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Article ; Online: Lessons learned from postmarketing withdrawals of expedited approvals for oncology drug indications.

Koole, Simone N / Huisman, Atse H / Timmers, Lonneke / Westgeest, Hans M / van Breugel, Edwin / Sonke, Gabe S / van Waalwijk van Doorn-Khosrovani, Sahar Barjesteh

The Lancet. Oncology

2024  Volume 25, Issue 3, Page(s) e126–e135

Abstract: In the past decade, there have been a record number of oncology therapy approvals by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Besides the EMA's conditional marketing authorisation programme and the FDA's ... ...

Abstract In the past decade, there have been a record number of oncology therapy approvals by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Besides the EMA's conditional marketing authorisation programme and the FDA's Accelerated Approval Program, we observe a tendency towards fast approval for exploratory studies with non-randomised, uncontrolled designs and surrogate endpoints. This issue raises concerns about the robustness and effectiveness of accepted treatments, leaving patients and health-care professionals in a state of uncertainty. A substantial number of accelerated approvals have recently been withdrawn in the USA, with some still authorised in Europe, emphasising discrepancies in regulatory standards that affect both patients and society as a whole. We highlight examples of drugs, authorised on the basis of surrogate endpoints, that were later withdrawn due to an absence of overall survival benefit. Our findings address the challenges and consequences of accelerated approval pathways in oncology. In conclusion, this Policy Review calls for regulatory bodies to better align their procedures and insist on robust evidence, preferably through unbiased randomised controlled trials. Drug approval processes should prioritise patient benefit, overall survival, and quality of life to minimise risks and uncertainties for patients.
MeSH term(s) Humans ; Drug Approval ; Europe ; Medical Oncology ; Product Surveillance, Postmarketing ; Safety-Based Drug Withdrawals
Language English
Publishing date 2024-02-02
Publishing country England
Document type Journal Article ; Review
ZDB-ID 2049730-1
ISSN 1474-5488 ; 1470-2045
ISSN (online) 1474-5488
ISSN 1470-2045
DOI 10.1016/S1470-2045(23)00592-2
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