1
|
Noguchi E, Yaginuma H, Fujiwara Y. Challenges in Expediting the Development of Oncology Drugs. JCO Oncol Pract 2023; 19:216-217. [PMID: 36657099 DOI: 10.1200/op.22.00705] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Emi Noguchi
- Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | | | | |
Collapse
|
2
|
Mizuno T, Katsuya Y, Sato J, Koyama T, Shimizu T, Yamamoto N. Emerging PD-1/PD-L1 targeting immunotherapy in non-small cell lung cancer: Current status and future perspective in Japan, US, EU, and China. Front Oncol 2022; 12:925938. [PMID: 36091105 PMCID: PMC9459234 DOI: 10.3389/fonc.2022.925938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Non-small cell lung cancer (NSCLC), one of the deadliest types of cancers worldwide, has been the target of immunotherapy due to its high immune antigenicity. With the addition of immune-checkpoint inhibitors (ICIs), including anti-PD-1/PD-L1 antibodies, as an indispensable and powerful regimen for the treatment of this lethal disease, the median survival time for patients with stage IV NSCLC is approximately 2 years. In contrast, the response rate to ICIs remains less than 50%, even if the patients are selected using biomarkers such as PD-L1. Pharmaceutical companies have begun to develop additional anti-PD-1/PD-L1 antibodies to overcome resistance and are devising further immunotherapy combinations. More than 20 anti-PD-1/PD-L1antibodies have been approved or are currently in development. Numerous combination therapies are under development, and several combination therapies have provided positive results in randomized controlled trials. This review aimed to examine the current status of approved and investigational anti-PD-1/PD-L1antibodies for NSCLC in Japan, the United States, the European Union, and China. Further, this review discusses the challenges and future perspectives for developing new ICIs in alignment with the global developments in Japan.
Collapse
Affiliation(s)
- Takaaki Mizuno
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Katsuya
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Jun Sato
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Takafumi Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
- *Correspondence: Noboru Yamamoto,
| |
Collapse
|
3
|
Maeda H, Fukuda Y, Uchida M. Assessment of Drugs Approved by Public Knowledge-Based Applications (Kouchi-shinsei) During the Last Two Decades in Japan. Clin Pharmacol Ther 2021; 110:1127-1135. [PMID: 34110632 PMCID: PMC8518418 DOI: 10.1002/cpt.2332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022]
Abstract
Public knowledge‐based application (“Kouchi‐shinsei” in Japanese) is unique to Japan, implemented to eliminate the off‐label use of unapproved indications, dosages, and administrations because of drug lag. The guidance for public knowledge‐based application was issued in 1999. This study comprehensively investigated the trends of items approved by public knowledge‐based application in Japan during the last 2 decades. Prescription drugs approved from January 2000 to December 2019 were surveyed. In Japan, 1,855 drugs were approved within the target survey period. Among them, 219 (11.8%) were approved by public knowledge‐based application. Considering the changes in the number of items approved by public knowledge‐based application over the years, the number of items approved in 2000 was 7, reaching a maximum of 34 items in 2011, and decreased after that, 8 items were approved in 2019. The regulatory characteristics of drugs approved by public knowledge‐based application and those of other drugs were compared. By public knowledge‐based application, more anticancer and pediatric drugs were approved (P < 0.001), and only one drug for orphan diseases was approved (P < 0.001). In addition, the review time of public knowledge‐based applications was significantly shorter than that of normal applications regardless of time point. The approval system using public knowledge‐based application began in 2000, following issuance of the “Guidance for off‐label use of prescription drugs.” Furthermore, the approved items were mostly drugs for cancer, infectious diseases, and pediatric drugs. We anticipate the promotion of public knowledge‐based application to accommodate the approval of drugs for orphan diseases.
Collapse
Affiliation(s)
- Hideki Maeda
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityTokyoJapan
| | - Yuka Fukuda
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityTokyoJapan
| | - Marika Uchida
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityTokyoJapan
| |
Collapse
|
4
|
Tanaka M, Idei M, Sakaguchi H, Kato R, Sato D, Sawanobori K, Kawarasaki S, Hata T, Yoshizaki A, Nakamura M, Ikuma M. Evolving Landscape of New Drug Approval in Japan and Lags from International Birth Dates: Retrospective Regulatory Analysis. Clin Pharmacol Ther 2020; 109:1265-1273. [PMID: 33048367 PMCID: PMC8246743 DOI: 10.1002/cpt.2080] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/26/2022]
Abstract
The Pharmaceuticals and Medical Devices Agency (PMDA) has approved hundreds of new drugs in recent years. We retrospectively analyzed the new drugs approved in Japan from 2008 to 2019, and identify the first-in-world approvals and clarify the current drug lag. The new drug and the drug lag were defined as a drug with a new active substance and a difference between the approval date in Japan and the international birth date, respectively. Among 400 new drugs approved in Japan during the last 12 years, 80 (20.0%) were first approved in Japan, and 320 were outside Japan (the United States: 202, 50.5%; Europe: 82, 20.5%; other regions: 36, 9.0%). Of these, 45 new drugs have not yet been approved outside Japan, and the remaining 355 have been globally approved in Japan and overseas. The number of new drug approvals were the largest in oncology followed by metabolic/endocrine and infectious diseases. The median drug lags (year) among all 400 new drugs and 355 new drugs with global approvals were 4.3 and 4.7 in the first tertile (2008-2011), 1.5 and 2.6 in the second tertile (2012-2015), and reduced to 1.3 and 2.2 in the third tertile (2016-2019), respectively. Substantial drug lag remains in neurology, psychiatry, and therapeutic areas where the number of new drug approvals was relatively small. Collectively, one-fifth of the new drugs approved in Japan are first-in-world approvals. Drug lag has been greatly decreased, although it still exists.
