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美国植物药产品开发中遗传毒性测试的现行监管观点

Current regulatory perspectives on genotoxicity testing for botanical drug product development in the U.S.A.

机构信息

Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA.

出版信息

Regul Toxicol Pharmacol. 2010 Feb;56(1):1-3. doi: 10.1016/j.yrtph.2009.09.012. Epub 2009 Sep 24.

Abstract

Genotoxicity testing is an important part of preclinical safety assessment of new drugs and is required prior to Phase I/II clinical trials. It is designed to detect genetic damage such as gene mutations and chromosomal aberration, which may be reflected in tumorigenic or heritable mutation potential of the drug. Botanical new drugs in the U.S. are entitled to a waiver for preclinical pharmacology/toxicology studies, including genotoxicity testing, in support of an initial clinical trial under IND, contingent on previous human experience. Recently, ethical concerns have been raised over conducting Phase I/II clinical trials of new drugs with positive genotoxicity findings in healthy volunteers. Although the relevance of this issue to patients, as opposed to healthy volunteers, depends on the drug's indication, duration of treatment, and specific findings related to the assays, the regulatory view is to avoid exposing patients to genotoxic compounds unnecessarily in clinical trials. This philosophy may impact on herbal supplement marketing and botanical drug development, in that genotoxicity data are often lacking while consumers are exposed to the herbal supplement, or healthy volunteers are tested in an initial Phase I/II clinical trial on the botanical drug. This paper presents results of a survey conducted on genotoxicity data in botanical INDs submitted to the Agency and discusses the significance of this information. The information presented indicates that the sponsors of botanical INDs have increasingly recognized the importance of genotoxicity information and may have prioritized its acquisition in their strategic drug development programs.

摘要

遗传毒性试验是新药临床前安全性评估的重要组成部分,需要在进行 I/II 期临床试验之前进行。它旨在检测遗传损伤,如基因突变和染色体畸变,这些损伤可能反映药物的致癌或遗传性突变潜力。在美国,植物新药有资格免除临床前药理学/毒理学研究,包括遗传毒性试验,以支持 IND 下的首次临床试验,但前提是有先前的人类经验。最近,人们对在健康志愿者中进行具有阳性遗传毒性发现的新药 I/II 期临床试验提出了伦理方面的担忧。尽管与健康志愿者相比,这个问题与患者的相关性取决于药物的适应证、治疗持续时间以及与检测相关的具体发现,但监管观点是避免在临床试验中不必要地将患者暴露于遗传毒性化合物。这种理念可能会影响草药补充剂的营销和植物药的开发,因为遗传毒性数据通常缺乏,而消费者会接触到草药补充剂,或者在植物药的初步 I/II 期临床试验中测试健康志愿者。本文介绍了对提交给该机构的植物性 IND 中的遗传毒性数据进行的一项调查结果,并讨论了这些信息的意义。所提供的信息表明,植物性 IND 的赞助商越来越认识到遗传毒性信息的重要性,并可能在其药物开发战略中优先获取该信息。

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