Potential Impact of Accelerated Approval on the Drug Lags for Anticancer Drugs Between the United States and Japan

Authors

DOI:

https://doi.org/10.21423/JRS-V08NAGASAWA

Keywords:

accelerated approval, anticancer drug, drug lag, oncology, Japan

Abstract

The term 'drug lag' represents the difference in the timing of drug approval among countries. The impact of accelerated approvals on the drug lag for anticancer drugs between the United States (U.S.) and Japan was evaluated using publicly available information to identify anticancer drugs approved in the U.S. or Japan between January 2006 and March 2017. A logistic regression analysis was conducted to determine the association between the oncology drugs lags and potential factors, including accelerated approval. The median drug lag was 805 days. The drug lag was extended for drugs that were approved in the U.S. under accelerated approval (884 days) compared to the standard approval (606 days). A total of 170 approvals were available for the analysis of drug lags. A multivariate logistic regression analysis revealed that the following factors contributed significantly to the drug lags (p < 0.05): accelerated approval (odds ratio [OR] 4.48), Phase III study (OR 3.69), major cancer (OR 0.38), and international/global development (OR 0.32). Accelerated approval in the U.S. is one of the significant factors that extend the drug lags for anticancer drugs. The current drug development and approval process in Japan may have advantages, however, since a new regulation to reduce drug lag for anticancer drugs, the conditional early approval system, may help minimize drug lags and support decision making not only for regulators but also pharmaceutical companies.

https://doi.org/10.21423/jrs-v08nagasawa

References

Asano, K., Tanaka, A., Sato, T., & Uyama, Y. (2013). Regulatory Challenges in the Review of Data From Global Clinical Trials: The PMDA Perspective. Clinical Pharmacology and Therapeutics, 94(2), 195-198. https://www.doi.org/10.1038/clpt.2013.106

Cancer Today. (2012). Cancer Fact Sheet. Retrieved September 30, 2019 from https://gco.iarc.fr/today/fact-sheets-cancers

Druker, B. J., Guilhot, F., O'Brien, S. G., Gathmann, I., Kantarjian, H., Gattermann, N., Deininger, M. W. N., Silver, R. T., Goldman, J. M., Stone, R. M., Cervantes, F., Hochhaus, A., Powell, B. L., Gabrilove, J. L., Rousselot, P., Reiffers, J., Cornelissen, J. J., Hughes, T., Agis, H., Fischer, T., Verhoef, G., Shepherd, J., Saglio, G., Gratwohl, A., Nielsen, J. L., Radich, J. P., Simonsson, B., Taylor, K., Baccarani, M., So, C., Letvak, L., & Larson, R. A. (2006). Five-Year Follow-up of Patients Receiving Imatinib for Chronic Myeloid Leukemia. New England Journal of Medicine, 355(23), 2408-2417. https://www.doi.org/10.1056/NEJMoa062867

European Medicines Agency. (2018). Enhanced early dialogue to facilitate accelerated assessment of PRIority Medicines (PRIME). Retrieved September 30, 2019 from https://www.ema.europa.eu/documents/regulatory-procedural-guideline/enhanced-early-dialogue-facilitate-accelerated-assessment-priority-medicines-prime_en.pdf

European Medicines Agency. (2016). Guideline on the scientific application and the practical arrangements necessary to implement Commission Regulation (EC) No 507/2006 on the conditional marketing authorisation for medicinal products for human use falling within the scope of Regulation (EC) No 726/2004}. Retrieved September 30, 2019 from https://www.ema.europa.eu/documents/scientific-guideline/guideline-scientific-application-practical-arrangements-necessary-implement-commission-regulation-ec/2006-conditional-marketing-authorisation-medicinal-products-human-use-falling_en.pdf

Fukuoka, M., Wu, Y-L, Thongprasert, S., Sunpaweravong, P., Leong, S-S., Sriuranpong, V., Chao, T-Y, Nakagawa, K., Chu, D-T., Saijo, N., Duffield, E. L., Rukazenkov, Y., Speake, G., Jiang, H., Armour, A. A., To, K-F., Yang, J. C-H., & Mok, T. S. K. (2011). Biomarker Analyses and Final Overall Survival Results From a Phase III, Randomized, Open-Label, First-Line Study of Gefitinib Versus carboplatin/paclitaxel in Clinically Selected Patients With Advanced Non-Small-Cell Lung Cancer in Asia (IPASS). Journal of Clinical Oncology, 29(21), 2866-2874. https://www.doi.org/10.1200/JCO.2010.33.4235

