FY 2018 Report from the Director
Fiscal Year 2018 was productive and exciting at the Center for Biologics Evaluation and Research (CBER). We continued to support the promise of 21st Century medicine, advancing science and technology in the service of public health.
One of the highlights of FY 2018 was the approval of two gene therapies: Luxturna, the first directly administered gene therapy for a specific genetic disorder, an inherited retinal disease, and Yescarta, a cell-based gene therapy for certain types of adult, large B-cell lymphoma. We also approved HEPLISAV-B, a Hepatitis B vaccine to prevent infection caused by all known subtypes of hepatitis B virus in adults 18 through 70 years of age, Shingrix, a vaccine for the prevention of shingles in adults 50 years of age and older, and Fluarix Quadrivalent, to prevent influenza disease in children as young as 6 months of age. In addition, CBER/FDA granted an Emergency Use Authorization to the Department of Defense to enable the use of Freeze-Dried Plasma to treat hemorrhage or coagulopathy of U.S. military personnel injured during military combat when plasma is not available or its use is not practical.
FDA’s ongoing contributions to controlling Zika virus included CBER’s approval of the cobas Zika Test and the Procleix Zika Virus Assay (Nucleic Acid Tests), the first donor screening tests for the direct detection of Zika Virus RNA in human plasma from individual donors.
The report below highlights these and other CBER accomplishments that reflect our responses to new and ongoing scientific and regulatory challenges, such as those posed by advanced therapies, emerging infectious diseases, and threats to the blood supply. It also reflects how we are carefully focusing our own research and stakeholder outreach so they support our efforts to meet those challenges. Just to highlight one aspect of stakeholder outreach undertaken this year, we launched the INTERACT program (CBER INitial Targeted Engagement for Regulatory Advice on CBER producTs). These meetings enable sponsors to obtain preliminary informal consultation with the Agency at an early stage of development prior to a pre-IND meeting.
Our successes this year also included meeting or exceeding the expectations of the Prescription Drug User Fee Act VI and the Medical Device User Fee Amendments, as detailed below. CBER also initiated or completed efforts on behalf of the 21st Century Cure Act, including patient experience in regulatory decision making, providing grants to research institutions, drafting guidances for regenerative medicine, and contributing to a guidance on antibacterial and antifungal drug development.
CBER is pleased to provide this report, which demonstrates the Center’s continuing dedication to our vision and our mission of meeting the challenge of improving public health, nationally and globally.
Peter Marks, M.D., Ph.D.
Center for Biologics Evaluation and Research
Advancing access to safe and effective products
CBER advanced public health in 2018 by achieving or exceeding expectations in its scientific and regulatory overview of new products. These achievements included the following accomplishments:
- All four standard schedule (non-priority) and one priority Biologic License Applications received in FY 2018 were under review and within the review-time goal at the close of FY 2018.
- CBER acted within the goal timelines for all 11 BLA PDUFA applications received in FY 2017, as of September 2018. Among the six applications with standard schedules, four were approved, one was in Complete Response status, and one was withdrawn; among five Priority schedule applications, three were approved, one was in Complete Response status, and one was withdrawn.
- CBER exceeded the FY 2018 goal of 95% approval for 510(k) submissions by issuing a decision on 100% of submissions received in the FY 2018 cohort within 90 FDA days, as of June 30, 2018.
- CBER exceeded the FY 2018 goal of 95% for the “within-90-FDA-days” approval of Real Time PMA Supplements by issuing a MDUFA decision on 100% of submissions received within that time limit, as of June 30, 2018.
- CBER exceeded the FY 2018 goal of 95% approval of PMA 180-day supplements by issuing a MDUFA decision on 100% of submissions within that time limit.
- CBER completed its coordination of the Innovation Fund as required by the 21st Century Cures Act, and invested $14 million of its resources by the end of FY 2018. As part of our commitment to achieving the goals of the 21st Century Cures Act, CBER awarded nearly $3 million in grants to support research at five institutions aimed at developing more innovative, consistent, and dependable manufacturing of biological products.
