Clinical trial considerations for pediatric cancer drug development

J Biopharm Stat. 2023 Nov 2;33(6):859-874. doi: 10.1080/10543406.2023.2172424. Epub 2023 Feb 7.

Abstract

Oncology has been one of the most active therapeutic areas in medicinal products development. Despite this fact, few drugs have been approved for use in pediatric cancer patients when compared to the number approved for adults with cancer. This disparity could be attributed to the fact that many oncology drugs have had orphan drug designation and were exempt from Pediatric Research Equity Act (PREA) requirements. On August 18, 2017, the RACE for Children Act, i.e. Research to Accelerate Cures and Equity Act, was signed into law as Title V of the 2017 FDA Reauthorization Act (FDARA) to amend the PREA. Pediatric investigation is now required if the drug or biological product is intended for the treatment of an adult cancer and directed at a molecular target that FDA determines to be "substantially relevant to the growth or progression of a pediatric cancer." This paper discusses the specific considerations in clinical trial designs and statistical methodologies to be implemented in oncology pediatric clinical programs.

Keywords: RACE Act; pediatric clinical programs.

MeSH terms

  • Adult
  • Child
  • Drug Approval
  • Drug Development
  • Humans
  • Medical Oncology
  • Neoplasms* / drug therapy
  • Orphan Drug Production
  • United States
  • United States Food and Drug Administration