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Phase 0 Clinical Trials: Conceptions and Misconceptions

2008; Lippincott Williams & Wilkins; Volume: 14; Issue: 3 Linguagem: Inglês

10.1097/ppo.0b013e318172d6f3

1540-336X

Shivaani Kummar, Larry Rubinstein, Robert J. Kinders, Ralph E. Parchment, Martin Gutierrez, Anthony J. Murgo, Jay Ji, Barbara Mroczkowski, Oxana K. Pickeral, Mel Simpson, Melinda G. Hollingshead, Sherry X. Yang, Lee J. Helman, Robert H. Wiltrout, Jerry M. Collins, Joseph E. Tomaszewski, James H. Doroshow,

Health Systems, Economic Evaluations, Quality of Life

Phase 0 clinical trials, developed in response to the United States Food and Drug Administration (FDA)'s recent exploratory Investigational New Drug (IND) guidance, are intended to expedite the clinical evaluation of new molecular entities. The exploratory IND supports the performance of first-in-human testing of new investigational agents at subtherapeutic doses based on reduced manufacturing and toxicologic requirements, allowing the demonstration of drug-target effects and assessment of pharmacokinetic–pharmacodynamic relationships in humans earlier in clinical development. The objectives of a phase 0 cancer clinical trial are to establish at the very earliest opportunity—before large numbers of patients have been accrued and exposed to potential drug-associated toxicity—whether an agent is modulating its target in a tumor, and consequently whether further clinical development is warranted. We review here the fundamental requirements of clinical studies conducted under an exploratory IND and address some common misconceptions regarding oncologic phase 0 trials.