Hartmann, M., Mayer-Nicolai, C., & Pfaff, O. (2013). Approval Probabilities and Regulatory Review Patterns for Anticancer Drugs in the European Union. Critical Reviews in Oncology/Hematology, 87(2), 112-121. https://www.doi.org/10.1016/j.critrevonc.2013.01.004

Hirai, Y., Yamanaka, Y., Kusama, M., Ishibashi, T., Sugiyama, Y., & Ono, S. (2012). Analysis of the Success Rates of New Drug Development in Japan and the Lag Behind the US. Health Policy, 104(3), 241-246. https://www.doi.org/10.1016/j.healthpol.2011.11.008

Honig, P.K. (2014). Recent Trends and Success Factors in Reducing the Lag Time to Approval of New Drugs in Japan. Clinical Pharmacology and Therapeutics, 95(5), 467-469. https://www.doi.org/10.1038/clpt.2013.256

International Conference of Harmonization Expert Working Group. Ethnic Factors in the Acceptability of Foreign Clinical Data E5 (R1). Retrieved September 30, 2019 from https://www.pmda.go.jp/files/000156836.pdf

Inoue, A., Saijo, Y., Maemondo, M., Gomi, K., Tokue, Y., Kimura, Y., Ebina, M., Kikuchi, T., Moriya, T., & Nukiwa, T. (2003). Severe Acute Interstitial Pneumonia and Gefitinib. Lancet, 361(9352), 137-139. https://www.doi.org/10.1016/S0140-6736(03)12190-3

Kawabata-Shoda, E., Masuda, S., & Kimura, H. (2012). Anticancer Drug Development From Traditional Cytotoxic to Targeted Therapies: Evidence of Shorter Drug Research and Development Time, and Shorter Drug Lag in Japan. Clinical Pharmacology and Therapeutics, 37(5), 547-552. https://www.doi.org/10.1111/j.1365-2710.2012.01332.x

Kogure, S., Koyama, N., & Hidaka, S. (2017). Utilization of the Bridging Strategy for the Development of New Drugs in Oncology to Avoid Drug Lag. Journal of Clinical Pharmacology, 57(11), 1479-1490. https://www.doi.org/10.1002/jcph.951

Maeda, H., & Kurokawa, T. (2015). Recent Trends for Drug Lag in Clinical Development of Oncology Drugs in Japan: Does the Oncology Drug Lag Still Exist in Japan? International Journal of Clinical Oncology, 20(6), 1072-1080. https://www.doi.org/10.1007/s10147-015-0825-4

Ministry of Health, Labour and Welfare. (2017). Conditional Early Approval System for Drugs (in Japanese). Retrieved September 30, 2019 from https://www.pmda.go.jp/files/000220723.pdf

Ministry of Health, Labour and Welfare. (2017). Demographic Statistics (Confirmed Number) in 2017 (in Japanese). Retrieved September 30, 2019 from https://www.mhlw.go.jp/toukei/saikin/hw/jinkou/kakutei17/index.html

Ministry of Health, Labour and Welfare. (n.d.). Review Meeting for Unapproved and Off-label Drugs with High Medical Need (in Japanese). Retrieved September 30, 2019 from http://www.mhlw.go.jp/stf/shingi/other-iyaku_128701.html

Ministry of Health, Labour and Welfare. (n.d.). Sakigake Designation System} (in Japanese). Retrieved September 30, 2019 from http://www.mhlw.go.jp/seisakunitsuite/bunya/kenkou_iryou/iyakuhin/topics/tp150514-01.html

Ministry of Health, Labour and Welfare. (2005). The Revision of the Guideline for Clinical Evaluation Methods of Anticancer Drugs in Japan (in Japanese). Retrieved September 30, 2019 from https://www.pmda.go.jp/files/000206740.pdf

Nakajima, K., Dagher, R., Strawn, L., Urushidani, J., Kurokawa, T., & Chiba, K. (2015). The Relationship Between Development Start Lag and Approval Lag in Oncology Drug Development in Japan. Therapeutic Innovation and Regulatory Science, 49(6), 911-919. https://www.doi.org/10.1177/2168479015579518

