Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.
Moffitt Cancer Center, Tampa, Florida, USA.
Clin Pharmacol Ther. 2018 Nov;104(5):940-948. doi: 10.1002/cpt.1180. Epub 2018 Sep 14.
Race, ethnicity, sex, and age are demographic factors that can influence drug exposure and/or response, and can consequently affect treatment outcome. We evaluated demographic subgroup enrollment patterns in new therapeutic products approved by the US Food and Drug Administration (FDA) for the treatment of select cancers-breast, colorectal, lung, and prostate-that have comparative differences in morbidity and/or mortality among some demographic subgroups. In submissions of products approved between 2008 and 2013, participants (n = 22,481) were white (80%), from outside the United States (74%), between 17 and 64 years old (59%), and men (56% and 53%, including and excluding sex-specific indications, respectively). In pivotal trials of products approved between2014 and 2017, participants (n = 3,612) were white (71%), between 17 and 64 years old (61%), and men (48% and 63%, including and excluding sex-specific indications, respectively). The US-relevant minority populations were under-represented. A broader representation of patient subgroups in clinical trials may contribute to better understanding of exposure and/or response variability, and consequently help personalize drug therapy.
种族、民族、性别和年龄是影响药物暴露和/或反应的人口统计学因素,因此可能会影响治疗结果。我们评估了美国食品和药物管理局 (FDA) 批准的用于治疗某些癌症(乳腺癌、结直肠癌、肺癌和前列腺癌)的新型治疗产品的人口统计学亚组招募模式,这些癌症在某些人口统计学亚组中发病率和/或死亡率存在差异。在 2008 年至 2013 年期间批准的产品提交中,参与者(n = 22,481)为白人(80%),来自美国以外地区(74%),年龄在 17 至 64 岁之间(59%),并且为男性(56%和 53%,分别包括和不包括特定性别适应症)。在 2014 年至 2017 年期间批准的产品的关键试验中,参与者(n = 3,612)为白人(71%),年龄在 17 至 64 岁之间(61%),并且为男性(48%和 63%,分别包括和不包括特定性别适应症)。美国相关的少数族裔人口代表性不足。临床试验中患者亚组的更广泛代表性可能有助于更好地理解暴露和/或反应的变异性,并最终有助于个性化药物治疗。