Restrict Some Lung Cancer Drugs: Petition
Ochsner MD Anderson Cancer Center system medical director of precision medicine Marc Matrana is calling on FDA to require a labeling change for immunotherapies used to treat non-small cell lung cancer involving a Limitation of Use to exclude patients with ROS Proto-Oncogene 1, Receptor Tyrosine Kinase (“ROS1”) and Rearranged during Transfection, Tyrosine Kinase Inhibitors (“RET”) rearrangements (or gene fusions) from the indicated patient populations to redirect such patients to safer and more effective targeted Tyrosine Kinase Inhibitors. The 6/11 petition says prescribing information for the drugs should reflect that patients with ROS1 and RET rearrangements should use targeted therapies as their first-line option.
“Current immunotherapy labeling does not reflect the emerging evidence showing reduced effectiveness and increased toxicity in ROS1- and RET-positive patients,” the petition says. “By failing to warn clinicians that immune checkpoint inhibitors are inappropriate as first-line therapy for these populations, current labeling creates a reasonable likelihood of clinicians initiating a therapy that (1) provides minimal chance of benefit, (2) delays access to highly effective tyrosine kinase inhibitors, and (3) increases risk of hospitalization due to rapid progression or immune-mediated toxicity.”