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On this week's episode, Grace Colón, Josh Schimmer, Sam Fazeli, Tess Cameron, Eric Schmidt, and Yaron Werber kick off with a discussion on recent policy moves including the appointment of Vinay Prasad as the director of the FDA's CBER division and nomination of Casey Means for U.S. Surgeon General, noting the impact on the XBI and uncertainty around vaccine gene therapy approvals. The group pondered what kind of regulator Prasad may be, predicting a stricter approach than his predecessor, Peter Marks. The conversation covered the shifting dynamics in vaccine approvals under the new FDA leadership, highlighting that delays like Novavax's flu combo signal heightened scrutiny, with mRNA follow-ons likely to pass under stricter labels, while new vaccines face raised efficacy bars. On the policy front, Trump's proposed “Most Favored Nation” drug pricing strategy raises alarms over a potential trillion-dollar hit to innovation and unintended consequences for U.S. drug prices. The conversation shifts to early data on Genocury's in vivo CAR-T, PTC's mixed Huntington's disease results, and Krystal's gene therapy for neuropathic keratitis. The episode concludes with a roundup of Q1 earnings results. *This episode aired on May 9, 2025.
President Donald Trump unveiled a sweeping drug pricing policy this week, seeking to lower drug prices in the U.S. by up to 80% through a reprisal of the Most Favored Nation rule he attempted to introduce in his first term. The rule would essentially link U.S. prices to those paid in other nations where medications are cheaper. Biopharma reaction was one of tentative relief, with BMO Capital Markets analysts suggesting the executive order had “more bark than bite.” Meanwhile, the Centers for Medicare and Medicaid Services announced that among the next 15 drugs to undergo IRA-prescripted price negotiations could be drugs payable through Medicare Part B, and not just Part D, where the first two rounds have applied. Into all of this action steps Vinay Prasad, the outspoken oncologist and hematologist who was named last week as the next director of the FDA's Center for Biologics Evaluation and Research. While the S&P Biotech ETF fell by more than 5% upon the news, overall reaction was fairly measured, with cell and gene therapy executive Audrey Greenberg summing up Prasad's selection as “anything but a status quo appointment.” Over in the weight loss and obesity space, Eli Lilly can't seem to lose. This weekend, Lilly announced full data from a head-to-head trial showing a “superior benefit-to-risk ratio” for its Zepbound over Novo Nordisk's Wegovy. And last week, the Indiana-based pharma won a court battle against compounders when a judge sided with the FDA, stating that tirzepatide—the active ingredient in both Zepbound and diabetes sister drug Mounjaro—was no longer in shortage. Add on a presidential shoutout during Trump's Monday press conference for its U.S. manufacturing investments, and it really was Lilly's week. Flying less high are some 2,000 Bayer employees who lost their jobs in the first quarter of 2025 as part of the company's new operating model, which is intended to make Bayer “much more agile.” On a less direct flight is Galapagos, which reversed course on plans to spin out a portion of the company and find a new CEO. Instead, CEO Paul Stoffels will make a quicker exit and the Belgian biotech could sell off its cell therapy assets as it looks to build up a new pipeline in house, having abandoned the spinout idea altogether. Stay tuned. Finally, in ClinicaSpace this week, we took a deep dive into the HIV treatment space, where companies like Gilead and Immunocore are targeting a cure, while the Trump administration slashes funding for HIV research.
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.The White House has announced a new drug pricing policy that includes the revival of the most favored nations rule and extends to the private markets, leveraging the patent system, drug importation, and more. Meanwhile, Lilly's Zepbound has been found to have a superior benefit-risk ratio compared to Novo's Wegovy, BMS and Sanofi settle a Plavix lawsuit with Hawaii for $700 million, and biopharma companies are focusing on developing a cure for HIV as federal funding for related research is being cut. Sino Biological offers comprehensive solutions for autoimmune diseases, and Roche promises a $300 million investment in China production after a multibillion-dollar investment in the US. On the other hand, Lexeo and IGM have both announced significant layoffs. Novartis CEO has expressed concerns about Trump's pricing controls.Funding for HIV-related research and infrastructure is being cut by the Trump administration, leading biopharma companies like Gilead and Immunocore to focus on finding a cure for HIV. In the field of neurology, there is a need for more precise diagnostic tools to effectively treat neurodegenerative conditions. The new HHS vaccine requirement has been criticized by leading vaccine physician Paul Offit as potentially being anti-vaccine activism disguised as policy. Companies like Novartis, Bayer, and AstraZeneca are exploring new indications and innovations in radiopharmaceuticals, hoping to capitalize on a market that could reach $16 billion by 2033. The FDA has faced delays in reviewing certain drugs, while biotech stocks have fallen after the appointment of Vinay Prasad to succeed Marks at CBER. Vertex has decided to abandon AAV in the gene therapy space.Upcoming events include a webinar on surviving and thriving in the biotech downturn. Job opportunities in the biopharma industry include positions at Takeda, Daiichi Sankyo, and AbbVie. Heather McKenzie, senior editor at BioSpace, is open to suggestions for future coverage topics in neuroscience, oncology, cell & gene therapy, metabolic, or other areas.
TWiV reviews new CBER chief at FDA, ending of Gates Foundation in 2045, gain of function executive order, origins of bat viruses ancestral to SARS-CoV and SARS-CoV-2, and single dose Sudan virus replicon vaccine protects guinea pigs from disease. Hosts: Vincent Racaniello, Alan Dove, and Rich Condit Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Support science education at MicrobeTV Prasad replaces Marks at FDA (US News) Gates Foundation ends 2025 (Gates Foundation) Gain of function Executive Order (White House) DURC policy (HHS) Origins of bat viruses ancestral to SARS-CoV and SARS-CoV-2 (Cell) Sudan virus replicon vaccine (Nat Comm) Letters read on TWiV 1217 Timestamps by Jolene Ramsey. Thanks! Weekly Picks Rich – Andor Season 2 Alan – Sequencing Mendel's pea plant traits, and a good Science news article on the work Vincent – 2023 summer warmth unparalleled over the past 2,000 years Listener Pick Brian – Virology Capabilities Test (VCT): A Multimodal Virology Q&A Benchmark Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.
Pink Sheet Executive Editor Derrick Gingery, Senior Editor Sue Sutter and Editor-in-Chief Nielsen Hobbs consider early excitement and concern about Vinay Prasad's potential impact on product development as director of the US Food and Drug Administration's Center for Biologics Evaluation and Research (:20). They also consider the consequences of the FDA missing product-specific guidance publication deadlines (14:59) and its potential impact on the upcoming user fee reauthorization negotiations (20:00). More On These Topics From The Pink Sheet Tougher Approval Standards May Follow Vinay Prasad's Appointment To Lead US FDA's CBER: https://insights.citeline.com/pink-sheet/agency-leadership/us-fda/tougher-approval-standards-may-follow-vinay-prasads-appointment-to-lead-us-fdas-cber-WEULXI5EJRE43BWU752PGDGE44/ US FDA Guidance Roadblock: Writing Continues, But Publication Has Slowed Or Stopped: https://insights.citeline.com/pink-sheet/biosimilars-and-generics/generics/us-fda-guidance-roadblock-writing-continues-but-publication-has-slowed-or-stopped-TZF4DMPEMVHT3JJPRUX7LJJIHU/
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma e Biotech world. Takeda's $30 billion investment in the U.S. is making headlines, along with their opposition to Trump's proposal on drug prices. The FDA's appointment of Vinay Prasad is stirring up mixed reactions within the industry. On another note, Lilly's legal victory against compounders, Novavax's growing sales, and Gilead's significant investment in U.S. manufacturing are all key developments. The FDA vaccine advisors are gearing up for a meeting to discuss COVID-19 updates, while Vor Bio is seeking an exit due to funding challenges. Biotech stocks took a hit following Prasad's appointment to lead CBER, highlighting the industry's current challenges including vaccine hesitancy and job market struggles.
