Mozobil for Stem Cell Circulation Increase

yorkere

New member
This drug is now already being used in clinical practice; it apparently provides for increase in stem cell population within the bone marrow & then released into the bloodstream...

Has anyone else heard of this?

Since it is already approved, I suppose that it could be used for off-label application, right?

Robert

NDA Filed for Mozobil

Genzyme Files Applications for Approval of Mozobil in the United States and Europe

CAMBRIDGE, Mass., June 17, 2008 /PRNewswire-FirstCall/ -- Genzyme Corporation announced today that it has submitted marketing applications in both the United States and the European Union for Mozobil (plerixafor), a product candidate intended to enhance mobilization of hematopoietic stem cells for collection and subsequent autologous transplantation in patients with lymphoma and multiple myeloma. The company has requested priority review of its U.S. application and, if granted, Mozobil could be approved by the end of this year. European approval is expected in 2009. Additional global applications in up to 60 countries are expected to follow.
Important Clinical Role

Mozobil is designed to mobilize stem cells from the bone marrow into the bloodstream where they can be collected, making it more likely for a patient with certain types of cancers to receive a successful transplant. Specifically, patients with non-Hodgkin's and Hodgkin's lymphomas and multiple myeloma often receive high-dose chemotherapy, a process that destroys bone marrow. A stem cell transplant is required to replenish blood-forming bone marrow cells destroyed by high-dose chemotherapy. Stem cells differentiate into the mature red blood cells, white blood cells, and platelets that a healthy person needs.

Currently, before a transplant can take place, patients may receive a prescribed dose of chemotherapy and/or other drugs, called growth factors, to help mobilize their hematopoietic stem cells into the bloodstream. Once the cells are released into the bloodstream, they are easier to collect in preparation for a transplant.

In order for the transplant to take place, a minimum number of approximately 2 million cells per kilogram of body weight must be collected. For many patients, this process can take three or four hours over multiple days to complete. Even then, some patients are not able to mobilize enough cells, and a transplant is not possible.

Genzyme conducted two phase 3 studies that confirmed the potential of Mozobil to effectively and predictably prepare lymphoma and multiple myeloma patients for an autologous transplant. Both studies successfully met primary and secondary endpoints. Patients who received Mozobil in conjunction with a growth factor achieved more rapid and effective mobilization of stem cells in preparation for autologous transplant than patients treated with growth factor alone. In addition, more patients treated with Mozobil plus a growth factor achieved a composite endpoint of optimal stem cell collection and successful transplantation, compared to patients mobilized with placebo plus a growth factor. Mozobil was well tolerated in both trials, with the most common adverse events being gastrointestinal effects and injection site reactions.

"There is a lot of excitement among treating physicians about Mozobil," said Mark Goldberg, M.D., senior vice president of clinical research at Genzyme. "The product has great potential to meet an important, unmet medical need and has numerous potential benefits for patients."

More than 900 patients have received Mozobil through a compassionate use program in the United States, and similar compassionate use programs have recently begun in Europe.
Commercialization Plans

Genzyme plans to launch Mozobil in the U.S. and Europe in 2009. Upon commercial launch, Mozobil will be marketed and sold by Genzyme's existing Transplant sales force, which has a commercial presence in more than 55 countries worldwide. In addition, the company will leverage its Oncology business and clinical infrastructure.

Approximately 55,000 stem cell transplants are performed each year for multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma, and other conditions in markets where Genzyme has a commercial infrastructure, including the United States, Europe, Latin America and the Asian Pacific countries. Genzyme believes that over time, Mozobil will be used in the majority of these procedures, and peak sales of the product in the transplant setting are expected to reach $400 million annually.

In addition to the patient benefit, Mozobil also may offer significant economic benefits for transplant centers. Mozobil has the potential to decrease the number of apheresis days and provide transplant centers with more predictable and efficient use of the apheresis center, while reducing the number of patients who may fail to mobilize sufficient numbers of cells and therefore require a second mobilization procedure.
Additional Therapeutic Opportunities

Numerous Genzyme and investigator-sponsored trials are planned or underway to study Mozobil's use in other settings such as allogeneic hematopoietic stem cell transplants. Genzyme is also studying the use of Mozobil to improve the efficacy of chemotherapy and/or immunotherapy in various types of hematologic malignancies such as chronic lymphocytic leukemia and acute myelogenous leukemia, and is pursuing preclinical work to explore the role that Mozobil may play in cord blood transplantation, solid organ transplantation, cardiovascular disease, renal ischemic disease, and a variety of additional types of solid tumor malignancies.

