`RESEARCH
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`APPLICATION NUMBER:
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`208700Orig1s000
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`ADMINISTRATIVE and CORRESPONDENCE
`DOCUMENTS
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`ACTION PACKAGE CHECKLIST
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`APPLICATION INFORMATION
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`NDA # 208700
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`BLA #
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`NDA Supplement #
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`If NDA, Efficacy Supplement Type;
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`(an action package is not requiredfor SE8 or SE9 supplements)
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`Proprietary Name: Lutathera
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`luletium Lu 177 dotatate
`Established/Proper Name:
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`Dosage Form: 370 MBq/mL (10 mCi/mL) in single-dose vial
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`Applicant: Advanced Accelerator Applications USA, Inc.
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`(AAA)
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`Agent for Applicant (if applicable):
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`RPM: Nataliya Fesenko
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`Division: DOP2
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`For ALL 505(h112] applications, two months prior to EVERY action:
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`[I 505090)
`NDA Application Type: E 505(b)(l)
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`Efficacy Supplement:
`El 50503)“) D ”WM” 0 Review the information in the 505(b)(2) Assessment and submit
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`the draft2 to CDER 0ND 10 for clearance.
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`0 Check Orange Book for newly listed patents and/0r
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`Efficacy Supplement.
`El 351(k) El 351(a)
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`I] No changes
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`Note: Ifpediatric exclusivity has been granted or the pediatric
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`information in the labeling ofthe listed drug changed, determine whether
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`pediatric information needs to be added to or deletedfrom the labeling of
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`Actions
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`0 User Fee Goal Date is
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`................................Estimates.£3_1:1§§__2__=..lasagna9.13.m.._Mr.;s____._._._..m_m._..".._s____ m.
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`Previous actions (specifiz type and datefor each action taken)
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`I] TA
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`DCR
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`E Lutathera has previously been
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`reviewed under the original NDA
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`04—27-16 under rolling review with
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`Priority Review Designation. FDA
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`issued a Complete Response issued
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`If accelerated approval or approval based on efficacy studies in animals, were promotional
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`Note: Promotional materials to be used within 120 days after approval must have been
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`submitted (for exceptions, see
`httpsi-‘wwwida.govtdownloads,®ru asiGuidanceComplijnceRgatulatorflnformation/Guida
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`noes: 1191069965.de . If not submitted, exlain
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`' The Application Information Section is (only) a checklist. The Contents of Action Package Section (beginning on page 2) lists .
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`the documents to be included in the Action Package.
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`2 For resubmissions, 505(b)(2) applications must be cleared before the action, but it is not necessary to resubmit the drafi 505(b)(2)
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`Assessment to CDER 0ND IO unless the Assessment has been substantively revised (e.g., new listed drug, patent certification
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`Answer all questions in all sections in relation to the pending application, i.e., if the pending application is anNDA or BLA
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`Supplement, then the questions should be answered in relation to that supplement, not in relation to the original NDA or BLA.
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`Version: 1206/”
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`NDA 208700
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`Page 2
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`[I Standard E Priority
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`Type 1: New Molecular Entity (confirmed with OPQ 1-23—2018)
`Chemical classification (new NDAs only):
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`(confirm chemical classification at time ofappraval)
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`E Fast Track granted 4/21/15 under IND 022719 El Rx-to-OTC full switch
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`Rolling Review (see comment below)
`El Rx—to-OTC partial switch
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`E Orphan drug designation
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`1:] Breakthrough Therapy designation
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`flVQTE: Set the submission property in DARRTS and notify the CDER Breakthrough Therapy Program Manager;
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`Refer to the “RPMBT Checklistfor Considerations afler Designation Granted”for other required actions: 3:; ”T Shari-spam!)
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`NDAS: Subpan H
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`I: Accelerated approval (21 CFR 314.510)
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`I] Restricted distribution (21 CFR 314.520)
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`Subpart 1
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`1:] Approval based on animal studies
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`I] Submitted in response to a PMR
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`[:I Submitted in response to a PMC
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`1:] Submitted in response to a Pediatric Written Request
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`BLAs: Subpart E
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`E] Accelerated approval‘(21 CFR 601.41)
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`I:I Restricted distribution (21 CFR 601.42)
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`Subpart H
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`I] Approval based on animal studies
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`REMS: El MedGuide
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`[:I MedGuide w/o REMS
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`IE REMS not required
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`Comments:
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`Under the original NDA, first review cycle, the NDA was granted a Priority Review Designation and was under Rolling Review.
