CURRENT APPROACH TO DEVELOPMENT OF BIOSIMILAR PRODUCTS CONTAINING MONOCLONAL ANTIBODIES AS AN ACTIVE SUBSTANCE – NON-CLINICAL AND CLINICAL STUDIES OF THE FIRST RUSSIAN RITUXIMAB BIOSIMILAR, ACELLBIA®

Objective. Evaluation of pharmacokinetics, pharmacodynamics, safety and efficacy of rituximab biosimilar (Acellbia,  BIOCAD, Russia) used as  monotherapy in patients with indolent B-cell non-Hodgkin’s lymphoma in comparison with the parameters of innovator rituximab – MabThera.Materials and methods. 92 patients (aged 18 years and older with diagnosed CD20-positive follicular non-Hodgkin’s lymphoma, stage II-IV by Ann Arbor, 1-2 histologic grade, or marginal zone lymphoma) were enrolled into the study. Patients were randomised in 1:1 ratio to receive 375 mg/sq.m of Acellbia or MabThera on days 1, 8, 15 and 22.Results. Overall response rate in both arms was equivalent: 39.52% in BCD-020 arm and 36.57% of patients in RTX arm (p=0.8250). Within the first week after a single infusion of Acellbia or MabThera, the level of  CD19 and CD20-positive cells rapidly decreased to almost undetectable values without any obvious recovery by the end of observation (upon intergroup comparison p>0.05 at all specified time points). 90% CI for the geometric mean of a Acellbia/MabThera  AUC0-t ratio fell within standard bioequivalence range 80-125% (80.1-118.2% for the ratio of AUC0-168 after a single dose). Within the whole study period  the frequency of AEs, including severe AEs (grade 3-4), associated with the use of monotherapy, were equal in both arms without any significant differences. Conclusions. Acellbia is non-inferior to MabThera in terms of efficacy, pharmacokinetics, pharmacodynamics and immunogenicity. Acellbia was well tolerated, with the safety profile comparable with MabThera’s parameters

Management of chronic lymphocytic leukemia (CLL) in the elderly: a position paper from an international Society of Geriatric Oncology (SIOG) Task Force

Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is> 70 years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living and social support. Comorbidity scoring and geriatric assessment tools are helpful in achieving such multidimensional evaluation in a systematic manner. The introduction of new drugs including novel monoclonal antibodies and kinase inhibitors offers enhanced opportunities for the treatment of elderly patients with CLL. This position paper of a Task Force of the International Society of Geriatric Oncology (SIOG) reviews currently available evidence relevant to such patients. All types of elderly patient (i. e. chronological age> 65-70 years) are considered, from robust (fit) to vulnerable (unfit) to the terminally ill. Among the topics covered are the following: (i) the relationship between chronological age, prognosis and survival, (ii) assessment of biological aging, (iii) biological age as a determinant of treatment feasibility and tolerance and (iv) tailoring of both first and further-line treatment to the circumstances of the individual patient