Overview

On 16 November 2016, Gedeon Richter Plc officially notified the Committee for Medicinal Products for Human Use (CHMP) that it wishes to withdraw its application for a marketing authorisation for Cavoley, for reducing neutropenia.

Cavoley is a medicine that contains the active substance pegfilgrastim, which stimulates the production of neutrophils (a type of white blood cell that fights infections). It was to be available as a solution for injection under the skin.

Cavoley was developed as a 'biosimilar' medicine. This means that Cavoley was intended to be highly similar to a biological medicine (the 'reference medicine') already authorised in the European Union called Neulasta.

Cavoley was to be used in cancer patients to reduce neutropenia (low levels of neutrophils). Neutropenia is a side effect of certain cytotoxic (cell-killing) cancer treatments because the treatments also kill white blood cells. Cavoley was to be used to reduce the duration of neutropenia and the occurrence of febrile neutropenia (neutropenia with fever).

The active substance in Cavoley, pegfilgrastim, consists of filgrastim that has been 'pegylated' (attached to a chemical called polyethylene glycol). Filgrastim is very similar to a human protein called granulocyte-colony-stimulating factor (G-CSF). It encourages the bone marrow to produce more neutrophils and improves the patient's ability to fight off infections.

Because filgrastim is pegylated, its removal from the body is slowed down, allowing the medicine to be given less often.

The company presented results of studies in healthy people designed to show that Cavoley is highly similar to its reference medicine Neulasta in terms of chemical structure, purity, the way it works and how the body handles the medicine. A further study in patients receiving cancer medicines compared the safety and effectiveness of Cavoley and Neulasta.

The application was withdrawn after the CHMP had evaluated the documentation provided by the company and formulated lists of questions. After the CHMP had assessed the company's responses to the last round of questions, there were still some unresolved issues.

Based on the review of the data and the company's response to the CHMP list of questions, at the time of the withdrawal, the CHMP had some concerns and was of the provisional opinion that Cavoley could not have been approved for reducing neutropenia. The CHMP was concerned that study results had not shown that Cavoley was handled by the body in the same way as the reference medicine Neulasta.

Therefore, at the time of the withdrawal, the CHMP was of the opinion that the company had not demonstrated that Cavoley is highly similar to Neulasta.

In its letter notifying the Agency of the withdrawal of the application, the company stated that having considered the CHMP's conclusion, it has decided to withdraw the application but to continue developing the product and follow the CHMP's advice to eliminate the remaining uncertainty.

The company informed the CHMP that there are no ongoing clinical trials or compassionate-use programmes for Cavoley.

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Key facts

Name of medicine
Cavoley
Active substance
pegfilgrastim
International non-proprietary name (INN) or common name
pegfilgrastim
Therapeutic area (MeSH)
Neutropenia
Anatomical therapeutic chemical (ATC) code
L03AA13
EMA product number
EMEA/H/C/004342
Marketing authorisation applicant
STADA Arzneimittel AG
Withdrawal of application
16/11/2016

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