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SCEMBLIX (NDA-215358)

(ASCIMINIB HYDROCHLORIDE)

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

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11/25/2025 (SUPPL-12)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Myelosuppression

Additions and/or revisions underlined:

. . .

Neutropenia occurred in 121 (22%) patients receiving SCEMBLIX, with Grade 3 and 4 neutropenia reported in 42 (8%) and 35 (6%) patients, respectively.

 . . .

Anemia occurred in 72 (13%) patients receiving SCEMBLIX, with Grade 3 anemia occurring in 23 (4%) patients. Among the patients with Grade 3 or 4 anemia, median time to first occurrence of events was 24 weeks (range, 0.1 to 207 weeks). SCEMBLIX was temporarily withheld in 3 (0.5%) patients due to anemia [see Adverse Reactions (6.1)].

. . .

 

5.2 Pancreatic Toxicity

Additions and/or revisions underlined:

. . .

SCEMBLIX was permanently discontinued in three (0.5%) patients, while it was temporarily withheld in 6 (1.1%) patients due to pancreatitis. Elevation of serum lipase and amylase occurred in 110 of 556 (20%) patients receiving SCEMBLIX, with Grade 3 and Grade 4 pancreatic enzyme elevations occurring in 41 (7%) and 11 (2%) patients, respectively.

. . .

 

5.3 Hypertension

Additions and/or revisions underlined:

Hypertension occurred in 98 of 556 (18%) patients receiving SCEMBLIX, with Grade 3 or 4 hypertension reported in 53 (10%) and 1 (0.2%) patients, respectively. Among the patients with Grade 3 or 4 hypertension, median time to first occurrence was 45 weeks (range, 0.1 to 365 weeks). SCEMBLIX was temporarily withheld in 5 (0.9%) patients due to hypertension [see Adverse Reactions (6.1)].

. . .

 

5.4 Hypersensitivity

Additions and/or revisions underlined:

Hypersensitivity occurred in 172 of 556 (31%) patients receiving SCEMBLIX, with Grade 3 or 4 hypersensitivity reported in 6 (1.1%) patients [see Adverse Reactions (6.1)].

. . .

 

5.5 Cardiovascular Toxicity

Additions and/or revisions underlined:

Cardiovascular toxicity (including ischemic cardiac and CNS conditions, arterial thrombotic and embolic conditions) and cardiac failure occurred in 65 (12%) and in 13 (2.3%) of 556 patients receiving SCEMBLIX, respectively [see Adverse Reactions (6.1)].

. . .

6 Adverse Reactions

6.1 Clinical Trials Experience

Extensive changes; please refer to label for complete information

10/02/2025 (SUPPL-10)

Approved Drug Label (PDF)

7 Drug Interactions

7.1 Effect of Other Drugs on SCEMBLIX

Additions and/or revisions underlined:

Strong CYP3A4 Inducers

Concomitant use of SCEMBLIX with strong CYP3A4 inducers decreases both the asciminib Cmax and AUC [see Clinical Pharmacology (12.3)].

7.2 Effect of SCEMBLIX on Other Drugs

Additions and/or revisions underlined:

Substrates of BCRP

Asciminib is a BCRP inhibitor. Concomitant use of SCEMBLIX may increase the plasma concentration of BCRP substrates [see Clinical Pharmacology (12.3)], which may increase the risk of adverse reactions associated with these substrates.

Avoid coadministration of SCEMBLIX at all recommended doses with rosuvastatin. Closely monitor for adverse reactions in patients treated with SCEMBLIX at all recommended doses with concomitant use of other BCRP substrates. Reduce the dosage of the other BCRP substrates as recommended in their Prescribing Information when used concomitantly with SCEMBLIX at all recommended doses.

10/29/2024 (SUPPL-8)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Myelosuppression

Additions and/or revisions underlined:

Thrombocytopenia, neutropenia, and anemia have occurred in patients receiving SCEMBLIX. Thrombocytopenia occurred in 156 of 556 (28%) patients receiving SCEMBLIX, with Grade 3 or 4 thrombocytopenia reported in 39 (7%) and 53 (10%) of patients, respectively. Among the patients with Grade 3 or 4 thrombocytopenia, median time to first occurrence of events was 6 weeks (range, 0.1 to 64 weeks). SCEMBLIX was permanently discontinued in 11 (2%) patients, while it was temporarily withheld in 70 (13%) patients due to thrombocytopenia.

Neutropenia occurred in 120 (22%) patients receiving SCEMBLIX, with Grade 3 and 4 neutropenia reported in 41 (7%) and 35 (6%) patients, respectively. Among the patients with Grade 3 or 4 neutropenia, median time to first occurrence of events was 7 weeks (range, 0.1 to 180 weeks). SCEMBLIX was permanently discontinued in 7 (1.3%) patients, while it was temporarily withheld in 52 (9%) patients due to neutropenia.

Anemia occurred in 70 (13%) patients receiving SCEMBLIX, with Grade 3 anemia occurring in 22 (4%) patients. Among the patients with Grade 3 or 4 anemia, median time to first occurrence of events was 22 weeks (range, 0.1 to 207 weeks). SCEMBLIX was temporarily withheld in 2 (0.4%) patients due to anemia [see Adverse Reactions (6.1)].

