By Diagnostics World Staff
August 2, 2016 | Foundation Medicine announced that the U.S. Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS) have accepted FoundationOne for Parallel Review as an innovative technology most likely to benefit from the efficiencies of this program. The FDA also accepted Foundation Medicine’s request for review as part of its Expedited Access Pathway (EAP) for breakthrough devices.
If approved, FoundationOne could be the first FDA-approved comprehensive genomic profiling (CGP) assay to incorporate multiple companion diagnostics (CDx) to support precision medicine in oncology, including an indication for use as a companion diagnostic across a diverse range of solid tumors. Importantly, obtaining a Medicare National Coverage Determination (NCD) from CMS concurrently with FDA approval will allow FoundationOne to be offered as a covered benefit under Medicare and avoid the significant time interval and uncertainty that often occurs between FDA approval and an NCD. Based on discussions with FDA and CMS, Foundation Medicine believes the Parallel Review will conclude in the second half of 2017.
“The acceptance of FoundationOne for EAP and Parallel Review is a significant advancement towards the achievement of precision medicine, enhancing patient access to targeted therapies and clinical trials,” said Michael Pellini, M.D., CEO of Foundation Medicine in the company’s statement. “While we proceed with FDA and CMS, we will continue our work with Palmetto GBA, our Medicare Administrative Contractor (MAC) in North Carolina and a recognized thought leader in molecular diagnostics. We will also continue our work with the MAC in Massachusetts, National Government Services (NGS). Specifically, we will work with Palmetto through its MolDx Program to expand coverage of well-validated CGP assays, such as FoundationOne, to include additional cancer indications beyond the existing local coverage determination (LCD), which currently covers a subset of patients with non-small cell lung cancer (NSCLC). Pursuing avenues at both the local and national levels maximizes the opportunity for Medicare beneficiaries with cancer to have access to FoundationOne.”
FoundationOne is a CGP assay for cancer that uniquely detects genomic alterations, including substitutions, insertions and deletions, copy number alterations and select gene rearrangements in 324 genes using DNA isolated from formalin-fixed paraffin-embedded tumor tissue specimens using next-generation sequencing and computational analysis. It is intended that FoundationOne, if approved, will be used to identify patients who may benefit from treatment for solid tumor malignancies in accordance with FDA approval. FoundationOne will also be intended to provide treating physicians with important information, including cancer related variants and molecular signatures to inform molecular eligibility for clinical trials or treatment management according to clinical care guidelines.
Dr. Pellini continued, “Beyond its application in cancer care, an FDA-approved FoundationOne incorporating multiple companion diagnostics would provide a significant and highly differentiated offering for our biopharma partners. We believe this approach, which is designed to expedite approval of additional biomarkers on FoundationOne, both accelerates and de-risks companion diagnostic approval for our biopharma partners seeking a coordinated regulatory strategy for therapeutic drug approval.”
Parallel Review provides for concurrent review of medical devices for FDA approval and a national coverage determination by CMS to facilitate patient access to innovative medical devices. The FDA granted Foundation Medicine’s request for EAP because it met the three criteria necessary for inclusion in the program, one of which is the large unmet need for comprehensive genomic profiling of tumors. Under the EAP, the FDA works with device sponsors to try to reduce the time and cost from development to an approval decision.