Perspectives on Licensing Vaccines by the Animal Rule Mary Kate Hart, Ph.D. Director, Nonclinical Research DynPort Vaccine Company LLC, A CSC Company 1 Overview • Vaccine development by DynPort Vaccine Company LLC (DVC): perspectives and considerations • The Animal Rule: what it is and what it is not • DVC’s approach to meeting the Animal Rule requirements Proprietary 2 Vaccine Development by DVC: Perspectives and Considerations Proprietary 3 Bona fides • DVC has been engaged in advanced development of biodefense products since 1998. • Product portfolio includes: – Live bacterial vaccine (tularemia) – Live viral vaccines (Venezuelan equine encephalitis virus; Cell Culture Smallpox Vaccine) – Inactivated viral vaccines (seasonal and pandemic influenza with Baxter) – Recombinant peptide vaccines (plague, anthrax, botulinum neurotoxin) – Plasma-derived biotherapeutics (BioScavenger with Baxter) – Therapeutic immunoglobulin (Vaccinia immune globulin) • Customers include Department of Defense, National Institutes of Allergy and Infectious Diseases and Department of Health and Human Services • Licensed one of the first biodefense-specific products Proprietary 4 Perspectives on Biodefense Vaccines • Developing vaccines for biodefense – What are we building? – What are the customer’s requirements? – What are the risks? Proprietary 5 What are we building? • The most important criterion: build with the end in sight. – Proof-of-Concept does not ensure a viable product. • Product developers need clear requirements: – What is an acceptable level of protection? – What is the final indication? – What is the final format expected to be? (Single-dose, multi-dose, filled syringes, something else?) – What is a “licensable” product? • Product plan should not radically change over time: – Product development plans must be flexible, but cannot be anarchistic. Government customer may require forward planning (4-5 years) to ensure funding is available. – Animal Rule provides many daunting challenges, and approach to compliance should be set early. Proprietary 6 What are the requirements? • We need to know: • Because: – Nature and identity of threat – Level of protection required – Onset vs. duration of protection – Administration strategy – Storage conditions – Initial delivery amount – Ongoing requirements – Regulatory strategy – Specificity of the response – Nonclinical and clinical study design – Administration and testing paradigm – Clinical strategy – Formulation, stability and format – Manufacturing strategy – Manufacturing strategy – Overall program design (licensed vs. unlicensed) Deviations from the plan always result in significant cost and schedule ramifications. A clear plan for development of the product is necessary in advance, and modifications should be made only when absolutely necessary. Proprietary 7 Risk Management is Crucial to Success • Murphy’s Law is first, last and always the operating principle. • Development of biodefense medical countermeasures is inherently a high-risk enterprise: – Lack of prior art (make it up as you go). – Compliance with the Animal Rule: new licensure strategy. – The product may not work as expected. – Logistics of countermeasure use still being worked out. Proprietary 8 The Animal Rule: What it is and What it is Not Proprietary 9 FDA Animal Rule • Allows for approval of vaccines in which efficacy testing in humans is unethical • Is not a shortcut to approval, or applicable to products that can be licensed by other approaches • Need to understand pathophysiology of the disease • Use dosages scaled to reproduce the human response • Well-controlled animal studies will provide data that are likely to predict a benefit in humans • Demonstrate effect in two species – nonhuman primates [NHPs] – Rodents • Additional considerations available in Concept Paper (e.g., use of well-characterized materials) Proprietary 10 Animal Rule Challenges • Meet the traditional licensure requirements AND • Design proof-of-concept studies – Demonstrate relevance of animal model • Model considerations; small and large animal models desired – Provide rationale for use of Animal Rule – Define protection – Good Documentation Practices essential • Design of Animal Rule studies – Determine correlate that predicts clinical benefit – Support selection of human dosage – Good Laboratory Practices required – Efficacy demonstrated in animals – Bridge from animals to human response to predict clinical benefit Proprietary 11 Development Timeline – Traditional Approach IND R&D PreClinical BLA Phase 1 Phase 2 Phase 3 FDA Approval To the Market Clinical Studies YEARS 6.5 7 1.5 TOTAL: 15 years Proprietary 12 Development Timeline – Animal Rule Approach IND R&D PreClinical BLA Phase 1 Phase 2 Phase 3 Animal Rule – Efficacy Studies To the FDA Approval Market TOTAL: Unknown Proprietary 13 Animal Rule-Based Vaccine Development • Pathway to Licensure is a “work in progress” – Uncertain requirements from a regulatory standpoint – Conservative approaches in determining what is acceptable • There are NO licensed vaccines that demonstrate efficacy by the Animal Rule • Detailed planning essential due to government funding restrictions – Changes in protocols affect schedule/cost and can result in major delays – NHP availability – Facility expertise and availability Proprietary 14 DVC’s Approach to Meeting the Animal Rule Requirements Proprietary 15 DVC Vaccine Program Technical Approach • Expertise and coordination between technical areas: – Science: technical oversight and integration – Quality: oversight of product and clinical studies – Regulatory: FDA communications, strategy for licensure – Manufacturing: material for clinical and nonclinical studies – Nonclinical: animal studies (safety, immunogenicity, efficacy) – Clinical: Phase 1,2,3 safety and immunogenicity trials Proprietary 16 Balance: Manufacturing Development, Animal Model Development and the Human Response Justify why human trials are not feasible or ethical; justify appropriateness of selected animal models CGMP Demonstrate manufacturing consistency – effective change control Correlate of Protective Immunity GDP/ GLP Bridge to human response; support selection of human effective dose Proprietary GCP 17 DVC Program Technical Approach • • • • Science: technical oversight and integration Quality: oversight of product and clinical studies Regulatory: FDA communications, strategy for licensure Manufacturing: material for clinical and nonclinical studies • Nonclinical: animal studies (safety, immunogenicity, efficacy) • Clinical: Phase 1,2,3 safety and immunogenicity trials Proprietary 18 Regulatory FDA Interactions • Pre-IND meeting • IND submitted with all development plans included • Type C meetings – Discussion of aspects of technical development plan • Study designs provided for comment prior to conducting the study • Timing of interactions is critical: – Too soon: insufficient detail to receive specific comments – Too late: cost and schedule impacts due to FDA comments Proprietary 19 FDA Communication • Close FDA communication is vital; no vaccine has yet been licensed under the Animal Rule – Workshops – Working groups – Formal meetings – Review of strategy – Review of study protocols Proprietary 20 DVC Program Technical Approach • • • • Science: technical oversight and integration Quality: oversight of product and clinical studies Regulatory: FDA communications, strategy for licensure Manufacturing: material for clinical and nonclinical studies • Nonclinical: animal studies (safety, immunogenicity, efficacy) • Clinical: Phase 1,2,3 safety and immunogenicity trials Proprietary 21 Development of a Manufacturing Process Phase 1 Emphasis on Safety Phase 2 Scientific Evaluation Phase 3 Control and Validation – Source characterization – Raw materials traced and qualified – Characterization of purified bulk and FDP – Testing /clearance of Impurities – Description of manufacturing – Assay development – Formulation – Quality – Purified bulk and FDP characterization – Assay development – Increased stability – Continued formulation development – Product characterization – Change Control – Reference standard – Quality – Process optimized – Process and assay Validation – Specifications – Consistency Lot production – Quality Proprietary 22 DVC Program Technical Approach • • • • • • Science: technical oversight and integration Quality: oversight of product and clinical studies Regulatory: FDA communications, strategy for licensure Manufacturing: material for clinical and nonclinical studies Nonclinical: animal studies (safety, immunogenicity, efficacy) Clinical: Phase 1,2,3 safety and immunogenicity trials Proprietary 23 Critical Issues • What is the intended label indication? • How does disease in the animal model compare to human disease? Are sufficient hallmarks covered? • Demonstrating correlate of protective immunity in animals, including humans – Is the mechanism of protection clearly defined? • Are functional in vitro assays