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`This application is a Clan; 2 Resubmission (under 6 months review).
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`Is the product subject to official FDA lot release per 21 CFR 610.2
`“ BLAs only:
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`(approvals only)
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`E] FDA Talk Paper
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`13 Other
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`'30 Exclusivity
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`ls approval of this application blocked by any type of exclusivity (orphan, 5—year
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`El Yes
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`Patent Information:
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`Verify that form FDA-3542a was submitted for patents that claim the drug for
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`which approval is sought.
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`>11 Verified Form submitted
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`cycle. No form was submitted
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`E] Not applicable because drug is
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`NDA 208700
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`Page 3
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`CONTENTS OF ACTION PACKAGE
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`Officer/Employee List
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`‘2‘ List of officers/employees who participated in the decision to approve this application and E Included
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`Documentation of consent/non-consent by officers!employees (fink)
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`E Included
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`labeling issued 01-26-18
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`-Comp1ete Response letter without
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`labeling issued 12-19-16
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`4‘ Copies of all action letters (including approval letter with final labeling)
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`Labeling
`4° Package Insert (write submission/communication date at upper right offirstpage ofP1) —
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`K4
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`changes format, in response to
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`Ellififiiiéd
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`'3' Medication Guide/Patient Package Inserflnstrucdons for Use/Device Labeling (write
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`submisszon/commumcatton date at upper right offirstpage ofeach piece)
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`- Most-recent drafi labeling (fit is division-proposed labeling, it should be in
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`Labels (full color carton and immediate—container labels) (write
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`‘20 Proprietary Name
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`I Acceptability/‘non-acceptability letter(s) (indicate dare(s))
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`Proprietary Name Review
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`Uploaded 01-08-18
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`1st cycle:
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`Uploaded 5—26-16
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`04-05—16 IND 077219 Proprie :
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`NDA 1208700
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`‘2‘ Labeling reviews (indicate dates ofreviews}
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`RPM:
`1St Cycle: Review
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`uploaded 6-22-16
`DMEPA:
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`2mi cycle:
`01-22-18 TL concurrence 1-22—18
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`12-26-17 TL concurrence 12-26-
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`11—9-17 TL concurrence 11-13-17;
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`1“ cycle: Review uploaded 8-22-
`16 TL concurrence 8-22—16
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`DRISK: NIA
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`OPDP: 2le Review cycle: Review
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`uploaded 12-04—17
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`1" cycle: Pre-Decisional Consult
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`Memo uploaded 11-21-16
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`SEALD: E None
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`CSS: E None
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`Product Quality E None
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`Other: [I None DPMH review
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`uploaded 2.”1 cycle: 12-21- 17
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`cycle
`0:0 RPM Filing Review‘lMemc of Filing Meeting (indicate date ofeach review)
`'3‘ All NDA 505(b)(2) Actions: Date each action cleared by 505(b)(2) Clearance Committee X Not 3 09(2)
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`l £211:gigted 01 25 2018 (D0
`‘3' NDAs/NDA supplements only: Exclu31v1ty Summary (signed by Division Director)
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` _.:. Application integrity Policy (AI?) Status and Related Documents
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`llttpilwwu. fdagow’ICECi/EnforcemenL‘kctlonsi’ApplicantsnillteggtyPollcvrdefziult. him
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`0 Applicant'is on the AIP
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`This application is on the AIP
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`If yes, Center Director’s Exception for Review memo (indicate date)
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`If yes, 0C clearance for approval (indicate date ofclearance
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`El Not an AP action
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`‘9 Pediatrics (approvals only)
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`a Date reviewed by PeRC. If PeRC review not necessary, explain: This product in
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`this proposed indication was granted orphan drug designation on 5/211'15
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`esinationii0 -2710
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`CDER Medical Policy Council Breakthrough Therapy Designation
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`Determination Review Template(s) (l'ncfua‘e only the compfeted rempiaie(s) and
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`not the meetin minutes)
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`CDER Medical Policy Council Brief— Evaluating a Breakthrough Therapy
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`Designation for Rescission Tem - late(s)
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`4 Filing reviews for scientific disciplines are NOT required to be included in the action package.
