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Acute Myeloid Leukemia: Developing Drugs and Biological Products for Treatment: Draft Guidance for Industry

DraftOncology Center of Excellence Center for Drug Evaluation and Research Center for Biologics Evaluation and Research08/17/2020

Description

The purpose of this guidance is to assist sponsors in the clinical development of drugs and biological products for the treatment of acute myeloid leukemia (AML). Specifically, this guidance addresses FDA’s current thinking regarding the overall development program and clinical trial designs for the development of drugs to support an indication of treatment of AML, including indications limited to an individual phase of treatment (e.g., maintenance, transplantation preparative regimen, etc.).

Scope & Applicability

Product Classes

4
Biological Products

Requires analytical comparability per ICH Q5E

CAR T Cells

DLT criteria for chimeric antigen receptor T cells

CAR T cell

Post-study salvage treatment

Gene Therapy

A type of ATMP involving recombinant nucleic acids or viral vectors.

Stakeholders

2
Sponsor

Entity responsible for submitting applications under section 524B

Healthy volunteers

Possible to conduct the FIH trial in healthy volunteers

Regulatory Context

Attributes

10
Absolute neutrophil count

Criterion for documenting Complete Remission

Status at last contact

Final status including alive and TI, alive and transfusion-dependent, dead, or lost

Duration of platelet TI

Duration of platelet transfusion independence post baseline

Duration of RBC TI

Duration of Red Blood Cell transfusion independence post baseline

Platelet transfusion dependence

Baseline status for transfusion independence assessment.

RBC transfusion dependence

Baseline status for transfusion independence assessment.

Treatment arm

Variable that assists the transfusion independence assessment

Marrow blasts percentage

Marrow blasts percentage used for CR response

TI

Abbreviation for Transfusion Independence

Transfusion Independence

Clinical benefit resulting from relief of insufficient hematopoiesis

Identified Hazards

Hazards

2
myelosuppressive

Expected toxicity resulting in complications from cytopenias

Prolonged neutropenia

Toxic event used as a stopping rule in active AML patients.

Related CFR Sections (2)

See Also (8)