FDA Grants Accelerated Approval to Tudriqev Plus Nivolumab for Advanced Cutaneous Melanoma After Anti-PD-1 Therapy – Replimune

Replimune Group  announced that the FDA has granted accelerated approval for TudriqevTM (vusolimogene oderparepvec-wtpg), previously referred to as RP1, in combination with nivolumab for the treatment of adults with unresectable advanced cutaneous melanoma who experienced disease progression on an anti-PD-1 antibody-based regimen.
This indication is approved under accelerated approval based on objective response rate and duration of response. Continued approval for this indication may be contingent on verification of clinical benefit in a confirmatory trial(s).

The IGNYTE trial enrolled 140 patients with 91 patients with at least one non-injected lesion included in the efficacy-evaluable population. In this population, Tudriqev plus nivolumab achieved an objective response rate (ORR) of 24.2%, with a median duration of response of 14.1 months. Treatment was well tolerated with mostly mild-to-moderate adverse events. The patient population included patients with Stage 4 disease (80%), prior anti-PD-1 adjuvant treatment (13%), PD-L1 negative status (54%), lung (45%) and liver lesions (24%). The IGNYTE study data were published in the Journal of Clinical Oncology and are available here.

“This is a transformative moment for Replimune, marking years of pioneering research to bring Tudriqev to patients desperately in need of new treatment options for advanced melanoma. We are deeply grateful to the melanoma community, including patients and investigators who participated in the clinical trial, for their tremendous support of this approval. We also would like to thank the FDA for recognizing the urgency to get this therapy to patients. Replimune is now focused on critical activities to deliver Tudriqev to as many patients as possible.” – Sushil Patel, Ph.D., CEO of Replimune.

There are limited treatment options for advanced melanoma, and more than half of patients experience progression within six months of treatment on immune checkpoint inhibitors like anti-PD-1 therapy. These patients face a poor prognosis, with a median overall survival of less than one year following progression.

“Advanced melanoma patients have few options after anti-PD-1 therapy and face high morbidity and poor survival outcomes. With the approval of Tudriqev, we have a potent oncolytic immunotherapy that can be used in a broad population, including BRAF-naïve or pretreated, and adjuvant relapsed patients. Importantly, the therapy in combination with nivolumab drives immune activation with a favorable risk-benefit profile and can be injected into superficial and visceral lesions.” – Michael K. Wong, MD, PhD, primary investigator of the IGNYTE study and Former Physician in Chief and Professor of Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, NY.

“The approval of RP1 in combination with nivolumab is a meaningful step forward for patients with advanced melanoma who have failed to benefit from immunotherapy. Every year, more than 8,500 people die of melanoma in the U.S., and new treatment options are urgently needed.” – Sam Guild, President of AIM at Melanoma.

Tudriqev combined with nivolumab was well-tolerated. The most common (incidence ≥ 10%) adverse reactions in patients treated with Tudriqev combined with nivolumab were nausea, diarrhea, vomiting, constipation, decreased appetite, abdominal pain, fatigue, pyrexia, chills, injection site reaction, influenza like illness, infections, musculoskeletal pain, arthralgia, headache, dizziness, cough, dyspnea, rash, pruritic and hemorrhage. Most treatment-related adverse reactions were grade 1 and 2 and transient. There were no grade 4 or 5 common adverse events. See additional Important Safety Information below.

Tudriqev is administered via direct intratumor injection into superficial and deep and/or visceral lesions. For deep/visceral tumors, administration is guided by imaging technology. The recommended dose of Tudriqev is based on tumor size.

To verify the clinical benefit of Tudriqev, a confirmatory Phase 3 trial, IGNYTE-3, is ongoing and assessing Tudriqev in combination with nivolumab (NCT06264180). For additional information about the trial, please visit https://replimune.com/clinical-trials/ignyte-3/.

Replimune is committed to helping patients in the U.S. with advanced melanoma gain access to treatment with Tudriqev. Eligible patients who are prescribed Tudriqev will have access to ReplimuneConnect Plus, a comprehensive program offering information on access, reimbursement and financial support.