获得加速批准的抗癌药物适用性撤回的预测因素:一个追溯队列研究
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Updated: Sep 14, 2025

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Ariadna Tibau1,2,3,4, Edward R Scheffer Cliff1,2,5,6, Alejandra Romano3,4
1Program on Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
通过加速途径批准的具有较低临床益处的药物更有可能被撤回. 突破性疗法名称和基因组向疗法显示更低的戒断率,表明持续的益处.
科学领域:
- 在瘤学瘤学.
- 药物审批过程 药物审批过程
- 临床试验设计 临床试验设计
背景情况:
- 美国食品和药物管理局 (FDA) 的加速批准途径可以根据代用终点为严重疾病提供早期药物获取.
- 确认性试验是强制性的,如果批准后的数据显示出不利的益处风险概况,则可以撤回适应症.
- 这项研究调查了与撤销先前获得加速批准的抗癌药物适用性相关的因素.
研究的目的:
- 为了确定FDA加速批准后药物指示撤回的预测因素.
- 分析药物特征,试验设计和批准后结果之间的关联.
- 为临床决策提供有关使用加速批准疗法的信息.
主要方法:
- 美国食品和药物管理局 (FDA) 批准的抗癌药物 (1992-2022) 的回顾性队列研究.
- 提取了关于关键试验特征,结果和确认性研究时间表的数据.
- 使用欧洲医学瘤学会-临床益处尺度 (ESMO-MCBS) 评估临床益处.
- 使用多变量后勤回归来确定与退出相关的因素.
主要成果:
- 在167个加速批准中,102个 (61%) 转换为普通批准,31个 (19%) 撤回,34个 (20%) 仍在进行中.
- 较低的临床益处 (ESMO-MCBS得分) 与更高的戒断率相关 (OR,4.63;p=0.008).
- 突破性治疗 (OR 0.26;p=0.01) 和基因组向疗法 (OR 0.26;p=0.02) 与更低的戒断率有关.
结论:
- 基于有限的早期临床益处的加速批准显示出更高的撤回率.
- 具有突破性疗法名称和基因组向机制的疗法更有可能显示持续的临床益处并获得定期批准.
- 患者和医疗保健提供者在评估加速批准疗法时应考虑这些因素.
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