OnCo
ideasIdea

Joint FDA-EMA-MHRA-PMDA scientific advice by default before pivotal cancer trials

Before a company runs its big trial, all the major regulators should agree together on the design in one meeting, so the same trial can be approved everywhere.

FDA-EMA parallel scientific advice exists but is used for a handful of products a year. The proposal is to make a joint written advice procedure covering endpoints, comparator, population and statistical plan the default for phase 3 oncology programmes, with PMDA, MHRA, Health Canada and TGA as standing participants. Advice would be recorded as a single agreed letter identifying any residual divergence, and divergence would be published in aggregate.

Hypothesis
Programmes with joint advice require fewer region-specific supplementary trials and reach approval in a second region a median of six months sooner than programmes with sequential single-agency advice.
Rationale
Most regional divergence in oncology approvals traces to disagreements over comparator, endpoint (PFS versus OS) or population fixed years earlier at design. Resolving them once, early, is cheaper than reconciling them at filing.
What would test it
Retrospectively compare approval divergence for products that used parallel advice with matched products that did not; then prospectively offer joint advice to all phase 3 oncology programmes for two years and track the same measures.
Maturity
early clinical
Who has to act
regulator
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks

Connected

2top