Imlygic
Generic: TALIMOGENE LAHERPAREPVEC
Basic Information
Manufacturer
Amgen Inc
Product Type
HUMAN PRESCRIPTION DRUG
Route of Administration
INTRALESIONAL
FDA Set ID
64ffb680-ea8c-42fc-9649-9e8c0eb77ddb
Indications & Usage
1 INDICATIONS AND USAGE IMLYGIC is a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery.
Limitations of use : IMLYGIC has not been shown to improve overall survival or have an effect on visceral metastases.
IMLYGIC is a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery.
Limitations of use : IMLYGIC has not been shown to improve overall survival or have an effect on visceral metastases.
( 1 )
Limitations of use : IMLYGIC has not been shown to improve overall survival or have an effect on visceral metastases.
IMLYGIC is a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery.
Limitations of use : IMLYGIC has not been shown to improve overall survival or have an effect on visceral metastases.
( 1 )
Adverse Reactions
6 ADVERSE REACTIONS The most commonly reported adverse drug reactions (≥ 25%) in IMLYGIC-treated patients were fatigue, chills, pyrexia, nausea, influenza-like illness, and injection site pain.
The following adverse reactions are discussed in greater detail in another section of the label: Herpetic Infection [see Warnings and Precautions ( 5.2 )] Injection Site Complications [see Warnings and Precautions ( 5.3 )] The most commonly reported adverse drug reactions (≥ 25%) in IMLYGIC-treated patients were fatigue, chills, pyrexia, nausea, influenza-like illness, and injection site pain.
( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Amgen at 1-855-IMLYGIC (1-855-465-9442) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The safety of IMLYGIC was evaluated in 419 patients who received at least 1 dose of either IMLYGIC (n = 292) or subcutaneously administered granulocyte-macrophage colony-stimulating factor (GM-CSF) (n = 127) in an open-label, randomized clinical study of patients with stage IIIB, IIIC, and IV melanoma that was not considered to be surgically resectable [see Clinical Studies ( 14 )] .
The median duration of exposure to IMLYGIC was 23 weeks (5.3 months).
Twenty-six patients were exposed to IMLYGIC for at least 1 year.
Most adverse reactions reported were mild or moderate in severity and generally resolved within 72 hours.
The most common grade 3 or higher adverse reaction was cellulitis [see Warnings and Precautions ( 5.3 )] .
Pyrexia, chills, and influenza-like illness can occur any time during IMLYGIC treatment but were more frequent during the first 3 months of treatment.
Table 4 below lists adverse reactions with a 5% or greater incidence in the IMLYGIC arm compared to the GM-CSF arm in the clinical study [see Clinical Studies ( 14 )] .
Table 4.
Adverse Reactions Reported with At Least a 5% Greater Incidence in Patients Treated with IMLYGIC Compared to GM-CSF Adverse Reactions IMLYGIC ( n = 292) GM-CSF ( n = 127) Any Grade n (%) Grade 3 n (%) Any Grade n (%) Grade 3 n (%) General disorders and administration site conditions Fatigue 147 (50.3) 6 (2.1) 46 (36.2) 1 (< 1) Chills 142 (48.6) 11 (8.7) Pyrexia 125 (42.8) 11 (8.7) Influenza-like illness 89 (30.5) 2 (< 1) 19 (15.0) Injection site pain 81 (27.7) 2 (< 1) 8 (6.3) Gastrointestinal disorders Nausea 104 (35.6) 1 (< 1) 25 (19.7) Vomiting 62 (21.2) 5 (1.7) 12 (9.5) Diarrhea 55 (18.8) 1 (< 1) 14 (11.0) Constipation 34 (11.6) 8 (6.3) 1 (< 1) Abdominal pain 26 (8.9) 2 (< 1) 3 (2.4) Musculoskeletal and connective tissue disorders Myalgia 51 (17.5) 1 (< 1) 7 (5.5) Arthralgia 50 (17.1) 2 (< 1) 11 (8.7) Pain in extremity 48 (16.4) 4 (1.4) 12 (9.5) 1 (< 1) Nervous system disorders Headache 55 (18.8) 2 (< 1) 12 (9.5) Dizziness 28 (9.6) 4 (3.2) Respiratory, thoracic , and mediastinal disorders Oropharyngeal pain 17 (5.8) 1 (< 1) Investigations Weight decreased 17 (5.8) 1 (< 1) 1 (< 1) Other adverse reactions associated with IMLYGIC in the open-label, randomized study include rash, dermatitis, glomerulonephritis, vitiligo, worsening psoriasis, cellulitis, pneumonitis, vasculitis, herpetic keratitis, obstructive airway disorder, plasmacytoma at the injection site, deep vein thrombosis, and oral herpes.