available? • Is the challenge material characterized and have the route and dosage been determined? • Breakthrough of protection? • How is protection defined? • Are there multiple subtypes to consider? • Statistical considerations? • May need multiple animal models to satisfy Animal Rule requirements Proprietary 24 Nonclinical Strategy for Vaccines • Demonstrate Safety (Tox studies) • Model selection: Animal studies must demonstrate that the vaccine is likely to clinically benefit humans. – Enable selection of a protective dosage for humans. • Identify a marker of immunity that predicts protection and can be measured in both animals and humans. – Mechanism of protection: is it known? • Pivotal animal studies – Demonstrate efficacy – Bridge immune responses to human immune responses Proprietary 25 Considerations for Animal Model Selection • Species – Susceptibility to pathogen by the route of exposure intended for the label indication • Similarity to human response – Display similar characteristics to human disease and pathogenesis – Immune response • • • • • Endpoints of study Manipulations required Cost Facility space and required biosafety containment level Availability of sufficient animals Proprietary 26 Development of Animal Models PreClinical Phase 1 Phase 2 Emphasis on development Scientific evaluation, prevalidation studies • The studies often use research-grade products • FDA communication on animal model design • Proof-of-concept studies • Animal studies to • Develop and present a support design of regulatory strategy pivotal studies Phase 3 Control and validation • Facility, process and assay validation complete • Demonstrate efficacy in animal models (GLP) • Nonclinical safety studies • Change control (how do • Collect supportive manufacturing changes data from clinical affect product study performance in animal models) • Reproductive toxicity Proprietary 27 Proof-of-Concept Studies • Good Documentation Practices • Identification and development of relevant animal models – Preferably more than one animal species – Animal study endpoint is clearly related to the desired benefit in humans • • • • Route of administration Adjuvant requirement Formulation optimization Dose and schedule requirements – Animal data supports effective dose in humans • Immunological Response – Development of assays to detect response Proprietary 28 Addressing the Requirements Animal Rule Requirements Study Design Understand the disease • Lethal dose for 50% of animals (LD50); natural history (pathophysiology) Demonstrate efficacy in more than one species which react as humans would with similar endpoint (e.g., survival) • Test article administration combined with an active challenge • Evaluate immune response • Establish assay to be used as correlate • Breakthrough of protection Select effective human dosage • Establish vaccination regimen that induces immune response similar to that observed in the clinic. Demonstrate efficacy in challenge study • Evaluate dosage in clinical trials Proprietary 29 Bridging the Immune Response – Vaccine Example Clinical Study Efficacy Study Human Sample NHP Sample Immunology Assay Proprietary 30 DVC Program Technical Approach • • • • • • Science: technical oversight and integration Quality: oversight of product and clinical studies Regulatory: FDA communications, strategy for licensure Manufacturing: material for clinical and nonclinical studies Nonclinical: animal studies (safety, immunogenicity, efficacy) Clinical: Phase 1,2,3 safety and immunogenicity trials Proprietary 31 DVC Clinical Efforts IND R&D PreClinical BLA Phase 1 Phase 2 Phase 3 Animal Rule – Efficacy Studies Proprietary To the FDA Approval Market 32 Conclusions • The Animal Rule is a last-resort approach to vaccine licensure, with unique challenges and no exceptions to the licensure requirements under other regulations. • The challenges may be met with careful planning and coordination of technical activities. • No vaccines have been licensed to date using this new regulatory approach. This adds risk to a program. • Licensure under the Animal Rule will increase the program’s cost and likely extend the time to licensure. • FDA communication is essential for success. Proprietary 33 Acknowledgments • Chemical Biological Medical System-Joint Vaccine Acquisition Program (CBMS-JVAP), Department of Defense (DoD) Contract DAMD 17-98-C-8024 • National Institute Of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Contract No. N01-AI-50041 Proprietary 34