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`NDA 208700
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`letter, Formal Dispute Resolution Request dccisional letters, etc.) (do not include
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`OPDP letters regarding pre—launch promotional maten'als as these are non-
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`disclosable; do not include Master File letters; do not include previous action letters,
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`as these are located elsewhere in package)
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`(completed CDER MPC templates can bejouad in DARRTS as clinical reviews or on
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`the fig-Elat- (L)
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`01-24-18 Clinical, DMEPA IR
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`1—24-18 FDA modified labeling to
`include additional revisions to P1
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`01-23-18 Clinical IR
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`1—22-18 FDA modified labeling to
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`include additional revisions to PI
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`1-19-18 FDA modified labeling to
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`include additional revisions to P1
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`1-17-18 Clinical, DMIP IR
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`1-12-18 FDA modified labeling to
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`1-10-18 Clinical (PMC) IR
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`1-5-18 Clinical (PMR) [R
`12-27-17 Clinical 1R
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`12-27-17 DMEPA (carton and
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`Container) [R
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`12-19-17 FDA modified labeling
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`12-18-17 Clinical (PMR/PMC
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`Communication)
`12-5-17 Clinical IR
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`11-17-17 DMEPA (Carton and
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`Container) IR
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`11-17-17 FDA modified labeling
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`to include additional revisions to
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`PI
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`11-16—17 Statistics [R
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`1 1—14-17 Clinical IR.
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`11-14-17 Acknowledge
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`11—13—17 Clinical Pharmacology
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`11-8-17 Clinical & Stat IR
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`1 1-7-17 Midcycle Communication,
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`letter uploaded 1—16-18
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`11—6-17 Midcycle Agenda
`10—27-17 Statistics IR
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`10-24-17 Statistics IR
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`10—23-17 (1) Clinical [R
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`10-23-17 (2) Clinical 1R
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`10-11-17 (1) Clinical IR
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`10-11-17 (2) Clinical IR
`10-10-17 Statistics IR
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`10—3-17 Clinical Pharmacology
`10-2-17 Clinical IR
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`9—28-17 Clinical IR
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`9—21-17 Clinical IR
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`9-20-17 Clinical IR
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`8-31-17 Clinical IR
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`8-25-17 Clinical Pharmacology IR
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`8-25— 1 7 Acknowledge Class '2
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`8-23-17 Clinical Pharmacology IR
`8-17-17 Statistics IR
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`8-14-17 Clinical IR
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`6-23-17 Stats IR, uploaded 6-26-
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`6-13-17 Clinical IR
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`6-7-17 Statistics 1R
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`Outgoing Communications under
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`2-10-17 Type A Meeting, Meeting
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`Minutes upioadm' 2-13-17
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`11-21-16 Discipline Review letter
`9-19-16 CMC IR
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`8-16-16 CMC IR
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`8—12-16 Clinical Pharmacology IR
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`8-2—16 Mid-Cycle
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`Connnunication, letter uploaded 8-
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`7-28-16 CMC IR
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`7-21-16 CMC IR
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`7-18—16 Clinical IR, uploaded 7—
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`7-13-16 OSI FfU IR
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`7-11-16 OSI IR
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`7-7-16 Clinical/Stats IR
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`7-7-16 Stats F/U 1R
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`7-5-16 Stats IR
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`6—30—16 General Correspondence
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`6-23-16 No Filing Issues Identified
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`Letter with Clinical Pharmacology
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`IR & Labeling Comments
`6-21-16 Stats/Clinical [R
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`6-10-16 Stats IR
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`6-9-16 Clinical IR
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`6-9—16 Stats FfU IR
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`6—6-16 Clinical Pharmacology IR
`6—3-16 Clinical/OSI IR
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`6—1-16 Stats IR
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`5-24-16 OSI IR
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`5-23-16 OSI IR
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`5-18-16 CMC IR sent via fax
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`5-17-16 Form 3542a IR
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`5—16-16 OSI IR
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`5-5—16 IRT/QT IR
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`5—2- 1 6 NBA Acknowledgement
`Letter
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`4-18- 16 Pre—sub
