FDA/NIH/DARPA Microphysiological Systems Program and Qualification of Drug Development Tools Suzanne Fitzpatrick, PhD, DABT US Food and Drug Administration Challenges to FDA Recent breakthroughs in science and technology have the potential to transform our ability to prevent, diagnose and treat disease. However, major investments in basic and translational research are not efficiently yielding new products needed to benefit patients/populations Product development is increasingly costly, success rates remain low, many uncertainties exist, including, as a major component, failures in predicting toxicity despite extensive animal testing 2 STRATEGIC PLAN: Vision “FDA will advance regulatory science to speed innovation, improve regulatory decision-making, and get safe and effective products to people in need. 21st Century regulatory science will be a driving force as FDA works with diverse partners to protect and promote the health of our nation and the global community” What is Regulatory Science? The application of science to the development and utilization of new tools, standards, and approaches for the assessment of product efficacy, safety, and quality Critical to effectively translate cutting-edge developments in science and technology into promising products and therapies. 4 1. Modernize Toxicology to Enhance Product Safety Develop better models of human adverse response Identify and evaluate biomarkers and endpoints that can be used in nonclinical and clinical evaluations Use and develop computational methods and in silico modeling Advancing Regulatory Science • FDA-NIH Joint Leadership Council formed in 2010 • Issued RFA for Advancing Regulatory Science through Novel Research & ScienceBased Technologies Program ($7M, 4 awards): o Accelerating Drug & Device Evaluation through Innovative Clinical Trial Design o Replacement Ocular Battery o Heart-Lung Micromachine for Safety and Efficacy Testing o Characterization/Bioinformatics-modeling of Nanoparticle: Complement Interactions Microphysiological Systems DARPA –BAA-11-73 Reconfigurable platform Ten or more in vitro physiological systems Able to monitor resident tissues for up to 4weeks Uses human cells Commercial availability Includes plan for validating integrated platform performance 70 million over 5 years Applications jointly reviewed by DARPA, FDA, and NIH Contracts were awarded to Wyss and MIT 7 DARPA-FDA-NIH Microphysiological Systems Program • Started in 2011 to support the development of human microsystems, or organ “chips,” to screen for safe and effective drugs swiftly and efficiently (before human testing) • Collaboration through coordination of independent programs Engineering platforms and biological proof-of-concept (DARPA-BAA-11-73: Microphysiological Systems) Underlying biology/pathology and mechanistic understanding (RFA-RM-12-001 and RFA RM-11-022) Advise on regulatory requirements, validation and qualification Integrated Microphysiological Systems for Drug Efficacy and Toxicity Testing (UH2/UH3) • GOAL: Develop in vitro microphysiological systems representative of major organs/tissues in the human body, that will facilitate the assessment of biomarkers, bioavailability, efficacy, and toxicity of therapeutic agents prior to clinical trials. • SCOPE/ACTIVITIES: o Multicellular architecture representative of the tissue of origin o Functional representation of normal human biology o Reproducible and viable operation under physiological conditions maintained up to 4 weeks in culture o Capacity for representation of normal and disease phenotypes, o Capacity for representation of population diversity o Amenable to high content screening for repeated dose efficacy testing, and for toxicology, and safety screening Stem/Progenitor Cell-Derived Human Micro-organs and -tissues (U18) • GOAL: Develop stem- and progenitor-derived cell resources to seed circulatory, endocrine, gastrointestinal, immune, integumentary, musculoskeletal, nervous (including eye), reproductive, respiratory and urinary microsystems. • SCOPE/ACTIVITIES: o Improvements in differentiation efficiencies towards cell-type diversity, genetic complexity, population diversity, and disease modeling o Development of 3D culturing approaches to enhance cellular microenvironments 24 months UH3 phase: - Incorporation of differentiated stem- and progenitor-derived cells - Integration of various organ systems Integration & validation U18 generated cell resources UH2 generated organ systems Base period Period 1 Period 2 DARPA bioengineering Platform + 2 systems 4 systems 7 systems 10 systems • Multicellular architecture • Vascularization, innervation, hormonal, humoral and immunological signaling • Genetic diversity and pharmacogenomic capacity • Representation of normal and disease phenotypes 60 months • Cell viability for 4 weeks • Integrated system predicts human in vivo efficacy, toxicity, and pharmacokinetics: o o o o safe and effective safe and ineffective unsafe, but effective unsafe and ineffective Period 3 The Challenges in Predicting Human Response: System Complexity Chemical Tissue Dose Tissues Molecular Targets Cellular Systems Cell Cellular Changes Networks Toxicity Molecular Pathways Predict Health Outcomes Of Interest The Challenges in Predicting Human Response: Outcome Modifiers Chemical External Factors Acute/Chronic? Metabolism (including disease, interacting systems) Tissue Dose Tissues Molecular Targets Cellular Systems Cell Cellular Changes Networks Toxicity Molecular Pathways Predict Metabolism Individual Variability Response Health Outcomes Of Interest The Challenges in Predicting Human Response: Assay Considerations Source? External Factors Chemical S9(?) QC? (including disease, interacting systems) Metabolites? Tissue Dose Acute/Chronic? ASSAY Molecular Targets Cellular Systems Cell Cellular Changes Networks Toxicity Molecular Pathways • • • • Predict Solubility? Concentration? Health Outcomes Protein binding? Of Interest Relationship