- CBER assessed regulatory agencies of 14 countries to ensure their inspection of medical products regulated by the Center could be recognized by the FDA, as per required by the MRA. CBER continued to assess the remaining European Union member states to meet December 2018 and July 2019 commitments.
- CBER/FDA granted an EUA to the Department of Defense (DoD) to enable the emergency use of Pathogen-Reduced Leucocyte-Depleted Freeze-Dried Plasma manufactured by the Centre de Transfusion Sanguine des Armées (French FDP). The product is used to treat hemorrhage or coagulopathy of U.S. Military personnel injured during military combat when plasma is not available or its use is not practical. The granting of the EUA demonstrates FDA’s commitment to the joint program that was started in FY 2018 to further enhance FDA’s support of DoD to ensure the efficient development of medical products to treat injured military personnel, focusing first on products regulated by CBER.
Approval of major, innovative, complex biologic products
FY 2018 was a productive year for approvals of novel biologic products, especially cell and gene therapies. CBER also approved new vaccines and continued to approve blood screening devices for emerging infections. The introduction of these products reflect the commitment of CBER scientists to support the development of products made using advanced and novel technologies.
Office of Vaccines Research and Review
- Fluarix Quadrivalent (Influenza Virus Vaccine), for the prevention of influenza disease caused by influenza subtype A viruses and type B viruses in people 6 months of age and older. (January 11, 2018)
- HEPLISAV-B (Hepatitis B Vaccine [Recombinant], Adjuvanted), for the prevention of infection caused by all known subtypes of hepatitis B virus in adults 18 through 70 years of age. (Nov. 9, 2017)
- Shingrix, (Zoster Vaccine Recombinant, Adjuvanted), for the prevention of herpes zoster (shingles) in adults aged 50 years and older. (October 20, 2017)
Office of Tissues and Advanced Therapies
- RECELL Autologous Cell Harvesting Device, indicated for the treatment of acute thermal burn wounds in patients 18 years of age and older. (Sept. 20, 2018)
- JIVI (Antihemophilic Factor [Recombinant], PEGylated aucl, for use in previously treated adults and adolescents (12 years of age and older) with hemophilia A (congenital Factor VIII deficiency) for: 1) On-demand treatment and control of bleeding episodes; 2) Perioperative management of bleeding; 3) Routine prophylaxis to reduce the frequency of bleeding episodes. (August 29, 2018)
- PANZYGA (immune globulin intravenous, human – ifas), indicated for the treatment of primary humoral immunodeficiency (PI) in patients two years of age and older, and for treatment of chronic immune thrombocytopenia. (Aug. 2, 2018)
- Hematopoietic Progenitor Cells, Cord (HPC-C), indicated for use in unrelated donor hematopoietic progenitor cell transplantation procedures in conjunction with an appropriate preparative regimen for hematopoietic and immunologic reconstitution, in patients with disorders affecting the hematopoietic system that are inherited, acquired, or result from myeloablative treatment. (June 21, 2018)
- ANDEXXA (Coagulation factor Xa (Recombinant) inactivated-zhzo), indicated for patients treated with rivaroxaban and apixaban, when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding. (May 3, 2018)
- Plasma Cryoprecipitate (For Further Manufacturing Use) (May 3, 2018)
- FIBRIN SEALANT (Human), indicated as an adjunct to hemostasis for mild to moderate bleeding in adults undergoing surgery when control of bleeding by standard surgical techniques (such as suture, ligature, and cautery) is ineffective or impractical. (Feb. 5, 2018)
- LUXTURNA (voretigene neparvovec), an adeno-associated viral (AAV) vector gene therapy for the treatment of patients with vision loss due to confirmed biallelic RPE65-mediated inherited retinal disease (IRD). This approval was for the third gene therapy approved by CBER and the first directly administered gene therapy for a specific genetic disorder. (Dec. 19, 2017)
