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(guó)家藥品監(jiān)督管理局藥品審評(píng)中心(以下簡(jiǎn)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(guó)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(guó)宮頸癌2022年新發(fā)病例約15萬(wàn),死亡人數(shù)約5.6萬(wàn)。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(shí)現(xiàn)根治,但約70%的局晚期宮頸癌患者在同步放化療后復(fù)發(fā),晚期轉(zhuǎn)移性(國(guó)際婦產(chǎn)科聯(lián)盟FIGO分期IVB期)或復(fù)發(fā)宮頸癌患者5年生存率不足20%。目前,針對(duì)復(fù)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(duì)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(dá),這類腫瘤具有浸潤(rùn)性強(qiáng)、無病生存期短、預(yù)后差等特點(diǎn),然而目前尚無針對(duì)HER2表達(dá)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(dá)的腫瘤細(xì)胞結(jié)合并內(nèi)吞,在腫瘤細(xì)胞溶酶體內(nèi)通過蛋白酶剪切釋放毒素,誘導(dǎo)細(xì)胞周期阻滯從而誘導(dǎo)腫瘤細(xì)胞凋亡。經(jīng)查詢,目前國(guó)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(guó)內(nèi)已進(jìn)口上市;Enhertu由阿斯利康和第一三共合作開發(fā),2023年國(guó)內(nèi)已進(jìn)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(guó)獲批上市。經(jīng)查詢EvaluatePharma數(shù)據(jù)庫(kù),2023年Kadcyla、Enhertu和愛地希全球銷售額合計(jì)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(xiàng)目累計(jì)研發(fā)投入約94,096萬(wàn)元。
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