[Federal Register Volume 90, Number 135 (Thursday, July 17, 2025)]
[Notices]
[Pages 33388-33389]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-13366]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2025-D-1071]


Development of Cancer Drugs for Use in Novel Combination--
Determining the Contribution of the Individual Drugs' Effects; Draft 
Guidance for Industry; Availability

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice of availability.

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SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing 
the availability of a draft guidance for industry entitled 
``Development of Cancer Drugs for Use in Novel Combination--Determining 
the Contribution of the Individual Drugs' Effects.'' This draft 
guidance is intended for sponsors developing drugs for use in 
combination for the treatment of cancer and provides recommendations 
for characterizing the safety and effectiveness of individual drugs for 
use in a novel combination regimen in oncology (i.e., demonstrating the 
contribution of each drug to the overall effect that is observed for 
the population). This guidance expands on the recommendations in the 
2013 guidance for industry entitled ``Codevelopment of Two or More New 
Investigational Drugs for Use in Combination.'' This guidance does not 
address contribution of effect in settings where an investigational 
drug is being developed in combination with a drug approved for the 
same indication for the purposes of comparing the approved drug to the 
combination or to fixed combinations of previously approved drugs for 
the approved indication(s).

DATES: Submit either electronic or written comments on the draft 
guidance by September 15, 2025 to ensure that the Agency considers your 
comment on this draft guidance before it begins work on the final 
version of the guidance.

ADDRESSES: You may submit comments on any guidance at any time as 
follows:

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on https://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand Delivery/Courier (for written/paper 
submissions): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2025-D-1071 for ``Development of Cancer Drugs for Use in Novel 
Combination--Determining the Contribution of the Individual Drugs' 
Effects.'' Received comments will be placed in the docket and, except 
for those submitted as ``Confidential Submissions,'' publicly viewable 
at https://www.regulations.gov or at the Dockets Management Staff 
between 9 a.m. and 4 p.m., Monday through Friday, 240-402-7500.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. If you do not wish 
your name and contact information to be made publicly available, you 
can provide this information on the cover sheet and not in the body of 
your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: https://www.govinfo.gov/content/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, 
Rm. 1061, Rockville, MD 20852, 240-402-7500.

[[Page 33389]]

    You may submit comments on any guidance at any time (see 21 CFR 
10.115(g)(5)).
    Submit written requests for single copies of this guidance to the 
Division of Drug Information, Center for Drug Evaluation and Research, 
Food and Drug Administration, 10001 New Hampshire Ave., Hillandale 
Building, 4th Floor, Silver Spring, MD 20993-0002, or Office of 
Communication, Outreach and Development, Center for Biologics 
Evaluation and Research, Food and Drug Administration, 10903 New 
Hampshire Ave., Bldg. 71, Rm. 3103, Silver Spring, MD 20993-0002. Send 
one self-addressed adhesive label to assist that office in processing 
your requests. See the SUPPLEMENTARY INFORMATION section for electronic 
access to the guidance document.

FOR FURTHER INFORMATION CONTACT: Donna Rivera, Oncology Center of 
Excellence, Food and Drug Administration, [email protected]; or 
Phillip Kurs, Center for Biologics Evaluation and Research, Food and 
Drug Administration, 240-402-7911.

SUPPLEMENTARY INFORMATION:

I. Background

    FDA is announcing the availability of a draft guidance for industry 
entitled ``Development of Cancer Drugs for Use in Novel Combination--
Determining the Contribution of the Individual Drugs' Effects.'' This 
draft guidance describes FDA's recommendations for characterizing the 
safety and effectiveness of individual drugs for use in a novel 
combination regimen (i.e., demonstrating the contribution of each drug 
to the overall effect that is observed for the population) in treating 
cancer, including use of data external to a trial for demonstration of 
contribution of effect for the following types of novel combinations in 
oncology: (1) two (or more) investigational drugs that have not been 
previously approved by FDA for any indication; (2) an investigational 
drug with a drug(s) approved for a different indication; or (3) two (or 
more) drugs approved for a different indication(s). This guidance 
expands on the recommendations in the 2013 guidance for industry 
entitled ``Codevelopment of Two or More New Investigational Drugs for 
Use in Combination.''
    Combination therapy in oncology is an important treatment modality. 
Scientific advances have increased our understanding of the 
pathophysiological processes that underlie many cancers. This increased 
understanding has provided further impetus to develop new therapeutic 
approaches using combinations of drugs directed at multiple therapeutic 
targets to improve treatment response, minimize adverse events, or 
both. A novel combination of drugs may be considered for development 
when the necessity of each drug in the proposed combination is 
supported by a strong biologic rationale including the nonclinical 
characterization of each drug in the combination and early clinical 
evidence. A critical aspect of codevelopment of novel combinations of 
oncology drugs is the characterization of the safety and effectiveness 
of the individual drugs in the combination because the benefit of using 
the individual drugs in combination is weighed against the added 
toxicity when they are used together. In some cases, the conventional 
approach to demonstrating contribution of effect by employing a 
standard factorial design may be infeasible. Therefore, FDA is 
providing recommendations regarding the use of external data for 
demonstrating the contribution of the individual drugs to the effect of 
a combination regimen and the key aspects to consider including 
selection of data source(s) and endpoints, and suitability of a data 
source.
    This draft guidance is being issued consistent with FDA's good 
guidance practices regulation (21 CFR 10.115). The draft guidance, when 
finalized, will represent the current thinking of FDA on ``Development 
of Cancer Drugs for Use in Novel Combination--Determining the 
Contribution of the Individual Drugs' Effects.'' It does not establish 
any rights for any person and is not binding on FDA or the public. You 
can use an alternative approach if it satisfies the requirements of the 
applicable statutes and regulations.
    As we develop final guidance on this topic, FDA will consider 
comments on costs or cost savings the guidance may generate, relevant 
for Executive Order 14192.

II. Paperwork Reduction Act of 1995

    While this guidance contains no collection of information, it does 
refer to previously approved FDA collections of information. The 
previously approved collections of information are subject to review by 
the Office of Management and Budget (OMB) under the Paperwork Reduction 
Act of 1995 (PRA) (44 U.S.C. 3501-3521). The collections of information 
in 21 CFR part 312 have been approved under OMB control number 0910-
0014; the collections of information in 21 CFR part 314 have been 
approved under OMB control number 0910-0001; and the collections of 
information in 21 CFR part 601 have been approved under OMB control 
number 0910-0338.

III. Electronic Access

    Persons with access to the internet may obtain the guidance at 
https://www.fda.gov/drugs/guidance-compliance-regulatory-information/guidances-drugs, https://www.fda.gov/vaccines-blood-biologics/guidance-compliance-regulatory-information-biologics/biologics-guidances, 
https://www.fda.gov/regulatory-information/search-fda-guidance-documents, or https://www.regulations.gov.

    Dated: July 14, 2025.
Grace R. Graham,
Deputy Commissioner for Policy, Legislation, and International Affairs.
[FR Doc. 2025-13366 Filed 7-16-25; 8:45 am]
BILLING CODE 4164-01-P