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.Novo Nordisk predicts a brighter future for Wegovy with the end of the semaglutide shortage, but analysts remain skeptical as Eli Lilly's Zepbound gains ground in sales. The new HHS vaccine requirement has raised questions about its true intentions, with leading vaccine physician Paul Offit criticizing the lack of clarity. Meanwhile, pharmaceutical imports from Ireland are on the rise, biotech stocks fell after Vinay Prasad was named to succeed Marks at CBER, and Lotte Biologics' ADC facility in Syracuse offers end-to-end services for antibody manufacturing. CRISPR's Casgevy is gaining traction with more gene therapy proof of concept expected in 2025, impacting M&A and IPOs in the biotech industry. Summit Pharmaceuticals is nearing the first global phase III data for Keytruda, set to lose exclusivity in 2028 and potentially face competition from biosimilars. A report suggests that low-price drug nations are benefiting from US innovation, undervaluing innovative medicines by 90%. VC financing in biopharma declined by 20% in Q1, but megarounds kept the median deal size high. M&A and IPOs faced challenges due to policy issues, leading to an increase in licensing deals. Novo vows to improve market access for Wegovy, while Trump orders FDA to ease US plant expansion and increase inspections of foreign facilities. BMS pledges a $40 billion investment in the US, Novartis makes M&A moves, and Lilly remains unfazed by CVS's decision to side with Novo in the obesity market battle. Some drugmakers are stockpiling products in the US amid Trump's trade war. NGM terminates half of its staff as its lead asset moves through a registrational study. Job opportunities in clinical quality assurance audit, RBQM central statistical monitoring, and field medical capabilities are available.
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma e Biotech world. Pharma industry tensions rise as Trump tariffs miss sector for now. FDA's interim CBER head appointed after key resignation. Xaira Therapeutics hires top AI academic. Novavax's COVID-19 shot review deadline missed by FDA. Trilink offers guide RNA for CRISPR workflow. Biotech sector sees investment surge. Beigene scraps candidate, Sarepta's gene therapy on hold in Europe. Biopharma professionals work long hours.In other news, there are safety concerns in Duchenne treatment. Democrats challenge Trump health cuts. And there are job opportunities in the biopharma industry.
Biopharma's reaction to the forced resignation of venerable CBER director Peter Marks has been swift and furious, with former FDA Commissioner Robert Califf saying on LinkedIn that “the FDA as we've known it is finished.” Analysts, meanwhile, called Marks' exit “arguably biotech investors' greatest fear,” as company shares across the industry tumbled. Marks' announcement added insult to injury for the agency, which was already reeling from the announced cuts of 10,000 employees across the Department of Health and Human Services, including 3,500 FDA staffers. Those layoffs began to roll out on Tuesday as some employees showed up to work only to discover they no longer had a job. Amid all this chaos, Cantor Fitzgerald analysts called for Kennedy himself to get the axe, saying in part that he was “undermining the trusted leadership of health care in this country.” Despite the turmoil, drug development continues in the obesity space, with Novo Nordisk presenting mixed data from its semaglutide franchise at the American College of Cardiology's annual conference last weekend. While an oral version of the blockbuster drug showed cardiovascular benefits for some patients, it failed to change the trajectory of other major adverse cardiovascular events. Meanwhile, Novo continues its battle against compounding pharmacies manufacturing copycat versions of semaglutide—as multiple players scramble for a piece of this massive pie. On the Alzheimer's front, Eli Lilly's Kisunla failed last week to win the recommendation of the EU's Committee for Medicinal Products for Human Use. This decision is consistent with CHMP's recent stance on anti-amyloid antibodies, as Biogen and Eisai have also struggled to get Leqembi approved in Europe. On a positive note, pharma R&D returns grew again in 2024, but Deloitte warned that this progress is “fragile.” The firm urged companies to be bold and embrace cutting edge technology like gene therapy and AI. These returns can't help everyone, however, as the past week has seen an uptick in layoffs across biopharma, including at Carisma Therapeutics, Organon and Tenaya Therapeutics. Finally, as April kicks off cancer conference season, BioSpace took a deep dive into the recent action in the always-hot in radiopharmaceuticals space.
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world. Altimmune, a biopharmaceutical company based in Maryland, has announced plans to test an investigational drug based on GLP-1 for the treatment of alcohol use disorder. This drug is also being studied by Eli Lilly and Novo Nordisk for alcohol- and liver-related conditions. Altimmune joins these companies in exploring the potential of GLP-1 agonists for this indication. The recommendations for flu vaccine usage were recently made by the FDA in a closed session involving representatives from CBER, the CDC, and the Department of Defense.In other news, Pfizer has ended a trial for an early-stage cancer drug, Sutro has cut half of its staff and deprioritized a drug for ovarian cancer, and Pliant has implemented a poison pill strategy. Additionally, Wacker Biotech is offering services for advanced therapies, including process development and production of DNA and RNA. The biotech industry continues to see shifts and developments in various companies and research areas.
Pink Sheet editors consider ex-FDA officials' advice for the Trump Administration on implementing FDA reforms (:24), comments CDER Director Patrizia Cavazzoni made before her departure from the agency about wanting to release review documents for applications that received complete response letters (12:35), and diverging trends between CDER and CBER novel application approvals (21:53). More On These Topics From The Pink Sheet Trump's US FDA Reforms Need Center Director, Staff Support To Succeed, Former Leaders Say: https://insights.citeline.com/pink-sheet/agency-leadership/us-fda/trumps-us-fda-reforms-need-center-director-staff-support-to-succeed-former-leaders-say-VCCGXSBJGZGXPHEYJFAHIHEI7A/ Exit Interview: US FDA's Patrizia Cavazzoni Says CDER Staff In ‘Best Place Possible': https://insights.citeline.com/pink-sheet/agency-leadership/us-fda/exit-interview-us-fdas-patrizia-cavazzoni-says-cder-staff-in-best-place-possible-IN6GTBFEJZDSNOI4T23CRYK7OY/ Innovation Drives Divergence: US FDA Drugs and Biologics Centers Follow Own Trajectories: https://insights.citeline.com/pink-sheet/pink-sheet-perspectives/innovation-drives-divergence-us-fda-drugs-and-biologics-centers-follow-own-trajectories-MDZ5DSCKKNEYPF6PVTXAMFHGF4/ US FDA's Median Review Time Remains Less Than One Year Despite Swell Of Missed Goal Dates: https://insights.citeline.com/pink-sheet/pink-sheet-perspectives/us-fdas-median-review-time-remains-less-than-one-year-despite-swell-of-missed-goal-dates-VIEE6AVOQRGMZNKB53B52GPQG4/ Clocking The Speed Of US FDA 2024 Novel Approvals: https://insights.citeline.com/pink-sheet/pink-sheet-perspectives/clocking-the-speed-of-us-fda-2024-novel-approvals-3HT7CAIO4VBJDIJZVGBHLAUCSY/
Join Karl and Erum in this special Thanksgiving replay of Aaron Schacht's episode as they revisit this fascinating conversation. Aaron is the CEO & Board Director of BiomEdit and he has a visionary approach to leveraging microbiome science and synthetic biology to tackle some of the biggest challenges in animal health. Whether it's creating healthier livestock, addressing sustainability issues, or revolutionizing methane reduction in agriculture, this episode covers it all. As Karl and Erum reflect on the year, they share what they're thankful for before introducing Aaron's episode. BiomEdit's innovative strides, led by Aaron, let us in on the potential in animal agriculture and the power of biotechnology. Please enjoy the full replay of Aaron Schacht's episode—a perfect listen for a Thanksgiving break or any time you're curious about how biology is shaping the future of our food systems and beyond! Grow Everything brings the bioeconomy to life. Hosts Karl Schmieder and Erum Azeez Khan share stories and interview the leaders and influencers changing the world by growing everything. Biology is the oldest technology. And it can be engineered. What are we growing? Learn more at www.messaginglab.com/groweverything Chapters: 00:00:00 A Thanksgiving Welcome: Reflections and Gratitude 00:00:49 Looking Ahead: Strategies for 2025 00:02:44 Global Biotech Highlights: Insights from Chile and India 00:06:47 The Biotech Boom: Startups and Industry Trends 00:09:18 Personal Gratitude: Moments That Matter 00:11:47 Replay Begins: Aaron Schacht and the BiomEdit Revolution 00:12:30 Breaking Boundaries: The Quest for Animal Health Innovation 00:14:02 Microbiomes Unleashed: Transforming Livestock Care 00:17:15 Human vs. Animal Health: Lessons from Both Worlds 00:20:45 Synthetic Biology Spotlight: Engineering Solutions for Animals 00:23:10 Catching Up: Why Animal Medicine Trails Human Innovation 00:25:33 Antibiotics Reimagined: Solving the Resistance Crisis 00:28:12 Microbiome Resilience: Unlocking Nature's Secrets 00:31:45 The Diversity Code: Harnessing Microbial Power 00:35:20 Bacteria as Tools: Crafting Solutions for Tomorrow 00:38:00 From Lab to Farm: Turning Science into Action 00:40:47 FDA Deep Dive: Understanding CDER, CBER, and CVM 00:42:50 Hidden Helpers: Exploring the Microbiome's Role in Health 00:45:16 Sustainability in Agriculture: Making an Impact 00:49:37 Tackling the Tough Questions: Challenges in Microbiome Science 00:51:12 Mapping the Invisible: Microbial Atlases for Progress 01:10:04 The Future Is Bright: BiomEdit's Vision for Animal Health 01:15:52 Closing the Loop: Reflections and Next Steps Topics Covered: biotech, biodesign, built environment, living environment, microbiome, research, discovery, brooklyn Episode Links: India's BioE3 Policy BIOMADE US Initiative for biomanufacturing Jugaad - (Indian English term) - involving the use of skill and imagination to find an easy solution to a problem or to fix or make something using cheap, basic items. The odds of you being alive - Neil deGrasse Tyson Have a question or comment? Message us here: Text or Call (804) 505-5553 Instagram / TikTok / Twitter / LinkedIn / Youtube / GrowEverything website Email: groweverything@messaginglab.com Music by: Nihilore Production by: Amplafy Media
From simple biomarker tests to cutting-edge precision medicine, the diagnostics industry is navigating a complex landscape of regulatory changes and technological advancements. In this episode, Andrew L'Huillier, a leader in the diagnostics industry and Director of Regulatory Affairs Liaison - Diagnostics at Merck, discusses his work on FlowScript and other groundbreaking diagnostic products. Learn about the challenges and opportunities in regulatory compliance, drug discovery, and the implementation of cGMP guidelines. Tune in and discover how precision medicine is revolutionizing healthcare and improving patient care! Resources: Connect with and follow Andrew L'Huillier on LinkedIn. Follow Merck on LinkedIn. Explore the Merck Website! Subscribe to the CDER, CBER, and CDRH newsletters! Discover AgencyIQ and 360Dx!
BioSpace's Lori Ellis and Chantal Dresner are bringing live updates from #DIA2024 in San Diego this week where we've been attending sessions on trial design, digital twins, cell and gene therapy regulation, clinical research workforce trends, professional development and many more. We discuss some of our key takeaways and event highlights, including Lori's exclusive interview with CBER director Dr. Peter Marks. Hosts Lori Ellis, Head of Insights, BioSpace Chantal Dresner, VP of Marketing, BioSpace
BioSpace's Lori Ellis and Chantal Dresner are bringing live updates from #DIA2024 in San Diego this week where the first day kicked off with an inspiring story from Tom and Emily Whitehead of the Emily Whitehead Foundation, setting the tone for patient-centric discussions. The following panel featuring Emer Cooke, Chair, ICMRA an Executive Director, European Medicines Agency; Peter Marks, Director, CBER, FDA; Carsten Linnerman, CEO, Neogene Therapeutics, AstraZeneca Group; Dean Kamen, Founder, DEKA; and Stacy Hurt, Chief Patient Officer, Parexel emphasized the imperative of collaboration to improve outcomes, between regulatory bodies as well as with patients. Tune in this week to hear more from the event!
How do we ensure strategic vision and thoughtful implementation when pursuing new opportunities in science and technology? Our guests discuss challenges around reimbursement, intellectual property, change management and the critical nature of early engagement. Additionally, we are joined by Tamei Elliott of DIA who shares insights on key discussions and themes of the upcoming meeting in San Diego. This is the third and final episode in our preparation for the roundtable discussion: Pioneering New Frontiers: Advanced Drug Delivery Technologies and Cell/Gene Therapies in Combination Products taking place at the DIA 2024 Global Annual Meeting. James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie is chairing the discussion between Rob Schulz, President and Chief operating officer of Suttons Creek, William Daunch, Chief Technology Officer, Focal Medical, Inc, Andrea Gray, Biomedical Engineer Advisor, CBER, FDA, and Michael Lehmicke, Senior Vice President, Science and Industry Affairs, Alliance for Regenerative Medicine. Lori Ellis will be covering DIA Global Annual meeting 2024, June 16-20 in San Diego. Host Lori Ellis, Head of Insights, BioSpace Guests James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie, United States Rob Schulz, President and COO, Suttons Creek, Inc., United States Tamei Elliott, Associate Director, Scientific Programs (Americas), DIA
Regulators suggest developers engage in discussions early, however those conversations cannot take place unless developers are sure of the asset's category. Existing confusion surrounding advanced therapy products may become more challenging as both science and technology evolve. With both developers and regulators, two risk adverse entities, addressing this evolution and continually updated regulations, advanced therapy product development continues to be a collaborative process. This is the second episode in our preparation for the roundtable discussion: Pioneering New Frontiers: Advanced Drug Delivery Technologies and Cell/Gene Therapies in Combination Products taking place at the DIA 2024 Global Annual Meeting. James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie is chairing the discussion between Rob Schulz, President and Chief operating officer of Suttons Creek, William Daunch, Chief Technology Officer, Focal Medical, Inc, Andrea Gray, Biomedical Engineer Advisor, CBER, FDA, and Michael Lehmicke, Senior Vice President, Science and Industry Affairs, Alliance for Regenerative Medicine. Lori Ellis will be covering DIA Global Annual meeting 2024, June 16-20 in San Diego. Host Lori Ellis, Head of Insights, BioSpace Guests James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie, United States Rob Schulz, President and COO, Suttons Creek, Inc., United States
With every new advancement in either science or technology there is increased excitement as we see the potential. Cell and gene therapies (CGT) as combination products are emerging as the stage in the evolution of technology and science merging together. While the potential benefits for patients are great, there are risks and challenges that must be carefully considered. This discussion is part of one of a precursor of the roundtable discussion: Pioneering New Frontiers: Advanced Drug Delivery Technologies and Cell/Gene Therapies in Combination Products taking place at the DIA 2024 Global Annual Meeting. James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie is chairing the discussion between Rob Schulz, President and Chief operating officer of Suttons Creek, William Daunch, Chief Technology Officer, Focal Medical, Inc, Andrea Gray, Biomedical Engineer Advisor, CBER, FDA, and Michael Lehmicke, Senior Vice President, Science and Industry Affairs, Alliance for Regenerative Medicine. Lori Ellis will be covering DIA Global Annual meeting 2024, June 16-20 in San Diego. Host Lori Ellis, Head of Insights, BioSpace Guests James Wabby, Global Head, Regulatory Affairs, Emerging Technologies and Combination Products, AbbVie, United States Rob Schulz, President and COO, Suttons Creek, Inc., United States
Join Emily Walsh Martin, PhD for an in-depth interview with Sabrina Mogle, co-founder of RareMoon Consulting. They talk about what drove her to dedicate her career to the orphan drug and advanced therapy space, and how helping clients navigate regulatory conversations on the path from idea to BLA keeps her motivated today. They also discuss her advice for clients in interacting with regulators given the evolving CBER and global regulatory landscape. Do they make it through the whole episode without either providing the standard regulatory wisdom of “it depends”? Listen to find out! Have you registered for the ASGCT Annual Meeting yet? Meet us in Baltimore, May 7-11, for the only must-attend event in cell and gene therapy. There's no better place to deep dive in this field than the ASGCT Annual Meeting—you will not find the same breadth or depth of CGT research anywhere in the world. Check out the full program and learn more about the meeting at www.annualmeeting.asgct.org. Music by: https://www.steven-obrien.net/--------------------------Bright New Morning - Steven O'Brien (Used for free under a Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/)Show your support for ASGCT!: https://asgct.org/membership/donateSee omnystudio.com/listener for privacy information.
ORDER QUALITY MEAT TO YOUR DOOR HERE: https://wildpastures.com/promos/save-20-for-life/bonus15?oid=6&affid=321 Save 20% and get $15 off your FIRST order! Support your local farms and stay healthy! GET HEIRLOOM SEEDS & NON GMO SURVIVAL FOOD HERE: https://heavensharvest.com/ USE Code WAM to get FREE shipping in the United States! HELP THE WAM LEGAL DEFENSE FUND HERE: https://gogetfunding.com/wam-legal-defense/ GET YOUR APRICOT SEEDS at the life-saving Richardson Nutritional Center HERE: https://rncstore.com/r?id=bg8qc1 BUY GOLD AND SILVER HERE: https://kirkelliottphd.com/wam/ Josh Sigurdson reports on the shocking vaccine death rate we're only just beginning to see. New reports are coming out showing that disability claims have skyrocketed 55% among women since the rollout of the injections and immune systems are destroyed and heart and cancer deaths become so common they're normalized. People continue to beg for restrictions, masks and injections in the face of hundreds of vaccine related studies, peer reviewed and not. The CDC has acknowledged much of this. Pfizer and Moderna's own patents show they knew it would cause cancer and heart failure. The FDA, HHS and CBER acknowledged that gene editing tools were sure to cause cancer death among many. In this video, we go over MANY studies, we expose the trolls and we talk about solutions to this global genocide. Stay tuned for more from WAM! HELP SUPPORT US AS WE DOCUMENT HISTORY HERE: https://gogetfunding.com/help-wam-cover-history/ Buy HEALTHY organic coffee with your day's worth of antioxidants HERE: https://www.r1kln3trk.com/3PC4ZXC/FFJPPD/ GET AN EXTENDED FREE TRIAL FOR ICKONIC WHEN YOU SIGN UP HERE: https://www.ickonic.com/affiliate/josh10 BUY YOUR PRIVATE CLEARPHONE HERE: https://www.r1kln3trk.com/3PC4ZXC/F9D3HK/ LION ENERGY: Never Run Out Of Power! PREPARE NOW! https://www.r1kln3trk.com/3PC4ZXC/D2N14D/ GET VITAMINS AND SUPPLEMENTS FROM DR. ZELENKO HERE: https://zstacklife.com/?ref=WAM GET TIM'S FREE Portfolio Review HERE: https://bit.ly/redpilladvisor And become a client of Tim's at https://www.TheLibertyAdvisor.com STOCK UP ON STOREABLE FOODS HERE: http://wamsurvival.com/ OUR GOGETFUNDING CAMPAIGN: https://gogetfunding.com/help-keep-wam-alive/ OUR PODBEAN CHANNEL: https://worldaltmedia.podbean.com/ Find us on Vigilante TV HERE: https://vigilante.tv/c/world_alternative_media/videos?s=1 FIND US on Rokfin HERE: https://rokfin.com/worldalternativemedia FIND US on Gettr HERE: https://www.gettr.com/user/worldaltmedia See our EPICFUNDME HERE: https://epicfundme.com/251-world-alternative-media JOIN OUR NEWSLETTER HERE: https://www.iambanned.com/ JOIN our Telegram Group HERE: https://t.me/worldalternativemedia JOIN US on Rumble Here: https://rumble.com/c/c-312314 FIND WAM MERCHANDISE HERE: https://teespring.com/stores/world-alternative-media FIND OUR CoinTree page here: https://cointr.ee/joshsigurdson JOIN US on SubscribeStar here: https://www.subscribestar.com/world-alternative-media We will soon be doing subscriber only content! Follow us on Twitter here: https://twitter.com/WorldAltMedia Help keep independent media alive! Pledge here! Just a dollar a month can help us alive! https://www.patreon.com/user?u=2652072&ty=h&u=2652072 BITCOIN ADDRESS: 18d1WEnYYhBRgZVbeyLr6UfiJhrQygcgNU World Alternative Media 2023
In this episode, hosts Marla Dalton, PE, CAE, and William Schaffner, MD, talk with Peter Marks, MD, PhD, director of the Center for Biologics Evaluation and Research (CBER) at the US Food and Drug Administration. He shares his insights on the origin of Operation Warp Speed during the COVID-19 pandemic, his efforts to transform the way that FDA approaches approval and licensure of new vaccines and other prevention tools, and his thoughts on how artificial intelligence may improve future work.Show notesBefore joining FDA, Dr. Marks was clinical director of hematology at Brigham and Women's Hospital in Boston, MA. He worked in industry for several years on hematology and oncology drug development and then returned to academic medicine at Yale University where he led the Adult Leukemia Service and served as chief clinical officer of Smilow Cancer Hospital. He joined FDA in 2012 as CBER deputy director and became director in2016. In 2022, he became a member of the National Academy of Medicine. Born in Brooklyn, NY, the father of 2 grown children now lives with his wife in Washington, DC.
The FDA's Center for Biologics Evaluation and Research (CBER)'s Dr. Peter Marks makes his second appearance on Cell & Gene: The Podcast. This time Dr. Marks talks to Host, Erin Harris, about base editing and prime editing and their potential to meet unmet medical need. They discuss what clinical holds say about the FDA's views on gene editing. They also discuss heritable genome editing.
On this episode I was joined by Aaron Snyder, VP of Quality Assurance at Allotex. Aaron discusses: • Distinguishing differences in framework between the Device QSR/QMS and Drug cGMP's • Learnings from Training FDA CDER and CBER on device requirements • Lessons from being Head of QA at a manufacturing site and internal audit • Teaching through AAMI and his YouTube channel: Quality Systems Explained Aaron Snyder is a quality management systems expert and is currently VP of QA at Allotex. Prior to joining Allotex, Aaron served in roles at Fresenius Kabi, Molnlycke, Waters Corporation, Covidien, Cardinal Health, and General Electric. He has worked with a wide range of pharmaceuticals, medical devices and combination products. Aaron is a member of the AAMI Faculty and teaches several courses focused on various QMS topics. Aaron is also and avid content creator and dissects, presents and teaches on QMS and cGMP's topics on his YouTube channel: Quality Systems Explained.
Broadcasters/telecoms assess Mawar's fury. REC opens new enforcement database. FCC fines PayG $1.4M for missing USF payments. CBer blames a milk crate as the cause of jamming in Rockford, IL.
If FDA approves Sarepta's gene therapy for Duchenne muscular dystrophy, patients will soon face the difficult choice between taking this treatment or waiting for a better option among the “unprecedented” amount of innovation ahead in DMD, as taking both may not be an option, BioCentury Executive Director Lauren Martz said on the latest BioCentury This Week podcast. Martz and colleagues assess the landscape for DMD gene therapies ahead of the May 29 PDUFA date for delandistrogene moxeparvovec.Also on the show, BioCentury Washington Editor Steve Usdin discusses takeaways from his conversation with FDA's Peter Marks; three tasks for Monica Bertagnolli to prioritize at NIH; and what the debt ceiling means for the life sciences. And on the heels of Bio€quity Europe, Editor in Chief Simone Fishburn delivers her insights from BioCentury's European conference.This week's podcast is sponsored by Cancer Research Horizons.
placemakingpodcast@gmail.com Facebook-f Twitter Linkedin Instagram Economic Trends and their Effects on Local Real Estate Development with Mervin Jebaraj – Ep. 71 About the Guest Mervin Jebaraj is the director of the Center for Business and Economic Research. He has contributed to economic thinking and public policy discussion that journalists, business people, and community leaders alike rely on to understand how national and regional issues impact Northwest Arkansas and Arkansas as a whole. Arkansas Business and the Northwest Arkansas Business Journal recognized Mervin in their 40 Under 40 lists and on the Arkansas 250 list. He makes presentations that share the center's expertise directly to over 5,000 individuals annually and tens of thousands more hear and see his economic analysis and commentary through TV, radio and print media. Jebaraj serves on the Community Development Advisory Council of the Federal Reserve Bank of St. Louis, the Board of Directors of the National Association for Business Economics, the Board of Directors of the Northwest Arkansas National Airport, and on the Board of Directors of the Walton Arts Center. Mervin earned a B.A. in Economics and International Relations and a Master's in Public Administration and Public Policy from the University of Arkansas. To Learn More About Mervin Jebaraj and the CBER, Check out the Following Websites: LinkedIn - Mervin Jebaraj CBER UARK Website Recommended Reading Section P.S. We spend (a lot) of time, sweat, tears, and money creating each episode of The Placemaking Podcast. We do this without the support of sponsors as we want to keep the advertisements out of the picture and provide an add-free listening experience. YOUR support ensures we can keep delivering these discussions ad-free! If you feel compelled to donate to the show (and receive some cool bonuses...) you can check out my Patron Page. The Weekly Real Estate Development Workshop Receive the latest news Subscribe To Our Weekly Updates Find Us Here Facebook-f Twitter Linkedin-in Youtube The Placemaking Podcast All Rights Reserved © 2020
This podcast episode provides a short recap of the day long workshop hosted by the FDA's Office of Therapeutic Products (OTP) a new office within CBER. The goal of the workshop was to share knowledge and best practices from experts in the field of advanced manufacturing and analytical technologies (AMAT) for regenerative medicine therapies. Innovative manufacturing technologies and alternative testing methods were discussed along with, challenges and best practices critical for chemistry, manufacturing, and controls (CMC) of cellular and gene therapies and tissue engineered medical products.
Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research (CBER) within the Food and Drug Administration (FDA) sits down with Cell & Gene: The Podcast host Erin Harris to discuss the most anticipated areas of innovation in clinical development, and he offers recommendations to companies in their engagement with the FDA in order to make manufacturing more streamlined and cost effective. Dr. Marks also provides advice to listeners about how and when to engage with CBER, and much more.
On the heels of Congress' reauthorization of the Prescription Drug User Fee Authorization (PDUFA) Act, BridgeBio's Chief Regulatory Affairs Officer, Adora Ndu, explains the Commitment Letter, the programs that may be rolled out under PDUFA VII, why right-sizing CBER will help the cell and gene sector going forward as well as how sponsor companies can prepare for 2023 from a regulatory perspective.
In April 2022, FDA issued new draft guidance on Diversity Plans to Improve Enrollment of Participants from Underrepresented Racial and Ethnic Subgroups in Clinical Trials. Because this guidance applies to all medical products, CDER, CBER, and CDRH all contributed, but this draft was led by Project Equity from FDA's Oncology Center of Excellence (OCE). “It is important that we be able to evaluate new therapies in the context of a diverse population that will use these medical products because the diseases for which these products are intended present in variable fashion across the population and because populations respond variably to medical products,” explains OCE Project Equity Lead Lola Fashoyin-Aje. “But we should reconsider the question regarding why diversity in clinical trials is important. Because the question really ought to be: What are we missing when trials are not diverse, when the study population in the clinical trial is not diverse? What are the missed opportunities for advancing science or advancing clinical medicine and, ultimately, for driving improvements in population outcomes?”
Check out the first episode of the year with Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research, FDA, and Jim Weiss, our Founder, and Chairman! Learn about how the US is evolving to living with an endemic, the role of communications for the FDA, and what's in store for the next generation of therapies.
The FDA’s Acting Commissioner Dr. Janet Woodcock brings listeners inside the FDA. While the agency’s hands are full with a global pandemic, the FDA is also still tasked with shepherding accelerated approvals for rare and chronic disease treatments, improving clinical trials, and assessing the cost effectiveness of medications. Plus, the patient perspective of FDA-accelerated approval medications. Sickle cell advocate Teonna Woolford stresses the urgency behind approving medications. And patient correspondent Nichole Davis shares her journey with fibromyalgia and the importance of health literacy. Guest:Dr. Janet WoodcockActing Commissioner, Food and Drug AdministrationAs Acting Commissioner, Dr. Woodcock oversees the full breadth of the FDA portfolio and execution of the Federal Food, Drug, and Cosmetic Act and other applicable laws. This includes assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices; the safety and security of our nation's food supply, cosmetics, dietary supplements, products that give off electronic radiation; and the regulation of tobacco products.Dr. Woodcock began her FDA career in 1986, joining the agency’s Center for Biologics Evaluation and Research (CBER) as Director of the Division of Biological Investigational New Drugs, as well as serving as CBER’s Acting Deputy Director for a period of time. She later became Director of the Office of Therapeutics Research and Review in CBER, which included the approval of the first biotechnology-based treatments for multiple sclerosis and cystic fibrosis during her tenure.Links:Dr. Janet WoodcockTeonna WoolfordThe Sickle Cell Reproductive Health Education DirectivePatients Rising Diversity, Equity, and Inclusion CouncilOp-Ed: How long-haul COVID-19 could offer clues for treating other puzzling chronic illnessesDrug Board is Wrong Rx for Colorado What Do You Do When Kids Are Still Unvaccinated?Supply vs. Demand: When Will the Scales Tip on COVID-19 Vaccination in the US?Patient Correspondent: Nichole DavisPatients Rising Concierge Need help?The successful patient is one who can get what they need when they need it. We all know insurance slows us down, so why not take matters into your own hands. Our Navigator is an online tool that allows you to search a massive network of health-related resources using your zip code so you get local results. Get proactive and become a more successful patient right now at PatientsRisingConcierge.orgHave a question or comment about the show, want to suggest a show topic or share your story as a patient correspondent?Drop us a line: podcast@patientsrising.orgThe views and opinions expressed herein are those of the guest(s)/ author(s) and do not reflect the official policy or position of Patients Rising.
Pink Sheet reporters and editor discuss the influence of the emergency use authorization on FDA decisions, another twist in the march-in rights debate, and how CBER is not using the real-time oncology review program.
Dan Chen returns for the Science Commune segment and speaks with Dr. Peter Marks, Director of the FDA’s Center for Biologics Evaluation and Research (CBER). Dr. Marks reflects on his fortuitous path from academia to industry to government, plus the differences between each area. Dr. Marks explains the research and regulatory role of CBER, especially as it pertains to the latest cell therapies. And finally, the two discuss the impressive speed of COVID-19 vaccine science breakthroughs and regulatory approval.
Pink Sheet reporters and editor discuss coronavirus vaccine allocation and prioritization proposals, sponsors submitting before phase III is completed, and a CBER proposal to create a coaching staff for inexperienced gene therapy sponsors.
Pink Sheet reporters and editor discuss coronavirus vaccine allocation and prioritization proposals, sponsors submitting before phase III is completed, and a CBER proposal to create a coaching staff for inexperienced gene therapy sponsors.
Subscribe to the podcast through iTunes and Google Play. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care, and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Dr. Clifford A. Hudis (CH): Welcome to this ASCO in Action podcast. This is ASCO's monthly podcast, series where we explore policy and practice issues that can impact oncologists, the entire cancer care delivery team, and the individuals we care for, people with cancer. My name is Clifford Hudis, and I'm the CEO of ASCO, as well as the host of the ASCO in Action podcast series. For today's podcast, I am delighted to have as my guest, Dr. Richard Pazdur, the Director of the Food and Drug Administration's Oncology Center of Excellence. The OCE was established to expedite the review of novel cancer therapies and products by bringing together expertise from across the FDA. And we'll touch on this a little bit during our conversation. Dr. Pazdur, welcome and thank you for joining me today. Dr. Richard Pazdur (RP): It's a pleasure Dr. Hudis. CH: Thanks. So I want to kick off our discussion by diving right into a hot button issue, expanded access. Can you provide our listeners with some background on this, and explain what the FDA's expanded access program is, and why an oncologist might want to pursue expanded access for an individual patient? RP: Of course. The FDA's expanded access program provides a way that patients with serious or life-threatening diseases or conditions such as cancer can try investigational medical products for treatment when no satisfactory therapies are available, and when there is no opportunity for the patient to enroll in a clinical trial. The process-- to make a request, the patient's physicians will approach the pharmaceutical company to ask for its agreement that the company will provide the medical product. The company has the right to approve or disapprove the physician's request. Then the physician needs to send the request to the FDA. This process can be complex to navigate, particularly for oncologists or physicians who don't have experience working with the clinical trials or these types of requests. FDA allows the vast majority of these requests to proceed. And the FDA has been working to improve the expanded access programs for a number of years, including the development of a more streamlined application process, a more streamlined form. But for many key health care professionals, especially those not familiar with the expanded access program, this process may appear confusing or somewhat burdensome. CH: And so is this a segue to Project Facilitate, which you announced at our annual meeting a few weeks ago? Can you talk a little bit about that and, its practical implications? RP: Yes. The Project Facilitate call center is a pilot program only for oncology that will serve a single point of contact. We have FDA oncology staff there, oncology nurses, oncology pharmacists who will assist the physician and their health care team throughout the process to submit and expanded access request for an individual cancer patient. This is a concierge service to support the patient's medical team throughout the process. It ranges from the initiation of the FDA form 3926. The process will also provide information about IRBs, particularly central IRBs, and really will also follow up on the status of a given patient to determine if that patient has received any benefit from the therapy and if there were any adverse events that need to be reported to the FDA. CH: So imagine that Project Facilitate works as hoped for. What's the thumbnail before and after experience? That is, how will things appear to be different to the physicians and to the patients? RP: It should make the process easier for physicians to get information that they need to submit an expanded access request. As I said before, it's often somewhat complicated, especially for physicians don't have experience with either the drug or with the process. And it's obviously easier to talk to somebody over the phone to ask specific questions rather than just being directed to a website. We're also working in conjunction with Reagan-Udall Foundation for the FDA, which started the expanded access navigator website to educate patients and health care professionals about the expanded access process. This navigator approach offers information provided by companies about their expanded access policy, and now includes the expanded access programs listed in ClinicalTrials.gov. Patients and physicians can look for treatment options. They could discuss clinical trials, and company information could be provided at the navigator at Navigator.Reagan-Udall.org. So this is really to give patients and their physicians information about what is out there. Once the patient obviously has this information and their doctor, then the doctor can utilize the Project Facilitate, which allows easier access to actually submitting these forms and going through the actual process. I'd like to emphasize that companies are now required by the 21st Century Cures Act to publicly list their expanded access policy. And the Reagan-Udall Navigator website helps them comply with that requirement. Again, so once the physician and the patient have identified the investigational therapy they want to try, the physician or other members of the health care team then can contact Project Facillitate for assistance in locating IRB resources and help with the FDA form 3926. CH: So I think you mentioned this when you launched this or announced it at the annual meeting just now, that physicians do already-- or at least before project facilitate often would successfully go straight to pharmaceutical companies and ask for treatments. And I guess in some cases they'd be denied, and in some cases they would be approved. And that would be through the company's expanded access programs. Obviously, that means that regulators wouldn't necessarily know the full extent of expanded access use. So assuming that Project Facilitate will allow the FDA to collect much more data on expanded use, how will the data be useful? And obviously, I'm hinting at the fact that some fear that it will be actually a negative. RP: Well, prior to launching Project Facilitate, the expanded access requests for cancer patients arrived at multiple places within the FDA and were forwarded separately to FDA oncology or hematology divisions. Sometimes these requests could be delayed, being sent from one place to another in the agency. So this gives a focus point for physicians to contact. In addition, we're seeing that most of the expanded access requests were coming from patients and physicians at larger academic centers. The patients who don't live near these cancer centers and may not be able to get on clinical trials can also hopefully have access to investigational agents by having a more facile and easier process to use here. We're also seeing that many companies have turned down requests from patients, and we have no idea what really the number of requests a company may get if they're turning down these requests. Because generally, they don't come to the FDA. So really, by having the initial contact at the FDA we'll be able to determine number one, the number of patients that are requesting a single patient access. We'll also be able to determine and discuss with the companies their reasons for denying these requests. And there could be multiple reasons. And we also have a process in place that can follow up with what are the benefits that an individual patient may have from this therapy or, as I stated before, were there any adverse events. We have also heard this kind of urban myth-- and I label that in quotations, "urban myth," that companies fear that perhaps adverse events may be held against them when their drug is coming for drug approval. We have not done that. We take into context where the adverse event reporting is coming from. And there really are no instances that I am aware of in oncology where a report of an adverse event has delayed or curtailed an approval of a drug. CH: So really, this is a bright ray of sunshine on a dark corner of drug access. And if it works right, you'll just have much more understanding of the overall use of expanded access. Right? RP: Yeah. I think that gives some clarity to the process here. Here again, we don't know the numbers at this time of actually the number of patients. We only know the numbers of patients that receive a affirmative position from the drug company regarding that the process can continue. But we don't know the numbers of patients that may be requesting single patient access and are denied by an individual drug company. And also, the reasons. And, as I stated before, there can be very legitimate reasons, including inadequate supply of the drug, lack of support staff to follow up on these drug requests, potential interference with clinical trials that the patient may be eligible for. CH: You just used a phrase about patients requesting. And I thought as you described this process you were referring to physicians requesting on behalf of patients. And so I do want to ask, are there resources that are aimed directly at patients or is it really solely aimed at the oncologists in this case? RP: Well, here again, this is a two-prong process. Project Facilitate, the FDA portion of this, is for physicians to call up for assistance in filling out the form and also navigating the process once the decision is made. The other prong of this is, as I stated before, by Reagan-Udall foundation, which patients can call to look at what our options available to them that are potentially listed on ClinicalTrials.gov. And that is also for patients and physicians. However, the portion of the program that is Project Facilitate is for the requesting physician. CH: All right. Well, that's clear. So once we talk about patient's involvement, and even many physicians I think for that matter, we quickly can drift towards the very heated discussion that took place in public over the last year in the area or that we call Right to Try. And I wonder if you could talk for a minute and help us, for the listeners, make this distinction between expanded access and Right to Try. RP: Of course. These programs, Right to Try and single patient INDs are really mutually exclusive programs. The main difference between these programs are first, that under Right to Try the drugs have to complete a Phase I trial. For single patient INDs, it could be done anywhere, even within the context that the drug is being conducted in a Phase I trial. However, the major difference is that the FDA and the IRB does not review Right to Try applications, whereas under a single patient IND, the FDA obviously has to give permission for the patient to proceed as well as an IRB has to review these requests. CH: So to be very clear, Project Facilitate is supporting the single patient INDs, and Right to Try is a separate matter entirely. They are distinctly different programs. Project Facilitate does not apply to Right to Try. That is an independent, separate program. CH: Great. So, you know, one of the problems for a busy clinician is figuring out how to do all this under pressure with a sick patient, and the other pressures of clinic and administration and research. If our listeners want to learn about this more casually, where can they go not under duress, just to start reading up and learning about how to access the program? RP: They could go-- physicians can go and learn more about the program at our website, www.FDA.gov/oce. The Project Facilitate phone number is 240-402-0004. That's 240-402-0004. And the email address is ONCProjectFacilitate@FDA.HHS.gov. CH: That's great. So hopefully, some of our listeners will take advantage of that and learn about this when they're not under pressure so that they're familiar with it if they have to turn to it some months later. Now you mentioned that the host is the Oncology Center of Excellence. And I mentioned in my introduction that we would want to talk a little bit about that. CH: You've been at the helm of the OCE since it was established a little over two years ago, I think. Now that you've been in the role a while, I wonder if you could talk a little bit about your view of what the OCE should be accomplishing, and maybe how that aim has evolved over these two years. RP: Yes. The OCE basically was an offshoot of the Moonshot Program several years ago, and was aimed to be the first center that coordinates activity among the therapeutic center. Obviously, at the FDA there is a center for drugs, a center for biologics, and a center for radiologic health and devices. And they all can review oncology products. The OCE has a designation to really coordinate the activities, particularly in the clinical review of the products that involve the treatment of cancer. So, this is a unique center within the FDA, and is somewhat of an experiment at the FDA to see how we can really coordinate the activities of drugs that affect cancer patients. And here again, the oncology center is primarily designated for the clinical review. And we don't really get into the manufacturing of drugs. That's handled in the individual centers, whether it be a biologic and CBER, the Center for Biological Evaluation and Research or CDER, the Center for Drug Evaluation and Research. With that given said, in addition to the actual bread and butter of reviewing applications, we have many research projects that we're doing. We have a big project looking at real world data. We have a project looking at updating labels called Project Renewal. We have, as I stated before, this project that we launched at this year's ASCO, Project Facilitate. We also have a project aimed at really improving our relationships with international drug regulators. We have monthly meetings, teleconferences with five different regulatory agencies throughout the world to go over applications and discuss different regulatory policies. We have a host of a symposium that we conduct both here at the FDA, inviting external stakeholders including physicians, leading academics, patients to come to the FDA really to discuss important topics to our drug reviewers and the entire discipline of regulatory and oncology, so to speak, how we make decisions in medicine. We have a whole, also, program that we're developing aimed at educating physicians and other health care professionals for educating other health care professionals on how we evaluate drugs, what our thought processes are here at the FDA. So, in addition to the regulatory work, there is a whole body of scientific work that we're also doing, including independent research on different databases, looking at patient populations more likely to respond to different drugs, ways of evaluating and describing toxicities, ways of really looking at patient experiences while they're getting drugs, and different ways of reporting patient reported outcomes. We'd like to thank ASCO, obviously, for their assistance during and helping us with many of these projects throughout the year, especially the educational projects involving fellows, involving different topics that we've found of interest that needed to really have a public disclosure in the community, really, to get input from leading academics, as well as treating physicians. CH: Wow. You are busy. And there's a lot we could unpack there. But I do want to pick up on a couple of things. First of all, you described this as an experiment, so I'm curious. And not to put you on the spot, but if you have an experiment, I presume that just some metric that you would use to call it a success or failure. And I wonder where you think you are right now in that regard. It sounds like you've gotten a tremendous amount done. But are you satisfied, for example? Have you covered the ground you wanted to or do you think that you could be doing more? RP: Well, people who know me realize that I'm never satisfied. So, I think we're in the middle of this experiment. I think it's going quite well. And I think that this is really going to be aimed at-- and the evaluation of the success or failure of this is going to be really how the individuals that work here at the FDA really evaluate drugs and how we facilitate the evaluation of drugs. And also the really important of retention of staff here at the FDA is a major issue, also. And I think many of the projects that we have ongoing really develop our reviewers in really having a real world approach to how oncology drugs are used. So it's very difficult to say what success and failure will ultimately be. But I think we're on, really, the correct path, and pretty much a straight path of looking at a successful venture here. CH: You know, one of the things you said reminded me of another urban myth. And I don't know if you realize this. But when you describe the careful coordination with, I think you said five regulatory agencies around the world, it raises the myth, I believe, but you can address this with some facts, that many people in the United States believe that others around the world have faster access to a broader range of effective therapies. I wonder if you want to expand on that or comment on that at all before we move on. RP: Well, that is an urban myth, and probably was generated 20, 30, 40 years ago when that may have been the fact. Obviously, that antedated my coming to the FDA. But I can say the vast majority of drugs are approved first in the United States. And those include very important drugs such as the PD1 drugs, the targeted drugs, et cetera. They are approved first in the United States. We have taken a very active approach to really rapid approvals of our drugs without sacrificing quality, by having a smarter approach to how we review these drugs, with putting multiple reviewers on particular applications, by cutting down on unnecessary paperwork that many of our reviewers had to do, and really focusing on really the core material that we have at hand, and really emphasizing does this drug really demonstrate safety and efficacy. At the end of the day, I charge all of our reviewers with the following statement. Would the American public be better with this drug than without it? And that's the ultimate decision that we have to make at the time of approval. CH: Well, that's another perfect segue to a hot topic, which you and I have discussed actually offline before this. But I'm going to come back to it. The expedited approval of anticancer therapies was recently the subject of a paper in The Journal of the American Medical Association. And if I remember correctly, they looked at 93 cancer drugs that had been approved through accelerated approval process. But what they claimed is that only 19 of the 93 clearly extended the lives of the patients taking them. That's a value judgment, obviously, about why drugs are approved and introduced to the market. But I wonder if you would want to talk a little bit about your view of some of the complexities and challenges that are inherent in accelerated drug approval, and what your view is of this particular study of the approval outcomes. RP: I think many times people don't understand that it isn't just about overall survival. Obviously, that's the gold standard. But we've had very careful discussions throughout the years that there are many ways to evaluate benefit to the patient. And that includes reduction of the size of the tumor, delay in the progression of the disease, the establishment of complete response rates in hematological diseases. So we have to have some flexibility, both in terms of how we approve drugs and what clinical trials we're going to ask for after drugs have been approved on the accelerated approval pathway. Although overall survival is a very important end point, it's an important efficacy endpoint as well as a safety endpoint, it does have limitations. As we move more toward a targeted therapy and subsegment common diseases into molecular subtypes, many times we find that we have very limited populations. And simply, we don't have the size of a population that we approve the drug on to really do a large, randomized trial. So we have to weigh that issue with what type of trial we're going to ask for, both with the initial approval of the drug as well as with, perhaps, the subsequent studies that we ask for after an accelerated approval. In addition to that, many times we find that we have situations where the disease itself may have a very long natural history, such as CLL or other diseases that may have very long natural histories, where one cannot really do a long-term survival study because it would extend many, many, many years. And many times-- and I think we have to be realistic about this, that there may not be equipoise here to allow a randomized trial to be done looking at overall survival as a primary end point. For example, if we already have information that a drug may have a response rate of 50% or 60% and the comparator drug may have a response rate of 10%, patients will not want to go on a study that looks at overall survival as the primary end point. And many times, we have to take a look at time to progression or progression free survival and those end points, and actually allow for a switch in therapies or crossover at the time of disease progression, which renders the evaluation of overall survival somewhat difficult, and may confound that evaluation. So, there are many reasons why overall survival, although a gold standard, may not be applicable to all situations. And I think that's going to be increasingly so as we get into a more targeted therapy approach and have better definitions of who is going to respond. So here again, it's long natural history of diseases either by its natural history or by the therapies that have been approved that prolong disease. It could be due to the limited populations, which preclude a randomized trial. And it could be due to the lack of equipoise, which really bands that patients have access during the course of disease. I think a much more important question, and one that we are constantly looking at, is not so much what does an individual drug do to the natural history of the disease and prolonging survival in patients that have metastatic disease, but what is the impact over the years of multiple drugs being approved on the basis of progression-free survival or response rates when they are used either in combination or sequentially. And we could see that, for example, in multiple myeloma, where the course of that disease has been significantly changed, and patients' lives have been prolonged. And the vast majority of the drugs that have been approved have been on non-survival endpoints. And this is true not only for multiple myeloma, but also probably for renal cell cancer. CH: Yeah. That's interesting. It's a challenging analysis, of course. But that would be a very interesting, essentially public health roll up of all of these incremental decisions. Right? RP: Correct. CH: Yeah. So, as I said before, the OCE has been in operation just over two years. During that time, more than 80 therapies and products have been approved, I think. Right? And there've been more than a dozen guidance documents approved, 60 workshops and symposia for oncologists and for patients. And there were several of those workshops that we at ASCO were privileged to co-sponsor along with you. This is the favorite child question. But what's your proudest achievement so far? RP: A difficult question, but an easy question, too. It's about the people that work here and the patients that we serve. And I think my brightest moments are when we see the development of our people coming in and taking leadership positions both within the agency in a regulatory context of their job, but also in the academic fields and participating in conferences, publishing papers, and really finding enjoyment in the job that they have outside of the day-to-day regulatory activity. One of the things that I have always emphasized since I came here 20 years ago from an academic medicine position at M.D. Anderson is really to give the agency a much more academic perspective. And I've always stated that I think we do much more academic work here at the FDA than many academic centers. And I'm not talking about the generation simply of papers or research grants. I'm talking about actually critical thinking of what goes on at an application, since we have a multi-disciplinary team of statisticians, clinicians, clinical pharmacologists, toxicologists, manufacturing people that all work together. So it's really about-- my greatest accomplishment is really about the young people that have come in that I've mentored, and really have assumed roles, and really will be my lasting legacy here. But I also want to emphasize that one of the things that I have repeatedly highlighted to this staff is really to consider the patient in really any regulatory decision. Here again, it's not about a P value. It's not about a primary end point. Granted, those things are important, but we really have to bring together the whole body of information about a drug in making a regulatory decision and making that a patient-focused thing. And as I stated before, at the end of the day will the American patient-- will the American public be better off with this drug than without it? CH: Well, Rick, I got to say that's an inspiring description. It makes me wish I were younger, and maybe I could come and be mentored. But alas, it may be too late for me. But we really are proud to work with you, and to work with so many of your staff in many productive collaborations. I want to thank you again for joining me today for this ASCO in Action podcast. We always appreciate your expertise and your perspectives. And we look forward to continuing to work with you to ensure that patients with cancer have access to safe and effective treatments. RP: And thank you, Cliff. It's been a pleasure. And here again, I really think ASCO for providing a lot of resources to us in conducting symposium, and really in fostering better cancer care for patients. I think that's the ultimate goal of both organizations. CH: It sure is. And I want to remind our listeners that you can follow the FDA Oncology Center of Excellence on Twitter. Their handle is @FDAOncology. That's one word. You can follow me @CliffordHudis, and you can follow ASCO @ASCO. For more information on the latest cancer policy news and updates, visit ASCOAction.ASCO.org. And Rick, I'm going to ask you once more to remind the listeners of the way they can access Project Facilitate. RP: They can learn about Project Facilitate from our website at www.FDA.gov/OCE. And our project facilitate phone number is 240-402-0004. And the email address is ONCProjectFacili tate@FDA.HHS.gov. ONCProjectFacilitate is spelled O N C P R O J E C T F A C I L I T A T E @FDA.HHS.gov. CH: That's great. So until next time, I want to thank everyone for listening to this ASCO in Action podcast.
LEXINGTON, Ky. (Jan. 28, 2019) – The Center for Business and Economic Research (CBER) is the applied economic research branch of the University of Kentucky’s Gatton College of Business and Economics. Its purpose is to disseminate economic information and provide economic and policy analysis to assist decision makers in Kentucky’s public and private sectors. The current director of CBER is Jenny Minier (pronounced ma-near). Minier is Sturgill (pronounced stir-jill) Professor of Business and Public Policy and Professor of Economics in the Gatton College, and also teaches in UK’s Martin School of Public Policy and Administration. On this week’s episode of “Behind the Blue,” UKPR‘s Carl Nathe talks with Minier about the work of CBER, including helping to put together the 30th Annual Economic Outlook Conference, sponsored by Central Bank, on February 13. Become a subscriber to receive new episodes of “Behind the Blue” each week. UK’s latest medical breakthroughs, research, artists and writers will be featured, along with the most important news impacting the university. For questions or comments about this or any other episode of “Behind the Blue, “ email BehindTheBlue@uky.edu (mail to: BehindTheBlue@uky.edu) or tweet your question with #BehindTheBlue.
Dr. Sachin S, Kunde discusses his manuscript "Guidance on Preparing an Investigational New Drug Application for Fecal Microbiota Transplantation Studies." To view the abstract http://bit.ly/1bkcx4k.