The U.S. Food and Drug Administration
recently approved Afinitor (everolimus), the first drug approved specifically
to treat non-cancerous kidney tumors (renal angiomyolipomas) not requiring
immediate surgery in patients with tuberous sclerosis complex (TSC).
TSC is a rare genetic
disease that causes the growth of various non-cancerous tumors in the brain,
kidney and other vital organs. It affects as many as 40,000 patients in the United States ,
with an estimated 70 to 80 percent developing kidney problems. TSC generally
causes multiple tumors in both kidneys that compress normal kidney tissues as
they increase in size, leading to kidney failure and bleeding.
Afinitor blocks the
uncontrolled activity of the mTOR kinase, which plays a critical role in the
development and growth of the various non-cancerous tumors occurring in
patients with TSC.
The FDA granted Afinitor
orphan drug designations to treat renal angiomyolipomas and a certain type of
brain tumor called subependymal giant cell astrocytoma (SEGA) in patients with
TSC in 2009. An orphan designation is given to a drug intended to treat a
disease or condition affecting fewer than 200,000 patients in the United States
and for which the drug, based on supporting data, has shown promise in the
treatment of the disease.
The drug’s application
was granted priority review, a designation given to drugs that offer major
advancements in treatment or provide a treatment where no adequate therapy
exists. FDA completed review of this application in four months.
The FDA has previously
approved Afinitor to treat patients with advanced renal cell carcinoma that has
progressed after treatment with other cancer therapies; SEGA associated with
TSC in patients who require treatment but are not candidates for surgical
removal of the tumor; and progressive neuroendocrine tumors located in the
pancreas that cannot be removed by surgery or that have spread to other parts
of the body.
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