- YESCARTA (axicabtagene ciloleucel), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to, or relapsed after, at least two other kinds of treatment. This is the second gene therapy approved by the FDA and the first for certain types of non-Hodgkin lymphoma. (Oct. 18, 2017)
Office of Blood Research and Review
- Imugen Babesia microti Arrayed Fluorescent Immunoassay (AFIA), the first donor screening tests for the detection of antibodies to Babesia microti (B. microti) in human plasma samples, and the Babesia microti Nucleic Acid Test (NAT), for the detection of B. microti DNA in human whole blood samples. Babesiosis parasites are transmitted by tick bites and by transfusion of blood or blood components from an infected donor. Because the tests could prevent the transmission of Babesia infection through blood transfusion, they were granted Priority Review status. (March 6, 2018)
- cobas Zika Test (Nucleic Acid Test), the first donor screening test for the direct detection of Zika Virus RNA in human plasma from individual donors, including donors of whole blood, and blood components for transfusion, as well as other living donors, to prevent virus transmissions. (Oct. 5, 2017)
- Albuminex (Human) 5% and 25%, indicated for adults and children for hypovolemia, ascites, hypoalbuminemia including from burns, acute nephrosis, acute respiratory distress syndrome, and cardipulmonary bypass.
Advancing Product Development & Ensuring Product Safety
CBER not only facilitates the development and availability of new medical products; through workshops, meetings, and conferences, it also shares and seeks important new knowledge about diseases and treatments and works to ensure the safety of products already on the market.
Center for Biologics Evaluation and Research
- 2018 Center for Biologics Evaluation and Research Science Symposium
Scientific topics related to the regulation of biologics, highlighting CBER research showcasing how scientific research informs regulatory decision-making and providing a forum for developing collaborations within FDA and with external organizations. (June 25, 26, 2018).
Office of Vaccines Research and Review
- “Science and Regulation of Live Microbiome-Based Products Used to Prevent, Treat, or Cure Diseases in Humans” (Sept. 17, 2018)
Public workshop in cooperation with the National Institute of Allergy and Infectious Diseases to exchange information with the scientific community about the clinical, manufacturing, and regulatory considerations associated with live microbiome-based products, when administered to prevent, treat, or cure diseases or conditions in humans.
- Vaccines and Related Biological Products Advisory Committee (VRBPAC) meetings
- Consultation meeting at the World Health Organization on the composition of influenza vaccines for the Northern Hemisphere (Geneva, Switzerland, Feb. 19-21, 2018).
- Participation in WHO’s Global Advisory Committee for Vaccine Safety (GACVS). This committee provides independent, authoritative, scientific advice to WHO on vaccine safety issues of global or regional concern with the potential to affect in the short- or long-term national immunization programs. (June 2018)
- Participated in ten meetings of the interagency collaboration Influenza (Flu) Risk Management Meeting (FRMM) between October 1, 2017 and August 31, 2018 to discuss:
- seasonal influenza surveillance
- influenza vaccine stockpiling program
- H7N9 influenza virus surveillance
- generation of candidate vaccine viruses
- reagents for seasonal and pandemic influenza vaccines
- influenza vaccine effectiveness studies
- progress made in the Seasonal Influenza Vaccine Improvement (SIVI) program, an interagency collaboration to maintain the effectiveness of influenza vaccines despite the mutation of circulating viral strains.
