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Qinlock
Sponsor
Device/Product name
Qinlock
Active Ingredient
Ripretinib
Date of decision
Published
Submission type
New chemical entity
ATC codes
Not yet assigned
Decision
Approved
What was the decision based on
The decision was based on quality (chemistry and manufacturing), nonclinical (pharmacology and toxicology), clinical (pharmacology, safety and efficacy) and risk management plan information submitted by the sponsor. The benefit-risk profile of Qinlock was considered favourable for the therapeutic use approved.
What steps were involved in the decision process
Registration timeline
The following table summarises the key steps and dates for this application.
This evaluation was facilitated through Project Orbis, an initiative of the United States (US) Food and Drug Administration (FDA) Oncology Center of Excellence (OCE). Under this project, the FDA, Health Canada (HC) and the TGA collaboratively reviewed the application. This innovative evaluation process provided a framework for process alignment and management of evaluation issues in real-time across jurisdictions.
Each regulator agency maintained its regulatory process to make independent decisions about the approval (market authorisation).
| Description | Date |
|---|---|
| Positive Designation Orphan Priority | 4 December 2019 4 December 2019 |
| Submission dossier accepted and first round evaluation commenced | 13 January 2020 |
| Evaluation completed | 24 June 2020 |
| Delegate's overall benefit-risk assessment | 22 June 2020 |
| Sponsor's pre-Advisory Committee response | Not applicable |
| Advisory Committee meeting | Not applicable |
| Registration decision (Outcome) | 10 July 2020 |
| Completion of administrative activities and registration on ARTG | 13 July 2020 |
| Number of working days from submission dossier acceptance to registration decision* | 123 |
*Target timeframe for priority applications is 150 working days from acceptance for evaluation to the decision
Date of entry onto ARTG
Original publication date
Black triangle scheme
Yes. This product will remain in the scheme for 5 years, starting on the date the product is first supplied in Australia
Dose forms
Tablet
Strength
50 mg
Other ingredients
Crospovidone; hypromellose acetate succinate; lactose monohydrate; magnesium stearate; microcrystalline cellulose; silicon dioxide
Containers
Bottle
Pack sizes
90 tablets
Routes of administration
Oral
Dosage
The recommended dosage of Qinlock is 150 mg (three 50 mg tablets) orally once daily with or without food until disease progression or unacceptable toxicity.
For further information refer to the Product Information.
Pregnancy category
DDrugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.The use of any medicine during pregnancy requires careful consideration of both risks and benefits by the treating health professional. This must not be used as the sole basis of decision making in the use of medicines during pregnancy. The TGA does not provide advice on the use of medicines in pregnancy for specific cases. More information is available from obstetric drug information services in your State or Territory.
What was approved
Qinlock (ripretinib) was approved for the following therapeutic use:
Qinlock is a kinase inhibitor indicated for the treatment of adult patients with advanced gastrointestinal stromal tumours (GIST) who have received prior treatment with 3 or more kinase inhibitors, including imatinib.
What is this medicine and how does it work
Ripretinib is a switch-control tyrosine kinase inhibitor with a dual mechanism of action. Ripretinib binds to both the switch pocket and the activation loop to lock the kinase in the inactive state, preventing downstream signalling and cell proliferation. This dual mechanism of action provides broad inhibition of KIT and platelet-derived growth factor receptor A (PDGFRA) kinase activity, including wild type and multiple primary and secondary mutations. Ripretinib also inhibits other kinases in vitro, such as platelet-derived growth factor receptor beta (PDGFRB), tunica interna endothelial cell kinase 2 (TIE2), vascular endothelial growth factor receptor-2 (VEGFR2), and BRAF.
What post-market commitments will the sponsor undertake
- Qinlock (ripretinib) is to be included in the Black Triangle Scheme. The Product Information (PI) and Consumer Medicines Information (CMI) for Qinlock must include the black triangle symbol and mandatory accompanying text for five years, which starts from the date that the sponsor notifies the TGA of supply of the product.
- The Qinlock Core-Risk Management Plan (RMP) (version 0.2, dated 22 May 2020, data lock point 31 May 2019), with Australian specific Annex (version 1.0, dated 16 January 2020), included with submission PM-2019-05961-1-4, and any subsequent revisions, as agreed with the TGA will be implemented in Australia.
An obligatory component of risk management plans is routine pharmacovigilance. Routine pharmacovigilance includes the submission of periodic safety update reports (PSURs).
Unless agreed separately between the supplier who is the recipient of the approval and the TGA, the first report must be submitted to the TGA no later than 15 calendar months after the date of the approval letter. The subsequent reports must be submitted no less frequently than annually from the date of the first submitted report until the period covered by such reports is not less than three years from the date of the approval letter.
The annual submission may be made up of two PSURs each covering six months. If the sponsor wishes, the six monthly reports may be submitted separately as they become available.
If the product is approved in the European Union (EU) during the three years period, reports can be provided in line with the published list of EU reference dates no less frequently than annually from the date of the first submitted report until the period covered by such reports is not less than three years from the date of the approval letter.
The reports are to at least meet the requirements for PSURs as described in the European Medicines Agency’s Guideline on Good Pharmacovigilance Practices (GVP) Module VII-periodic safety update report (Rev 1), Part VII.B Structures and processes.
Note that submission of a PSUR does not constitute an application to vary the registration. Each report must have been prepared within ninety calendar days of the data lock point for that report.