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`Acknowledgement Letter uploaded
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`01-18—1 8 TCON with Applicant
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`(PI revisions), minutes uploaded
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`1-10-18 Wrap—up Meeting,
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`01-03-13 Monthly Internal Team
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`Meetin_, minutes uploaded 01-1 7-
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`Internal documents: memoranda, telecons, emails, and other documents considered
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`important to include in the action package by the reviewing office/division (e.g.,
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`Regulatory Briefing minutes, Medical Policy Council meeting minutes)
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`12-18—17 Internal labeling meeting
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`11-13—17 Internal labeling meeting
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`#7, minutes uploaded 01-04-18
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`1 1-08-17 Internal labeling meeting
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`1 1-08-17 lntemal labeling meeting
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`1 1-08—17 Internal labeling meeting
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`#4, minutes uploaded 1-04-18
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`11-07—17 Internal labeling meeting
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`#3, minutes uploaded 11-0 7-1 7
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`1 1-06-17 Agenda for Mid—Cycle
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`Communication to Applicant
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`1 1-03-17 Labeling meeting,
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`minutes uploaded 11-07-1 7
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`10-30-17 Internal Midcycle
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`Summary Meeting, summary
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`minutes uploaded 11/21/17
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`10-] 1-17 Applicant TCO'N
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`internal minutes uploaded 01-04-
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`10—02-17 Internal Team Meeting
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`08-17-17 Planning meeting,
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`summary minutes uploaded 09-22—
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`11-21-16 OPDP Pre—Decisional
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`Consult Memo
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`1 1-20-16 DRISK Deferral Review
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`Memo
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`1 1—8-16 DPMH consult memo
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`10—26-16 TCON with Applicant—
`re CR, uploaded 10-2 7—16
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`10-23 - l 7 Internal Team Meeting
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`#2, minutes uploaded 1-} 6-18
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`10-21—16 TCQN with Applicant,
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`minutes uploaded 10-24—1 6
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`9-12—16 Delay in review
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`completion memo by CDTL
`8—1 8-16 DMIP consult review
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`memo
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`8-11-16 TCON with Applicant,
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`minutes uploaded 8—15—16
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`7-27—16 Internal Mid-Cycle
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`minutes uploaded 8—10—16
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`7-12-16 TCON with Applicant,
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`Isummary minutes uploaded 7—13-
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`6—30-1 6 TCON with Applicant,
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`summary minutes uploaded 7-6-16
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`6-23-16 Priority Review
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`NDA 208700
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`Designation Memo
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`6-8—16 Filing meeting, minutes
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`uploaded 6-1 0—16
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`5-17-16 Planning meeting,
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`summary minutes uploaded 5-18-
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`Minutes of Meetings
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`If not the first review cycle, any end-of—review meeting (indicate date ofmtg)
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`under IND 077219, minutes
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`u u loaded 3-] 7-16
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`Biogy-itddréamflfj7219; Sponsor:
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`m 3-2—16 (1“ cycle), October 30,
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`Not held
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`5-22—1 7 Type B Guidance under
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`5-18-17 Type C Guidance Written
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`responses Only under IND 077213
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`EOPZ meeting (indicate date ofmtg)
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`c Other mllestone meetmgs (e.g., EOP2a, BPD Iype 3, CMC focused milestone
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`meetings) (indicate dates ofmtgs)
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`2—15
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`‘1‘ Advisory Committee Meeting(s)
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`Decisions] and Summary Memos
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`multidisciplinary review on 12-19-
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`1"t cycle: DD signed DARRTS
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`2'1d cycle. CDTL signed
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`multidisciplinary review on 01-24-
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`1;, cycle: CDTL signed
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`multidisciplinary review on 12-16-
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`§_ESPN ’1 PMC uploaded 11%
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`1‘“ cycle: No separate review;
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`2‘“1 cycle: CDER, Division of
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`Clinical Review uploaded 10—6-17
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`Medial Imaging Products/ Clinical
