Extended indication

Treatment of adult patients with relapsed or refractory marginal zone lymphoma (MZL).

Therapeutic value

No estimate possible yet

Registration phase

No registration expected

Product

Active substance

Parsaclisib

Domain

Hematology

Reason of inclusion

New medicine (specialité)

Main indication

Indolent non-Hodgkin’s lymphoma

Extended indication

Treatment of adult patients with relapsed or refractory marginal zone lymphoma (MZL).

Manufacturer

Incyte

Portfolio holder

Incyte

Mechanism of action

Other, see general comments

Route of administration

Oral

Therapeutical formulation

Tablet

Budgetting framework

Intermural (MSZ)

Additional remarks
Werkingsmechanisme: Antineoplastic agents, phosphatidylinositol-3-kinase (PI3K) inhibitors

Registration

Registration route

Centralised (EMA)

Type of trajectory

Conditional marketing authorisation

ATMP

No

Orphan drug

Yes

Registration phase

No registration expected

Additional remarks
Incyte heeft eind juli 2022 de ‘Marketing Authorization Application’ (MAA) voor parsaclisib voor marginal zone lymphoma (MZL) ingetrokken bij de EMA. Parsaclisib zal dus niet geregistreerd worden voor MZL.

Therapeutic value

Current treatment options

Andere PI3K delta remmers zoals, umbralisib en copalisib.

Therapeutic value

No estimate possible yet

Substantiation

Uit de HOVON-richtlijn 2021 staat dat waar mogelijk patiënten met R/R MZL geïncludeerd moeten worden in studies, bijvoorbeeld met nieuwe vormen van immuuntherapie of ‘targeted drugs’. Er zijn nog geen gepubliceerde data uit de studie Ferero bekend.

Duration of treatment

continuous

Frequency of administration

1 times a day

Dosage per administration

20 mg eerste 8 weken, daarna 2,5 mg

References
HOVON-richtlijn, Marginale Zone Lymfoom (2021)
NCT03144674 (CITADEL-204, fase 2b) NCT04796922 (CITADEL-302, fase 3 icm folliculair lymfoom)

Expected patient volume per year

Patient volume

< 225

Market share is generally not included unless otherwise stated.

References
HOVON-richtlijn MZL (2021)
Horizonscan record umbralisib
Additional remarks
Ongeveer 10-15% van de Non Hodgkin Lymfoom gevallen is een marginale zone lymfoom. In Nederland zijn er 3.000 nieuwe patiënten per jaar. Hiervan zijn dus ongeveer 300 patiënten met marginale zone lymfoom. Naar verwachting zal 50% hiervan op enig moment een tweedelijnsbehandeling ondergaan. Het patiëntvolume zal daardoor maximaal 150-225 patiënten bedragen. Echter worden er beperkte patiëntaantallen verwacht gezien concurrerende geneesmiddelen.

Expected cost per patient per year

References
medicijnkosten.nl
Additional remarks
Kosten per patiënt per jaar afhankelijk van ziekteprogressie of onaanvaardbare toxiciteit. 

Kosten idelalisib (Zydelig) €125 per dag (op basis van: 2xper dag)

Potential total cost per year

There is currently nothing known about the possible total cost.

Off label use

There is currently nothing known about off label use.

Indication extension

Indication extension

Yes

Indication extensions

Mantle Cell Lymphoma & Follicular lymphoma

References
Mantle Cell Lymphoma (NCT03235544; fase 2 , NCT04849715; fase 3), Follicular lymphoma (NCT03126019; fase 2 & NCT04796922; fase 3 icm R/R MZL)
Additional remarks
CITADEL-203 (NCT03126019) is evaluating patients with relapsed or refractory follicular lymphoma (FL) Grade 1, 2 or 3a who received at least two prior systemic therapies, had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≤2, and were ineligible for hematopoietic stem cell transplantation (HSCT). CITADEL-205 (NCT03235544) is evaluating patients with relapsed or refractory mantle cell lymphoma (MCL), who received one to three prior systemic therapies and were either naive to or were previously treated with a BTK inhibitor. Eligible patients had an ECOG PS ≤2, and radiologically measurable lymphadenopathy or extranodal lymphoid malignancy.

Other information

There is currently no futher information available.