Van Oosterhout J P, Van der Laan J W, De Waal E J, Olejniczak K, Hilgenfeld M, Schmidt V, Bass R
Preclinical Assessment Group of the Medicines Evaluation Board in The Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Regul Toxicol Pharmacol. 1997 Feb;25(1):6-17. doi: 10.1006/rtph.1996.1077.
For the past 20-30 years, lifespan carcinogenicity studies for pharmaceuticals have been required to be carried out in two rodent species. Due to scientific progress, the necessity/justification of lifespan studies in two species for the assessment of carcinogenic risk of pharmaceuticals is currently under discussion. A study in one species (either rat or mouse) might suffice. To appraise the need for a study in a second species, a database was compiled of all pharmaceuticals tested for carcinogenicity for which a marketing authorization was applied for in Germany and The Netherlands since 1980. The incidence of treatment-related tumor findings was determined in either rat or mouse or in both. Tumor findings occurred for nearly 50% of all compounds, with the rat being more sensitive than the mouse. Specific attention was given to the question whether tumor findings in mice ever caused the regulatory authorities to refuse registration, to restrict the proposed therapeutic indication of a pharmaceutical, or to apply a cautionary label. It was found that no tumor findings in mice alone ever led to such a regulatory action. In addition, whether mouse studies had been important in interpreting the results of rat studies was determined. A negative mouse study (no tumors found) was rarely used to declare the rat findings irrelevant to humans. A mechanistic explanation was used as a much more important argument in the assessment of tumor findings in rats. In case of transspecies findings, the target organs were the usual ones, such as lung and liver, or the tumors occurred as a result of an exaggerated pharmacodynamic action expected from the pharmacology of the compound. The results of the database thus question the need of maintaining the requirement of rodent carcinogenicity studies in two species.
在过去的20到30年里,一直要求对药物进行两种啮齿动物物种的终生致癌性研究。由于科学的进步,目前正在讨论在两种物种中进行终生研究以评估药物致癌风险的必要性/合理性。在一个物种(大鼠或小鼠)中进行的研究可能就足够了。为了评估是否需要在第二个物种中进行研究,我们编制了一个数据库,该数据库涵盖了自1980年以来在德国和荷兰申请上市许可并进行致癌性测试的所有药物。确定了在大鼠或小鼠或两者中与治疗相关的肿瘤发现的发生率。几乎50%的化合物出现了肿瘤发现,大鼠比小鼠更敏感。我们特别关注了小鼠中的肿瘤发现是否曾导致监管当局拒绝注册、限制药物的拟议治疗适应症或贴上警示标签的问题。结果发现,仅在小鼠中出现的肿瘤发现从未导致此类监管行动。此外,还确定了小鼠研究在解释大鼠研究结果方面是否重要。阴性的小鼠研究(未发现肿瘤)很少被用来宣称大鼠的发现与人类无关。在评估大鼠的肿瘤发现时,机制解释被用作一个重要得多的论据。在跨物种发现的情况下,靶器官通常是常见的器官,如肺和肝,或者肿瘤是由于化合物药理学预期的药效学作用过度而发生的。因此,该数据库的结果对维持在两种物种中进行啮齿动物致癌性研究这一要求的必要性提出了质疑。