Beck, Lydia ORCID: 0000-0003-2785-1836, Witt, Ruth, Nesper-Brock, Martina, Milde, Till, Hettmer, Simone, Fruehwald, Michael C., Roessig, Claudia, Fischer, Matthias, Reinhardt, Dirk ORCID: 0000-0002-7027-4483, Taylor, Lenka A., Riedel, Claudia, Witt, Olaf and van Tilburg, Cornelis M. (2021). A Study of Regulatory Challenges of Pediatric Oncology Phase I/II Trial Submissions and Guidance on Protocol Development. Clin. Pharmacol. Ther., 110 (4). S. 1025 - 1038. HOBOKEN: WILEY. ISSN 1532-6535

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Abstract

The purpose of this study was to identify key deficiencies in pediatric oncology early phase clinical trial protocols in Germany and to provide guidance for efficient trial protocol development. A systematic review of the response letters of German competent authorities (CAs) and Ethics Committees to phase I/II pediatric oncology trial submissions in the period from 2014 to 2019 was performed. Documents were requested from all five Society for Paediatric Oncology and Haematology in Germany (GPOH) phase I/II trial networks plus all nine German Innovative Therapies for Children with Consortium Cancer (ITCC) centers. A blinded dataset containing aggregated data from 33 studies was analyzed for validation. All deficiencies were reviewed, listed, and weighted using a structured matrix according to frequency, category, significance, and feasibility. In total, documents of 17 trials from 6 different sites were collected. Two hundred fifty deficiencies identified by the CAs were identified and categorized into eight categories. Toxicity and safety was the most prominent category (27.6%), followed by Manufacturing and Import (18%). The majority of deficiencies were categorized as minor and potential measures as easy to address, but an important group of major and difficult to implement deficiencies was also identified. The blinded validation dataset confirmed these findings. The majority of the EC deficiencies could be resolved by changing the wording in the patient-facing documents. In conclusion, this study was able to detect a pattern of key deficiencies. Most of the shortcomings can be anticipated by minor changes in the protocol and increased awareness can prevent time-consuming revisions, withdrawals, or even rejections. A corresponding guideline describing key regulatory aspects is provided.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Beck, LydiaUNSPECIFIEDorcid.org/0000-0003-2785-1836UNSPECIFIED
Witt, RuthUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nesper-Brock, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Milde, TillUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hettmer, SimoneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fruehwald, Michael C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roessig, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reinhardt, DirkUNSPECIFIEDorcid.org/0000-0002-7027-4483UNSPECIFIED
Taylor, Lenka A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riedel, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Witt, OlafUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Tilburg, Cornelis M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-600149
DOI: 10.1002/cpt.2319
Journal or Publication Title: Clin. Pharmacol. Ther.
Volume: 110
Number: 4
Page Range: S. 1025 - 1038
Date: 2021
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1532-6535
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LABEL DRUG-USE; CHILDREN; ADOLESCENTS; CANCERMultiple languages
Pharmacology & PharmacyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60014

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