US FDA’s Pediatric Cancer Targets List Spurs Questions On Breadth, Prioritization
Initial draft list of molecular target candidates has industry, investigators and patient advocates asking how the agency intends to prioritize targets and same-in-class molecules for pediatric studies, and how frequently it will update the list; industry representatives divided as to whether ‘broader is better’ when it comes to the target list.
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Nancy Goodman, founder of Kids v Cancer, got two bills through Congress via PDUFA riders but struck out with Give Kids a Chance Act, which did not make it into the omnibus government funding legislation. She hopes to prevail next year.
Early advice meetings allow sponsors to hear the FDA’s current thinking about relevance of a specific molecular target and expectations for early assessment of an adult cancer drug in children unless a waiver or deferral is justified; agency has waived subsequent pediatric studies for some same-in-class products, including PD-1/L1 inhibitors.
Agency urged to prioritize studies based on strength of preclinical and adult data, and good mechanistic understanding of how multiple therapies are expected to work together; new pediatric study requirements for molecularly targeted agents take effect in August 2020.