title: Review of oncology and hematology drug product approvals at the US Food and Drug Administration between July 2005 and December 2007.
abstract: BACKGROUND
  The Office of Oncology Drug Products (OODP) in the Center for Drug Evaluation and Research at the US Food and Drug Administration began reviewing marketing applications for oncological and hematologic indications in July 2005. We conducted an overview of products that were reviewed by the OODP for marketing approval and the regulatory actions taken during July 2005 to December 2007.
  
  
  METHODS
  We identified all applications that were reviewed by the OODP from July 1, 2005, through December 31, 2007, and reviewed the actions that OODP took. We also sought the basis for the actions taken, including the clinical trial design, endpoints used, patient accrual in the trial(s) supporting approval, and the type of regulatory approval.
  
  
  RESULTS
  During the study period, the OODP reviewed marketing applications for 60 new indications and took regulatory action on 58 indications. Regulatory action was based on a risk-benefit evaluation of the data submitted with each application. Products that demonstrated efficacy and had an acceptable risk-benefit ratio were granted either regular or accelerated marketing approval for use in the specific indication that was studied. Regular approval was based on endpoints that demonstrated that the drug provided clinical benefit as evidenced by a longer or better life or a favorable effect on an established surrogate for a longer or better life. Accelerated approval was based on a less well-established surrogate endpoint that was reasonably likely to predict a longer or better life. Of the 53 new indications that were approved during the study period, 39 received regular approval, nine received accelerated approval, and five were converted from accelerated to regular approval. Five applications were not approved, and two applications were withdrawn before any regulatory action was taken. Eighteen of the 53 indications that were approved were for new molecular entities.
  
  
  CONCLUSIONS
  During the study period, regulatory action was taken on 58 of the 60 marketing applications. Fifty-three applications were approved. A variety of clinical trial endpoints were used in the approval trials.
authors.affiliation: Division of Biometrics V, Office of Translational Sciences, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA. rajeshwari.sridhara@fda.hhs.gov
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sridhara
authors.forename: John R
authors.initials: JR
authors.lastname: Johnson
authors.forename: Robert
authors.initials: R
authors.lastname: Justice
authors.forename: Patricia
authors.initials: P
authors.lastname: Keegan
authors.forename: Aloka
authors.initials: A
authors.lastname: Chakravarty
authors.forename: Richard
authors.initials: R
authors.lastname: Pazdur
mesh_terms: D000970:Antineoplastic Agents; D002986:Clinical Trials as Topic; D017277:Drug Approval; D006401:Hematologic Agents; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000970:Antineoplastic Agents; D006401:Hematologic Agents