Thursday, July 27, 2023

Breakthrough Therapy Designation (BTD) vs. Project ORBIS

 The Breakthrough Therapy Designation (BTD) and Project ORBIS are two regulatory designations that can be used to expedite the development and review of new drugs. BTD is a US Food and Drug Administration (FDA) designation, while Project ORBIS is an international collaboration between the FDA and other regulatory agencies.

Breakthrough Therapy Designation

BTD is intended for drugs that have the potential to provide a significant improvement over available therapies for serious or life-threatening conditions. To qualify for BTD, a drug must meet the following criteria:

  • There must be preliminary clinical evidence that demonstrates the drug may have substantial improvement on at least one clinically significant endpoint over available therapy.
  • The drug must address an unmet medical need.
  • The drug must have the potential to be developed more quickly than through the standard drug development process.

Once a drug is granted BTD, the FDA will work with the drug developer to expedite the development and review process. This may include providing the developer with early access to the FDA, more frequent meetings with the FDA, and the opportunity to participate in rolling review.

Project ORBIS

Project ORBIS is an international collaboration between the FDA and other regulatory agencies to accelerate the review and approval of new cancer drugs. Under Project ORBIS, the FDA will work with other regulatory agencies to conduct concurrent review of new cancer drugs. This allows patients in multiple countries to have access to new cancer drugs sooner.

To be eligible for Project ORBIS, a drug must meet the following criteria:

  • The drug must have been granted BTD by the FDA.
  • The drug must be intended to treat cancer.
  • The drug must be the subject of a marketing application in at least one other country that is participating in Project ORBIS.

Comparison

BTD and Project ORBIS are both designed to expedite the development and review of new drugs. However, they have different eligibility criteria and they offer different benefits.

BTD is a more flexible designation than Project ORBIS. BTD can be granted to drugs for any serious or life-threatening condition, while Project ORBIS is only available for cancer drugs. BTD also offers a wider range of benefits, such as early access to the FDA, more frequent meetings with the FDA, and the opportunity to participate in rolling review.

Project ORBIS, on the other hand, offers the benefit of concurrent review by multiple regulatory agencies. This can help to speed up the review process and get new cancer drugs to patients sooner.

BTD and Project ORBIS are two valuable tools that can be used to expedite the development and review of new drugs. If you are developing a new oncology drug, consider these designations to see if either of these designations is right for you.

Breakthrough Therapy Designation vs. Fast Track: Understanding the Difference

In drug development and regulatory pathways, the U.S. Food and Drug Administration (FDA) offers several programs to expedite the review and approval process for promising medical products. Two of these programs are the "Breakthrough Therapy Designation" and "Fast Track Designation." While both aim to accelerate the development of innovative treatments, they have distinct criteria and implications for drug sponsors. In this article, I give an overview of the differences between Breakthrough Therapy Designation and Fast Track Designation and how they impact the drug development journey.

  1. Breakthrough Therapy Designation (BTD):

Introduced in 2012, Breakthrough Therapy Designation is intended for drugs that demonstrate substantial improvement over existing therapies for serious or life-threatening conditions. This designation is granted based on preliminary clinical evidence and is designed to speed up the development and review process.

Criteria for Breakthrough Therapy Designation:

  • The drug must treat a serious or life-threatening condition.
  • Preliminary clinical evidence indicates that the drug may offer substantial improvement over existing therapies.
  • The drug's benefits outweigh the potential risks.

Advantages of Breakthrough Therapy Designation:

  • Intensive FDA guidance: Sponsors receive enhanced support from the FDA during drug development, including more frequent meetings to discuss trial designs and endpoints.

  • Expedited review: The FDA works closely with sponsors to expedite the review process, potentially leading to faster approval.

  • Rolling Review: Sponsors can submit portions of the New Drug Application (NDA) as data become available, rather than waiting for the completion of the entire application.
  1. Fast Track Designation:

The Fast Track Designation, established in 1997, is intended to facilitate the development and expedite the review of drugs that address unmet medical needs for serious conditions. This program is broader in scope compared to Breakthrough Therapy Designation and covers a wider range of medical products, including drugs, biologics, and medical devices.

Criteria for Fast Track Designation:

  • The drug must treat a serious or life-threatening condition.
  • There should be evidence that the drug could address an unmet medical need.
  • The drug's benefits, based on early data, should show potential to justify fast track status.

Advantages of Fast Track Designation:

  • More frequent communication with the FDA: Sponsors have the opportunity to engage with the FDA regularly to discuss the development plan and seek guidance.

