FDA Grants Orphan Drug Designation (ODD) to AlloVir’s Posoleucel, an Allogeneic, Off-the-Shelf, Multi-Virus Specific T-Cell Therapy, for the Treatment of Virus-Associated Hemorrhagic Cystitis
ODD for posoleucel adds to RMAT designation by FDA and OMP and PRIME designations by EMA
Phase 3 registrational study of posoleucel in virus-associated hemorrhagic cystitis is ongoing
An inflammatory disease of the bladder, virus-associated HC is a serious complication of hematopoietic stem cell transplantation (HSCT) that can significantly prolong hospitalization and increase mortality and for which there are currently no approved or effective antiviral treatment options. The company’s Phase 3 study of posoleucel for the treatment of virus-associated HC is ongoing and enrolling adult and pediatric patients following allogeneic HSCT (allo-HSCT).
“This Orphan Drug Designation acknowledges the urgent need for new treatment options for patients who have undergone hematopoietic stem cell transplantation and are at risk for developing viral infections and hemorrhagic cystitis,” said Ercem Atillasoy, M.D., Chief Regulatory and Safety Officer,
In addition to this ODD, posoleucel has been granted Regenerative Medicine Advanced Therapy (RMAT) designation from the FDA, and Orphan Medicinal Product (OMP) and PRIority MEdicines (PRIME) designations from the
ODD is granted by the FDA to drugs or biological products intended for the treatment of diseases or conditions that impact fewer than 200,000 people in the
About Virus-Associated Hemorrhagic Cystitis (HC)
Virus-associated HC is a well-described complication after HSCT in which a viral infection causes the bladder lining to become inflamed, resulting in hematuria, or blood in the urine. More than half of patients with HC experience clot formation and/or severe bladder hemorrhage with renal impairment. Bleeding may be life-threatening, requiring urologic interventions including cystectomy, or the removal of the urinary bladder.
Clinical manifestations of HC include kidney dysfunction or failure, blood in the urine and severe abdominal pain frequently requiring narcotics. With no approved or effective antiviral treatments, virus-associated HC is primarily managed with supportive care, including forced diuresis, continuous bladder irrigation, platelet transfusion and anti-spasmodics, in addition to urinary and opioid analgesics.
Newly published data1 demonstrate that patients with virus-associated HC had a 70% higher risk of mortality, and the viral disease was associated with significantly prolonged hospitalization, including increased intensive care unit stay and hospital readmission rates.
HC can be caused by several viruses, including AdV and CMV; however, up to 90% of HC cases are caused by BKV. HC is the primary clinical manifestation associated with BKV following HSCT, occurring in up to 25% of pediatric patients and up to 54% of adult patients.
About Posoleucel (Viralym-M, ALVR105)
AlloVir’s lead product, posoleucel, is in late-stage clinical development as an allogeneic, off-the-shelf, multi-virus specific T-cell therapy targeting six viral pathogens in immunocompromised individuals: BKV, CMV, AdV, EBV, HHV-6 and JCV. In the positive Phase 2, proof-of-concept CHARMS study, more than 90% of patients who failed conventional treatment and received posoleucel, demonstrated a complete or partial clinical response based on predefined criteria, most with complete elimination of detectable virus in the blood and resolution of major clinical symptoms.
About AlloVir’s Ongoing Clinical Studies with Posoleucel
- A Phase 3 (NCT04390113), multicenter, double-blind, placebo-controlled study to assess the efficacy and safety of posoleucel for the treatment of patients with virus-associated HC following allo-HSCT is open and recruiting patients.
- A proof-of-concept study (NCT04693637) targeting the prevention of clinically significant disease caused by BKV, CMV, AdV, EBV, HHV-6 and JCV in patients following allo-HSCT is open and recruiting patients. Approximately 90% of all allo-HSCT patients experience at least one infection associated with BKV, CMV, AdV, EBV or HHV-6, and more than 60% of these patients experience infections caused by two or more of these five viruses within 100 days post allo-HSCT. Data from the open-label phase of the study are anticipated before year-end.
- A Phase 2 proof-of-concept study (NCT04605484) for the preemptive treatment of BK viremia in adult kidney transplant recipients is also ongoing and recruiting patients. BK viremia, which is detected in up to 20% of kidney transplant patients, can lead to decreased kidney survival and a return to end-stage renal disease and dialysis.
For more information on clinical trials of posoleucel, visit www.clinicaltrials.gov.
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Economic and Clinical Burden of Virus-Associated Hemorrhagic Cystitis in Patients Following Allogeneic Hematopoietic Stem Cell Transplantation in
the United States; McGuirk, Joseph et al.; Transplantation and Cellular Therapy, Official Publication of the American Society for Transplantationand Cellular Therapy, Volume 27, Issue 6, 505.e1 - 505.e9; https://www.astctjournal.org/article/S2666-6367(21)00708-9/fulltext.