US FDA’s ‘Project Optimus’ Will Encourage Move Away From Conventional Dose-Finding For Modern Cancer Therapies
Simply carrying forward the maximum tolerated dose into later-stage trials does not account for the importance of long-term tolerability – and the fact that higher doses are not necessarily better for patients.
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The “Breakthrough” era in oncology drug development creates new stress points in the effort to accelerate time-to-market. One important one involves the age-old challenge of finding the right dose – particularly in an era when the old idea of pushing the dose no longer makes sense.
Aduhelm’s ‘Complex’ Circumstances Drove Extensive In-House Advice Process Before Accelerated Approval, Cavazzoni Says
Accelerated approval was considered as option in response to the negative advisory committee vote, but it was not a ‘default,’ CDER officials say. ‘It fit like a glove.’
A central biostatistics team would embrace an academic focus that could elevate the specialty within FDA. It’s a question, Pazdur says, for the next commissioner.