The FDA has granted accelerated approval to Adaptimmune Therapeutics for afamitresgene autoleucel (afami-cel [Tecelra]), the company announced in a release.1 The drug is indicated for the treatment of adults with unresectable or metastatic synovial sarcoma who have received prior chemotherapy, are HLA-A*02:01P, -A*02:02P, -A*02:03P, or -A*02:06P positive and whose tumor expresses the MAGE-A4 antigen as determined by FDA-approved or cleared companion diagnostic devices.
Afami-cel is the first engineered cell therapy for a solid tumor cancer approved in the US, and the first new treatment for synovial sarcoma in more than 10 years, ending a long-standing therapeutic gap.
Trial Name: Spearhead 1 Study in Subjects With Advanced Synovial Sarcoma or Myxoid/Round Cell Liposarcoma
Clinicaltrials.gov Identifier: NCT04044768
Summary: This is a study to investigate the efficacy and safety of ADP-A2M4 in HLA-A*02 eligible and MAGE-A4 positive subjects with metastatic or inoperable (advanced) Synovial Sarcoma (Cohort 1, 2 and 3) or MRCLS (Cohort 1).
“The approval of Tecelra is a momentous step in Adaptimmune’s journey to redefine the way cancer is treated and the culmination of a decade of groundbreaking [research and development],” said Adrian Rawcliffe, chief executive officer at Adaptimmune, in the release.1 “I want to thank the patients, caregivers, investigators, and clinical teams as well as everyone at Adaptimmune and our partners who made possible this watershed moment for cell therapy and for people with synovial sarcoma.”
“We are committed to advancing our robust clinical pipeline to serve more patients in need and plan to progress lete-cel, the next late-stage investigational treatment in our sarcoma franchise, with a rolling BLA submission to the FDA next year.”
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The approval of afami-cel is supported by results of the SPEARHEAD-1 (NCT04044768 [Cohort 1]) multicenter, open-label, phase 2 clinical trial.2 Between December 2019 and July 2021, 44 patients with cytogenically confirmed synovial sarcoma were enrolled and received afami-cel.
Afami-cel achieved a 43% overall response rate, with a complete response rate of 4.5%. Patients experienced a median response duration of 4 months (95% CI: 4.6, not reached) and 39% of responders had a duration of response of 12 months or longer.
“This study shows that T-cell receptor therapy can be used to effectively target solid tumours and provides rationale to expand this approach to other solid malignancies,” wrote investigators.2