Kids Wait 6.5 Years More Than Adults to Access New Cancer Drugs

There is a median 6.5-year lag between first-in-human and first-in-child clinical trials, with a range of 0 to 27.7 years

U.S. Food and Drug Administration (FDA) approved cancer drugs took around 6.5 years to go from the first clinical trial in adults to the first trial in children, according to a study done at the Dana-Farber/Boston Children's Cancer and Blood Disorders Center, published in the European Journal of Cancer.//

"Despite knowing that these agents are effective anticancer drugs, it's taking too long to even start studying these therapies in children," says Steven G. DuBois, MD, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, corresponding author on the study. "As a doctor taking care of young cancer patients, this is tremendously frustrating. If I were a parent of a child with cancer, I wouldn't stand for this."

‘Lag of 6.5-year between first-in-human and first-in-child clinical trials could not only ensure the safety of vulnerable pediatric population but also to study agents basing on the activity in adults with cancer.’
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The team at Dana-Farber/Boston Children's conducted a systematic analysis of the time from first-in-human trials to first-in-child trials of agents first approved by the FDA for any oncology indication from 1997 to 2017. The investigators utilized clinical trials registry data, published literature and oncology abstracts to identify relevant trials and start dates.

Delayed pediatric trials

In that timeframe, 126 drugs received initial FDA approval for an oncology indication. After excluding hormonal modulators (not relevant to children's cancers), 117 agents remained for analysis. Fifteen of 117 drugs (12.8%) had not yet had a pediatric trial, while 6 of 117 drugs (5.1%) included children in the initial FDA approval.

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The data showed a median 6.5-year lag between first-in-human and first-in-child clinical trials, with a range of 0 to 27.7 years.

"Some may argue that this lag is appropriate to ensure safety of a vulnerable pediatric population and to only study agents in children that are on a path to FDA approval, based upon activity in adults with cancer," says DuBois. "Others may argue that this lag is too long for children with life-threatening diseases and that some agents that fail in adult indications may nevertheless prove to be important drugs for pediatric indications."