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“FDA Modernizes Clinical Trials with New Guidelines for Efficiency and Diversity”

FDA releases draft recommendations to modernize clinical trials, incorporating RWE, technology, and increasing diversity.



The United States Food and Drug Administration (FDA) has announced additional steps to modernize clinical trials in an effort to increase efficiency and improve patient outcomes. The agency has released draft recommendations and is seeking feedback on how they should be applied to increasingly diverse trial types and data sources.

The new guidelines aim to address challenges in clinical trial design and execution, including the use of real-world evidence (RWE) and increasing diversity in clinical trial populations. The FDA recognizes the importance of incorporating RWE in clinical trials to provide a more comprehensive understanding of a drug’s safety and efficacy in real-world settings. The agency is also committed to increasing diversity in clinical trials to ensure that all patient populations receive equal access to potentially life-saving treatments.

The draft recommendations suggest new approaches to trial design, such as the use of adaptive designs and master protocols, to increase efficiency and reduce costs. Adaptive designs allow for changes to be made during the trial based on emerging data, while master protocols enable multiple drugs to be tested simultaneously in a single trial. The FDA also recommends the use of innovative trial designs, such as basket and umbrella trials, which allow for the testing of multiple drugs in a single trial on patients with similar genetic profiles or disease types.

The FDA is also exploring the use of decentralized clinical trials, which rely on technology to enable patients to participate in trials from their homes. This approach has the potential to increase participation in clinical trials and reduce the burden on patients who may have difficulty traveling to study sites. The FDA acknowledges that the use of technology in clinical trials has the potential to improve efficiency and reduce costs while maintaining the integrity of the data.

Finally, the FDA is committed to increasing diversity in clinical trials by encouraging the inclusion of underrepresented populations, such as women, racial and ethnic minorities, and the elderly. The agency is exploring ways to incentivize the inclusion of these populations in clinical trials and is partnering with patient advocacy groups to increase awareness and understanding of the importance of clinical trial diversity.

In conclusion, the FDA’s draft recommendations for modernizing clinical trials represent a significant step forward in improving patient outcomes and increasing efficiency in drug development. By incorporating RWE, innovative trial designs, and technology, while also increasing diversity in clinical trial populations, the agency is working to ensure that all patients have equal access to potentially life-saving treatments. The FDA is requesting feedback on these draft recommendations, and it is hoped that the final guidelines will reflect the input of a diverse range of stakeholders.





FDA Grants First DNA Test for Dozens of Cancer Types

FDA grants marketing authorization for DNA test assessing predisposition for multiple cancer types.



The U.S. Food and Drug Administration (FDA) has recently made a groundbreaking announcement by granting the first marketing authorization for a DNA test that assesses predisposition for dozens of cancer types. This significant development comes in the form of the Invitae Common Hereditary Cancers Panel, an in vitro diagnostic test capable of detecting genetic variants associated with an elevated risk of developing certain cancers. This test marks a major advancement in personalized medicine, as it can evaluate DNA samples to identify variants in 47 genes known to be linked with an increased likelihood of developing specific types of cancer.

By utilizing next-generation sequencing technology, the Invitae Common Hereditary Cancers Panel offers a comprehensive assessment of multiple genes in a single test. This enables healthcare professionals to gain valuable insights into an individual’s genetic predisposition for certain cancers. With this information, physicians can provide appropriate monitoring and potential therapies tailored to each patient’s specific needs.

Cancer remains one of the leading causes of death in the United States, and the availability of this test brings a vital public health tool into the hands of medical professionals. It equips them with additional information to guide patient care, potentially leading to earlier detection and intervention for those at higher risk. However, it is important to note that this test does not evaluate all known cancer-related genes, and patients should consult with a healthcare professional to interpret the results accurately.

The Invitae Common Hereditary Cancers Panel underwent rigorous evaluation by the FDA under the De Novo premarket review pathway. Extensive testing, involving over 9,000 clinical samples, demonstrated an accuracy rate of ≥99.0% for all tested variant types. While the test carries the possibility of false positive and false negative results, the risks are mitigated by the analytical and clinical performance validation, along with appropriate labeling.

In addition to granting marketing authorization, the FDA has established special controls that define requirements related to labeling and performance testing. These measures ensure the safety and effectiveness of similar devices in the future, potentially expediting the regulatory process for subsequent tests.

The FDA’s decision to grant marketing authorization for the Invitae Common Hereditary Cancers Panel is a significant milestone in the field of genetic testing and personalized medicine. It offers individuals valuable information about their health, empowering them to make informed decisions regarding monitoring and potential therapies. As technology continues to advance, such tests have the potential to revolutionize cancer care by enabling earlier detection and personalized treatment strategies.

Read the press release here: https://www.fda.gov/news-events/press-announcements/fda-grants-first-marketing-authorization-dna-test-assess-predisposition-dozens-cancer-types?utm_medium=email&utm_source=govdelivery

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FDA Launches Pilot Program to Help Further Accelerate Development of Rare Disease Therapies

FDA launches pilot program to accelerate rare disease therapies, improving communication between sponsors and FDA staff. #RareDiseaseTherapies #FDA #ClinicalTrials



In a significant move to expedite the development of novel drug and biological products for rare diseases, the U.S. Food and Drug Administration (FDA) has introduced a pilot program aimed at fostering more frequent communication between sponsors and FDA staff. This initiative, known as the Support for clinical Trials Advancing Rare disease Therapeutics (START) Pilot Program, aims to address clinical development challenges and generate high-quality data to support the future marketing applications of potentially life-saving therapies.