  • Rolling Review: Similar to Breakthrough Therapy Designation, sponsors can submit sections of the NDA as data become available.

  • Priority Review: Upon approval, the drug is eligible for a faster review process, which shortens the time to market.

Key Differences:

  1. Criteria: Breakthrough Therapy Designation focuses on substantial improvement over existing therapies, while Fast Track Designation centers on addressing unmet medical needs.


  2. Scope: Fast Track Designation covers drugs, biologics, and medical devices, whereas Breakthrough Therapy Designation is specific to drugs and biologics. A BTD can be granted for a combination drug-device or biologic-device product as long as the drug or biologic is the primary mechanism of action.


  3. FDA Support: While both programs provide enhanced FDA support, Breakthrough Therapy Designation is generally reserved for products with more compelling evidence of significant improvement.

Conclusion:

Both Breakthrough Therapy Designation and Fast Track Designation offer valuable opportunities for drug sponsors to expedite the development and regulatory review process for their innovative medical products. These programs reflect the FDA's commitment to fostering the advancement of treatments for serious and life-threatening conditions. Sponsors must carefully evaluate the specific criteria and benefits of each designation to determine the most appropriate pathway for their drug development, ultimately working towards bringing new and effective therapies to patients in need.

Understanding the Spectrum of FDA Meetings: A Comprehensive Overview

The U.S. Food and Drug Administration (FDA) plays a critical role in ensuring the safety, efficacy, and quality of medical products. As part of the regulatory process, the FDA holds various types of meetings with sponsors, investigators, and other stakeholders. These meetings serve as opportunities for transparent communication, guidance, and collaboration between the FDA and those involved in drug development, clinical trials, and regulatory submissions. In this article, I discuss the different types of FDA meetings and their significance in the drug development process.

  1. Pre-IND (Investigational New Drug) Meetings

Pre-IND meetings are conducted before the submission of an Investigational New Drug application. They offer an opportunity for sponsors to discuss their drug development plans with the FDA. During these meetings, sponsors can seek guidance on study design, preclinical data requirements, and any specific concerns regarding their proposed investigational product. These meetings help ensure that the development plans are aligned with the FDA's expectations, potentially avoiding delays during the regulatory review process.

  1. End-of-Phase 1 Meetings

At the completion of Phase 1 clinical trials, sponsors can request an end-of-Phase 1 meeting with the FDA. This meeting allows for discussions about Phase 2 trial designs, dosing regimens, and the overall safety profile of the investigational product. Feedback from the FDA at this stage helps sponsors plan their Phase 2 studies more effectively and enhances the likelihood of success.

  1. End-of-Phase 2 Meetings

Similarly, an end-of-Phase 2 meeting provides an opportunity for sponsors to discuss Phase 3 trial designs based on the data from Phase 2 trials. The FDA can provide insights on the adequacy of the evidence for safety and efficacy and help ensure that the Phase 3 trials are appropriately designed to address regulatory requirements.

  1. Pre-NDA/BLA (New Drug Application/Biologics License Application) Meetings

Before submitting a New Drug Application or Biologics License Application, sponsors can request a pre-NDA or pre-BLA meeting with the FDA. During this meeting, sponsors can seek guidance on the format and content of their applications, addressing specific questions related to safety, efficacy, and data requirements. Feedback obtained at this stage aids in streamlining the application and ensures that the submitted data are comprehensive and meet regulatory expectations.

  1. Type A, B, and C Meetings

Type A, B, and C meetings are typically scheduled within specific timeframes in response to critical issues or challenges faced by sponsors during the drug development process.

  • Type A Meetings: These are necessary for issues that are causing significant delays or other concerns regarding the drug development program. They are usually held within 30 days of the request to address urgent matters.


  • Type B Meetings: These meetings are scheduled for important topics that require more in-depth discussions. They are generally held within 60 days of the request.


  • Type C Meetings: These meetings involve general communication, clarification, or follow-up on previous discussions and do not have specific timeframes for scheduling.

  1. Advisory Committee Meetings

Advisory Committee Meetings are convened to obtain independent expert advice and recommendations on matters related to drug approvals. These committees, consisting of external experts, review and discuss data from clinical trials and other relevant information. The FDA considers the advisory committee's input in its final decision-making process, although the committee's recommendations are non-binding.

FDA meetings play a crucial role in facilitating effective communication between sponsors and the regulatory authority. By providing guidance, addressing concerns, and fostering collaboration, these meetings contribute to a smoother drug development and regulatory submission process. Sponsors are encouraged to take advantage of these opportunities to ensure their products meet the highest standards of safety and efficacy while serving the needs of patients.

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