"We're just beginning to unlock the potential of Mozobil," said Joseph Lobacki, senior vice president of the Transplant business unit at Genzyme.
About Mozobil

Mozobil, a novel small molecule CXCR4 chemokine receptor antagonist, has been shown in multiple earlier studies to rapidly and effectively increase the number of stem cells in circulation in the blood. Once circulating in the blood, stem cells can be collected for use in a stem cell transplant. Mozobil has been granted orphan drug status in the United States and European Union and the pivotal trials have undergone Special Protocol Assessment by the FDA and Protocol Assistance by the EMEA. Genzyme has been developing Mozobil since its acquisition of AnorMED, Inc. in 2006.
 

barbara

Pioneer Founding member
One would think so. I am going to submit this to the host of Ask the Doctor this month and see what he has to say about this product. Sounds very promising for some uses.
 

yorkere

New member
The really interesting aspect to this is the increase in stem cell circulating population en vivo vice ex vivo...this would avoid the FDA trying to insist that use of the cells for specific application to a site of interest constitutes use of a new, unapproved DRUG!

Robert
 

barbara

Pioneer Founding member
Stemtrition also mobilizes stem cells en vivo. What happens after that (ex vivo) is where the FDA has decided to get involved. Mozobil evidently encourages increases in the marrow, Stemtrition releases stem cells from the connective tissue and some from the marrow as well. In some cases, this is enough to help relieve or eliminate the condition, but in people with severe chronic disease or injuries, a stem cell transplant (s) is more than likely needed as well.
 

yorkere

New member
Mozobil

At any rate, this injectable drug represents very promising and profound possibilities. It was apparently approved back in 2008....I suspect not too much is known about long-term repeat use. I suppose the cells are Mesenchymal...

What would the Stem Cell Consultant have to say about this?

Robert
 

Jeannine

Pioneer Founding member
I've been taking IGF-1 recently and it does contain VEGF. I do notice that I feel much better when taking it. Yesterday I went to the doctor for a regular checkup and his office is down a very long hallway and I usally have to stop after climbing the stairs before the hallway. Yesterday was the firt time I didn't have to stop. The biggest problem with IGF-1 is the price. The lower dosage ones don't really do much and the higher dosage ones cvost at least $85 per month.

I am looking into a possible distributorship to try and get it cheaper and offier it on our Seachange Website.
 

barbara

Pioneer Founding member
Robert - I asked the Consultant per your request. Here is his answer:


Mozobil has speific effects on certain types of stem cells, i.e., the particular stem cells that form blood cells, as quoted in their advertisement:

"This drug is now already being used in clinical practice; it apparently provides for increase in stem cell population within the bone marrow & then released into the bloodstream... Mozobil is intended to enhance mobilization of hematopoietic stem cells into the blood stream"
I suspect the drug is very similar to GM-CSF in its ability to mobilize hematopoietic stem cells into the blood stream. Howeveer, hematopoietic stem cells have basically a single purpose - to make hematopoietic cells, i.e., blood cells. It will NOT form other type of cells, except maybe some types of endothelial cells.
Therefore, if you want more blood cells circulating in your system - that is good, especially for the uses it was designed - for patients with lymphoma and multiple myeloma.

Any other use of Mozobil to mobilize other types of stem cells for mesodermal tissues, ectodermal tissues or endodernal repair is out of the question.

His reply about VEGF:

Same drug as Robert mentioned: Mobolize for hematopoietic stem cells and VEGF for eondohelial cells (NOT epithelial cells) that form the lining for blood vessels. VEGF has been well known for its activity for a relatively long time.

They are still going after what I would call progenitor cells, i.e., cells committed to a specific end cell type. This is in contrast to the stem cells that are not committed to any particular cell type.

In this way, Stemtrition is unique in its properties for stimulating the human stem cells for COPD repair as well as those for Parkinson's and Alzheimer's repair among other conditions.
 

yorkere

New member
Mozobil

Well, it looks like my bubble has just been busted; for a short while I was happily excited, which was probably good for my own circulation...looking forward to the next item I can come across to boost it even more...

Jeannine, where in the world have you been able to obtain Insulin-like Growth Factor 1 (IGF-1)!? It indeed has been synthesized, & is very, very hard to get, due to it being very tightly controlled. The genuine product is also hugely expensive. Can you provide some details?

Would you believe that the reason it is so strongly controlled is because of the fear/concern that ATHLETES would grab hold of it due to it's anabolic characteristics! Honest to God, that's the reason it is just about impossible to obtain... Better that thousands of people languish with one monstrous ailment or another than run the risk that some competitive athlete gain an "unfair" edge by using this stuff...

Sorry; I'm on my soapbox again...

Robert
 
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