Phase 0 clinical trials: conceptions and misconceptions.
Phase 0 clinical trials, developed in response to the United States Food and Drug Administration (FDA)'s recent exploratory Investigational New Drug (IND) guidance, are intended to expedite the clinical evaluation of new molecular entities. The exploratory IND supports the performance of first-in-human testing of new investigational agents at subtherapeutic doses based on reduced manufacturing and toxicologic requirements, allowing the demonstration of drug-target effects and assessment of pharmacokinetic-pharmacodynamic relationships in humans earlier in clinical development. The objectives of a phase 0 cancer clinical trial are to establish at the very earliest opportunity-before large numbers of patients have been accrued and exposed to potential drug-associated toxicity-whether an agent is modulating its target in a tumor, and consequently whether further clinical development is warranted. We review here the fundamental requirements of clinical studies conducted under an exploratory IND and address some common misconceptions regarding oncologic phase 0 trials.
Kummar
Shivaani
S
Center for Cancer Research, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland 20892, USA.
Rubinstein
Larry
L
Kinders
Robert
R
Parchment
Ralph E
RE
Gutierrez
Martin E
ME
Murgo
Anthony J
AJ
Ji
Jay
J
Mroczkowski
Barbara
B
Pickeral
Oxana K
OK
Simpson
Mel
M
Hollingshead
Melinda
M
Yang
Sherry X
SX
Helman
Lee
L
Wiltrout
Robert
R
Collins
Jerry
J
Tomaszewski
Joseph E
JE
Doroshow
James H
JH
D035843:Biomedical Research / Q000331:legislation & jurisprudence / Q000379:methods*; D002986:Clinical Trials as Topic; D015507:Drugs, Investigational; D006801:Humans; D010599:Pharmacokinetics; D010600:Pharmacology; D014481:United States; D014486:United States Food and Drug Administration
D015507:Drugs, Investigational