Thursday, January 23, 2025

Neurofibromatosis Treatment Progresses: FDA Grants Priority Review to Mirdametinib for NF1-Associated Plexiform Neurofibromas

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Key Takeaways

  • Mirdametinib has shown promising results in reducing tumor size and improving quality of life in patients with NF1-associated plexiform neurofibromas.
  • The FDA’s Priority Review highlights the urgent need for new treatments for NF1-PN, particularly in adults who currently have no approved therapies.
  • SpringWorks Therapeutics aims to bring mirdametinib to market by early 2025, offering new hope for patients suffering from this challenging condition.

Neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PN) represent a significant challenge for patients and healthcare providers alike, given the condition’s potential to cause severe morbidity and the current lack of effective treatments. With the FDA granting Priority Review to mirdametinib, an investigational MEK inhibitor developed by SpringWorks Therapeutics, there is renewed hope for those affected by this condition.

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The Food and Drug Administration (FDA) has granted Priority Review status to SpringWorks Therapeutics’ New Drug Application (NDA) for mirdametinib, an investigational MEK inhibitor aimed at treating neurofibromatosis type 1-associated plexiform neurofibromas in both adults and children. The NDA includes data from the Phase Ib ReNeu trial, which evaluated the safety and efficacy of mirdametinib in patients over two years old with NF1-associated plexiform neurofibromas, a condition that causes significant morbidity.

Mirdametinib Receives FDA Priority Review Following Promising Phase Ib ReNeu Trial Results

The Priority Review status is based on data from the Phase Ib ReNeu trial, a multi-center, open-label study that evaluated the efficacy, safety, and tolerability of mirdametinib in patients aged two years and older with inoperable neurofibromatosis. The study involved 114 patients who received mirdametinib at a dosage of 2 mg/m2 twice daily, administered orally in a three-week on, one-week off dosing schedule. The primary endpoint of the study was the confirmed objective response rate (ORR), defined by a reduction of at least 20% in target tumor volume, as assessed by MRI and reviewed by an independent central panel.

The results, presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, were promising. Mirdametinib treatment led to a robust ORR, deep and durable responses, and improvements in pain management and health-related quality of life. These benefits were observed across both adult and pediatric cohorts, highlighting the potential of mirdametinib as a transformative therapy for neurofibromatosis. The safety profile of the drug was also deemed manageable, further supporting its potential as a new standard of care.

Neurofibromatosis type 1 is a genetic disorder that affects approximately one in 3,000 people worldwide. Of those, 30% to 50% develop NF1-associated plexiform neurofibromas, which are benign tumors that can cause significant complications due to their proximity to vital organs. These tumors also carry a lifelong risk of malignant transformation, with an estimated 8% to 13% of patients developing malignancies. The need for effective treatments is therefore critical, particularly for adults who currently have no approved therapies.

Neurofibromatosis

Neurofibromatosis Treatment Advances as Mirdametinib Receives Key FDA Designations and Awaits 2025 Approval

Mirdametinib has already received multiple designations from regulatory bodies, including Orphan Drug status from both the FDA and European Commission, as well as Fast Track and rare pediatric disease designations from the FDA. The FDA has set a Prescription Drug User Fee Act (PDUFA) target action date of February 28, 2025, for the NDA review. Notably, there are no plans to hold an advisory committee meeting, indicating confidence in the data presented.

As SpringWorks Therapeutics progresses with the development of mirdametinib, the healthcare community and patients are closely watching the FDA’s review process. The possibility of mirdametinib’s approval represents a significant milestone in the treatment of neurofibromatosis-associated plexiform neurofibromas, a condition that currently has limited therapeutic options, particularly for adults. The Phase Ib ReNeu trial’s promising results have generated optimism, as mirdametinib could offer a new, effective treatment for this challenging condition, improving the quality of life for patients who have long faced significant morbidity.

If mirdametinib receives FDA approval, it could be a game-changer for individuals with neurofibromatosis, providing a much-needed therapeutic option and potentially setting a new standard in care for this patient population. The drug’s Priority Review status underscores the urgency of addressing this unmet medical need, and the focus now shifts to the final stages of the regulatory process. With the Prescription Drug User Fee Act (PDUFA) date set for February 28, 2025, there is hope that mirdametinib could soon be available to patients in the U.S. and Europe, offering a new ray of hope for those affected by this debilitating condition.

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Resource: Springworks, August 29, 2024


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