Using a Benefit-Risk Analysis Approach to Capture Regulatory Decision Making: Melanoma

Clin Pharmacol Ther. 2019 Jul;106(1):123-135. doi: 10.1002/cpt.1461. Epub 2019 May 21.

Abstract

Drug regulators seek to make decisions regarding drug approvals based on analysis of the relevant benefits and risks. In this work, 25 US Food and Drug Administration (FDA) decisions on melanoma drugs were identified and analyzed based on clinical trial results published between 1999 and 2017. In each case, the benefits and risks of the new drug in each clinical trial relative to a comparator (typically the control arm of the same clinical trial) were quantified. The benefits and risks were analyzed using a common scale to allow for direct comparison. A sensitivity analysis was conducted using vemurafenib to explore the magnitude of uncertainty in the quantitative assessments. The associated FDA decision outcomes of the new drugs were consistent with the benefits and risks quantified in this work.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Decision Making*
  • Drug Approval / organization & administration*
  • Humans
  • Kaplan-Meier Estimate
  • Melanoma / drug therapy*
  • Melanoma / mortality
  • Melanoma / pathology
  • Neoplasm Staging
  • Randomized Controlled Trials as Topic
  • Research Design
  • Risk Assessment
  • Uncertainty
  • United States / epidemiology
  • United States Food and Drug Administration / organization & administration*
  • United States Food and Drug Administration / standards

Substances

  • Antineoplastic Agents