PDF
Abstract
To fully implement precision medicine, a deeper understanding of biomarkers, companion diagnostics, and their use in clinical trials is needed. Here, we describe key events in biomarker discovery and clinical trial design, and how those stages may be streamlined to fast-track approval of companion diagnostics (CDx). We discuss crucial qualities of a successful CDx that include understanding the prevalence of the marker in the intention to treat population, careful consideration of the scoring scheme that will be used in later clinical trial stages, and reliability of the performance of the CDx, in addition to other necessary features.
Keywords
Biomarkers
/
companion diagnostics
/
oncology
/
personalized medicine
/
drug development
/
clinical trials
/
regulatory approval
Cite this article
Download citation ▾
Noreen McBrearty, Devika Bahal, Suso Platero.
Fast-tracking drug development with biomarkers and companion diagnostics.
Journal of Cancer Metastasis and Treatment, 2024, 10: 3 DOI:10.20517/2394-4722.2023.134
| [1] |
Administration USFaD. List of cleared or approved companion diagnostic devices (in vitro and imaging tools). Avaliable from: https://www.fda.gov/medical-devices/in-vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools [Last accessed on 16 Jan 2024]
|
| [2] |
Farmer H,Lord CJ.Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy.Nature2005;434:917-21
|
| [3] |
Fong PC,Boss DS.Poly(ADP)-ribose polymerase inhibition: frequent durable responses in BRCA carrier ovarian cancer correlating with platinum-free interval.J Clin Oncol2010;28:2512-9
|
| [4] |
Flaherty KT,Kim KB.Inhibition of mutated, activated BRAF in metastatic melanoma.N Engl J Med2010;363:809-19 PMCID:PMC3724529
|
| [5] |
Boone B,Ferdinande L.EGFR in melanoma: clinical significance and potential therapeutic target.J Cutan Pathol2011;38:492-502
|
| [6] |
Administration USFaD. Transcript biomarker terminology - speaking the same language. Avaliable from: https://www.fda.gov/drugs/biomarker-qualification-program/transcript-biomarker-terminology-speaking-same-language [Last accessed on 16 Jan 2024]
|
| [7] |
Fridlyand J,Walrath JC.Considerations for the successful co-development of targeted cancer therapies and companion diagnostics.Nat Rev Drug Discov2013;12:743-55
|
| [8] |
Pickl M,Venturi M.Predictive markers in early research and companion diagnostic developments in oncology.N Biotechnol2012;29:651-5
|
| [9] |
Kafatos G,Burdon P.Biomarker testing and mutation prevalence in metastatic colorectal cancer patients in five European countries using a large oncology database.Future Oncol2021;17:1483-94
|
| [10] |
Tran B,Tie J.Impact of BRAF mutation and microsatellite instability on the pattern of metastatic spread and prognosis in metastatic colorectal cancer.Cancer2011;117:4623-32 PMCID:PMC4257471
|
| [11] |
Hélias-Rodzewicz Z,Baudoux L.Variations of BRAF mutant allele percentage in melanomas.BMC Cancer2015;15:497 PMCID:PMC4491198
|
| [12] |
Eroglu Z.Combination therapy with BRAF and MEK inhibitors for melanoma: latest evidence and place in therapy.Ther Adv Med Oncol2016;8:48-56 PMCID:PMC4699264
|
| [13] |
De Roock W,Bernasconi D.Effects of KRAS, BRAF, NRAS, and PIK3CA mutations on the efficacy of cetuximab plus chemotherapy in chemotherapy-refractory metastatic colorectal cancer: a retrospective consortium analysis.Lancet Oncol2010;11:753-62
|
| [14] |
Cheng YS,Zheng W.Improving therapy of severe infections through drug repurposing of synergistic combinations.Curr Opin Pharmacol2019;48:92-8 PMCID:PMC6858965
|
| [15] |
Weth FR,Weth AF.Unlocking hidden potential: advancements, approaches, and obstacles in repurposing drugs for cancer therapy. Br J Cancer 2023.
|
| [16] |
Ahn S,Lee K.HER2 status in breast cancer: changes in guidelines and complicating factors for interpretation.J Pathol Transl Med2020;54:34-44 PMCID:PMC6986968
|
| [17] |
Mrozkowiak A,Piascik A.HER2 status in breast cancer determined by IHC and FISH: comparison of the results.Pol J Pathol2004;55:165-71.
|
| [18] |
Remon J,Soria JC.Successes and failures: what did we learn from recent first-line treatment immunotherapy trials in non-small cell lung cancer?.BMC Med2017;15:55
|
| [19] |
Corrado Rizzi. Failed CheckMate-026 lung cancer trial comes up in securities complaint against bristol-myers squibb. Avaliable from: https://www.classaction.org/news/failed-checkmate-026-lung-cancer-trial-comes-up-in-securities-complaint-against-bristol-myers-squibb [Last accessed on 16 Jan 2024]
|
| [20] |
Abrahao-Machado LF.HER2 testing in gastric cancer: an update.World J Gastroenterol2016;22:4619-25 PMCID:PMC4870069
|
| [21] |
Friedman CF,Kurzrock R.Atezolizumab treatment of tumors with high tumor mutational burden from MyPathway, a multicenter, open-label, phase IIa multiple basket study.Cancer Discov2022;12:654-69 PMCID:PMC9394388
|
| [22] |
Administration USFaD. FDA approves pembrolizumab for adults and children with TMB-H solid tumors. Avaliable from: https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-pembrolizumab-adults-and-children-tmb-h-solid-tumors [Last accessed on 16 Jan 2024]
|
| [23] |
Marabelle A,Lopez J.Association of tumour mutational burden with outcomes in patients with advanced solid tumours treated with pembrolizumab: prospective biomarker analysis of the multicohort, open-label, phase 2 KEYNOTE-158 study.Lancet Oncol2020;21:1353-65
|
| [24] |
Wittlinger F.The pre-clinical discovery and development of osimertinib used to treat non-small cell lung cancer.Expert Opin Drug Discov2021;16:1091-103
|
| [25] |
Butterworth S,Finlay MRV,Waring MJ.The structure-guided discovery of osimertinib: the first U.S. FDA approved mutant selective inhibitor of EGFR T790M.Medchemcomm2017;8:820-2 PMCID:PMC6072417
|
| [26] |
Greig SL.Osimertinib: first global approval.Drugs2016;76:263-73
|
| [27] |
Institute of Medicine (US) Committee on Conflict of Interest in Medical Research, Education, and Practice; Lo B, Field MJ, editors. Conflict of Interest in Medical Research, Education, and Practice. Washington (DC): National Academies Press (US); 2009.