Office of Tissues and Advanced Therapies
- NIST-FDA Genome Editing Workshop on measurement and standards needs for genome editing, especially for therapeutic products. The goal was to clarify regulatory needs and challenges, and to inform the efforts of the recently launched NIST Genome Editing Consortium, regarding safety of genome editing and standardization of reporting. (April 23-24, 2018)
- Convened the 21st U.S. - Japan Cellular and Gene Therapy Conference, “Neurodegenerative Diseases: Biology, Cellular and Gene Therapy” in collaboration with the Ministry of Education Culture, Sports, Science, and Technology, Japan. The goal of the conference was to exchange ideas on cutting edge and diverse areas of biomedical research and enhance opportunities for collaborations among scientists from the U.S. and Japan. CBER clarified U.S. regulatory approaches to the clinical development of cellular and gene therapies. (March 1, 2018)
- NIST-FDA Flow Cytometry Workshop: Building Measurement Assurance in Flow Cytometry, which focused on identifying problems in clinical and manufacturing settings and exploring potential solutions and needs in standards development. (October 25, 2017)
- Public workshop “Immune Globulin Potency in the 21st Century” to discuss new challenges for Industry to meet U.S. potency requirements for Immune Globulin (IG) products and to identify measures to address these challenges. The workshop included presentations and panel discussions by experts from academic institutions, industry, and government agencies. (Nov. 8-9, 2017)
Office of Blood Research and Review
- Convened the Blood Products Advisory Committee (BPAC) to discuss strategies for reducing the risk of transfusion-transmitted Zika virus. Seated as a device classification panel, BPAC also discussed the device classification of human leukocyte antigen, human platelet antigen, and human neutrophil antigen devices. (Nov. 30, – Dec. 1, 2017)
- Convened BPAC to discuss available strategies to control the risk of bacterial contamination of platelets, including bacterial testing using culture-based devices, rapid bacterial detection devices, and implementation of pathogen reduction technology. Seated as a device panel, the BPAC also discussed the reclassification from class III to class II of in vitro diagnostic devices indicated for use as aids in the diagnosis of human immunodeficiency virus (HIV) infection. (July 18-19, 2018).
Office of Biostatistics and Epidemiology
Active Surveillance Initiatives
Biological Effectiveness and Safety (BEST) Initiative
An expansion of the CBER program within the Sentinel Initiative to help build a national program for detecting in near real time, rare adverse events and for conducting safety assessments of biological products. BEST provides CBER with access to electronic health record (ERH) sources from >20 million patients for rapid safety and effectiveness studies of blood, advanced therapeutics, and vaccines. (See OBE section, 2017 Director’s Letter: award of two contracts).
- Performed query studies (>200 simple, 18 medium, 15 complex) on blood components to identify transfusions and adverse events (AEs), such as transfusion-related acute lung injury.
- Used new natural language processing (NLP) method to identify transfusion-associated circulatory overload (TACO) and post-transfusion sepsis cases; validated cases using ERH record review.
- Demonstrated use of NLP to automate AE reporting to the FDA Adverse Event Reporting System (FAERS).
- Biologics Effectiveness and Safety (BEST) Sentinel Initiative Industry Day
Meeting with industry to review CBER requirements and needs to build additional capacity for: 1) biologics post-market, near real-time safety and effectiveness surveillance; 2) access to large sources of clinical patient-centered data, particularly de-identified electronic health records; 3) innovative approaches to conduct surveillance using sophisticated query tools, machine learning, artificial intelligence, and natural language processing. Contracts were awarded later in FY 2018. (Feb. 12, 2018)
TTIMS is a blood monitoring system to evaluate risks of HIV, hepatitis B, and hepatitis C in >60% of US blood supply.
- Analyzed the first 30 months of donor testing data; conducted HIV recency testing (time elapsed before a measurable amount of antibody to, or genetic material of, the infectious organism is produced) and donor risk questionnaires.
- Determined by interim analyses that no apparent increase in HIV prevalence or risk had occurred since the start of TTIMS.
Centers for Medicare & Medicaid Services collaboration
This product safety and effectiveness surveillance collaboration provides access to Medicare data for about 58 million mostly elderly people in the US.
- Completed a study in over 13 million persons 65 years of age and older that showed cell-culture and high-doses of influenza vaccine were marginally more effective than egg-based quadrivalent influenza vaccines in preventing hospitalization and emergency room visits during the 2017-18 season.