5.2 Pancreatic Toxicity

Additions and/or revisions underlined:

Pancreatitis occurred in 11 of 556 (2%) patients receiving SCEMBLIX, with Grade 3 pancreatitis occurring in 6 (1.1%) patients. SCEMBLIX was permanently discontinued in three (0.5%) patients, while it was temporarily withheld in 6 (1.1%) patients due to pancreatitis. Elevation of serum lipase and amylase occurred in 107 of 556 (19%) patients receiving SCEMBLIX, with Grade 3 and Grade 4 pancreatic enzyme elevations occurring in 41 (7%) and 11 (2%) patients, respectively. SCEMBLIX was permanently discontinued in 11 (2%) patients due to the elevation of serum lipase and amylase [see Adverse Reactions (6.1)].

5.3 Hypertension

Additions and/or revisions underlined:

Hypertension occurred in 90 of 556 (16%) patients receiving SCEMBLIX, with Grade 3 or 4 hypertension reported in 49 (9%) and 1 (0.2%) patients, respectively. Among the patients with Grade 3 or 4 hypertension, median time to first occurrence was 32 weeks (range, 0.1 to 365 weeks). SCEMBLIX was temporarily withheld in 5 (0.9%) patients due to hypertension [see Adverse Reactions (6.1)].

5.4 Hypersensitivity

Additions and/or revisions underlined:

Hypersensitivity occurred in 168 of 556 (30%) patients receiving SCEMBLIX, with Grade 3 or 4 hypersensitivity reported in 7 (1.3%) patients [see Adverse Reactions (6.1)]. Reactions included rash, edema, and bronchospasm.

5.5 Cardiovascular Toxicity

Additions and/or revisions underlined:

Cardiovascular toxicity (including ischemic cardiac and CNS conditions, arterial thrombotic and embolic conditions) and cardiac failure occurred in 60 (11%) and in 13 (2.3%) of 556 patients receiving SCEMBLIX, respectively [see Adverse Reactions (6.1)]. Grade 3 cardiovascular toxicity was reported in 14 (2.5%) patients, while Grade 3 cardiac failure was observed in 5 (0.9%) patients. Grade 4 cardiovascular toxicity occurred in 4 (0.7%) patients, with fatalities occurring in 4 (0.7%) patients. Grade 4 cardiac failure was reported in 1 (0.2%) patient with fatality occurring in 1 (0.2%) patient. Permanent discontinuation of SCEMBLIX occurred in 4 (0.7%) patients due to cardiovascular toxicity and in 1 (0.2%) patient due to cardiac failure, respectively. In the majority of patients, cardiovascular toxicity occurred in patients with preexisting cardiovascular conditions or risk factors, and/or prior exposure to multiple TKIs.

Arrhythmia, including QTc prolongation, occurred in 35 of 556 (6%) patients receiving SCEMBLIX, with Grade 3 or 4 arrhythmia reported in 10 (1.8%) and 2 (0.4%) patients, respectively. QTc prolongation occurred in 5 of 556 (0.9%) patients receiving SCEMBLIX, with Grade 3 QTc prolongation reported in 2 (0.4%) patients [see Adverse Reactions (6.1)].

6 Adverse Reactions

6.1 Clinical Trials Experience

Extensive changes; please refer to label for complete information

8 Use in Specific Populations

8.5 Geriatric Use

Additions and/or revisions underlined:

Among the 556 patients receiving SCEMBLIX in the ASC4FIRST, ASCEMBL and X2101 studies, 130 (23%) were 65 years of age and older and 31 (6%) were 75 years of age and older.

Overall, no differences in safety or efficacy of SCEMBLIX were observed between patients 65 years of age and older compared to younger patients.

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

PATIENT INFORMATION

What is SCEMBLIX?

SCEMBLIX is a prescription medicine used to treat adults with:

newly diagnosed or previously treated Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in chronic phase (CP).

11/08/2023 (SUPPL-4)

Approved Drug Label (PDF)

7 Drug Interactions

7.2 Effect of SCEMBLIX on Other Drugs

(Additions and/or revisions underlined)

Substrates of OATP1B or BCRP

Asciminib is an OATP1B and BCRP inhibitor. The effect of concomitant use of SCEMBLIX with OATP1B and BCRP substrates has not been established in clinical studies. However, based upon a mechanistic understanding of the elimination of asciminib and its in vitro inhibitory potential [see Clinical Pharmacology (12.3)], concomitant use of SCEMBLIX increases the Cmax and AUC of OATP1B and BCRP substrates, which may increase the risk of adverse reactions of these substrates.

Avoid coadministration of SCEMBLIX at all recommended doses with rosuvastatin and atorvastatin. Closely monitor for adverse reactions in patients treated with SCEMBLIX at all recommended doses with concomitant use of other OATP1B or BCRP substrates. Reduce the dosage of the other OATP1B or BCRP substrates as recommended in their Prescribing Information when used concomitantly with SCEMBLIX at all recommended doses.


