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Registration of
oncology productsZwiers onco database findings
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Why a database?
2
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Methodology
3
Obtain data from the European Public Assessment Report
(EPAR; EMA website) in the period 2010-2017
Overall ~70 fields per product
Determine which data to collect and how, for example:
literature or safety pharmacology part of main studies;
which products are for treatment of advance cancer;
exclude hormone-sensitive cancers from reproductive
toxicology analysis
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Example of EPAR
4
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Characteristics of database
5
In total 71 drugs:
Small molecules 52 (73%), Biotech 19 (27%)
Non-advanced 29 (41%), Advanced 42 (59%)
Small Molecules Biotech
Non-advanced 20 (38%) 9 (47%)
Advanced 32 (62%) 10 (53%)
Total 52 19
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What to expect?
6
1. Procedures & timelines
2. Preclinical
3. Clinical
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1. Procedures and timelines
7
Is there an impact of conditional approval on time to
positive CHMP opinion?
Is there a difference for orphan drugs?
Are there products with no special status at all?
Small molecules versus biotech?
Does it hurt if you do not have scientific advice?
Does company size matter?
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Procedural timelines
8
Without Spec Status Conditional
approval
Accelerated
Assess
Small Mol (n=52) 358 (n=30) 400 (n=12) 212 (n=10)
Biotech (n=19) 417 (n=11) 330 (n=4) 197 (n=4)
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Timelines ‘Without Special Status’
9
Orphan Status
yes no
Small Mol (n=28) 348 (n=12) 351 (n=16)
Biotech (n=11) 486 (n=5) 359 (n=6)
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Time required to answer first round of questions
10
(in months)
> 3 months
15 Small mol ( 30%)
7 Biotech ( 40%)
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Time required to answer first round of questions
11
Small mol :212 (n=10)
Biotech :197 (n=4)
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Scientific Advice meetings
12
For 20% of the small molecule products no SA meetings!
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Effect of scientific advice on review
13
Small molecules
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Effect of scientific advice on review
14
Biotech
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Timelines and company size
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Conclusions
16
Is there a positive impact of conditional approval
on time to positive CHMP opinion?
No, only
for
biotech
Is there a difference for orphan drugs? No
Are there products with no special status at all? Yes – 30%
Small molecules versus biotech? Yes
Does it hurt if you do not have scientific advice? No
Does company size matter? Yes
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2. Preclinical
ICH S6 and S9
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ICH S9 Nonclinical Evaluation for Anticancer Pharmaceuticals
“In the development of anticancer drugs, clinical studies often involve cancer patients whose
disease condition is progressive and fatal.
In addition, the dose levels in these clinical studies often are close to or at the adverse effect
dose levels.
For these reasons, the type, timing and flexibility called for in the design of non-clinical studies
of anticancer pharmaceuticals can differ from those elements in non-clinical studies for other
pharmaceuticals.”
ICH S6 Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals
“Regulatory standards for biotechnology-derived pharmaceuticals have generally been
comparable among the European Union, Japan and United States. All the regions have
adopted a flexible, case-by case, science-based approach to preclinical safety evaluation
needed to support clinical development and marketing authorisation. In this rapidly evolving
scientific area, there is a need for common understanding. “
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Results - safety pharmacology
18
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Results - Genotoxicity
19
Small molecules: if in vitro is positive, in vivo might not be warranted (S9)
Biotech: studies are not needed (S6).
For 50 compounds genotoxicity studies – 21 compounds were positive
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Preclinical findings in general
20
Small molecules:
• Development is comparable to typical small molecule;
• Often studies are conducted in 2 species (rodent/non-
rodent).
Biotech:
• Often studies were not conducted or only for 1 species,
as suggested by the S6 guideline.
• Effect of S9 guideline limited?
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3. Clinical – what to expect?
21
Are volunteers participating in studies for oncology
products?
Would you give a compound which is positive in genotox
studies to volunteers?
What is the typical size of the database?
How often do companies submit with only phase I/II data?
Are dedicated studies done for: pediatrics/QTc/ drug
interactions?
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Healthy volunteers studied
22
% of products (N of N)
Small Molecules 67 (35 of 52)
Biotech 5 (1 of 19)
Positive genotoxicity 19 (7 of 36)
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Patient exposure
23
Around 55% less than 1.000 subjects
Exposure categories
1: <500
2: 500-1000
3: 1000-1500
4: 1500-2500
5: 2500-3500
6: >3500
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No Phase III
24
N % Advanced Orphan Conditional
approval
Accelerated
Assessment
Small Mol 11 21 6 5 5 2
Biotech 5 26 2 5 5 2
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Dedicated DDI and QT studies
25
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Special populations: pediatrics
26
Products without pediatric studies (67) have:
- Class waiver (n=42)
- Product specific waiver (n=4)
- Deferred measures (n=20)
- Literature studied (n=1)
Pediatric study
N 4
% 6%
Type 3 small molecules, 1 biotech
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Conclusions
27
Are volunteers participating in studies for oncology
products?
Yes
Would you give a compound which is positive in genotox
studies to volunteers?
Yes
What is the typical size of the database? <1.000 in ~ 55%
How often do companies submit with only phase I/II
data?
20-25%
Are dedicated studies done for special populations/
pediatrics/QTc/ drug interaction?
Yes
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28