to plasma levels? Exposure? A Chemical Testing Paradigm for MPS Cells Cellular Systems Cell Changes Molecular Targets Cellular Networks Molecular Pathways Function Test Compounds # 1 Evaluate and optimize cell response Test Compounds # 2 3D organ structure assemblies Linked multiple organ systems Evaluate and optimize organ response Test Compounds # 3 Evaluate and optimize system response Criteria for Selecting Test Compounds Do individual organ models respond to test compounds with the expected organ-specific effects? Do linked organ system models respond to test compounds with the expected systemic effects? Selection of test compounds should consider: ◦ Individual organ function linked organ functions ◦ Direct organ toxicities dependent organ toxicities ◦ Study read-outs? health outcomes of interest? Limitations of Current Validation Strategies Clear that a “one size fits all” approach no longer viable Clear that in vivo animal studies cannot be the gold standard that new toxicology methods are against. Clear need to determine the relevance of in vitro results to what occurs in humans rather than what occurs in rodents and other test animals. Drug Development Tool Qualification FDA program that provides a mechanism for formal review by CDER to qualify new tools that would benefit drug development Currently, 3 programs have been implemented: ◦ Biomarkers ◦ Clinical outcome assessments ◦ Animal models But the concept should be applicable to any tool proposed for use in regulatory decision making Can the concept of “qualification” help to position MPS assays for eventual regulatory use? What is a Biomarker? A characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes (abnormal biologic processes), or biological responses to a therapeutic intervention A measurable characteristic that is not a clinical assessment of the patient ◦ Clinical measures are those evaluating or closely relating to how a patient feels or functions, or survival Biomarker Qualification A conclusion that within a carefully and specifically stated “context of use” the biomarker has been demonstrated to reliably support a specified manner of interpretation and application in drug development ◦ Utility in drug development, particularly regulatory decisions, is central to purpose of qualification ◦ Particularly for biomarkers expected to have application in multiple different drug development programs 20 Context of Use Key concept in the qualification process Refers to a clearly articulated description delineating the manner and purpose of use for the tool (when and how will it be used?) Also defines the boundaries the available data adequately justify the use of the tool Models and assays are inevitably associated with limitations: important to define: The context in which results are intended to be used The specific human outcomes that will be predicted Context of Use How the biomarker is used in drug development What decision is made based on the data What action, and how, drug development is altered by the biomarker results Adequately specifying the CoU is often a difficult first step towards qualification ◦ Determines what kind of data are needed Types of Biomarkers (1) Categorize by how it is used in drug development Prognostic biomarker ◦ Indicates future clinical course of the patient with respect to some specified clinical outcome, in the absence of any additional Tx intervention ◦ No connection to any particular new Tx Types of Biomarkers (2) Predictive biomarker ◦ Measured prior to an intervention ◦ Identifies patients who are relatively susceptible to a particular drug effect versus less susceptible patients Benefit or harm Exists only for a Tx with some effect Types of Biomarkers (3) Pharmacodynamic biomarker (PD) ◦ Response-indicator biomarker ◦ Post Tx measurement ◦ Marker that reveals whether, or how large, a biological response has occurred in that particular patient ◦ May or may not be Tx-specific Development occurs in a Tx by Tx manner Types of Biomarkers (4) Efficacy-response biomarker Efficacy-surrogate biomarker, Surrogate endpoint ◦ Small subset of general pharmacodynamic biomarkers ◦ Predicts the clinical outcome of the patient at some later time ◦ Developed Tx by Tx Qualification of a Drug Development Tool (DDT) The qualification of DDT begins with a meeting of CDER personnel and the biomarker sponsors Consultation on information need to compile a comprehensive evidence to support the application for qualification of a DDT CDER and other appropriate FDA scientists undertake a multi-disciplinary formal review of the DDT submission from the sponsor Decision reached regarding qualification of DDT If positive, decision is publically communicated in form of a guidance Qualification of a Drug Development Tool (DDT) Once qualification is granted, any drug sponsor can submit data obtained with the qualified DDT without being asked for further evidence in support of its suitability ◦ FDA Draft Guidance on Qualification of Drug Development Toolshttp://www.fda.gov/downloads/Drugs/GuidanceComplian ceRegulatoryInformation/Guidances/UCM230597.pdf DDT Qualification is a complex process that requires significant time and resources Qualifying DDTs for regulatory purposes more feasible in collaborative approach with representatives from government, industry, academics Summary Selection of the appropriate test chemicals and endpoints of interest will be important in developing and externally validating MPS assays ◦ Organ System level ◦ Adverse Function Toxicity Would a common library of positive/negative controls be useful in comparing assay performance and determining predictivity? What specific (human) outcome data will be used to anchor assay performance? Can a specific context of use be defined? Thanks to the Following People FDA Partners in this Project ◦ NIH/NCATS- Dan Tagle ◦ DARPA-Barry Pallotta For Use of Their Slides ◦ ◦ ◦ ◦ ◦ Dan Tagle Abby Jacobs Tom Colatsky Marc Walton Jesse Goodman