FDA Questions Safety/Efficacy of Bluebird’s Eli-Cel
FDA says it is challenged to determine the overall benefit-risk profile of Bluebird bio’s eli-cel (elivaldogene autotemcel) gene therapy, indicated for treating patients less than 18 years of age with early cerebral adrenoleukodystrophy who do not have an available and willing human leukocyte antigen-matched sibling hematopoietic stem cell donor. In an advisory committee briefing document released in advance of a 6/9 panel meeting to review the therapy, FDA says the benefit-to-risk ratio is “difficult to characterize because of the uncertain benefit and the uncertain magnitude of the risk of MDS” [myelodysplastic syndrome], a life-threatening malignancy which occurred in three subjects.
The advisory committee will be asked to discuss whether the efficacy data support the presence of a clinically meaningful benefit related to eli-cel, and, if so, in what population. Additionally, panel members will be asked to discuss whether there should be increased concerns about MDS occurrence in eli-cel because of similar events seen in the company’s related product, lovo-cel, for treating sickle cell disease, which was placed on clinical hold by FDA.