ZYNTEGLO™ (gene therapy)
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Product Information
Scientific name: beti-cel (betibeglogene autotemcel)
Brand name: ZYNTEGLO™
RESPONSIBLE: bluebird bio Inc. -
Clinical Trial/Study Information
Northstar (HGB-204)
Trial Name: Northstar (HGB-204)
Code: NCT01745120
Phase: 1b
Eligible patient diagnosis: TDT (non β0/β0 genotype, β0/β0 genotype or IVS-I-110 mutation) (adult & paediatric/adolescent; ages 12 – 35)
No. of Patients enrolled: 18 [6 with non β0/β0 genotype, 8 with β0/β0 genotype or IVS-I-110 mutation, 4 with other mutations including β+/β+, B0/β+, BE/β+] (Last update: April 2019)
Study Sites: 6 Sites per countryCompletion date: February 2018
Scope of the Study / Aim: Transfusion independence post-infusion for at least 24 months
Results & more information: Thompson A, et al (2019)Northstar (HGB-205)
Trial Name: Northstar (HGB-205)
Code: NCT02151526
Phase: 1b
Eligible patient diagnosis: TDT or SCD (all genotypes) (adult & paediatric/adolescent ; ages 5 – 35)
No. of Patients enrolled: 7 → 4 [3 with βE/β0 genotype, 1 with IVS-I110 mutation] & 3 [with SCD] (Last update: Jan 2022)
Study Sites: 1 Sites per countryCompletion date: February 2019
Scope of the Study / Aim: Transfusion independence post-infusion for at least 24 months
Results & more information: Thompson A, et al (2019)Northstar-2 (HGB-207)
Trial Name: Northstar-2 (HGB-207)
Code: NCT02906202
Phase: 3
Eligible patient diagnosis: : TDT (non β0/β0 genotype) (adult & paediatric ; ages 0- 50)
No. of Patients enrolled: 23 (Last update: 18/6/2023)
Study Sites: 8 Sites per countryCompletion date: March 2022
Scope of the Study / Aim: Transfusion independence post-infusion
Results & more information: Locatelli F, et al (2022)Northstar-3 (HGB-212)
Trial Name: Northstar-3 (HGB-212)
Code: NCT03207009
Phase: 3
Eligible patient diagnosis: β0/β0 genotype or IVS-I-110 mutation (adult & paediatic ; ages 0 – 50)
No. of Patients enrolled: 18 (Last update: 4/4/2023)
Study Sites: 9 Sites per countryCompletion date: November 2022
Scope of the Study / Aim: Transfusion independence post-infusion
Long-term follow-up study (LTF-303) (13 years follow up study)
Trial Name: Long-term follow-up study (LTF-303) (13 years follow up study)
Code: NCT02633943
Phase: Long-term follow-up study of Phase 1/2 studies [HGB-204, HGB-205], or Phase 3 studies [HGB-207, HGB-212]
Eligible patient diagnosis: TDT patients who participated in HGB-204, HGB205, HGB-207, HGB-212 (ages 0 – 50)
No. of Patients enrolled: 63 (Last update: 07/12/2024)
Study Sites: 15 Sites per countryAnticipated completion date: November 2035
Scope of the Study / Aim: After completing the parent clinical study (approximately 2 years), patients will be followed for an additional 13 years for a total of 15 years post infusion. Monitoring for malignancies, immune-related adverse events, haematologic disorders and neurologic disorders.
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Regulatory Information
Status: Authorised
Additional notable points:
- EMA: Conditional marketing authorization for patients 12 years and older with TDT who do not have a β0/β0
genotype (2019); marketing authorisation withdrawn from the EU at the request of the marketing authorisation holder (bluebird bio) (2022) - FDA: Approved to treat patients with beta-thalassemia who require regular red blood cell (RBC) transfusions (2022)
- MHRA: Not approved (2021)
- EMA: Conditional marketing authorization for patients 12 years and older with TDT who do not have a β0/β0
Update: 19 December 2024
- 35 patient cell collections have been completed to date (14 November 2024)
- Qualified Treatment Centre (QTC) network: >70 centres activated to –date (adult & paediatric) (14 November 2024)
New data
- Data presented at the 66th ASH Annual Congress (7 – 10 December 2024) in San Diego (USA) showed that:
- A total of 63 patients had received beti-cel across all clinical trials and subsequently enrolled in LTF-303 by the cut-off date of February 2024.
- Of these, 2 had 10 years follow-up and 51 had at least 5 years follow up
- 15/22 (68.2%) infused in the phase 1/2 studies achieved transfusion independence with an average Hb of 10.2g/dL
- 37/41 (90.2%) infused in the phase 3 studies achieved transfusion independence with an average Hb of 11.2g/dL. Current manufacturing in the commercial setting is similar to that of the phase 3 trials.
- 28/37 (75.7%) patients who achieved transfusion independence in Phase 3 studies are no longer undergoing iron chelation therapy
- No malignancies, insertional oncogenesis or vector derived replication competent lentivirus were reported.