- The cell-culture vaccine was 10.7% more effective; the high-dose vaccine was 8.4% more effective
- Completed a rapid surveillance of annual influenza vaccine and Guillain-Barre syndrome that found no increased risk during the 2017-18 influenza season.
VSD is a collaborative project between CDC’s Immunization Safety Office and eight health care organizations that monitors vaccine safety and studies rare and serious adverse events following immunization among 10 million persons in the US.
Science of Patient Input Initiative (SPI)
SPI includes methods and approaches of systematically obtaining, analyzing, and using information that captures patients’ experiences, perspectives, needs, and priorities in support of the development and evaluation of medical products.
The Office of Biostatistics and Epidemiology expanded its support of FDA efforts to integrate patient input on treatment preferences and outcomes into medical product development and regulatory decision-making, through its Science of Patient Input Initiative.
- Completed a Sentinel study assessing feasibility of identifying and characterizing a cohort of patients with hemophilia; used a mobile app to survey hemophilia patients.
- Launched three patient preference studies for prospective CBER products in the following disease areas: osteoarthritis, sickle cell disease, and brittle diabetes. These studies will provide important insights into patient perspectives and into the use of patient preference information (PPI) for regulatory decision making. PPI can answer questions about which benefits and risks are most important to patients, and which benefit-risk trade-offs they find acceptable. These efforts support patient-focused drug development requirements under 21st Century Cures and similar commitments under PDUFA VI.
- Sponsored or represented CBER in multiple inter-center initiatives and public workshops aimed at developing guidance documents for including patient experience data in submissions to FDA in order to inform regulatory decision making, as per the 21st Century Cures Act and PDUFA VI.
- Workshop: “Advancing Use of Patient Preference Information as Scientific Evidence in Medical Product Evaluation”
- Draft Guidance and Workshop: "Patient-Focused Drug Development: Collecting Comprehensive and Representative Input“
- Presentations at multiple national and international meetings on incorporation of patient input into regulatory decision making.
- Partnered with CDER to organize the FDA public workshop “Promoting the Use of Complex Innovative Designs in Clinical Trials.” This workshop discussed complex adaptive clinical trial designs, Bayesian and other innovative clinical trial designs, and clinical trial simulations for confirmatory trial design and planning. (March 20, 2018)
- Partnered with FDA’s Center for Drug Evaluation and Research (CDER) to support a public workshop convened by the Duke-Robert J. Margolis, MD, Center for Health Policy at Duke University, “Utilizing Innovative Statistical methods and Trial Designs in Rare Disease Settings.” Attendees discussed innovative statistical approaches to rare disease product development, such as using prior data from early phase trials to inform Phase 3 trial design and using patient registries. (March 19, 2018)
- Partnered with CDER on launching a pilot program for reviewing Complex and Innovative Trial Design (CID) proposals, fulfilling a PDUFA VI commitment.
CBER Guidances for Industry
CBER releases guidance documents as part of its effort to inform stakeholders of the Center’s current interpretation of its regulations and ways that regulated industry can remain in compliance. The Center also collaborates with other FDA Centers on joint guidances that include issues with broader intra-agency regulatory implications. A selection of these guidances is noted below.
Office of Blood Research and Review
- Further Testing of Donations that are Reactive on a Licensed Donor Screening Test for Antibodies to Hepatitis C Virus (Sept. 2018)
Recommends further testing of donations that are reactive on a licensed donor screening test for antibodies to hepatitis C virus (anti-HCV), as required under 21 CFR 610.40(e). It provides guidance to blood establishments on how to report the implementation of these recommendations.
- Recommendations for Requalification of Blood Donors Deferred Because of Reactive Test Results for Antibodies to Human T-Lymphotropic Virus Types I and II (anti-HTLV-I/II) (Sept. 2018)
Provides recommendations to blood establishments for an acceptable requalification method for deferred donors based on a determination that their previous reactive test results for anti-HTLV-I/II were false positives.
- Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components (July 2018)
Recommends that blood establishments test all donations collected in the U.S. and its territories with a licensed nucleic acid test (NAT) for ZIKV, using either individual (ID) NAT or minipool (MP) NAT. The guidance permits universal MP NAT, unless there is an increased risk of local, mosquito-borne ZIKV transmission in a geographic collection area based on certain conditions that would then trigger switching to ID NAT. This guidance supersedes the guidance document of the same title dated August 2016.
- Recommendations for Reducing the Risk of Transfusion-Transmitted Babesiosis—Draft (July 2018)
Recommendations for donor screening, donation testing, donor deferral and product management to reduce the risk of transfusion-transmitted babesiosis (TTB). The recommendations contained in this guidance apply to the collection of blood and blood components, except Source Plasma.
- Use of Serological Tests to Reduce the Risk of Transmission of Trypanosoma cruzi Infection in Blood and Blood Components (Dec. 2017)
Provides blood collection establishments with recommendations regarding the use of serological tests to reduce the risk of transmission of Trypanosoma cruzi infection (Chagas disease) in blood and blood components. These recommendations apply to the collection of blood and blood components, except Source Plasma, for transfusion or for use in manufacturing a product, including donations intended as a component of, or used to manufacture, a medical device.
- Amendment to "Revised Preventive Measures to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease by Blood and Blood Products" – Draft (Dec. 2017)
Provides revised recommendations intended to reduce the possible risk of transmission of variant Creutzfeldt-Jakob Disease (vCJD) by blood and blood products by: 1) revising and removing certain recommended deferrals for geographic risk of bovine spongiform encephalopathy (BSE) exposure; and 2) recommending deferral for individuals with a history of blood transfusion in Ireland from 1980 to the present.
- Implementation of Pathogen Reduction Technology in the Manufacture of Blood Components in Blood Establishments: Questions and Answers – Draft (Dec. 2017)
Provides blood establishments that collect or process blood and blood components, with recommendations for implementing a pathogen reduction device for the manufacture of pathogen-reduced blood components.
Office of Tissues and Advanced Therapies
- Long Term Follow-Up After Administration of Human Gene Therapy Products—Draft (July 2018)
Recommendations regarding the design of long term follow-up observational studies for the collection of data on delayed adverse events following administration of a gene therapy product
- Testing of Retroviral Vector-Based Human Gene Therapy Products for Replication Competent Retrovirus During Product Manufacture and Patient Follow-up--Draft (July 2018)
Recommendations regarding the testing for replication competent retrovirus during the manufacture of retroviral vector-based gene therapy products, and during follow-up monitoring of patients who have received retroviral vector-based gene therapy products.
- Human Gene Therapy for Hemophilia--Draft (July 2018)
Recommendations on the clinical trial design and related development of coagulation factor VIII (hemophilia A) and IX (hemophilia B) activity assays, including how to address discrepancies in factor VIII and factor IX activity assays. This guidance also includes recommendations regarding preclinical considerations to support development of gene therapy products for the treatment of hemophilia.
- Human Gene Therapy for Rare Diseases--Draft (July 2018)
Recommendations to stakeholders developing a human gene therapy product intended to treat a rare disease in adult and/or pediatric patients regarding the manufacturing, preclinical, and clinical trial design issues for all phases of the clinical development program.
- Human Gene Therapy for Retinal Disorders--Draft (July 2018)
Recommendations to stakeholders developing human gene therapy productsfor retinal disorders affecting adult and pediatric patients.
- Chemistry, Manufacturing, and Control (CMC) Information for Human Gene Therapy Investigational New Drug Applications (INDs)--Draft (July 2018)
Provides sponsors of a human gene therapy Investigational New Drug Application (IND), recommendations on how to provide sufficient chemistry, manufacturing, and control (CMC) information to ensure product safety, identity, quality, purity, and strength (including potency) of the investigational product (21 CFR 312.23(a)(7)(I)). This guidance applies to human gene therapy products and to combination products that contain a human gene therapy in combination with a drug or device.
