TY - JOUR
T1 - Designing phase 0 cancer clinical trials
AU - Murgo, Anthony J.
AU - Kummar, Shivaani
AU - Rubinstein, Larry
AU - Gutierrez, Martin
AU - Collins, Jerry
AU - Kinders, Robert
AU - Parchment, Ralph E.
AU - Ji, Uping
AU - Steinberg, Seth M.
AU - X.yang, Sherry
AU - Hollingshead, Melinda
AU - Chen, Alice
AU - Helman, Lee
AU - Wiltrout, Robert
AU - E.tomaszewski, Joseph
AU - Doroshow, James H.
PY - 2008/6/15
Y1 - 2008/6/15
N2 - Phase 0 trials are designed primarily to evaluate the pharmacodynamic and/or pharmacokinetic properties of selected investigational agents before initiating more traditional phase I testing. One of the major objectives of phase 0 trials is to interrogate and refine a target or biomarker assay for drug effect in human samples implementing procedures developed and validated in preclinical models. Thus, close collaboration between laboratory scientists and clinical investigators is essential to the design and conduct of phase 0 trials. Given the relatively small number of patients and tissue samples, showing a significant drug effect in phase 0 trials requires precise and reproducible assay procedures and innovative statistical methodology. Furthermore, phase 0 trials involving limited exposure of a study agent administered at low doses and/or for a short period allow them to be initiated under the Food and Drug Administration exploratory investigational new drug guidance with less preclinical toxicity data than usually required for traditional first-in-human studies. Because of the very limited drug exposure, phase 0 trials offer no chance of therapeutic benefit, which can impede patient enrollment, particularly if invasive tumor biopsies are required. The challenges to accrual are not insurmountable, however, and well-designed and executed phase 0 trials are feasible and have great potential for improving the efficiency and success of subsequent trials, particularly those evaluating molecularly targeted agents.
AB - Phase 0 trials are designed primarily to evaluate the pharmacodynamic and/or pharmacokinetic properties of selected investigational agents before initiating more traditional phase I testing. One of the major objectives of phase 0 trials is to interrogate and refine a target or biomarker assay for drug effect in human samples implementing procedures developed and validated in preclinical models. Thus, close collaboration between laboratory scientists and clinical investigators is essential to the design and conduct of phase 0 trials. Given the relatively small number of patients and tissue samples, showing a significant drug effect in phase 0 trials requires precise and reproducible assay procedures and innovative statistical methodology. Furthermore, phase 0 trials involving limited exposure of a study agent administered at low doses and/or for a short period allow them to be initiated under the Food and Drug Administration exploratory investigational new drug guidance with less preclinical toxicity data than usually required for traditional first-in-human studies. Because of the very limited drug exposure, phase 0 trials offer no chance of therapeutic benefit, which can impede patient enrollment, particularly if invasive tumor biopsies are required. The challenges to accrual are not insurmountable, however, and well-designed and executed phase 0 trials are feasible and have great potential for improving the efficiency and success of subsequent trials, particularly those evaluating molecularly targeted agents.
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U2 - 10.1158/1078-0432.CCR-07-4560
DO - 10.1158/1078-0432.CCR-07-4560
M3 - Article
C2 - 18559582
AN - SCOPUS:52449091099
SN - 1078-0432
VL - 14
SP - 3675
EP - 3682
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 12
ER -