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IceCure Medical Receives FDA Response to De Novo Classification Request for Breast Cancer

Key Takeaway: IceCure Medical announced that the FDA has denied its De Novo Classification request for the ProSense System, aimed at treating low-risk breast cancer. The FDA's decision does not affect the device's authorization for other indications, which remain available to patients. The company aims to address the FDA's concerns while continuing its ICE3 clinical study, expected to conclude in early 2024. Despite the FDA's denial, the interim analysis of the ICE3 study shows promising low recurrence rates among treated patients.

Market Sentiment Analysis

POSITIVE FACTORS

  • ProSense remains FDA cleared for other indications, ensuring access for patients.
  • The ICE3 trial is the largest of its kind, suggesting robust clinical oversight.
  • Interim results indicate a low recurrence rate for treated patients.

CONCERNS & RISKS

  • The FDA denied the De Novo Classification request for breast cancer.
  • The FDA's decision was influenced by a need for additional scientific literature.
  • This denial could delay broader adoption of the ProSense system for breast cancer treatment.

Full Press Release Details

IceCure Medical Receives FDA Response to De
Novo Classification Request for Breast Cancer
CAESAREA, Israel, September 20, 2023 --
IceCure Medical Ltd. (Nasdaq: ICCM), developer of the ProSense System, a minimally-invasive cryoablation technology that destroys
tumors by freezing as an alternative to surgical tumor removal, today announced that the U.S. Food and Drug Administration ("FDA")
has at this time denied the Company's De Novo Classification request for breast cancer which was submitted based on interim analysis
from its ICE3 study. The FDA's position on the De Novo Classification request for breast cancer has no effect on ProSense's
FDA cleared authorization for other indications in the U.S. and patients in the U.S. continue to have access to ProSense for those treatments.
The Company is pursuing all avenues to address the FDA's response as global adoption of ProSense outside of the United States continues
to build. IceCure filed the De Novo request with the FDA in October 2022 based on interim data from its ICE3 breast cancer study for the
Breakthrough Indication of early-stage (Luminal A T1 invasive) low-risk breast cancer patients who are at high risk to surgery (not suitable
for surgical alternatives). IceCure continues its ICE3 clinical study, the largest clinical trial of its kind, which is expected to complete
during the first quarter of 2024.
"The positive expected five-year results
based on the interim analysis of the ICE3 trial, which demonstrated a survival-based estimate for the 5-year ipsilateral breast tumor
recurrence (IBTR) of 4.3%*, allowed us a rare and unique opportunity to submit a De Novo Classification request and make our minimally-invasive
ProSense cryoablation procedure available to women sooner for this important and underserved indication," commented Eyal Shamir,
Chief Executive Officer. "We, along with our regulatory consultants, believe the FDA's response to the De Novo Classification
request is largely due to the FDA's need for additional scientific literature as a comparator rate of recurrence in patients treated
with lumpectomy. We are committed to working with the FDA to address its comments by using the broadly available published scientific
literature on recurrence outcomes in patients treated with lumpectomy. ProSense remains available in the U.S. under prior FDA clearances
and we will continue to execute our plan and progress towards achieving our primary objective of completing the 5-year follow ups with
our last patients in the ICE3 study by the first quarter of 2024, while we simultaneously evaluate all strategies to efficiently and effectively
address the FDA's comments."
The Company's ProSense system was given
a Breakthrough Device Designation by the FDA in March 2021, and previously received clearance in the U.S. for general minimally invasive
cryoablation applications, including kidney, liver and benign breast tumors. ProSense is approved for the treatment of malignant breast
tumors in other jurisdictions, including Europe, China, and Brazil.
ICE3 is the largest controlled multi-location
clinical trial ever performed for liquid nitrogen (LN2)-based cryoablation of small, low-risk, early-stage malignant breast tumors
without subsequently removing them. The trial began in 2014 and has 194 eligible patients) in 19 hospitals and medical centers across
the U.S., including Columbia University Medical Center and Mount Sinai Beth Israel. The expected survival-based estimate for the 5-year
IBTR was 4.3%* for patients who received ProSense system cryoablation treatment are free of recurrence, with one-third of patients reaching
5 years post treatment. Additionally, to date, there have been no significant device-related adverse events reported with no scarring
or change in shape and size of the breasts, while 100% of doctors and 100% of patients reported satisfaction with the cosmetic results.
on the last interim results release on October 19, 2022, there have been 6 cases of ipsilateral breast tumor recurrence ("IBTR")
out of 194 patients, or 3.09%. The survival-based estimate for the 5-year IBTR is 4.3% with a one-sided 95% confidence level, upper bound
of 8.4% for the entire study.
ProSense cryoablation is a minimally invasive,
non-surgical, outpatient 40-minute procedure that only requires a local 1% lidocaine injection (similar to its use by dentists when performing
certain dental procedures) enabling the patient to remain alert during the procedure and then walk out of the doctor's office to
resume their day. Cryoablation costs less than the current standard of care breast cancer surgery of lumpectomy or partial mastectomy
which requires general anesthesia and has cosmetic consequences.
About IceCure Medical
IceCure Medical (Nasdaq: ICCM)
develops and markets ProSense , an advanced liquid-nitrogen-based cryoablation therapy for the treatment of tumors (benign and cancerous)
by freezing, with the primary focus areas being breast, kidney, bone and lung cancer. Its minimally invasive technology is a safe and
effective alternative to hospital surgical tumor removal that is easily performed in a relatively short procedure. The system is marketed
and sold worldwide for the indications cleared and approved to date including in the U.S., Europe, and China.
This press release contains
forward-looking statements within the meaning of the "safe harbor" provisions of the Private Securities Litigation Reform
Act of 1995 and other Federal and Israeli securities laws. Words such as "expects," "anticipates," "intends,"
"plans," "believes," "seeks," "estimates" and similar expressions or variations of such
words are intended to identify forward-looking statements. For example, IceCure is using forward looking statement in this press release
when it discusses: the expected plan and progress towards completion of the follow-up on the ICE3 clinical study in February 2024; evaluating
all strategies to efficiently and effectively address the FDA's comments; and the expected 5-year results passed on the interim
analysis of the ICE3 trial. Historic results of scientific research and clinical and preclinical
trials do not guarantee that the conclusions of future research or trials will suggest identical or even similar conclusions. Because
such statements deal with future events and are based on IceCure's current expectations, they are subject to various risks and uncertainties
and actual results, performance, or achievements of IceCure could differ materially from those described in or implied by the statements
in this press release. The forward-looking statements contained or implied in this press release are subject to other risks and uncertainties,
many of which are beyond the control of the Company, including those set forth in the Risk Factors section of the Company's Annual Report
on Form 20-F for the year ended December 31, 2022 filed with the SEC on March 29, 2023, and other documents filed with or furnished to
the SEC which are available on the SEC's website, www.sec.gov. The Company undertakes no obligation to update these statements for revisions
or changes after the date of this release, except as required by law.

Frequently Asked Questions

What was the FDA's response to IceCure's De Novo request?

The FDA denied IceCure Medical's De Novo Classification request for breast cancer.

Is ProSense still available in the U.S. for other treatments?

Yes, ProSense remains available in the U.S. for other FDA-cleared indications.

What is the estimated 5-year recurrence rate for IBTR with ProSense?

The estimated 5-year ipsilateral breast tumor recurrence rate is 4.3%.

How long does the ProSense cryoablation procedure take?

The ProSense cryoablation procedure typically lasts about 40 minutes.

What are the benefits of the ProSense system?

ProSense is minimally invasive, outpatient, and has no significant adverse events reported.

Last updated: Sep 20, 2023