- Same Surgical Procedure Exception under 21 CFR 1271.15(b): Questions and Answers Regarding the Scope of the Exception (Nov. 2017)
Intended to provide FDA’s interpretation of the same surgical procedure exception in 21 CFR 1271.15(b). The guidance is provided in question-and-answer format and includes inquiries received by the Agency since the 2001 finalization of the tissue rules.
- Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use (Nov. 2017; corrected Dec. 2017)
Intended to improve stakeholders’ understanding of the definitions of minimal manipulation in 21 CFR 1271.3(f) and homologous use in 21 CFR 1271.3(c). It will also facilitate stakeholders’ understanding of how the regulatory criteria in 21 CFR 1271.10(a)(1) and (2) apply to their their human cells, tissues, and cellular and tissue-based products.
- Evaluation of Devices Used with Regenerative Medicine Advanced Therapies--Draft (Nov. 2017)
Addresses how FDA intends to simplify and streamline its application of regulatory requirements for combination device and cell or tissue products; what, if any, intended uses or specific attributes would result in a device used with a regenerative therapy product being classified as a Class III device; the factors to consider in determining whether a device may be labeled for use with a specific regenerative medicine advanced therapy (RMAT) or class of RMATs; when a device may be limited to a specific intended use with only one particular type of cell; and application of the least burdensome approach to demonstrate how a device may be used with more than one cell type.
- Expedited Programs for Regenerative Medicine Therapies for Serious Conditions--Draft (Nov. 2017)
Recommendations on the expedited development and review of regenerative medicine therapies, including as provided under section 506(g) of the Federal Food, Drug, and Cosmetic Act (FD&C Act), as added by section 3033 of the 21st Century Cures Act (Cures Act).
CBER in cooperation with other centers (Selected examples)
- Adaptive Designs for Clinical Trials of Drugs and Biologics – Draft (CDER/CBER, Sept. 2018)
This document provides guidance to sponsors and applicants submitting investigational new drug applications (INDs), new drug applications (NDAs), biologics licensing applications (BLAs), or supplemental applications on the appropriate use of adaptive designs for clinical trials to provide evidence of the effectiveness and safety of a drug or biologic.
- Hematologic Malignancy and Oncologic Disease: Considerations for Use of Placebos and Blinding in Randomized Controlled Clinical Trials for Drug Product Development--Draft (CDER/CBER, Aug. 2018)
Provides recommendations to industry regarding the use of placebos and blinding in randomized controlled clinical trials in development programs for drug or biological products for the treatment of hematologic malignancies and oncologic diseases.
- Osteoarthritis: Structural Endpoints for the Development of Drugs--Draft (CDER/CBER/CDRH, Aug. 2018)
Intended to assist sponsors who are developing drugs, devices, or biological products (medical products) to treat the underlying pathophysiology and structural progression of osteoarthritis.
- Expansion Cohorts: Use in First-In-Human Clinical Trials to Expedite Development of Oncology Drugs and Biologics--Draft (CDER/CBER/OCE, Aug. 2018)
Provide advice to sponsors regarding the design and conduct of first-in-human (FIH) clinical trials intended to efficiently expedite the clinical development of cancer drugs, including biological products, through multiple expansion cohort trial designs.
- Labeling for Biosimilar Products (CDER/CBER, July 2018)
Assists applicants develop draft labeling for proposed biosimilar products for submission in an application under section 351(k) of the Public Health Service Act (PHS Act) (42U.S.C. 262(k)). The recommendations for prescription drug labeling in this guidance pertain only to the prescribing information (commonly referred to as the package insert), except for certain recommendations in section V pertaining to FDA-approved patient labeling.