Collapse
Affiliation(s)
- Mototsugu Tanaka
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mayumi Idei
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hiroshi Sakaguchi
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Ryosuke Kato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Daisuke Sato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Kenji Sawanobori
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Shuichi Kawarasaki
- Office of New Drug 2, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshiyuki Hata
- Office of New Drug 3, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Asako Yoshizaki
- Office of New Drug 4, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Miki Nakamura
- Office of New Drug 5, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mutsuhiro Ikuma
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| |
Collapse
|
5
|
Bun S, Yonemori K, Sunadoi H, Nishigaki R, Noguchi E, Okusaka T, Nishida T, Fujiwara Y. Safety and Evidence of Off-Label Use of Approved Drugs at the National Cancer Center Hospital in Japan. JCO Oncol Pract 2020; 17:e416-e425. [PMID: 32956004 DOI: 10.1200/op.20.00131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In Japan, for pharmaceutical products to be covered by public medical insurance, their efficacy and safety must first be confirmed in clinical trials. To our knowledge, this study is the first investigation into the off-label use of pharmaceutical products at a high-volume cancer treatment center in Japan. The objective of this study is to explore the framework necessary for future pharmaceutical development and regulatory approval in the field of oncology by surveying the frequency of and indications for off-label use of pharmaceutical products at the National Cancer Center Hospital in Tokyo, Japan. MATERIALS AND METHODS The pharmaceutical products used off-label in daily practice from 2003 to 2015 at the National Cancer Center Hospital were retrospectively examined based on applications that had been submitted to an internal review committee requesting off-label use. RESULTS A total of 1,390 applications were submitted during the study period. The most frequently used supporting documents were the results of phase II trials, followed by case series and phase III trials. The cancer most frequently treated with off-label drugs was sarcoma (15.1%), followed by urologic cancer (9.2%) and GI cancer (7.6%). CONCLUSION As reported in previous studies, pharmaceutical products were generally used off-label for the treatment of rare cancers, for which large-scale clinical trials are difficult to conduct. Continued discussion of the types of frameworks that are needed to guide pharmaceutical development is necessary.
Collapse
Affiliation(s)
- Seiko Bun
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan.,Department of Pharmacy, National Center for Child Health and Development, Tokyo, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroko Sunadoi
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Rena Nishigaki
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Toshirou Nishida
- National Cancer Center Hospital, Tokyo, Japan.,Japan Community Health Care Organization, Osaka Hospital, Osaka, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| |
Collapse
|
6
|
Okuma HS, Yonemori K, Narita SN, Sukigara T, Hirakawa A, Shimizu T, Shibata T, Kawai A, Yamamoto N, Nakamura K, Nishida T, Fujiwara Y. MASTER KEY Project: Powering Clinical Development for Rare Cancers Through a Platform Trial. Clin Pharmacol Ther 2020; 108:596-605. [PMID: 32112563 PMCID: PMC7484913 DOI: 10.1002/cpt.1817] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/22/2020] [Indexed: 12/28/2022]
Abstract
For rare cancers, challenges in establishing standard therapies are greater than those for major cancers, and effective methods are needed. MASTER KEY Project is a multicenter study based in Japan, with two main parts: prospective registry study and multiple clinical trials. Advanced rare cancers, cancers of unknown primary origin, and those with rare tissue subtypes of common cancers are targeted. The registry study accumulates highly reliable consecutive data that can be used for future drug development. The multiple trials are conducted simultaneously, targeting either a specific biomarker or a rare tumor type of interest. The first interim data set from the registry part presented here shows the prevalence of genetic abnormalities, response rates, survival rates, and clinical trial enrollment rates. From May 2017 to April 2019, 560 patients (mean age = 53) were enrolled in the project. Frequent cancer types included soft tissue sarcomas, neuroendocrine tumors, and central nervous system tumors. Among the 528 patients with assessable data, 69% (364/528) had next‐generation sequencing tests, with 48% (176/364) harboring an “actionable” alteration. Seventy‐one (13%) patients have been enrolled in one of the clinical trials, with an accrual rate of 3.94 patients/month. A descriptive analysis of biomarker‐directed or non‐biomarker‐directed treatment survival was performed. This project is expected to accelerate development of treatments for rare cancers and show that comprehensive platform trials are an advantageous strategy.
Collapse
Affiliation(s)
- Hitomi S Okuma
- Department of Breast and Medical Oncology, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Shoko N Narita
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Tamie Sukigara
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Taro Shibata
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichi Nakamura
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Toshiro Nishida
- Department of Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
7
|
Shimazawa R, Ikeda M. Regulatory perspectives on next-generation sequencing and complementary diagnostics in Japan. Expert Rev Mol Diagn 2020; 20:601-610. [DOI: 10.1080/14737159.2020.1728256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Rumiko Shimazawa
- Department of Clinical Pharmacology, Tokai University School of Medicine, Isehara, Japan
| | - Masayuki Ikeda
- Department of Medical Informatics, Kagawa University Hospital, Takamatsu, Japan
| |
Collapse
|
8
|
Okuma HS, Fujiwara Y. Have We Found the Key to Unravel Treatment Development Lags for Rare Cancers?: MASTER KEY Project. Clin Pharmacol Ther 2019; 106:491-492. [PMID: 31121054 PMCID: PMC6766785 DOI: 10.1002/cpt.1453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Hitomi S Okuma
- Clinical Trial Management Section, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Clinical Trial Management Section, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|