On 16 December 2014, orphan designation (EU/3/14/1393) was granted by the European Commission to Kite Pharma UK, Ltd, United Kingdom, for autologous T cells transduced with retroviral vector encoding an anti-CD19 CD28/CD3 zeta chimeric antigen receptor for the treatment of diffuse large B‑cell lymphoma.
This medicine is now known as axicabtagene ciloleucel.
Autologous T cells transduced with retroviral vector encoding an anti-CD19 CD28/CD3 zeta chimeric antigen receptor for treatment of diffuse large B cell lymphoma has been authorised in the EU as Yescarta since 23 August 2018.
Diffuse large B-cell lymphoma is the most common cancer of the lymphatic system, a network of vessels that transport fluid (lymph) from tissues through the lymph nodes and into the bloodstream. The cancer affects a type of white blood cell called B lymphocytes, or B cells. In patients with this cancer, the B cells multiply too quickly and live for too long, so there are too many of them in the lymph nodes. The first sign of the disease is usually a lump in the neck, under the arm or in the groin area, which is caused by an enlarged lymph node. Patients with diffuse large B-cell lymphoma may also have fever, tiredness, night sweats or weight loss that have no obvious cause.
Although some people with diffuse large B-cell lymphoma can be cured, it remains a serious and life-threatening disease, particularly when the disease is diagnosed late or has come back after initial treatment.
At the time of designation, diffuse large B-cell lymphoma affected approximately 2.4 in 10,000 people in the European Union (EU). This was equivalent to a total of around 123,000 people*, and is below the ceiling for orphan designation, which is 5 people in 10,000. This is based on the information provided by the sponsor and the knowledge of the Committee for Orphan Medicinal Products (COMP).
*Disclaimer: For the purpose of the designation, the number of patients affected by the condition is estimated and assessed on the basis of data from the European Union (EU 28), Norway, Iceland and Liechtenstein. This represents a population of 511,100,000 (Eurostat 2014).
At the time of designation, several medicines were authorised for the treatment of diffuse large B-cell lymphoma in the EU. The main treatment was chemotherapy (medicines to treat cancer), sometimes in combination with radiotherapy (treatment with radiation), and immunotherapy (medicines that stimulate the immune system to kill the cancer cells. Autologous haematopoietic (blood) stem cell transplantation was also used in patients at risk of the disease coming back after treatment. This is a complex procedure where patients receive their own stem cells to help restore the bone marrow.
The sponsor has provided sufficient information to show that the medicine might be of significant benefit for patients with diffuse large B-cell lymphoma because early studies show a positive response in patients with progressive disease in whom other treatments did not work. This assumption will need to be confirmed at the time of marketing authorisation, in order to maintain the orphan status.
The abnormal B cells in patients with diffuse large B-cell lymphoma produce a protein on their surface called CD19.
This medicine is made up of immune cells (called T cells) which are taken from the patient and modified in the laboratory with a virus that carries a gene into the T cells so that they can recognise and attach to CD19. The T cells are then given back to the patient, where they are expected to attach to CD19 on the cancer cells and kill them, and to activate other T cells.
The type of virus used in this medicine ('retrovirus') is modified in order not to cause disease in humans.
The effects of the medicine have been evaluated in experimental models.
At the time of submission of the application for orphan designation, clinical trials with the medicine in patients with diffuse large B-cell lymphoma were ongoing.
At the time of submission, the medicine was not authorised anywhere in the EU for diffuse large B-cell lymphoma. Orphan designation of the medicine had been granted in the United States for this condition.
In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 13 November 2014 recommending the granting of this designation.
Designated orphan medicinal products are products that are still under investigation and are considered for orphan designation on the basis of potential activity. An orphan designation is not a marketing authorisation. As a consequence, demonstration of quality, safety and efficacy is necessary before a product can be granted a marketing authorisation.
Kite Pharma EU B.V.
Tufsteen 1
2132 NT Hoofddorp
Noord-Holland
The Netherlands
Tel. +31 2023 52630
E-mail: regulatory@kitepharma.com
The Committee for Orphan Medicinal Products reviewed the orphan designation of Yescarta at the time of marketing authorisation, and confirmed that the orphan designation should be maintained.
More information is available in the Yescarta : EPAR - Orphan Maintenance Assessment Report (post-authorisation).
| Date | Update |
|---|---|
| September 2021 | The sponsor's address was updated. |
| April 2017 | The sponsorship was transferred to Kite Pharma EU B.V., Netherlands. |
EMA publishes information on orphan medicinal product designation adopted by the Committee for Orphan Medicinal Products (COMP) on the IRIS online platform:
For contact details of patients’ organisations whose activities are targeted at rare diseases, see:
European Organisation for Rare Diseases (EURORDIS), a non-governmental alliance of patient organisations and individuals active in the field of rare diseases.
Orphanet, a database containing information on rare diseases, which includes a directory of patients’ organisations registered in Europe.
The list of medicines that have received an orphan designation in the EU is available on the European Commission's website: