PHASE 0 CLINICAL TRIAL: HOPE THROUGH RESEARCH

Dutta Baruah, Hima Dutta Baruah
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Abstract

This paper Development of a drug molecule has always been a long and an exclusive process. From preclinical to clinical testing, it takes almost 10-15 years with an expense of almost US$2 Billion. It has been observed that serious challenges faced by researchers resulting in highest rate of failure in development of new drug molecules in clinical research. Seeing these grievances, the US FDA in 2004 introduced a “Critical Path “document highlighting the major decline of the drug development process despite having new advances and technology in biomedical research and the majors to improve the quality and effectiveness of overall drug discovery and development process. Thus, in 2006 a new guidance was issued on Exploratory IND studies by US FDA which is called phase 0 clinical study. It uses the concept of micro dosing. Minimum 30-40% of drugs fail in phase 1 trial due to unfavorable pk and pd. Micro-dosing is a new toolkit used in the drug development process and includes low or minute intake of molecules hardly to show any pharmacological effect when administered by participants and thus, helps in evaluating pk profiles. It shows no therapeutic effect, so chances of adverse reactions are also low. It acts as a bridge between preclinical and clinical study and can be beneficial in reducing extensive use of animal testing. Human screening is conducted to enroll few healthy participants for minimal no. of 7 days for the conduction of phase 0 trial. With recent technology, research and development and advancement, micro dosing has become more and more revolutionary and is emerging as the dormant challenge to be enormously used in more and more drug development process and make a shift to the process in a positive direction. The First emerging development of phase 0 trial can be witnessed in successful oncology trial in patients with progressive malignancies. Results proved to show a good and a well-tolerated bioavailability, and a desirable pharmacokinetics and biochemical data and hence this evidence can be used further to guide the development process and improve the drug development scenario.
0期临床试验:希望通过研究
药物分子的开发一直是一个漫长而独特的过程。从临床前试验到临床试验,耗时近10-15年,费用近20亿美元。据观察,在临床研究中,研究人员面临的严峻挑战导致新药分子开发失败率最高。看到这些不满,美国食品和药物管理局于2004年推出了一份“关键路径”文件,强调了药物开发过程的主要衰退,尽管生物医学研究有了新的进展和技术,并且主要提高了整个药物发现和开发过程的质量和有效性。因此,2006年美国FDA发布了探索性IND研究的新指南,称为0期临床研究。它使用了微剂量的概念。由于不利的pk和pd,至少30-40%的药物在i期试验中失败。微剂量是一种用于药物开发过程的新工具,包括低剂量或微量的分子摄入,当参与者给药时几乎不会显示任何药理作用,因此有助于评估pk谱。它没有任何治疗效果,因此不良反应的几率也很低。它作为临床前和临床研究之间的桥梁,有助于减少动物试验的广泛使用。进行人体筛查,招募少量健康参与者,以达到最低的健康水平。7天内进行0期试验。随着近年来技术、研究和开发的不断进步,微给药越来越具有革命性,并正作为一种潜在的挑战出现在越来越多的药物开发过程中,并使其朝着积极的方向转变。在进展性恶性肿瘤患者的成功肿瘤试验中,可以看到第一个0期试验的新兴发展。结果显示出良好和耐受性良好的生物利用度,以及理想的药代动力学和生化数据,因此这一证据可以进一步用于指导开发过程和改善药物开发方案。
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