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`'3' Controlled Substance Sniff review(s) and Scheduling Recommendation (indicate date of
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`2'“i Cycle: Review uploaded 12-8-
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`17; TL concurrence 12/10/17
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`1"t cycle: Review uploaded 11—20—
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`16; TL concurrence l 1—20716
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`1"1 cycle:
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`1-24-17 Letters to Investigators (2)
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` v 031 Clinical Inspection Review Smnmarflies) (include copies ofOSI letters to 2nd Review cycle:
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`inveS‘iga‘O’S)
`10-7—16 081 Summary Review
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`0:. Risk Management
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`REMS Documents and REMS Supporting Document (indicate date(s) of
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`REMS Memo(s) and letter(s) (indicate date(s))
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`Risk management review(s) and recommendations (including those by OSE and
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`CSS) (indicate date ofeach review and indicate location/date ifincorporated
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`into another review)
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`None
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`8—19-16 Letters to Investigators (2)
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`’or Part 3 combination products, all reviews from the reviewing Centefls) should be entered into the official archive (for further
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`instructions, see “Section 508 Compliant Documents: Process for Regulatory Project Managers” located in the CST electronic
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`repository).
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`NDA 208700
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`Page II
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` E No separate review
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`Clinical Microbiology .Review(s) (indicate datefor each review)
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`Biostatistics
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`El None
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`2'“d cycle: No separate review;
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`DARRTS memo signed 01—04-18.
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`Signed concurrence in
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`multidisciplinary review on 01-24-
`18
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` 0:0 Statistical Division Director Review(s) (indicate datefor each review) 1*t cycle: No separate review;
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`DARRTS memo signed 1 1-22-16.
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`Signed concurrence in
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`multidisciplinary review on
`12/ 1 611 6.
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` 1"t cycle: No separate review;
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`DARRTS memo signed 1 1-22-16.
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`Signed concurrence in
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`multidisciplinary review on 12-15-
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`2nd cycle: No separate review;
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`DARRTS memo signed 01-03-18.
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`Signed concurrence in
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`multidisciplinary review on 01—24-
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` Statistical Review(s) (indicate datefor each review)
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`lst cycle: No separate review;
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`DARRTS memo signed 11-22-16.
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`Signed concurrence in
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`multidisciplinary review on 12—15-
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`16.
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`Statistical Team Leader Review(s) (indicate datejbr each review)
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`E 2““1 cycle: No separate review;
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`DARRTS memo signed 01-03-18.
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`Signed concurrence in
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`multidisciplinary review on 01-24-
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`NDA 208700
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`Page 12
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`Clinical Pharmacology
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`D None
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`‘3 Clinical Pharmacology Division Director Review(s) (indicate dateflar each review)
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`Clinical Pharmacology Team Leader Review(s) (indicate date1?)?“ each review)
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`WWWWWWWW
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`Clinical Pharmacology review(s) (indicate datefor each review)
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`at“
`2’Jd cycle: No separate review;
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`DARRTS memo signed 12-08—17.
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`Signed concurrence in
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`multidisciplinary review on 01—24-
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`1“ cycle: No separate review:
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`DARRTS memo signed 11—21-16.
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`Signed concurrence in
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`multidisciplinary review on 12-16-
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`E 2““ cycle: No separate review;
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`DARRTS memo signed 12-08—17.
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`Signed concurrence in
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`multidisciplinary review on 12-24-
`18.
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`1,, cycle' No separate review-
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`DARRTS memo signed 11-2l*16.
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`Signed concurrence in
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`multidisciplinary review on 12-15—
`16.
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`E 2‘“1 cycle: No separate review;
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`DARRTS memo signed 12-08-17.
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`Signed concurrence in
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`multidisciplinary review on 12-24—
`18.
