Promise of new translational safety biomarkers in drug development and challenges to regulatory qualification.

One promise of new translational safety biomarkers (TSBs) is their ability to demonstrate that toxicities in animal studies are monitorable at an early stage, such that human relevance of potential adverse effects of drugs can be safely and definitively evaluated in clinical trials. Another is that they would provide an earlier, more definitive and deeper insight to patient prognosis compared with conventional biomarkers. Recent experience with regulatory authorities indicates that resource demands for new TSB qualifications under the current framework are daunting and the rate of their expansion will be slow, particularly in light of mounting financial pressures on the pharmaceutical industry. Sponsors face a dilemma over engaging in safety biomarker qualification consortia. While it is clear new TSBs could be considered catalysts to drug development and that patient health, business and scientific benefits, described here using examples, should outweigh qualification costs, concerns exist that early ambiguities in biomarker interpretations at the introduction of such new TSBs might hinder drug development.

[1]  G. Dockray,et al.  Gastrin: old hormone, new functions , 2004, Pflügers Archiv.

[2]  F. Sistare,et al.  A Systematic Approach to Preclinical and Clinical Safety Biomarker Qualification Incorporating Bradford Hill's Principles of Causality Association , 2010, Clinical pharmacology and therapeutics.

[3]  R. J. Gerson,et al.  Weight-of-Biological Evidence Approach for Assessing Carcinogenicity , 1988 .

[4]  Amy G. Aslamkhan,et al.  Urinary biomarkers trefoil factor 3 and albumin enable early detection of kidney tubular injury , 2010, Nature Biotechnology.

[5]  Alan P. Brown Development of Serum Calcium and Phosphorus as Clinical Biomarkers for Drug‐Induced Systemic Mineralization: Case Study with a MEK Inhibitor , 2010 .

[6]  G. Betton,et al.  Gastric ECL-Cell Hyperplasia and Carcinoids in Rodents Following Chronic Administration of H2-Antagonists SK&F 93479 and Oxmetidine and Omeprazole , 1988, Toxicologic pathology.

[7]  Raffaella Corvi,et al.  The carcinoGENOMICS project: critical selection of model compounds for the development of omics-based in vitro carcinogenicity screening assays. , 2008, Mutation research.

[8]  P. Bernardi,et al.  High concordance of drug-induced human hepatotoxicity with in vitro cytotoxicity measured in a novel cell-based model using high content screening , 2006, Archives of Toxicology.

[9]  B. Andrews,et al.  New Technologies and Screening Strategies for Hepatotoxicity: Use of In Vitro Models , 2005, Toxicologic pathology.

[10]  John A. Wagner,et al.  A cost-effectiveness approach to the qualification and acceptance of biomarkers , 2006, Nature Reviews Drug Discovery.

[11]  J. DiMasi,et al.  Trends in Risks Associated With New Drug Development: Success Rates for Investigational Drugs , 2010, Clinical pharmacology and therapeutics.

[12]  K. Thurau,et al.  Adequate substitution with electrolytes in toxicological testing of "loop" diuretics in the dog. , 1982, Toxicology and Applied Pharmacology.

[13]  E. K. Alpar,et al.  Skeletal troponin-I release in orthopedic and soft tissue injuries , 2001, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[14]  Neil Kaplowitz,et al.  Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial. , 2006, JAMA.

[15]  I. Haber,et al.  Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension. , 2010, American journal of physiology. Lung cellular and molecular physiology.

[16]  Joseph V Bonventre,et al.  Next-generation biomarkers for detecting kidney toxicity , 2010, Nature Biotechnology.

[17]  James G Terry,et al.  Carotid intimal-media thickness as a surrogate for cardiovascular disease events in trials of HMG-CoA reductase inhibitors , 2005, Current controlled trials in cardiovascular medicine.

[18]  Krishna Prasad,et al.  Renal biomarker qualification submission: a dialog between the FDA-EMEA and Predictive Safety Testing Consortium , 2010, Nature Biotechnology.

