AI Article Synopsis
- The Innovative Therapies for Children with Cancer (ITCC) consortium aims to enhance access to new cancer treatments for children and adolescents, and its clinical trial progress from 2003 to 2018 was examined.
- A total of 61 trials, primarily industry-sponsored, involved 3,198 patients, showing a significant increase in trials and a shift toward biomarker-driven and combination targeted therapies in the second study period.
- The findings indicate a transformation in early drug development for childhood cancers, emphasizing more advanced trial designs and regulatory compliance to improve patient access to innovative treatments.
Article Abstract
Purpose: The aim of the Innovative Therapies for Children with Cancer (ITCC) consortium is to improve access to novel therapies for children and adolescents with cancer. The evolution of the ITCC clinical trial portfolio since 2003 was reviewed.
Methods: All ITCC-labeled phase I/II trials opened between January 1, 2003 and February 3, 2018 were analyzed in two periods (2003-2010 and 2011-2018), and data were extracted from the ITCC database, regulatory agencies' registries, and publications.
Results: Sixty-one trials (62% industry-sponsored) enrolled 3,198 patients. The number of trials in the second period increased by almost 300% (16 45). All biomarker-driven trials (n = 14) were conducted in the second period. The use of rolling six and model-based designs increased (1 of 9, 11% 21 of 31, 68%), and that of 3 + 3 designs decreased (5 of 9, 55% 5 of 31, 16%; = .014). The proportion of studies evaluating chemotherapeutics only decreased (5 of 16, 31% 4 of 45, 9%), the proportion of single-agent targeted therapies did not change (9 of 16, 56.2% 24 of 45, 53.3%), the proportion of combination targeted therapies trials increased (2 of 16, 12%, 17 of 45, 38%), the proportion of randomized phase II trials increased (1 of 7, 14% 8 of 14, 57%). More trials were part of a pediatric investigation plan in the second period (4 of 16, 25% 21 of 45, 46%). The median time for Ethics Committees' approvals was 1.7 times longer for academic compared with industry-sponsored trials.
Conclusion: This study reports a shift in the paradigm of early drug development for childhood cancers, with more biologically relevant targets evaluated in biomarker-driven trials or in combination with other therapies and with more model-based or randomized designs and a greater focus on fulfilling regulatory requirements. Improvement of trial setup and recruitment could increase the number of patients benefiting from novel agents.
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| http://dx.doi.org/10.1200/JCO.23.01237 | DOI Listing |
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