Wang Tao, Cao Xiao, He Yingjian, Chen Xiaoyuan
Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Medical Affairs, Zai Lab (Shanghai) Co., Ltd, Shanghai, China.
Transl Breast Cancer Res. 2022 Jan 31;3:2. doi: 10.21037/tbcr-21-43. eCollection 2022.
Many factors (pathological subtype differences, etiology, clinical practice, etc.) may cause ethnic sensitivities in drugs. For drugs approved in one region, their differences among ethnic groups and the potential impacts of such differences on their safety and efficacy must be explained before seeking approvals in another region. Despite potential ethnic sensitivities, if pharmaceutical companies are required to repeat the clinical research and development process in various countries, it will result in waste of resources and delays in drug approval. To address this issue, the International Conference on Harmonization (ICH) published a guideline entitled , known as ICH E5, in 1998. With an attempt to offer guidance on the monitoring and research & development (R&D) of innovation drugs, the concept of bridging studies was for the first proposed, which allows the adequate assessment of ethnic differences in safety, efficacy, dosage, or dose regimen of an innovation drug, and meanwhile minimizes the duplication of clinical data in two different regions to speed up the licensing of the drug in the new region. Here we take breast cancer as an example to describe the concept, types, strategies, statistical methods, and clinical practice of bridging studies, focusing on their development in China.
许多因素(病理亚型差异、病因、临床实践等)可能导致药物存在种族敏感性。对于在一个地区获批的药物,在寻求另一地区的批准之前,必须阐明其在不同种族群体间的差异以及这些差异对其安全性和有效性的潜在影响。尽管存在潜在的种族敏感性,但如果要求制药公司在各个国家重复临床研发过程,将会导致资源浪费和药物审批延迟。为解决这一问题,国际协调会议(ICH)于1998年发布了一项名为《种族因素对药品研发的影响》的指南,即ICH E5。为了尝试为创新药物的监测和研发提供指导,首次提出了桥接研究的概念,该概念能够充分评估创新药物在安全性、有效性、剂量或给药方案方面的种族差异,同时最大程度减少两个不同地区临床数据的重复,以加速新药在新地区的获批。在此,我们以乳腺癌为例,描述桥接研究的概念、类型、策略、统计方法及临床实践,重点阐述其在中国的发展情况。