A demand-offer critical analysis of current drug development. Phase I drugs versus TCGA sequencing data Journal Article


Authors: Repetto, M.; Crimini, E.; Belli, C.; Boscolo Bielo, L.; Ascione, L.; Meric-Bernstam, F.; Drilon, A.; Curigliano, G.
Article Title: A demand-offer critical analysis of current drug development. Phase I drugs versus TCGA sequencing data
Abstract: Background: Phase I clinical trials have become increasingly critical to regulatory approvals of novel agents. In phase I drug development, a global problem of unknown magnitude is the multiplicity of similar drugs being investigated against the same target, colloquially known as the ‘me too’ phenomenon. Methods: Ranging from December 2020 to December 2022 we annotated phase I clinical trials present on clinicaltrials.gov. Public databases were queried for annotation of investigational agents (IAs). Extensive literature research and data mining were performed to annotate agents not present in public databases. The Cancer Genome Atlas (TCGA) pan-cancer sequencing cohort was used to perform second-level analyses to evaluate tumour types with a higher number of IA matches. Results: A total of 1054 unique drug targets were identified. The most frequent IA classes were: cell products (1223), small-molecule inhibitors (1110), antibodies (733), and vaccines (346). Only a minority (8.9%) of phase I IAs were explored against a target without a competitive agent; 7% of agents shared targets with 2–3 other agents. Unfortunately, the majority (84%) shared targets with at least four other agents. Using data from the TCGA pan-cancer sequencing potentially underserved histologies were identified. Analysis of alteration-IA matches revealed potentially frequent and unexplored alterations in many tumour types. Conclusions: The majority of IAs (86%) shared targets with at least three other agents. We argue that these duplicative efforts could be redirected toward unmet needs instead. © 2023 Elsevier Ltd
Keywords: gene mutation; solid tumor; drug targeting; antineoplastic agent; drug development; peptide; data base; tumor antigen; monoclonal antibody; hematologic malignancy; gene therapy; oncolytic virus; oncolytic virotherapy; peptide vaccine; antibody; vaccine; personalized medicine; nucleic acid; phase 1 clinical trial (topic); tcga; data mining; human; article; whole genome sequencing; precision medicine; antibody drug conjugate; genetic profile; early drug development
Journal Title: European Journal of Cancer
Volume: 190
ISSN: 0959-8049
Publisher: Elsevier Inc.  
Date Published: 2023-09-01
Start Page: 112958
Language: English
DOI: 10.1016/j.ejca.2023.112958
PUBMED: 37451181
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Alexander Edward Drilon
    632 Drilon
  2. Matteo Repetto
    26 Repetto