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  1. Article ; Online: Extrapolation of Efficacy from Adults to Pediatric Patients of Drugs for Treatment of Partial Onset Seizures: A Regulatory Perspective.

    Mehrotra, Shailly / Bhattaram, Atul / Krudys, Kevin / Bewernitz, Michael / Uppoor, Ramana / Mehta, Mehul / Liu, Tao / Sheridan, Philip / Hershkowitz, Norman / Kozauer, Nicholas / Bastings, Eric / Dunn, Billy / Men, Angela Yuxin

    Clinical pharmacology and therapeutics

    2022  Volume 112, Issue 4, Page(s) 853–863

    Abstract: The US Food and Drug Administration (FDA) has concluded that the efficacy of drugs approved for the treatment of partial onset seizures (POS) in adults can be extrapolated to pediatric patients 1 month of age and above and that independent efficacy ... ...

    Abstract The US Food and Drug Administration (FDA) has concluded that the efficacy of drugs approved for the treatment of partial onset seizures (POS) in adults can be extrapolated to pediatric patients 1 month of age and above and that independent efficacy trials in this pediatric population are no longer needed. This paper focuses on the dosing, pharmacokinetic (PK), exposure-response, and clinical information that were leveraged from the approved drugs for the treatment of POS to conduct analyses that supported extrapolation of efficacy in pediatric patients. Clinical data from trials for eight drugs (levetiracetam, oxcarbazepine, topiramate, lamotrigine, gabapentin, perampanel, tiagabine, and vigabatrin) approved in both adults and pediatric patients for the treatment of POS were analyzed. Comparisons of exposures at approved doses, placebo response, and model-based exposure-response relationships were performed. Based on disease similarity, similar response to intervention, and similar exposure-response relationships in adults and pediatric patients, it was concluded that extrapolation of efficacy in pediatric patients aged 1 month and above is acceptable. PK analysis to determine pediatric dose and regimens that provide drug exposure similar to that known to be effective in adult patients with POS will be required, along with long-term open-label safety data in pediatric patients.
    MeSH term(s) Adult ; Anticonvulsants/adverse effects ; Anticonvulsants/pharmacokinetics ; Child ; Humans ; Lamotrigine/therapeutic use ; Levetiracetam/therapeutic use ; Pharmaceutical Preparations ; Seizures/chemically induced ; Seizures/drug therapy ; United States
    Chemical Substances Anticonvulsants ; Pharmaceutical Preparations ; Levetiracetam (44YRR34555) ; Lamotrigine (U3H27498KS)
    Language English
    Publishing date 2022-07-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 123793-7
    ISSN 1532-6535 ; 0009-9236
    ISSN (online) 1532-6535
    ISSN 0009-9236
    DOI 10.1002/cpt.2681
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: U.S. Food and Drug Administration approval: panitumumab for epidermal growth factor receptor-expressing metastatic colorectal carcinoma with progression following fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy regimens.

    Giusti, Ruthann M / Shastri, Kaushikkumar / Pilaro, Anne M / Fuchs, Chana / Cordoba-Rodriguez, Ruth / Koti, Kallappa / Rothmann, Mark / Men, Angela Yuxin / Zhao, Hong / Hughes, Monica / Keegan, Patricia / Weiss, Karen D / Pazdur, Richard

    Clinical cancer research : an official journal of the American Association for Cancer Research

    2008  Volume 14, Issue 5, Page(s) 1296–1302

    Abstract: Purpose: To describe the Food and Drug Administration review and marketing approval considerations for panitumumab (Vectibix) for the third-line treatment of patients with epidermal growth factor receptor-expressing metastatic colorectal carcinoma.: ... ...

    Abstract Purpose: To describe the Food and Drug Administration review and marketing approval considerations for panitumumab (Vectibix) for the third-line treatment of patients with epidermal growth factor receptor-expressing metastatic colorectal carcinoma.
    Experimental design: Food and Drug Administration reviewed a single, open-label, multicenter trial in which 463 patients with epidermal growth factor receptor-expressing metastatic colorectal cancer who had progressed on or following treatment with a regimen containing a fluoropyrimidine, oxaliplatin, and irinotecan were randomized (1:1) to receive best supportive care (BSC) with or without panitumumab (6 mg/kg every other week) administered until disease progression or intolerable toxicity. Progression and response were confirmed by an independent review committee masked to treatment assignment. At progression, patients in the BSC-alone arm were eligible to receive panitumumab.
    Results: Although median progression-free survival (PFS) was similar in both treatment arms ( approximately 8 weeks), the mean PFS was approximately 50% longer among patients receiving panitumumab than among those receiving BSC alone (96 versus 60 days, respectively) and the objective response rate in patients receiving panitumumab was 8%. However, no difference in overall survival was shown between the two study arms.
    Conclusions: Panitumumab received accelerated approval based on improvement in PFS and an independently confirmed response rate of 8%, similar to that observed with other active agents at this advanced stage of disease. Confirmation of clinical benefit will be required for full approval.
    MeSH term(s) Adult ; Aged ; Antibodies, Monoclonal/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Camptothecin/administration & dosage ; Camptothecin/analogs & derivatives ; Chemotherapy, Adjuvant ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/metabolism ; Colorectal Neoplasms/pathology ; Disease Progression ; Disease-Free Survival ; Drug Approval ; Fluorouracil/administration & dosage ; Humans ; Liver Neoplasms/drug therapy ; Liver Neoplasms/metabolism ; Liver Neoplasms/secondary ; Lung Neoplasms/drug therapy ; Lung Neoplasms/metabolism ; Lung Neoplasms/secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Organoplatinum Compounds/administration & dosage ; Receptor, Epidermal Growth Factor/metabolism ; Survival Rate ; United States ; United States Food and Drug Administration
    Chemical Substances Antibodies, Monoclonal ; Organoplatinum Compounds ; oxaliplatin (04ZR38536J) ; panitumumab (6A901E312A) ; irinotecan (7673326042) ; Receptor, Epidermal Growth Factor (EC 2.7.10.1) ; Fluorouracil (U3P01618RT) ; Camptothecin (XT3Z54Z28A)
    Language English
    Publishing date 2008-03-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial
    ZDB-ID 1225457-5
    ISSN 1557-3265 ; 1078-0432
    ISSN (online) 1557-3265
    ISSN 1078-0432
    DOI 10.1158/1078-0432.CCR-07-1354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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