

Viral reactivation: Hepatitis B virus (HBV) reactivation, in some instances leading to fulminant hepatitis, hepatic failure, and dying, can happen in sufferers handled with medication directed towards B cells. Ten of the 11 sufferers within the TRANSCEND examine with a previous historical past of HBV had been handled with concurrent antiviral suppressive remedy to forestall HBV reactivation throughout and after therapy with BREYANZI. Carry out screening for HBV, HCV, and HIV in accordance with medical pointers earlier than assortment of cells for manufacturing.

Extended Cytopenias

Sufferers could exhibit cytopenias not resolved for a number of weeks following lymphodepleting chemotherapy and BREYANZI infusion. Grade 3 or greater cytopenias persevered at Day 29 following BREYANZI infusion in 31% (84/268) of sufferers, and included thrombocytopenia (26%), neutropenia (14%), and anemia (3%). Monitor full blood counts previous to and after BREYANZI administration.


B-cell aplasia and hypogammaglobulinemia can happen in sufferers receiving therapy with BREYANZI. The adversarial occasion of hypogammaglobulinemia was reported as an adversarial response in 14% (37/268) of sufferers; laboratory IgG ranges fell beneath 500 mg/dL after infusion in 21% (56/268) of sufferers. Hypogammaglobulinemia, both as an adversarial response or laboratory IgG stage beneath 500 mg/dL after infusion, was reported in 32% (85/268) of sufferers. Monitor immunoglobulin ranges after therapy with BREYANZI and handle utilizing an infection precautions, antibiotic prophylaxis, and immunoglobulin substitute as clinically indicated.

Reside vaccines: The security of immunization with reside viral vaccines throughout or following BREYANZI therapy has not been studied. Vaccination with reside virus vaccines will not be really useful for at the least 6 weeks previous to the beginning of lymphodepleting chemotherapy, throughout BREYANZI therapy, and till immune restoration following therapy with BREYANZI.

Secondary Malignancies

Sufferers handled with BREYANZI could develop secondary malignancies. Monitor lifelong for secondary malignancies. Within the occasion {that a} secondary malignancy happens, contact Bristol Myers Squibb at 1-888-805-4555 for reporting and to acquire directions on assortment of affected person samples for testing.

Results on Capacity to Drive and Use Machines

Because of the potential for neurologic occasions, together with altered psychological standing or seizures, sufferers receiving BREYANZI are in danger for altered or decreased consciousness or impaired coordination within the 8 weeks following BREYANZI administration. Advise sufferers to chorus from driving and interesting in hazardous occupations or actions, corresponding to working heavy or doubtlessly harmful equipment, throughout this preliminary interval.

Opposed Reactions

Critical adversarial reactions occurred in 46% of sufferers. The commonest nonlaboratory, severe adversarial reactions (> 2%) had been CRS, encephalopathy, sepsis, febrile neutropenia, aphasia, pneumonia, fever, hypotension, dizziness, and delirium. Deadly adversarial reactions occurred in 4% of sufferers.

The commonest nonlaboratory adversarial reactions of any grade (≥ 20%) had been fatigue, CRS, musculoskeletal ache, nausea, headache, encephalopathy, infections (pathogen unspecified), decreased urge for food, diarrhea, hypotension, tachycardia, dizziness, cough, constipation, belly ache, vomiting, and edema.

Please see full Prescribing Info, together with Boxed WARNINGS and Medicine Information.

Bristol Myers Squibb: Making a Higher Future for Folks with Most cancers

Bristol Myers Squibb is impressed by a single imaginative and prescient—remodeling sufferers’ lives via science. The aim of the corporate’s most cancers analysis is to ship medicines that supply every affected person a greater, more healthy life and to make treatment a chance. Constructing on a legacy throughout a broad vary of cancers which have modified survival expectations for a lot of, Bristol Myers Squibb researchers are exploring new frontiers in customized medication, and thru modern digital platforms, are turning information into insights that sharpen their focus. Deep scientific experience, cutting-edge capabilities and discovery platforms allow the corporate to take a look at most cancers from each angle. Most cancers can have a relentless grasp on many components of a affected person’s life, and Bristol Myers Squibb is dedicated to taking actions to deal with all facets of care, from analysis to survivorship. As a result of as a frontrunner in most cancers care, Bristol Myers Squibb is working to empower all folks with most cancers to have a greater future.

Study extra concerning the science behind cell remedy and ongoing analysis at Bristol Myers Squibb right here.

About Bristol Myers Squibb

Bristol Myers Squibb is a worldwide biopharmaceutical firm whose mission is to find, develop and ship modern medicines that assist sufferers prevail over severe ailments. For extra details about Bristol Myers Squibb, go to us at or comply with us on LinkedIn, Twitter, YouTube, Fb and Instagram.

Celgene and Juno Therapeutics are wholly owned subsidiaries of Bristol-Myers Squibb Firm. In sure international locations exterior the U.S., as a consequence of native legal guidelines, Celgene and Juno Therapeutics are known as, Celgene, a Bristol Myers Squibb firm and Juno Therapeutics, a Bristol Myers Squibb firm.

Bristol Myers Squibb Cautionary Assertion Relating to Ahead-Wanting Statements

This press launch accommodates “forward-looking statements” inside the which means of the Non-public Securities Litigation Reform Act of 1995 relating to, amongst different issues, the analysis, growth and commercialization of pharmaceutical merchandise. All statements that aren’t statements of historic details are, or could also be deemed to be, forward-looking statements. Such forward-looking statements are based mostly on present expectations and projections about our future monetary outcomes, targets, plans and goals and contain inherent dangers, assumptions and uncertainties, together with inner or exterior elements that might delay, divert or change any of them within the subsequent a number of years, which are troublesome to foretell, could also be past our management and will trigger our future monetary outcomes, targets, plans and goals to vary materially from these expressed in, or implied by, the statements. These dangers, assumptions, uncertainties and different elements embrace, amongst others, that future examine outcomes is probably not in line with the outcomes thus far, that Breyanzi (lisocabtagene maraleucel) could not obtain regulatory approval for the indication described on this launch within the at the moment anticipated timeline or in any respect, any advertising and marketing approvals, if granted, could have important limitations on their use, and, if authorised, whether or not such product candidate for such indication described on this launch can be commercially profitable. No forward-looking assertion could be assured. Ahead-looking statements on this press launch must be evaluated along with the various dangers and uncertainties that have an effect on Bristol Myers Squibb’s enterprise and market, significantly these recognized within the cautionary assertion and threat elements dialogue in Bristol Myers Squibb’s Annual Report on Type 10-Ok for the yr ended December 31, 2021, as up to date by our subsequent Quarterly Studies on Type 10-Q, Present Studies on Type 8-Ok and different filings with the Securities and Alternate Fee. The forward-looking statements included on this doc are made solely as of the date of this doc and besides as in any other case required by relevant legislation, Bristol Myers Squibb undertakes no obligation to publicly replace or revise any forward-looking assertion, whether or not because of new info, future occasions, modified circumstances or in any other case.



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