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Drug Safety-related Labeling Changes (SrLC)

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IMJUDO (BLA-761289)

(TREMELIMUMAB-ACTL )

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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07/24/2024 (SUPPL-6)

8 Use in Specific Populations

8.4 Pediatric Use

Additions and revisions underlined:

The safety and effectiveness of IMJUDO have not been established in pediatric patients. Safety and efficacy were assessed but not established in a multi-center, open-label study (NCT03837899) in which 41 pediatric patients aged 1 to < 17 years with advanced solid tumors received IMJUDO in combination with durvalumab. No new safety signals were observed in pediatric patients in this study.

Tremelimumab-actl systemic exposure in pediatric patients ? 35 kg was within the range of the values previously observed in adults given the same weight-based dose, whereas the systemic exposure in pediatric patients < 35 kg was lower than that of adults.

01/25/2024 (SUPPL-4)

Approved Drug Label (PDF)

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/or revisions underlined:

 

Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including:

Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with IMJUDO. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include:

  • tingling, numbness or weakness of the arms or legs

  • persistent or severe muscle pain or weakness, muscle cramps, joint pain, joint stiffness or swelling

06/14/2023 (SUPPL-2)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Severe and Fatal Immune-Mediated Adverse Reactions

Extensive changes; please refer to label for complete information

5.2 Infusion- Related Reactions

Additions and/or revisions underlined:

IMJUDO with Durvalumab

Infusion-related reactions occurred in 10 (2.6%) patients receiving IMJUDO in combination with durvalumab.

IMJUDO with Durvalumab and Platinum-Based Chemotherapy

Infusion-related reactions occurred in 2.9% (17/596) of patients receiving IMJUDO in combination with durvalumab and platinum-based chemotherapy, including Grade 3 (0.3%) adverse reactions.

6 Adverse Reactions

6.1 Clinical Trials Experience

Extensive changes; please refer to label for complete information

8 Use in Specific Populations

8.1 Pregnancy

Additions and/or revisions underlined:

Animal Data

In a reproduction study, administration of tremelimumab-actl to pregnant cynomolgus monkeys during the period of organogenesis was not associated with maternal toxicity or effects on embryo-fetal development at exposure levels approximately 4 to 31-times higher than those observed at a recommended dose range of 75 mg to 300 mg based on area under the curve (AUC). CTLA-4 plays a role in maintaining maternal immune tolerance to the fetus to preserve pregnancy and in immune regulation of the newborn.

8.5 Geriatric Use

Additions and/or revisions underlined:

Of the 330 patients with metastatic NSCLC treated with IMJUDO in combination with durvalumab and platinum-based chemotherapy, 143 (43%) patients were 65 years or older and 35 (11%) patients were 75 years or older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/or revisions underlined:

What is IMJUDO?

IMJUDO is a prescription medicine used to treat adults with:

  • a type of liver cancer called unresectable hepatocellular carcinoma (uHCC). IMJUDO may be used in combination with durvalumab when your uHCC cannot be removed by surgery.

  • a type of lung cancer called non-small cell lung cancer (NSCLC). IMJUDO may be used in combination with durvalumab and chemotherapy that contains platinum when your NSCLC:

    • has spread to other parts of your body (metastatic), and

    • your tumor does not have an abnormal “EGFR” or “ALK” gene.

How will I receive IMJUDO?

  • Your healthcare provider will determine your treatment schedule and cycles of treatment.

  • Your healthcare provider will give you IMJUDO into your vein through an intravenous (IV) line over 60 minutes.

  • For the treatment of uHCC:

    • On the same day you receive IMJUDO, you will receive durvalumab through an intravenous (IV) line over 60 minutes.

    • IMJUDO is given to you as a single dose.

    • You will then receive durvalumab every 4 weeks

  • For the treatment of NSCLC:

    • On the same day you receive IMJUDO, you will receive durvalumab followed by platinum-containing chemotherapy. You will receive combination chemotherapy every 3 weeks for four cycles (Cycle 1 to 4).

    • You will then receive durvalumab for one cycle (Cycle 5), and then IMJUDO in combination with durvalumab for one cycle only (Cycle 6).

    • You will then receive durvalumab every 4 weeks.

    • Your healthcare provider will decide if you will also receive additional chemotherapy with each cycle.

What are the possible side effects of IMJUDO?

The most common side effects of IMJUDO when used in combination with durvalumab in adults with uHCC include:

  • rash      

  • itchiness

  • diarrhea

  • muscle or bone pain

  • feeling tired      

  • stomach area (abdominal) pain

The most common side effects of IMJUDO when used in combination with durvalumab and platinum-containing chemotherapy in adults with metastatic NSCLC include:

  • nausea   

  • decreased appetite

  • feeling tired or weak   

  • rash

  • muscle or bone pain     

  • diarrhea