[19]  Frank D Sistare,et al.  Research at the interface of industry, academia and regulatory science , 2010, Nature Biotechnology.

[20]  Serafino Pantano,et al.  Urinary clusterin, cystatin C, β2-microglobulin and total protein as markers to detect drug-induced kidney injury , 2010, Nature Biotechnology.

[21]  Frank D Sistare,et al.  Applications of toxicogenomics to nonclinical drug development: regulatory science considerations. , 2008, Methods in molecular biology.

[22]  J. DiMasi,et al.  The cost of biopharmaceutical R&D: is biotech different? , 2007 .

[23]  Deqin Sun,et al.  Electrochemiluminescent immunoassay for rat skeletal troponin I (Tnni2) in serum. , 2010, Journal of pharmacological and toxicological methods.

[24]  Frank D Sistare,et al.  Towards consensus practices to qualify safety biomarkers for use in early drug development , 2010, Nature Biotechnology.

[25]  D Amakye,et al.  A Prototypical Process for Creating Evidentiary Standards for Biomarkers and Diagnostics , 2008, Clinical pharmacology and therapeutics.

[26]  I. Kola,et al.  Can the pharmaceutical industry reduce attrition rates? , 2004, Nature Reviews Drug Discovery.

[27]  R. Prentice Surrogate endpoints in clinical trials: definition and operational criteria. , 1989, Statistics in medicine.

[28]  C. Laggner,et al.  Why drugs fail--a study on side effects in new chemical entities. , 2005, Current pharmaceutical design.

[29]  R. McKelvie,et al.  Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers. , 2007, The Canadian journal of cardiology.

[30]  S. Iscoe,et al.  Differential detection of skeletal troponin I isoforms in serum of a patient with rhabdomyolysis: markers of muscle injury? , 2002, Clinical chemistry.

[31]  Alexander Amberg,et al.  EU framework 6 project: predictive toxicology (PredTox)--overview and outcome. , 2011, Toxicology and applied pharmacology.

[32]  Frank D Sistare,et al.  Plasma MicroRNAs as sensitive and specific biomarkers of tissue injury. , 2009, Clinical chemistry.

[33]  Hugo A. Katus,et al.  Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. , 2000, European heart journal.

[34]  D. Dix,et al.  The ToxCast program for prioritizing toxicity testing of environmental chemicals. , 2007, Toxicological sciences : an official journal of the Society of Toxicology.

[35]  Cornel Pater Methodological considerations in the design of trials for safety assessment of new drugs and chemical entities , 2005, Current controlled trials in cardiovascular medicine.

[36]  P. O'Brien Cardiac troponin is the most effective translational safety biomarker for myocardial injury in cardiotoxicity. , 2008, Toxicology.

[37]  Ruili Huang,et al.  Dose-Response Modeling of High-Throughput Screening Data , 2009, Journal of biomolecular screening.

[38]  B. Cummins,et al.  Cardiac-specific troponin-I radioimmunoassay in the diagnosis of acute myocardial infarction. , 1987, American heart journal.

[39]  D. Choudhury,et al.  Drug-associated renal dysfunction and injury , 2006, Nature Clinical Practice Nephrology.

[40]  J. Wagner Strategic approach to fit-for-purpose biomarkers in drug development. , 2008, Annual review of pharmacology and toxicology.

[41]  R. W. Hansen,et al.  The price of innovation: new estimates of drug development costs. , 2003, Journal of health economics.

[42]  L. Hood,et al.  Circulating microRNAs, potential biomarkers for drug-induced liver injury , 2009, Proceedings of the National Academy of Sciences.

[43]  P Smith,et al.  Concordance of the toxicity of pharmaceuticals in humans and in animals. , 2000, Regulatory toxicology and pharmacology : RTP.

[44]  D. Gerhold,et al.  Kidney Injury Molecule-1 Outperforms Traditional Biomarkers of Kidney Injury in Multi-site Preclinical Biomarker Qualification Studies , 2010, Nature Biotechnology.