U.S. FDA Drug Approvals for Breast Cancer: A Decade in Review

Shaily Arora1, Preeti Narayan1, Christy L Osgood1

  • 1Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration, Silver Spring, Maryland.

Insights

FDA approved 30 breast cancer treatments from 2010-2020, primarily for metastatic breast cancer (MBC) using progression-free survival (PFS) endpoints. Many received expedited review pathways, showcasing advancements in breast cancer drug development.

Area of Science:

  • Oncology
  • Pharmacology
  • Regulatory Science

Background:

  • Breast cancer treatment has evolved significantly with numerous new drug approvals.
  • The period 2010-2020 saw substantial advancements in FDA-approved therapies for breast cancer.

Purpose of the Study:

  • To summarize 30 FDA approvals for breast cancer treatments between 2010 and 2020.
  • To analyze trial endpoints, results, and regulatory considerations for these approvals.

Main Methods:

  • Review of 30 FDA drug approvals for breast cancer from 2010-2020.
  • Analysis of trial design, endpoints (progression-free survival, overall survival, objective response rate, pathologic complete response, invasive disease-free survival), and regulatory pathways (regular, accelerated, priority review, Breakthrough Therapy Designation).

Main Results:

  • 23 approvals were regular, 7 were accelerated.
  • 26 approvals were for metastatic breast cancer (MBC), 4 for early breast cancer.
  • Progression-free survival was a key endpoint for MBC approvals (80.8%); pathologic complete response and invasive disease-free survival were used for early breast cancer.
  • Many indications benefited from expedited FDA review initiatives.

Conclusions:

  • The decade saw significant progress in breast cancer drug approvals, with a focus on metastatic disease.
  • FDA initiatives played a crucial role in advancing the development and approval of novel breast cancer therapies.
  • Endpoint selection varied based on disease stage, reflecting tailored regulatory approaches.

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