6.2 Postmarketing Experience The following adverse reactions have been identified during postapproval use of IMLYGIC.
Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Herpetic infections including disseminated herpetic infections [see Warnings and Precautions (5.2) ].
Serious including fatal disseminated herpetic infections in immunocompromised patient population [see Contraindications (4.1) and Warnings and Precautions (5.2) ].
The following adverse reactions are discussed in greater detail in another section of the label: Herpetic Infection [see Warnings and Precautions ( 5.2 )] Injection Site Complications [see Warnings and Precautions ( 5.3 )] The most commonly reported adverse drug reactions (≥ 25%) in IMLYGIC-treated patients were fatigue, chills, pyrexia, nausea, influenza-like illness, and injection site pain.
( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Amgen at 1-855-IMLYGIC (1-855-465-9442) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The safety of IMLYGIC was evaluated in 419 patients who received at least 1 dose of either IMLYGIC (n = 292) or subcutaneously administered granulocyte-macrophage colony-stimulating factor (GM-CSF) (n = 127) in an open-label, randomized clinical study of patients with stage IIIB, IIIC, and IV melanoma that was not considered to be surgically resectable [see Clinical Studies ( 14 )] .
The median duration of exposure to IMLYGIC was 23 weeks (5.3 months).
Twenty-six patients were exposed to IMLYGIC for at least 1 year.
Most adverse reactions reported were mild or moderate in severity and generally resolved within 72 hours.
The most common grade 3 or higher adverse reaction was cellulitis [see Warnings and Precautions ( 5.3 )] .
Pyrexia, chills, and influenza-like illness can occur any time during IMLYGIC treatment but were more frequent during the first 3 months of treatment.
Table 4 below lists adverse reactions with a 5% or greater incidence in the IMLYGIC arm compared to the GM-CSF arm in the clinical study [see Clinical Studies ( 14 )] .
Table 4.
Adverse Reactions Reported with At Least a 5% Greater Incidence in Patients Treated with IMLYGIC Compared to GM-CSF Adverse Reactions IMLYGIC ( n = 292) GM-CSF ( n = 127) Any Grade n (%) Grade 3 n (%) Any Grade n (%) Grade 3 n (%) General disorders and administration site conditions Fatigue 147 (50.3) 6 (2.1) 46 (36.2) 1 (< 1) Chills 142 (48.6) 11 (8.7) Pyrexia 125 (42.8) 11 (8.7) Influenza-like illness 89 (30.5) 2 (< 1) 19 (15.0) Injection site pain 81 (27.7) 2 (< 1) 8 (6.3) Gastrointestinal disorders Nausea 104 (35.6) 1 (< 1) 25 (19.7) Vomiting 62 (21.2) 5 (1.7) 12 (9.5) Diarrhea 55 (18.8) 1 (< 1) 14 (11.0) Constipation 34 (11.6) 8 (6.3) 1 (< 1) Abdominal pain 26 (8.9) 2 (< 1) 3 (2.4) Musculoskeletal and connective tissue disorders Myalgia 51 (17.5) 1 (< 1) 7 (5.5) Arthralgia 50 (17.1) 2 (< 1) 11 (8.7) Pain in extremity 48 (16.4) 4 (1.4) 12 (9.5) 1 (< 1) Nervous system disorders Headache 55 (18.8) 2 (< 1) 12 (9.5) Dizziness 28 (9.6) 4 (3.2) Respiratory, thoracic , and mediastinal disorders Oropharyngeal pain 17 (5.8) 1 (< 1) Investigations Weight decreased 17 (5.8) 1 (< 1) 1 (< 1) Other adverse reactions associated with IMLYGIC in the open-label, randomized study include rash, dermatitis, glomerulonephritis, vitiligo, worsening psoriasis, cellulitis, pneumonitis, vasculitis, herpetic keratitis, obstructive airway disorder, plasmacytoma at the injection site, deep vein thrombosis, and oral herpes.
6.2 Postmarketing Experience The following adverse reactions have been identified during postapproval use of IMLYGIC.
Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Herpetic infections including disseminated herpetic infections [see Warnings and Precautions (5.2) ].
Serious including fatal disseminated herpetic infections in immunocompromised patient population [see Contraindications (4.1) and Warnings and Precautions (5.2) ].