近日,江蘇恒瑞醫(yī)藥股份有限公司子公司蘇州盛迪亞生物醫(yī)藥有限公司的注射用瑞康曲妥珠單抗(SHR-A1811)被國家藥品監(jiān)督管理局藥品審評中心(以下簡稱“藥審中心”)納入擬突破性治療品種公示名單,公示期7日,這也是該產(chǎn)品第8次納入擬突破性治療品種公示名單。
宮頸癌發(fā)病率在我國居女性生殖系統(tǒng)腫瘤首位、女性惡性腫瘤第5位,死亡率居女性惡性腫瘤死亡的第6位1。我國宮頸癌2022年新發(fā)病例約15萬,死亡人數(shù)約5.6萬。高危型HPV持續(xù)感染是主要誘因,99.7%的宮頸癌檢出與HPV有關(guān)2。雖然篩查和疫苗接種使宮頸癌發(fā)病率有所下降,但該疾病仍是威脅全球女性健康的重要公共衛(wèi)生問題。
早期宮頸癌可通過手術(shù)、放化療等手段實現(xiàn)根治,但約70%的局晚期宮頸癌患者在同步放化療后復發(fā),晚期轉(zhuǎn)移性(國際婦產(chǎn)科聯(lián)盟FIGO分期IVB期)或復發(fā)宮頸癌患者5年生存率不足20%。目前,針對復發(fā)或轉(zhuǎn)移性宮頸癌的一線推薦治療為含鉑化療的聯(lián)合治療方案,一線治療失敗后二線免疫治療僅對少數(shù)患者有效,且一旦治療失敗,傳統(tǒng)的非鉑類單藥化療療效十分有限3-7,晚期宮頸癌患者面臨生存困境。約20%的宮頸癌患者存在HER2表達,這類腫瘤具有浸潤性強、無病生存期短、預(yù)后差等特點,然而目前尚無針對HER2表達宮頸癌的獲批藥物,臨床需求亟待滿足8。注射用瑞康曲妥珠單抗可通過與HER2表達的腫瘤細胞結(jié)合并內(nèi)吞,在腫瘤細胞溶酶體內(nèi)通過蛋白酶剪切釋放毒素,誘導細胞周期阻滯從而誘導腫瘤細胞凋亡。經(jīng)查詢,目前國外已上市的同類產(chǎn)品有Ado-trastuzumab emtansine(商品名Kadcyla)和Fam-trastuzumab deruxtecan(商品名Enhertu)。Kadcyla由羅氏公司開發(fā),2019年國內(nèi)已進口上市;Enhertu由阿斯利康和第一三共合作開發(fā),2023年國內(nèi)已進口上市。除此之外,由榮昌生物研發(fā)的維迪西妥單抗(商品名愛地希)于2021年在中國獲批上市。經(jīng)查詢EvaluatePharma數(shù)據(jù)庫,2023年Kadcyla、Enhertu和愛地希全球銷售額合計約為57.23億美元。截至目前,注射用瑞康曲妥珠單抗相關(guān)項目累計研發(fā)投入約94,096萬元。
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