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Welcome back to the D.I.S.C.O., FDA’s Drug Information Soundcast in Clinical Oncology, Burst Edition, brought to you by FDA’s Division of Drug Information in partnership with FDA’s Oncology Center of Excellence. Today we have a quick update on another recent FDA cancer drug approval.

On August 25, 2021, FDA approved ivosidenib (brand name Tibsovo) for adult patients with previously treated, locally advanced or metastatic cholangiocarcinoma with an isocitrate dehydrogenase-1 mutation as detected by an FDA-approved test. Today, the FDA also approved the Oncomine Dx Target Test as a companion diagnostic device to aid in selecting patients with cholangiocarcinoma for treatment with ivosidenib.

Ivosidenib was investigated in a randomized 2:1, multicenter, double-blind, placebo-controlled clinical trial, and consisted of 185 adult patients with locally advanced or metastatic cholangiocarcinoma with an isocitrate dehydrogenase-1 mutation. The patient’s disease must have progressed following at least one, but not more than two prior regimens, including at least one gemcitabine- or 5-flurouracil-containing regimen. Patients were randomized to receive either ivosidenib 500 mg orally once daily or matched placebo until disease progression or unacceptable toxicity.

The primary efficacy endpoint was progression-free survival as determined by independent review committee according to RECIST 1.1. The trial demonstrated a statistically significant improvement in progression-free survival for patients randomized to ivosidenib. The analysis of overall survival was not significant; 70% of patients randomized to placebo had crossed over to receive ivosidenib after radiographic disease progression.

The most common adverse reactions reported in more than 15% of patients with cholangiocarcinoma were fatigue, nausea, abdominal pain, diarrhea, cough, decreased appetite, ascites, vomiting, anemia, and rash.

This review used the Assessment Aid from the applicant to facilitate the FDA’s assessment.

Full prescribing information for these approvals can be found on the web at www.fda.gov/drugsatFDA.

Health care professionals should report serious adverse events to FDA’s MedWatch Reporting Program at www.fda.gov/medwatch.

Follow the Division of Drug Information on Twitter @FDA_Drug_Info and the Oncology Center of Excellence @FDAOncology. Send your feedback via email to [email protected]. Thanks for tuning into the D.I.S.C.O. Burst Edition.