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Author: Expert Scientific Group on Phase One Clinical Trials Publisher: TSO ISBN: 9780117037229 Category : Medical Languages : en Pages : 700
Book Description
This particular Expert Scientific Group was established following the very serious adverse reactions that occurred in the first-in-man clinical trial (that is the first time the drug is given to a human) of TGN1412 in March 2006. The trial was performed in a private clinic research unit at Northwick Park Hospital in London. TGN1412 is a monoclonal antibody that was being developed as a medicine to treat leukaemia and autoimmune diseases such as rheumatoid arthritis. In the clinical trial, six healthy male volunteers experienced severe systemic adverse reactions soon after receiving TGN1412 intravenously. All six volunteers developed a cytokine (small protein molecules that transmit signals between immune cells and tissue cells) release syndrome with multi-organ failure and required intensive treatment and supportive measures. The Expert Group states that the pre-clinical development studies that were performed with TGN1412 did not predict a safe dose for use in humans, even though current regulatory requirements were met. The Expert Scientific Group has set out 22 recommendations that should increase the safety of volunteers in future clinical trials, and these cover the following areas: the preclinical and early clinical development; the process of preparation and review of clinical trial applications, and early access to advice for both regulators and sponsors; the determining and administering of the initial doses in man; the clinical environment for first-in-man studies and the development of the skills and training to meet future needs.
Author: Expert Scientific Group on Phase One Clinical Trials Publisher: TSO ISBN: 9780117037229 Category : Medical Languages : en Pages : 700
Book Description
This particular Expert Scientific Group was established following the very serious adverse reactions that occurred in the first-in-man clinical trial (that is the first time the drug is given to a human) of TGN1412 in March 2006. The trial was performed in a private clinic research unit at Northwick Park Hospital in London. TGN1412 is a monoclonal antibody that was being developed as a medicine to treat leukaemia and autoimmune diseases such as rheumatoid arthritis. In the clinical trial, six healthy male volunteers experienced severe systemic adverse reactions soon after receiving TGN1412 intravenously. All six volunteers developed a cytokine (small protein molecules that transmit signals between immune cells and tissue cells) release syndrome with multi-organ failure and required intensive treatment and supportive measures. The Expert Group states that the pre-clinical development studies that were performed with TGN1412 did not predict a safe dose for use in humans, even though current regulatory requirements were met. The Expert Scientific Group has set out 22 recommendations that should increase the safety of volunteers in future clinical trials, and these cover the following areas: the preclinical and early clinical development; the process of preparation and review of clinical trial applications, and early access to advice for both regulators and sponsors; the determining and administering of the initial doses in man; the clinical environment for first-in-man studies and the development of the skills and training to meet future needs.
Author: Markus Müller Publisher: Springer Science & Business Media ISBN: 3709101441 Category : Medical Languages : en Pages : 438
Book Description
Today we witness an eventful time in which the powerful new forces of genomics, information technology and economics are rapidly changing the science and art of medicine. This will require more specialization than ever before. However, there is also an increasing demand for an integrated approach, which is provided by the discipline of Clinical Pharmacology (CP). CP pursues a scientific goal by studying drug action in patients and volunteers, a clinical goal by administering appropriate drug therapy and a regulatory goal by assessing the risk/benefit ratio of drug candidates in drug development and reimbursement. This introduction to current topics of CP covers traditional topics of clinical drug research and trial methodology but also provides insight in current topics like genomics, imaging technology and issues in drug reimbursement. A number of concrete case studies in clinical drug research and development help to give a better understanding of the general principles of CP.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309171148 Category : Medical Languages : en Pages : 221
Book Description
Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309316324 Category : Medical Languages : en Pages : 236
Book Description
Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.
Author: Shivaani Kummar Publisher: Academic Press ISBN: 0128125705 Category : Medical Languages : en Pages : 234
Book Description
Novel Designs of Early Phase Trials for Cancer Therapeutics provides a comprehensive review by leaders in the field of the process of drug development, the integration of molecular profiling, the changes in early phase trial designs, and endpoints to optimally develop a new generation of cancer therapeutics. The book discusses topics such as statistical perspectives on cohort expansions, the role and application of molecular profiling and how to integrate biomarkers in early phase trials. Additionally, it discusses how to incorporate patient reported outcomes in phase one trials. This book is a valuable resource for medical oncologists, basic and translational biomedical scientists, and trainees in oncology and pharmacology who are interested in learning how to improve their research by using early phase trials. Brings a comprehensive review and recommendations for new clinical trial designs for modern cancer therapeutics Provides the reader with a better understanding on how to design and implement early phase oncology trials Presents a better and updated understanding of the process of developing new treatments for cancer, the exciting scientific advances and how they are informing drug development
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309253187 Category : Medical Languages : en Pages : 248
Book Description
There is growing recognition that the United States' clinical trials enterprise (CTE) faces great challenges. There is a gap between what is desired - where medical care is provided solely based on high quality evidence - and the reality - where there is limited capacity to generate timely and practical evidence for drug development and to support medical treatment decisions. With the need for transforming the CTE in the U.S. becoming more pressing, the IOM Forum on Drug Discovery, Development, and Translation held a two-day workshop in November 2011, bringing together leaders in research and health care. The workshop focused on how to transform the CTE and discussed a vision to make the enterprise more efficient, effective, and fully integrated into the health care system. Key issue areas addressed at the workshop included: the development of a robust clinical trials workforce, the alignment of cultural and financial incentives for clinical trials, and the creation of a sustainable infrastructure to support a transformed CTE. This document summarizes the workshop.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309176611 Category : Medical Languages : en Pages : 279
Book Description
In June 1993 a clinical trial of fialuridine (FIAU), a promising new medication for hepatitis B, was abruptly terminated when one of the 15 out-patients participating in the National Institutes of Health (NIH) study was suddenly hospitalized with liver failure. Although all the remaining patients were contacted and told to stop taking their medication, six more subsequently developed severe toxicity. Five patients died, and two others were probably saved from death only by having liver transplants. In response to a request from the Secretary of the Department of Health and Human Services, the IOM committee has analyzed the FIAU clinical trials, making recommendations for additional safeguards for the conduct of future clinical trials. This evaluation included the review of documents pertaining to investigational new drug submissions, protocols and consent forms from other clinical trials, as well as information available from other clinical and preclinical experience with compounds related to FIAU and its parent drug, fiacitibine (FIAC), which is metabolized to FIAU. The committee does not seek to affix responsibility for the adverse outcome of this NIH trial, but instead focuses on whether any rules or procedures governing the clinical trials process itself need to be changed, and if so, what burdens or costs such changes might place on future clinical trials.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309157870 Category : Medical Languages : en Pages : 317
Book Description
The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309163358 Category : Medical Languages : en Pages : 151
Book Description
An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.
Author: Expert Scientific Group on Phase One Clinical Trials
Author: Expert Scientific Group on Phase One Clinical Trials
Author: Expert Scientific Group on Phase One Clinical Trials (Great Britain)
Author: Markus Müller
Author: Institute of Medicine
Author: Institute of Medicine
Author: Shivaani Kummar
Author: Institute of Medicine
Author: Institute of Medicine
Author: Institute of Medicine
Author: Institute of Medicine