Nakayama, H., Matsumaru, N., & Tsukamoto, K. (2019). The Drug Lag and Associated Factors for Orphan Anticancer Drugs in Japan Compared to the United States. Investigational New Drugs, 37(5), 1086-1093. https://www.doi.org/10.1007/s10637-018-0612-y

National Cancer Center. Cancer Information Service (in Japanese). Retrieved September 30, 2019 from http://ganjoho.jp/reg_stat/statistics/stat/summary.html

Ohwaki, K., & Nakabayashi, T. (2014). Relationship Between Drug Lag and Factors Associated With Clinical Trials in Japan. Journal of Clinical Pharmacy and Therapeutics, 39(6), 649-652. https://www.doi.org/10.1111/jcpt.12202

Okubo, T. K., & Ono S. (2019). Analysis of Global Drug Development Pathways and Postmarketing Safety in Japan: Local Studies May Reduce Drug-Related Deaths. Clinical and Translational Science, 12(4), 408-415. https://www.doi.org/10.1111/cts.12631

Pharmaceuticals and Medical Devices Agency. Estimation of Drug Lag (in Japanese). Retrieved September 30, 2019 from https://www.pmda.go.jp/files/000227686.pdf

Sinha, G. (2010). Japan Works To Shorten "Drug Lag", Boost Trials of New Drugs. Journal of the National Cancer Institute, 102(3), 148-151. https://www.doi.org/10.1093/jnci/djq017

Solomon, B. J., Mok, T., Kim, D-W., Wu, Y-L., Nakagawa, K., Mekhail, T., Felip, E., Cappuzzo, F., Paolini, J., Usari, T., Iyer, S., Reisman, A., Wilner, K. D., Tursi, J., & Blackhall, F. (2014). First-line Crizotinib Versus Chemotherapy in ALK-positive Lung Cancer. The New England Journal of Medicine, 371(23), 2167-2177. https://www.doi.org/10.1056/NEJMoa1408440

Tsuji, K., & Tsutani, K. (2008). Follow the leader. Nature, 453, 851-852.

U.S. Food and Drug Administration. (2014, May). Guidance for Industry: Expedited Programs for Serious Conditions - Drugs and Biologics. Retrieved September 30, 2019 from https://www.fda.gov/files/drugs/published/Expedited-Programs-for-Serious-Conditions-Drugs-and-Biologics.pdf

Ueno, T., Asahina, Y., Tanaka, A., Yamada, H., Nakamura, M., & Uyama, Y. (2014). Significant Differences in Drug Lag in Clinical Development Among Various Strategies Used for Regulatory Submissions in Japan. Clinical Pharmacology and Therapeutics, 95(5), 533-541. https://www.doi.org/10.1038/clpt.2013.223

Uyama, Y., Shibata, T., Nagai, N., Hanaoka, H., Toyoshima, S., & Mori, K. (2005) Successful bridging strategy based on ICH E5 guideline for drugs approved in Japan. Clinical Pharmacology and Therapeutics, 78(2), 102-113. https://www.doi.org/10.1016/j.clpt.2005.04.001

Yamada, T., Kusama, M., Hirai, Y., Arnold, F., Sugiyama, Y. & Ono, S. (2010). Analysis of Pharmaceutical Safety-Related Regulatory Actions in Japan: Do Tradeoffs Exist Between Safer Drugs and Launch Delay? The Annals of Pharmacotherapy, 44(12), 1976-1985. https://www.doi.org/10.1345/aph.1P153

Yamashita, K., Kaneko, M., & Nakamura, M. (2019). A Significant Anticancer Drug Approval Lag Between Japan and the United States Still Exists for Minor Cancers. Clinical Pharmacology and Therapeutics, 105(1), 153-60. https://www.doi.org/10.1002/cpt.1136

Yonemori, K., Hirakawa, A., Ando, M., Hirata, T. Yunokawa, M., Shimizu, C., Katsumata, N., Tamura, L., & Fujiwara, Y. (2011). The Notorious "Drug Lag" for Oncology Drugs in Japan. Investigational New Drugs, 29(4), 706-712. https://www.doi.org/10.1007/s10637-011-9638-0

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2020-08-12

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Scientific Articles