FDA Oncology Center of Excellence Site-Agnostic Approval

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FDA scientists working in the agency’s Oncology Center of Excellence (OCE) describe the Center’s role in the 5/2017 approval of a cancer treatment based on a biomarker without regard to the tumor’s site. The Experimental Biology and Medicine article describes the accelerated approval given to pembrolizumab for patients with solid tumors that have the microsatellite instability-high or mismatch repair deficient biomarker.

“As precision medicine continues to advance,” the report says, “therapeutic targets are evolving from tissue- or organ-based to gene- or pathway-based. FDA approvals are likely to describe increasingly the use of diagnostic tests to identify patients whose cancers harbor the targeted abnormalities and that may be required (companion diagnostics) for the safe and effective use of these drugs or suggested (complementary diagnostics) to provide physicians and patients with potentially useful information.”

The authors say OCE remains optimistic about the outlook for the future of oncology drug development. A number of initiatives are underway, they say, to improve greater patient access to trials, generalizability of trial data, and learning from electronic medical records and patient-reported outcomes. “We believe the OCE’s strong emphasis on excellence in regulatory science will ensure the rapid development of highly effective and less toxic therapies for patients with cancer,” they conclude.

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