Global clinical research is essential to ensure efficient drug development. FDA must evaluate if the results of clinical development programs inclusive of multiregional clinical trials are applicable to the intended use population in the U.S. and U.S. standard of care. With the release of this draft guidance FDA has provided sponsors with insights as to their expectations regarding factors that must be considered when assessing the appropriateness of including MRCTs in a clinical development program. Some of the factors highlighted include patient-related, disease-related, healthcare system, and socio-cultural factors that may influence clinical outcomes and potentially impact applicability to the US population.
The draft guidance also recommends sponsors prospectively plan the distribution of clinical sites in a MRCT to achieve enrollment of a population that adequately represents the U.S. population affected with the cancer indication being studied. FDA recommends a strategic allocation of study participation on the basis of major geographical regions (Africa, Asia, Europe, N America) with equal allocation of participants across regions for cancers that are common in the U.S. and proportional allocation for cancers less common in the U.S. compared to other regions.
FDA has been questioning the decreasing proportion of U.S. participants included in oncology clinical trials for some time now. The regulatory expectation has clearly been that the evidence generated in a clinical development program should be derived from study populations that enable the results to be interpretable in the context of U.S. patients with the disease or condition and U.S. medical practice. This draft guidance gives a nice overview of what FDA expects in terms of prospective planning and consideration that could be helpful in justifying clinical development plan decisions.
Today, FDA issued draft guidance on design, conduct and analysis of oncology multiregional clinical trials to achieve efficiency and generate data necessary to ensure results are applicable to the U.S. population and medical practice.
Guidance: https://lnkd.in/gT__m9Ng
FDA News Release: https://lnkd.in/gT__m9Ng
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