Biological markers increase clinical trial success rate of new breast cancer drugs

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Technology transfer moves more than manufacturing instructions. It moves process knowledge, supplier dependencies, labeling requirements, packaging specifications, and the evidence needed to demonstrate control. For medical device manufacturers, including those supporting drug-device combination products, these interfaces can become recurring sources of compliance gaps during site transitions, acquisitions, and remediation. The central problem is often not a missing procedure. It is a quality system that allows connected activities to change independently. A label revision may be approved while packaging artwork, supplier instructions, or production-system data still reflect an obsolete version. Staying inspection-ready requires manufacturers to manage these dependencies as one controlled system. Why Compliance Gaps Keep Recurring Findings are treated as documentation defects Revising a procedure can resolve an immediate discrepancy without changing the behavior that caused it. If unclear decision rights, weak escalation, or ineffective training remain, the same failure may surface elsewhere. Corrective and preventive action should distinguish the observed finding from its underlying cause and establish how effectiveness will be demonstrated. Ownership is divided across connected functions Quality, Regulatory Affairs, labeling, packaging engineering, operations, suppliers, and digital-system owners often maintain separate workflows. Each team may complete its assigned task while an interface remains uncontrolled. For example, changing an instruction for use can affect packaging configuration, translations, technical documentation, inventory disposition, and release controls. Transitions expose unresolved weaknesses Acquisitions and site transfers can introduce conflicting procedures, incomplete knowledge transfer, or different assumptions about validated processes. Regulatory changes add further demands. When these events coincide with CAPA or change-control backlogs, teams may prioritize administrative closure over risk reduction. Without a coordinated impact assessment, local fixes can create new gaps downstream. Establish the Regulatory Baseline Inspection readiness starts with knowing which requirements apply to the product, activity, and market. Pharmaceutical, device, and combination-product obligations are not interchangeable; transfer planning should identify the applicable requirements rather than assume one quality framework covers every operation. 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Prioritize gaps by potential patient or user harm, regulatory impact, likelihood of recurrence, and detectability. Document the rationale; an old overdue item is not automatically more important than a newly identified high-risk weakness. Align Quality, Labeling, Packaging, and Change Control Create a coordinated remediation plan with one accountable owner for each action, named contributors, acceptance criteria, and required evidence. Separate immediate containment from systemic correction. Containment might prevent obsolete labels from being issued; correction might redesign approval and implementation controls so obsolete versions cannot return. Use change control as the integration point. Before approval, evaluate effects on regulatory submissions or notifications, technical documentation, supplier controls, packaging performance, validation, electronic master data, inventory, and training. Record both identified impacts and justified decisions that particular activities are unaffected. During technology transfer, define readiness gates before production or release responsibilities move. These should address the transfer of process knowledge, acceptance criteria, receiving-site capability, required qualification or validation, approved documents, and personnel competence. The appropriate evidence depends on the product and process; a generic checklist cannot replace a documented assessment. Finally, verify implementation where the work happens. Confirm that current instructions are available, suppliers received approved requirements, systems contain correct versions, and affected personnel can perform their tasks. A signed approval is not evidence that every downstream change took effect. Mistakes That Undermine Inspection Readiness Closing CAPAs on task completion alone: Effectiveness checks should test whether the underlying failure has been controlled. Updating labels in isolation: Assess packaging, supplier, system, documentation, and inventory consequences. Counting closures instead of evidence: Dashboards need defensible records behind their status indicators. ...

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Using biological markers – genetic characteristics that are associated with some patients with breast cancer – can increase the success rate of clinical trials for breast cancer drugs by almost 50 per cent, says new research from the University of Toronto Mississauga.

“It’s been increasingly difficult for pharmaceutical companies to bring new drugs to market,” says Jayson Parker, a faculty member in the Department of Biology and medical biotechnology analyst at the University of Toronto. “On average, about 80 per cent of drugs fail at some point in the clinical trial process.”

There are currently no clear estimates of success rates in clinical trials for breast cancer drugs and the factors that can impact success. The research team examined clinical trial drug development programs from 1998 to 2012 to determine how often breast cancer drugs were brought to market. The study examined advanced and metastatic breast cancer as well as patients that have been exposed to the chemotherapy drugs taxane and anthracycline.

“We found that only 14 per cent of drugs that undergo human testing for advanced and metastatic breast cancer are eventually approved,” says Parker. “This is worse than the average for the industry as a whole.”

According to Parker, some researchers have hypothesized that in the era of personalized medicine, biological markers, or biomarkers, could be used to improve clinical trial success rates and help bring more drugs to market faster. To test this hypothesis, Parker and his team examined the clinical trial success rates for drugs tested on breast cancer patients who have a particular biomarker (HER2). Biomarkers form part of the pathway involved in cancer cell development and can influence how a patient responds to therapy.

When the team compared clinical trials that targeted patients with the HER2 biomarker to those that did not, they found the success rate of drug development increased from 15 per cent to 23 per cent.

Improving the success rate of clinical trials also has an economic impact. Parker’s team found that using the HER2 biomarker in the design of clinical trials resulted in a cost savings of 27 per cent. “This can means millions of dollars in cost reduction for a clinical trial,” says Parker.

Although this finding may be limited to the HER2 biomarker in breast cancer, Parker says the results are encouraging. “This is the first study that has made a systematic comparison between patients with and without a biomarker,” he says. “It provides us with concrete initial evidence that the use of a biomarker can help improve clinical trial success rates in breast cancer. We are now exploring whether this finding holds true for other biomarkers in other cancers.”

Parker conducted the study with graduate students in the Master of Biotechnology program (MBiotech), Nadia Lushina and Prabjot Bal, along with an oncologist at Johns Hopkins Medical School, Dr. Gilberto Lopes and oncologists at Sunnybrook Health Sciences Centre, Dr. Rebecca Dent and Dr. Teresa Petrella. The paper was published in the journal Breast Cancer Research and Treatment.

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