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Dr. Tommy CheungMBBS(HK), MRC(UK), FHKAM(Medicine), FRCP(Edin), Dip Clin Tox (HKPIC & HKCEM)
Deputy Medical Director
Phase 1 Clinical Trials Centre, HKU
How to meet the CFDA requirements for Phase 1 clinical trials
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OBJECTIVES
• Future reforms in China’s regulatory environment
• Accreditation for Phase 1 Facilities
• Supervision of Phase 1 Clinical Trials
• Common criticisms from CFDA
• Operations of the Phase 1 Clinical Trials Centre
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Current Situation
Obtain new drug application approval
elsewhere
Conduct China-specific trials
New drug application in China
Exemption from China-specific trials if previous
trials included large groups of Asian patients
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Current Situation
• Use China as part of international multi-center
trials – But wait until in Phase II or Phase III clinical study OR
– Received market authorization elsewhere
POTENTIALLY BEGINNING WITH PHASE I STUDY
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Current Situation
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Future Reforms in China
• Clinical trial approval vs. 60 working day response
• Allow pharmaceutical companies to run first in human Phase 1 trials in China
• Allow the use of multi-regional clinical trial data to support new drug applications in China
• Expansion of China’s fast track pathway
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Future Reforms in China
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Future Reforms in China
• Boost the supply of Phase 1 facilities
• Shift the focus from pre-approval supervision to
day-to-day operational supervision– More rigorous and regular inspections
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China Food and Drug Administration
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• National Institutes for Food and Drug Control
• Centre for Drug Evaluation• Centre for Food and Drug Inspection• National Committee on the assessment
of the Protected Traditional Chinese Medical Products
• Centre for Drug Re-evaluation• Centre for medical Device Evaluation• Administrative Service and Complaint
Centre• Internal Service Centre
• Information Centre of CFDA• Institute of Executive Development• Certification Centre for Licensed
Pharmacist of SFDA• China Pharmaceutical Newspaper• China Medico-pharmaceutical Science &
Technology Publishing House• China Centre for Food and Drug
International Exchange• Southern Medicine Economic Research
Institute of CFDA• Chinese Pharmaceutical Association
Affiliated Organizations of CFDA
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China Food and Drug Inspection
1994
Centre for Certification of Drug
Ministry of Health
1998
Centre for Certification of Drug SDA
2003
Centre for Certification of Drug
SFDA
2014
Centre for Food and Drug Inspection
CFDA
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Supervision of Clinical Trials in China
• Certification of Drug Clinical Research Institutions
• On-site inspection of drug registration
• Triggered inspection
• Routine inspection of drug clinical research institutions
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Accreditation for Phase 1 Facilities
• In 2003, CFDA initiated mandatory certification of
clinical research institution
• Ensure all clinical trials to be conducted in qualified
institutions with well trained investigators
• Re-certification every 3 years
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Accreditation for Phase 1 Facilities
• Time: 2-3 days
• Inspector: 3-5 inspectors from CFDA and invited
experts
• Procedure: Facility tour; review of equipment,
SOPs, investigator interview and data audit
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Accreditation for Phase 1 Facilities
• Investigator interview (qualification, experience, personnel, GCP training)
• Phase 1 facility (equipment and medical emergency management)
• SOPs
• Bio-analysis laboratory
• Institutional Review Board
• Study audit of completed clinical trials
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Key elements of Bio-analysis Inspection
• Storage condition
• Sample handling
• Assay validation
• Sample re-analysis
• Data comparison
• Audit trail
• Data quality
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Inspection of Phase 1 Clinical Trials
• On-site inspection for drug registration
• Triggered inspection
• Routine inspection of drug clinical research
institutions
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On-site Inspection
• Comparison of data submitted by sponsor to source record on site
• Inspection of pharmacological analysis, clinical trial
• Inspection conducted by PFDA or CFDI
• Inspection outcome: data accepted/ data not accepted/ conditional accepted
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Triggered Inspection
• Study audit conducted by PFDA or CFDI
• Triggered by complaints or requests from CDE/ CFDA
• Investigator, CRO, laboratories
• Verify compliance with GCP
• 30-50 cases each year
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Routine Inspection
• Conducted by PFDA
• Annual inspection plan
• No less than 2 facility inspections to each certified institutions in 1 year
• No less than 15% study audit of all clinical trials in the province in 1 year
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Common Criticisms
• AE determination and management
• Lack of equipment
• Subject identification
• Subject recruitment and selection
• Documentation and signing of informed consent form
• Medical history documentation
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Common Criticisms
• IMP dosage, route of administration and timing
• IMP importation, transportation and storage documentation
• Biological samples schedule determination
• Biological samples transfer log
• Biological samples storage condition monitoring
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Common Criticisms
• Inadequate documentation
• Inadequate or violation of SOPs
• Inadequate reserve samples
• Inadequate calibration of instruments
• Inconsistent manual integration
• Suboptimal maintenance of computer system
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Operations of the Phase 1 Clinical Trials Centre
HKUCTC
SMO
Training
Phase 1 Centre
CRO
Site Management Services
Contract Research Services
Phase 1, Early Phase & BE
Studies
Professional Training Services
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HKU-CTC
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Thank You!
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THANK YOU !