|
| [28] |
Vellanki PJ,Pathak A.Regulatory implications of ctDNA in immuno-oncology for solid tumors.J Immunother Cancer2023;11:e005344
|
| [29] |
Administration USFaD. Use of circulating tumor deoxyribonucleic acid for early-stage solid tumor drug development; draft guidance for industry; availability. Avaliable from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/use-circulating-tumor-deoxyribonucleic-acid-early-stage-solid-tumor-drug-development-draft-guidance [Last accessed on 16 Jan 2024]
|
| [30] |
Hernandez KM,Agius P.Contrived materials and a data set for the evaluation of liquid biopsy tests: a blood profiling atlas in cancer (BLOODPAC) community study.J Mol Diagn2023;25:143-55
|
| [31] |
Administration USFaD. FDA grants accelerated approval to pembrolizumab for first tissue/site agnostic indication. Avaliable from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-pembrolizumab-first-tissuesite-agnostic-indication [Last accessed on 16 Jan 2024]
|
| [32] |
U.S. FDA approves FoundationOne®CDx as a companion diagnostic for KEYTRUDA® (pembrolizumab) to identify patients with microsatellite instability-high (MSI-H) solid tumors. Avaliable from: https://www.foundationmedicine.com/press-releases/u.s.-fda-approves-foundationone%C2%AEcdx-as-a-companion-diagnostic-for-keytruda%C2%AE-%28pembrolizumab%29-to-identify-patients-with-microsatellite-instability-high-%28msi-h%29-solid-tumors [Last accessed on 16 Jan 2024]
|
| [33] |
Marabelle A,Lang L.544 Companion diagnostic assays for pembrolizumab in patients with MSI-H/dMMR tumors.J Immunother Cancer2022;10:A1-1063
|
| [34] |
Administration USFaD. FDA approves larotrectinib for solid tumors with NTRK gene fusions. Avaliable from: https://www.fda.gov/drugs/fda-approves-larotrectinib-solid-tumors-ntrk-gene-fusions [Last accessed on 16 Jan 2024]
|
| [35] |
Drilon A,Kummar S.Efficacy of larotrectinib in TRK fusion-positive cancers in adults and children.N Engl J Med2018;378:731-9
|
| [36] |
FoundationOne®CDx receives FDA-approval as a companion diagnostic for VITRAKVI®(larotrectinib) to identify patients with NTRK fusions across all solid tumors. Avaliable from: https://www.foundationmedicine.com/press-releases/foundationone%C2%AEcdx-receives-fda-approval-as-a-companion-diagnostic-for-vitrakvi%C2%AE(larotrectinib)-to-identify-patients-with-ntrk-fusions-across-all-solid-tumors#:~:text=today%20announced%20that%20it%20has,that%20have%20a%20neurotrophic%20receptor [Last accessed on 16 Jan 2024]
|
| [37] |
Cooper L.Changes in companion diagnostic labelling: implementation of FDA’s April 2020 guidance for industry for in vitro CDx labeling for specific oncology therapeutic groups.Ther Innov Regul Sci2022;56:689-97 PMCID:PMC9356945
|
| [38] |
Moore MW,Cotter PD.Challenges in the codevelopment of companion diagnostics.Per Med2012;9:485-96
|
| [39] |
Rockoff J. Tests are key but partners tricky. WSJ 2011;30. Avaliable from: https://www.wsj.com/articles/SB10001424053111903352704576538661653113814.html [Last accessed on 18 Jan 2024]
|
| [40] |
Jørgensen JT. The development of the HercepTest™ - from bench to bedside. In: Jørgensen JT, Winther H, editors. Molecular diagnostics. New York: Jenny Stanford Publishing; 2010. p.18.
|
| [41] |
Emergen Research. Companion diagnostics market by technology (immunohistochemistry, in situ hybridization, polymerase chain reaction, genetic sequencing), by disease indication (breast cancer, lung cancer, colorectal cancer, skin cancer), by application (hospitals, diagnostic laboratories), by region, forecasts to 2017-2027. Avaliable from: https://www.emergenresearch.com/industry-report/companion-diagnostics-market [Last accessed on 16 Jan 2024]
|
| [42] |
Administration USFaD. Developing and labeling in vitro companion diagnostic devices for a specific group of oncology therapeutic products- guidance for industry. Avaliable from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/developing-and-labeling-in-vitro-companion-diagnostic-devices-specific-group-oncology-therapeutic [Last accessed on 16 Jan 2024]
|
| [43] |
Olsen D.Companion diagnostics for targeted cancer drugs - clinical and regulatory aspects.Front Oncol2014;4:105 PMCID:PMC4032883
|