- Limited Population Pathway for Antibacterial and Antifungal Drugs--Draft (CDER/CBER, June 2018)
Describes criteria, processes, and other general considerations for demonstrating the safety and effectiveness of limited population antibacterial and antifungal drugs, as per 21 CFR 506(h)(5), supplemented by Section 3042 of the 21st Century Cures Act. It is intended to assist sponsors in developing certain new antibacterial and antifungal drugs for approval under the limited population pathway for antibacterial and antifungal drugs pathway.
The research laboratories at CBER create new knowledge that is essential to the fulfillment of our mission of ensuring that products we regulate are safe, pure, potent, and effective—and that new products will be available to the public.
- FDA Blood Supply and Demand Simulation Model Could Help Nation Prepare for Emergencies
Development of a blood supply model that estimates the amount of blood available in the system during both routine conditions and emergencies. This model is designed to help public health officials effectively plan strategies that will minimize any disruption of the blood supply should blood collection efforts be reduced during an emergency.
- High Replication Rate of Induced Pluripotent Stems Cells Appears to Contribute to Breaks in DNA
Demonstration that the high replication rate of induced pluripotent stems cells (iPSCs) correlates with measures of DNA strand breakage, indicating a potential source of DNA damage in these cells.
- FDA Model suggests that a hepatitis C vaccine could reduce transmission of the virus among injecting drug users
Demonstration that if an effective vaccine were available, its use in drug user populations has the potential to reduce hepatitis C virus transmission and reduce new hepatitis C infections in this population, even if the virus replicates at low levels in the vaccinated users.
- FDA comparison of characteristics of hemoglobin-based oxygen carriers could guide development of safe and effective artificial blood products
The first comprehensive molecular and chemical comparison of all hemoglobin (Hb)-based oxygen carriers (HBOCs) that have been tested in humans. The findings could help to explain the individual safety and efficacy characteristics of each type of HBOC, which would enable scientists to choose among various biochemical characteristics to support the design of safe and effective products.
- Maternal vaccination with pertussis vaccine containing only one immunity-stimulating component provides protection against disease in baboon model
Demonstration in a baboon model that vaccination during pregnancy with a mono-component pertussis vaccine comprised of pertussis toxoid alone was sufficient to protect newborn baboons against pertussis disease (whooping cough).
- FDA research to improve technique for studying multipotent stromal cell morphology
Demonstration of unexpected changes in the morphology (shape and size) of multipotent stromal cells (MSCs) have been documented when preparations of the cells interact with specific engineered culture systems. The finding is a step toward understanding how to accurately interpret studies that use such systems, called microfluidics platforms, so they can support the development of safe and effective medical products based on multipotent stromal cells.
- Results of FDA study support development of high throughput sequencing for viral safety evaluation of biologic materials
The findings of a study led by CBER scientists suggest that a highly sensitive, but complex, new technology to sequence the genetic material of viruses could be standardized and used for rapid screening of biologic products, including vaccines, to demonstrate absence of contamination. The results of the study support the development of standard reference virus reagents that can be used to validate the performance of their high throughput screening procedures to demonstrate absence of viral contamination for product safety.
- Universal influenza vaccine candidate reduces transmission of virus best when given nasally in mice
FDA scientists demonstrated the ability of their universal influenza vaccine candidate to reduce the transmission of influenza virus in mice, even though this vaccine does not completely block infection by the virus. The FDA findings are important because they suggest the vaccine could both help protect recipients and reduce transmission, even when virus strains emerge with differing envelope proteins -- a type of change, that when it occurs, can make existing influenza vaccines less effective.
- Malaria gene activity findings could form basis of improved test for monitoring disease spread
Scientists at the U.S. Food and Drug Administration (FDA), in collaboration with the Johns Hopkins Malaria Research Institute, identified changes in the expression of specific genes of human malaria parasite Plasmodium falciparum as they undergo development in the mosquito midgut. These newly identified genes and antigens could become the basis of an improved test for monitoring the disease burden in countries where malaria is transmitted.