Enhancing Communication and Collaboration:
Under the START Pilot Program, a limited number of sponsors will have the opportunity to obtain regular ad-hoc communication and advice from FDA staff. This communication will focus on addressing product-specific development issues such as clinical study design, selection of control groups, and fine-tuning the choice of patient population. By facilitating improved communication, the FDA aims to streamline the development process for rare disease therapies and ensure that patients with unmet medical needs receive timely access to innovative treatments.

Eligibility and Application Process:
The program is open to sponsors of products currently in clinical trials under an active Investigational New Drug application (IND) regulated by the Center for Biologics Evaluation and Research (CBER) and/or the Center for Drug Evaluation and Research (CDER). Eligibility criteria differ between CBER and CDER-regulated products. CBER-regulated products must be gene or cellular therapies addressing an unmet medical need for a rare disease likely to cause significant disability or death within the first decade of life. CDER-regulated products must be intended to treat rare neurodegenerative conditions, including rare genetic metabolic disorders. Detailed eligibility requirements can be found in the Federal Register Notice.

The Road Ahead:
The FDA plans to accept applications for the START program between January 2, 2024, and March 1, 2024. Participants will be selected based on their application readiness and ability to progress their development programs towards a marketing application. The agency will choose up to three participants for each center. After evaluating the pilot program and receiving feedback from selected sponsors, the FDA may consider a second iteration, which would be announced in the Federal Register at a later date.

Commitment to Rare Disease Therapies:
The FDA’s efforts to advance the development of therapies for rare diseases extend beyond the START Pilot Program. The agency has recently requested feedback from stakeholders on scientific challenges and opportunities related to cellular and gene therapies for rare diseases. This input will help inform the planning of future meetings, workshops, and educational programs to facilitate the development of regulatory tools and frameworks.

Additionally, the FDA has created the Learning and Education to Advance and Empower Rare Disease Drug Developers (LEADER 3D) program under the CDER Accelerating Rare disease Cures (ARC) initiative. Stakeholder feedback gathered through this program will contribute to identifying knowledge gaps in rare disease drug development and the creation of publicly available resources to guide stakeholders in designing and conducting clinical trials.

The FDA’s launch of the START Pilot Program demonstrates its commitment to expediting the development of rare disease therapies. By facilitating enhanced communication and collaboration between sponsors and FDA staff, the program aims to accelerate the availability of potentially life-saving treatments for patients with unmet medical needs. This pilot program, along with other ongoing initiatives, highlights the FDA’s dedication to improving the regulatory framework and recommendations for rare disease product sponsors, ultimately ensuring the safety, effectiveness, and quality of these important therapies.


Read the press release: https://www.fda.gov/news-events/press-announcements/fda-launches-pilot-program-help-further-accelerate-development-rare-disease-therapies?utm_medium=email&utm_source=govdelivery

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Popular Nasal Decongestant Falls Short: FDA Advisers Question Efficacy

FDA questions effectiveness of popular nasal decongestant phenylephrine, raising concerns about congestion relief.



In a surprising turn of events, government experts have cast doubt on the effectiveness of the leading decongestant found in popular over-the-counter medications like Sudafed and Dayquil. A recent review conducted by the Food and Drug Administration (FDA) found that the main drug ingredient, phenylephrine, offers no significant relief from nasal congestion. This revelation raises concerns among millions of Americans who rely on these medications for congestion relief.

Phenylephrine became the primary ingredient in over-the-counter decongestants after pseudoephedrine, an older ingredient, was moved behind pharmacy counters due to its potential for illegal drug processing. However, the FDA’s outside advisers unanimously voted against the efficacy of phenylephrine, prompting a reevaluation of its effectiveness. Despite phenylephrine-based versions dominating the market, accounting for four-fifths of the $2.2 billion oral decongestant market, the FDA’s conclusions suggest a need to reconsider their availability.

The FDA review identified significant flaws in the original studies that supported phenylephrine’s approval. These studies, conducted in the 1960s and 1970s, were deemed inadequate by modern standards. Furthermore, three recent, well-conducted studies by reputable pharmaceutical companies found no discernible difference between phenylephrine medications and placebos in relieving congestion. This raises concerns about the effectiveness of phenylephrine, which has relied on outdated research.

The FDA’s advisory panel’s unanimous vote against phenylephrine’s effectiveness could lead to regulatory action requiring drugmakers like Johnson & Johnson and Bayer to withdraw their phenylephrine-based oral decongestants from store shelves. This move may force consumers to opt for behind-the-counter pseudoephedrine products or phenylephrine-based nasal sprays and drops. However, it would necessitate extensive education efforts by the FDA, pharmacists, and drugstores to inform consumers about alternative options for treating congestion.

The Consumer Healthcare Products Association, representing nonprescription drugmakers, argued that the recent studies have limitations and advocated for continued “easy access” to phenylephrine. However, the FDA review highlighted the shortcomings of the original studies and the lack of modern scientific evidence supporting phenylephrine’s efficacy. Balancing public health concerns and consumer access will be a crucial challenge for regulators moving forward.

The FDA’s recent review has cast doubt on the effectiveness of phenylephrine, the key ingredient in popular nasal decongestants. This finding prompts a reevaluation of treatment options for nasal congestion and calls for further research to provide effective relief for individuals in need.

Check out the article from the Associated Press: https://apnews.com/article/sudafed-decongestants-phenylephrine-pseudoephedrine-fda-0f140bafae9a500c5fba05fe764ecb66

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