To: squetch who wrote (20573 ) 5/12/1998 8:08:00 AM From: Henry Niman Respond to of 32384
Here's more on the FDA approval process: Can Those New Cancer Drugs Win FDA Approval? By JEFF NESMITH c.1998 Cox News Service WASHINGTON -- Cancer patients and investors who developed a sudden and urgent interest last Monday in a little-known Maryland biotech company because of a newspaper article about the company's potentially life-saving drugs might consider this: The two chemicals are at a stage of development that gives them at best a one-in-five chance of ever being licensed by the U.S. Food and Drug Administration (FDA). The odds were developed by the Center for the Study of Drug Development at Tufts University in Boston. ''The new drug development process is lengthy, risky and costly,'' said Joseph A. DiMasi, director of economic analysis at the center. Interest in the two drugs, angiostatin and endostatin, was driven to a near-stampede last week by an article in Sunday editions of The New York Times. The 52-employee company that has the license to develop the patented chemicals, Entremed Inc., of Rockville, Md., said its telephones were flooded with calls from cancer patients who hoped to get into clinical trials of the drugs. The American Cancer Society and individual physicians also reported receiving calls. And stock in Entremed, which was trading at around $12 a share, jumped to over $80 Monday before settling to $54 at the end of the day. It continued to decline during the week. The two substances belong to a relatively new class of drugs, known as antiangiogenics, which turn off chemical processes involved in the body's construction of new blood vessels. Tumors have a voracious need for blood and must force the victim's body to construct special blood vessels to supply it. Even when a tumor consists of little more than a microscopic clump of cells, it is releasing chemicals that induce the nearest blood vessel to start growing branches in its direction. As the tumor grows, the branches grow with it and new ones are also grown. If antiangiogenic compounds can turn off the chemical signal mechanism and stop the vital blood supply, they could become a fourth route for cancer therapy, joining chemotherapy, radiation and surgery. Patent Office records show that more than 33 substances with potential antiangiogenic properties have been patented, and some have already been given to human volunteers in preliminary tests. Although angiostatin and endostatin have been used only on laboratory animals, the Times's article said that ''if all goes well'' the first human clinical trials could be begin within a year. But all does not always go well in the clinical obstacle course a potential new drug has to run between ''looks good'' and ''works well.'' That course typically involves five separate stages of review: - Early research and pre-clinical testing: laboratory studies, usually with animals, that attempt to measure a substance's toxicity and determine if it demonstrates chemical properties that might be useful as a drug. If a chemical passes this step, the drug company files an ''investigational new drug application'' with the FDA for permission to begin human experiments. If the FDA does not disapprove it within 30 days, the tests can begin. - Phase I clinical trials: tests on 20 to 80 healthy human volunteers to further assess the substance's safety. - Phase II clinical trials: tests on a larger group, usually between 100 and 300 patient volunteers, to evaluate the drug's effectiveness and look for side effects. - Phase III clinical trials: tests on a still-larger group of patients, from 1,000 to 3,000 volunteers, to confirm effectiveness and monitor reactions to long-term use. If all goes well in Phase III trials - and the company must produce at least two trials showing both safety and efficacy - the company files a ''new drug application'' for permission to market the drug. DiMasi reported last year that for every 5,000 compounds that are evaluated in early research phase, only five move to clinical trials. And of those five, he said, only one is eventually licensed by the FDA. The process takes an average of 15 years, he said. The money spent on drug research and development by biotech firms and pharmaceutical manufacturers works out to an average of $312 million for every drug that is eventually licensed, the Tufts center reported. But a single new drug can boost a company's sales by that much or more every year, and drug companies continue to lay out the investment. ----- (The Cox web site is at coxnews.com )