title: An FDA Perspective on the Regulatory Implications of Complex Signatures to Predict Response to Targeted Therapies.
abstract: As technologies evolve, and diagnostics move from detection of single biomarkers toward complex signatures, an increase in the clinical use and regulatory submission of complex signatures is anticipated. However, to date, no complex signatures have been approved as companion diagnostics. In this article, we will describe the potential benefit of complex signatures and their unique regulatory challenges, including analytic performance validation, complex signature simulation, and clinical performance evaluation. We also will review the potential regulatory pathways for clearance, approval, or acceptance of complex signatures by the FDA. These regulatory pathways include regulations applicable toin vitrodiagnostic devices, including companion diagnostic devices, the potential for labeling as a complementary diagnostic, and the biomarker qualification program.Clin Cancer Res; 23(6); 1368-72. ©2016 AACR.
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Beaver
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Abraham
authors.initials: A
authors.lastname: Tzou
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Gideon M
authors.initials: GM
authors.lastname: Blumenthal
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Amy E
authors.initials: AE
authors.lastname: McKee
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Kim
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland.
authors.forename: Richard
authors.initials: R
authors.lastname: Pazdur
authors.affiliation: U.S. Food and Drug Administration, White Oak, Maryland. Reena.Philip@fda.hhs.gov.
authors.forename: Reena
authors.initials: R
authors.lastname: Philip
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D057069:Diagnostic Test Approval; D055808:Drug Discovery; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D057285:Precision Medicine; D015398:Signal Transduction / Q000235:genetics*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D014408:Biomarkers, Tumor