Radiation-Therapeutic Agent Clinical Trials: Leveraging Advantages of a National Cancer Institute Programmatic Collaboration.
A number of oncology phase II radiochemotherapy trials with promising results have been conducted late in the overall experimental therapeutic agent development process. Accelerated development and approval of experimental therapeutic agents have stimulated further interest in much earlier radiation-agent studies to increase the likelihood of success in phase III trials. To sustain this interest, more forward-thinking preclinical radiobiology experimental designs are needed to improve discovery of promising radiochemotherapy plus agent combinations for clinical trial testing. These experimental designs should better inform next-step radiation-agent clinical trial dose, schedule, exposure, and therapeutic effect. Recognizing the need for a better strategy to develop preclinical data supporting radiation-agent phase I or II trials, the National Cancer Institute (NCI)-Cancer Therapy Evaluation Program (CTEP) and the NCI-Molecular Radiation Therapeutics Branch of the Radiation Research Program have partnered to promote earlier radiobiology studies of CTEP portfolio agents. In this Seminars in Radiation Oncology article, four key components of this effort are discussed. First, we outline steps for accessing CTEP agents for preclinical testing. Second, we propose radiobiology studies that facilitate transition from preclinical testing to early phase trial activation. Third, we navigate steps that walk through CTEP agent strategic development paths available for radiation-agent testing. Fourth, we highlight a new NCI-sponsored cooperative agreement grant supporting in vitro and in vivo radiation-CTEP agent testing that informs early phase trial designs. Throughout the article, we include contemporary examples of successful radiation-agent development initiatives.
Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address: Takeben@mail.nih.gov.
Naoko
N
Takebe
Radiation Research Program, National Cancer Institute, Bethesda, MD.
Mansoor M
MM
Ahmed
Radiation Research Program, National Cancer Institute, Bethesda, MD.
Bhadrasain
B
Vikram
Radiation Research Program, National Cancer Institute, Bethesda, MD.
Eric J
EJ
Bernhard
Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
James
J
Zwiebel
Radiation Research Program, National Cancer Institute, Bethesda, MD.
C
C
Norman Coleman
Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Charles A
CA
Kunos
D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000532:radiotherapy*; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D011853:Radiobiology; D012107:Research Design; D014481:United States
D011838:Radiation-Sensitizing Agents