06/26/2023 (SUPPL-3)

Approved Drug Label (PDF)

6 Adverse Reactions

6.1 Clinical Trials Experience

Additions and/or revisions underlined:

Clinically relevant adverse reactions in < 10% of patients treated with SCEMBLIX in X2101 included:

constipation, pancreatitis, pyrexia, dizziness, neuropathy peripheral, pneumonia, lower respiratory tract infection, dyspnea, pleural effusion, dry eye, vision blurred, arrhythmia, palpitations, cardiac failure congestive, decreased appetite, dyslipidemia, hypersensitivity, and urticaria.

10/12/2022 (SUPPL-1)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Myelosuppression

Additions and revisions underlined:

. . .

Neutropenia occurred in 69 (19%) patients receiving SCEMBLIX, with Grade 3 and 4 neutropenia reported in 26 (7%) and 30 (8%) patients, respectively. Among the patients with Grade 3 or 4 neutropenia, median time to first occurrence of events was 6 weeks (range, 0.1 to 180 weeks). Of the 69 patients with neutropenia, 4 (1.1%) patients permanently discontinued SCEMBLIX, while SCEMBLIX was temporarily withheld in 34 (10%) patients due to the adverse reaction.

Anemia occurred in 46 (13%) patients receiving SCEMBLIX, with Grade 3 anemia occurring in 19 (5%) patients. Among the patients with Grade 3 or 4 anemia, median time to first occurrence of events was 30 weeks (range, 0.4 to 207 weeks). Of the 46 patients with anemia, SCEMBLIX was temporarily withheld in 2 (0.6%) patients due to the adverse reaction [see Adverse Reactions (6.1)].

. . .

5.2 Pancreatic Toxicity

Additions and revisions underlined:

. . .

Of the 76 patients with pancreatic enzymes elevated, SCEMBLIX was permanently discontinued in 8 (2.2%) patients due to the adverse reaction [see Adverse Reactions (6.1)].

. . .

5.3 Hypertension

Additions and revisions underlined:

. . .

Hypertension occurred in 68 of 356 (19%) patients receiving SCEMBLIX, with Grade 3 or 4 hypertension reported in 32 (9%) and 1 (0.3%) patients, respectively. Among the patients with Grade 3 or 4 hypertension, median time to first occurrence was 14 weeks (range, 0.1 to 156 weeks). Of the 68 patients with hypertension, SCEMBLIX was temporarily withheld in 3 (0.8%) patients due to the adverse reaction [see Adverse Reactions (6.1)].

5.4 Hypersensitivity

Additions and revisions underlined:

. . .

Hypersensitivity occurred in 115 of 356 (32%) patients receiving SCEMBLIX, with Grade 3 or 4 hypersensitivity reported in 6 (1.7%) patients [see Adverse Reactions (6.1)].

. . .

5.5 Cardiovascular Toxicity

Additions and revisions underlined:

Cardiovascular toxicity (including ischemic cardiac and CNS conditions, arterial thrombotic and embolic conditions) and cardiac failure occurred in 46 (13%) and in 9 (2.5%) of 356 patients receiving SCEMBLIX, respectively [see Adverse Reactions (6.1)]. Grade 3 cardiovascular toxicity was reported in 12 (3.4%) patients, while Grade 3 cardiac failure was observed in 5 (1.4%) patients. Grade 4 cardiovascular toxicity occurred in 2 (0.6%) patients, with fatalities occurring in 3 (0.8%) patients. Permanent discontinuation of SCEMBLIX occurred in 3 (0.8%) patients due to cardiovascular toxicity and in 1 (0.3%) patient due to cardiac failure, respectively. Cardiovascular toxicity occurred in patients with pre-existing cardiovascular conditions or risk factors, and/or prior exposure to multiple TKIs.

Arrhythmia, including QTc prolongation, occurred in 24 of 356 (7%) patients receiving SCEMBLIX, with Grade 3 arrhythmia reported in 8 (2%) patients. QTc prolongation occurred in 3 of 356 (0.8%) patients receiving SCEMBLIX, with Grade 3 QTc prolongation reported in 1 (0.3%) patient [see Adverse Reactions (6.1)].

. . .

6 Adverse Reactions

6.1 Clinical Trials Experience

Extensive changes; please refer to label

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

PATIENT COUNSELING INFORMATION

Newly added information:

Infertility

Advise females of reproductive potential of the potential for impaired fertility from SCEMBLIX [see Use in Specific Populations (8.3), Nonclinical Toxicology (13.1)].

PATIENT INFORMATION

Additions and revisions underlined:

The most common side effects of SCEMBLIX include:

• nose, throat, or sinus (upper respiratory tract) infections

• muscle, bone, or joint pain

headache

• tiredness

• nausea

• rash

• diarrhea

• decreased blood platelet counts, white blood cell counts, and red blood cell counts

• increased blood fat (triglycerides) levels

• increased blood creatine kinase levels

• increased blood liver enzyme levels

• increased blood pancreas enzyme (amylase and lipase) levels

• increased blood uric acid levels