- A total of 63 patients had received beti-cel across all clinical trials and subsequently enrolled in LTF-303 by the cut-off date of February 2024.
Sources: bluebird bio Reports Third Quarter 2024 Results and Highlights Operational Progress and 2024 Guidance – bluebird bio, Inc.
Betibeglogene Autotemcel (beti-cel) Gene Addition Therapy Results in Durable Hemoglobin a Production with up to 10 Years of Follow-up with Transfusion-Dependent β-Thalassemia
Long-Term Follow-Up Data Continue to Support Beti-Cel as a Potentially Curative Gene Therapy for β-Thalassemia Patients Who Require Regular Transfusions Through Achievement of Durable Transfusion Independence and Normal or Near-Normal Adult Hb Levels – bluebird bio, Inc.
Update: 30 September 2024
- 39 patient cell collections have been completed [20 in 2023, 19 in 2024] (14 August 2024)
- Additional manufacturing capacity has been approved since the company expects rapid acceleration of request approvals in the coming months.
- Qualified Treatment Centre (QTC) network: 70 centres activated to –date (adult & paediatric) for thalassaemia (14 August 2024)
Update: 30 June 2024
- 21 patient cell collections have been completed [20 in 2023, 11 in 2024] (9 May 2024)
- Qualified Treatment Centre (QTC) network: 64 centres activated to –date (adult & paediatric) for thalassaemia (9 May 2024)
Update: 31 March 2024
- 27 patient cell collections have been completed [20 in 2023, 7 in 2024] (26 March 2024)
- Qualified Treatment Centre (QTC) network: 62 centres activated to –date (adult & paediatric) for thalassaemia (26 March 2024) https://www.zynteglo.com/support/find-a-qualified-treatment-center
- 49/62 are receiving referrals SCD patients for LYFGENIA
Sources: https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bio-provides-update-commercial-launch-progress-0
https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bio-reports-fourth-quarter-and-2023-annual-results-and
Update: 20 December 2023
- 16 patient cell collections have been completed (7 November 2023)
- Qualified Treatment Centre (QTC) network: 29 centres activated to date (adult & paediatric).
- 63 patients with transfusion-dependent beta-thalassaemia had received beti-cel across 4 clinical trials (HGB-204, HGB-205, HGB-207, HGB-212) (cut-off date: 30 January 2023) and showed sustained transfusion independence and improvements in iron management for up to 9 years of follow-up. All four studies are complete, and all patients have transitioned to a long-term follow-up study (LTF-303).
New data
- Data presented at the 65th ASH Annual Congress (9 – 12 December 2023) in San Diego (USA) showed that:
- Among patients in the Phase 3 studies, 90.2% (37/41) achieved transfusion independence, which was maintained for up to 6 years across ages and genotypes.
- Among patients in the Phase 1/2 studies, 68.2% (15/22) achieved transfusion independence, with 14 patients maintaining transfusion independence for up to 9 years.
- Among 12 adult patients and 22 pediatric patients in the Phase 1/2 and Phase 3 studies, clinically meaningful improvements in quality of life were demonstrated, including various quality of life assessments for mental, physical and psychosocial health, were demonstrated in both adult and pediatric patients up to 36 months.
- No malignancies, insertional oncogenesis, or vector-derived replication-competent lentivirus were reported.
- Across all studies, 37/51 patients restarted chelation, and 12 received phlebotomy post-infusion; however, 69% (35/51) were able to stop chelation therapy, demonstrating restoration of iron levels over time and reduced iron management burden in those patients.
Sources: https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bio-reports-third-quarter-2023-financial-results-and
https://investor.bluebirdbio.com/news-releases/news-release-details/long-term-data-presented-ash-support-beti-cel-potentially
Update: 30 September 2023
- 11 patient cell collections have been completed (8 August 2023)
- Qualified Treatment Centre (QTC) network: 16 centres activated to date. Plans to have 40 – 50 centres by the end of 2023.
Update: 30 June 2023
- First commercial ZYNTEGLO patients has been infused (9 May 2023).
- 6 patient cell collections have been completed (9 May 2023).
Update: 31 March 2023
- Apheresis for first commercial ZYNTEGLO patient has been completed (09 January 2023) and an additional 5 patient cell collections completed (29 March 2023).
- Early indicators continue to demonstrate significant patient demand for ZYNTEGLO. Approximately 40 patients have initiated the insurer authorisation process. None have received a negative response (29 March 2023). The company aims to expand manufacturing capacity to meet projected demand.
- Qualified Treatment Centre (QTC) network: 12 centres activated to –date. 30 centres are on-boarding or in negotiation. Plans to have 40 – 50 centres by the end of 2023.
- Insurance coverage. Outcomes-based agreements are in place with 3 of the largest pharmacy benefit managers in the US, representing dozens of downstream national and regional plans with a favourable coverage policy for ZYNTEGLO.
Sources: https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bioprovides-update-commercial-launch-progress-program
https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bioreports-fourth-quarter-and-full-year-2022-financial