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`1“' cycle: DARRTS memo signed
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`11—21-16. Signed concurrence in
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`multidisciplinary review on 12-15—
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`QT lRT Review uploaded 7-7-16
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`'3‘ OSI Clinical Pharmacology Inspection Review Summary (include copies ofOSI letters)
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`m None requested
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`NDA 208700
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`Page 13
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`Nonclinical
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`CI None
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`.‘ Pharmacology/Toxicology Discipline Reviews
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`o ADPfI‘ Review(s) (indicate datejbr each review)
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`Supervisory Review(s) (indicate datefor each review)
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`Pharm/tox review(s), including referenced IND reviews (indicate datejbr each
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`WWW)
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`E 2”“ cycle: No sepaiide review;
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`DARRTS memo signed 12-14—17.
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`Signed concurrence in
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`multidisciplinary review on 01-24-
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`Ist cycle' No separate revieW'
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`DARRTS memo signed 11/14/16.
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`Signed concurrence in
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`multidisciplinary review on
`12/16! 16.
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`E 2‘1d cycle: No separate review;
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`DARRT S memo signed 12-14-17.
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`Signed concurrence in
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`multidisciplinary review on 01-24-
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`1’“ cycle' No separate review-
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`DARRTS memo signed 11-14-16.
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`Signed concurrence in
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`multidisciplinary review on 12-15~
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`16.
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`cycle: No separate review;
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`DARRTS memo signed 12-14-17.
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`Signed concurrence in
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`multidisciplinary review on 12-24-
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`18'
`1“ cycle: DARRTS Memo signed
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`11-14—16; signed concurrence in
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`multidisciplinary review on 12-15-
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`'2' Reviews) by other disciplines/divisions/Centers requested by PIT reviewer {indicate date
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`7"
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`None El No care
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`'3' Statistical review(s) of carcinogenicity studies (indicate datefin" each review) -
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`@- ECAC/CAC report/memo ofmeeting
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`0? OSI Nonclinical Inspection Review Summary (include copies of 081 letters)
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`Elfigcllein PIT review pae
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`E None requested
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`NDA 208700
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`Page 14
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`Product Quality
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`I] None
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`v Product Quality Discipline Reviews“
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`Tertiary review (indicate datejbr each review)
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`Secondary review (e.g., Branch Chief) (indicate datefbr each review)
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`0
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`Integrated Quality Assessment (contains the Executive Summary and the primary
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`reviews from each product quality review discipline) (indicate datefor each
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`review)
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`Reviews by other disciplines/divisions/Centers requested by product quality review team (indicate date ofeach review)
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`0% Environmental Assessment (check one) (original and supplemental applications)
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`2'“1 cycle: OPQ Integrated
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`Quality Assessment final
`Review Date: 12—13-17
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`1“ cycle: Primary, secondary and
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`tertiary joint review— final tertiary
`signature 11-22—2016_
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`E 211d cycle: OPQ Integrated
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`Quality Assessment final
`Review Date: 12-13-17
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`1“t cycle: Primary, secondary and
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`tertiary joint review— final
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`signature 1 1-22—20 1 6
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`E 2nd cycle: OPQ Integrated
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`Quality Assessment final
`Review Date: 12-13-17
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`1st cycle: Microbiology review 11—
`14—16;CMC TL review 11-18-16
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`Microbiolm & CMC: Aproval
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`Categorical Exclusion (indicate review date)(all original applications and
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`all eficacy supplements that could increase the patient population)
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`[I Review8: FONSI (Indicate date of review)
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`El Review5r. Environmental Impact Statement (indicate ciate ofeach review)
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`2‘“1 cycle: 1243-17 see OPQ
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`Integrated Quality Assessment
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`final review.
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` lmi cycle: 11-22-16 see page 31 of
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`the Product Quality review
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`(Executive Summary)
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`“ Do not include Master File (MF) reviews or communications to MF holders. However, these documents should be made available
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`upon signatory request.
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`NDA 208700
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`Page 15
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`Facilities inspections (indicate date of recommendation; within one week of
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`taking an approval action, confirm that there is an acceptable recommendation
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`before issuing approval letter) (only original applications and efficacy
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`Supplements that require a manufacturing ficility inspection (e.g., new strength,
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`manufacturing process. or manufacturing site change)
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` ‘3' Facilities Review/Inspection
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`iSt cycle: Withhold
`
`recommendation - 11-10-16
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