[Federal Register Volume 90, Number 187 (Tuesday, September 30, 2025)]
[Notices]
[Pages 46900-46901]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-18897]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2025-D-3023]


E20 Adaptive Designs for Clinical Trials; International Council 
for Harmonisation; Draft Guidance for Industry; Availability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the availability of a draft guidance for industry entitled ``E20 
Adaptive Designs for Clinical Trials.'' The draft guidance was prepared 
under the auspices of the International Council for Harmonisation of 
Technical Requirements for Pharmaceuticals for Human Use (ICH). The 
draft guidance is intended to provide a transparent and harmonized set 
of recommendations for clinical trials with an adaptive design. The 
draft guidance focuses on principles for the planning, conduct, 
analysis, and interpretation of clinical trials with an adaptive design 
that aim to confirm the efficacy and support the benefit-risk 
assessment of a treatment. The draft guidance emphasizes principles 
that are critical for ensuring clinical trials produce reliable and 
interpretable results and that involve specific considerations with use 
of an adaptive design.

DATES: Submit either electronic or written comments on the draft 
guidance by December 1, 2025 to ensure that the Agency considers your 
comment on this draft guidance before it begins work on the final 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-3023 for ``E20 Adaptive Designs for Clinical Trials.'' 
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.
    You may submit comments on any guidance at any time (see 21 CFR 
10.115(g)(5)).
    Submit written requests for single copies of the draft 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. The 
guidance may also be obtained by mail by calling Center for Biologics 
Evaluation and Research at 1-800-835-4709 or 240-402-8010. See the 
SUPPLEMENTARY INFORMATION section for electronic access to the draft 
guidance document.

FOR FURTHER INFORMATION CONTACT: Regarding the guidance: Gregory Levin, 
Center for Drug Evaluation and Research, Food and Drug Administration, 
301-796-4228, [email protected]; or Phillip Kurs, Center for 
Biologics Evaluation and Research, Food and Drug Administration, 240-
402-7911.
    Regarding the ICH: Brooke Dal Santo, Center for Drug Evaluation and 
Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 
51, Rm. 6304, Silver Spring,

[[Page 46901]]

MD 20993-0002, 301-348-1967, [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    FDA is announcing the availability of a draft guidance for industry 
entitled ``E20 Adaptive Designs for Clinical Trials.'' The draft 
guidance was prepared under the auspices of ICH. ICH seeks to achieve 
greater regulatory harmonization worldwide to ensure that safe, 
effective, high-quality medicines are developed, registered, and 
maintained in the most resource-efficient manner.
    By harmonizing the regulatory requirements in regions around the 
world, ICH guidelines enhance global drug development, improve 
manufacturing standards, and increase the availability of medications. 
For example, ICH guidelines have substantially reduced duplicative 
clinical studies, prevented unnecessary animal studies, standardized 
the reporting of important safety information, and standardized 
marketing application submissions.
    The six Founding Members of the ICH are the FDA; the Pharmaceutical 
Research and Manufacturers of America; the European Commission; the 
European Federation of Pharmaceutical Industries Associations; the 
Japanese Ministry of Health, Labour, and Welfare; and the Japanese 
Pharmaceutical Manufacturers Association. The Standing Members of the 
ICH Association include Health Canada and Swissmedic. ICH membership 
continues to expand to include other regulatory authorities and 
industry associations from around the world (refer to https://www.ich.org/).
    ICH works by engaging global regulatory and industry experts in a 
detailed, science-based, and consensus-driven process that results in 
the development of ICH guidelines. The regulators around the world are 
committed to consistently adopting these consensus-based guidelines, 
realizing the benefits for patients and for industry.
    As a Founding Regulatory Member of ICH, FDA plays a major role in 
the development of each of the ICH guidelines, which FDA then adopts 
and issues as guidance for industry. FDA's guidance documents do not 
establish legally enforceable responsibilities. Instead, they describe 
the Agency's current thinking on a topic and should be viewed only as 
recommendations, unless specific regulatory or statutory requirements 
are cited.
    In June 2025, the ICH Assembly endorsed the draft guideline 
entitled ``E20 Adaptive Designs for Clinical Trials'' and agreed that 
the guideline should be made available for public comment. The draft 
guideline is the product of the Efficacy Expert Working Group of the 
ICH. Comments about this draft will be considered by FDA and the 
Efficacy Expert Working Group.
    The draft guidance provides transparent and harmonized 
recommendations for the planning, conduct, analysis, and interpretation 
of clinical trials with an adaptive design that aim to confirm the 
efficacy and support the benefit-risk assessment of a treatment. For 
the purpose of this draft guidance, an adaptive design is defined as a 
clinical trial design that allows for prospectively planned 
modifications to one or more aspects of the trial based on interim 
analysis of accumulating data from participants in the trial. Adaptive 
designs offer a variety of advantages and challenges. This draft 
guidance emphasizes principles that are critical for ensuring clinical 
trials produce reliable and interpretable results and that involve 
specific considerations with use of an adaptive design. While this 
draft guidance primarily focuses on confirmatory clinical trials, the 
principles are relevant to all clinical development phases.
    This draft guidance has been left in the original ICH format. The 
final guidance will be reformatted and edited to conform with FDA's 
good guidance practices regulation (21 CFR 10.115) and style before 
publication. The draft guidance, when finalized, will represent the 
current thinking of FDA on ``E20 Adaptive Designs for Clinical 
Trials.'' 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 (44 U.S.C. 3501-3521). The collections of information in 21 
CFR parts 50 and 56 relating to the protection of human subjects, 
informed consent, and institutional review boards have been approved 
under OMB control number 0910-0130. The collections of information in 
21 CFR part 312 relating to submission of investigational new drug 
applications, including efficient approaches to clinical trial design, 
study protocols, and the operation of data monitoring committees, have 
been approved under OMB control number 0910-0014. The collections of 
information in 21 CFR part 314 relating to submission of new drug 
applications have been approved under OMB control number 0910-0001. The 
collections of information in 21 CFR part 601 relating to submission of 
biologic license applications have been approved under OMB control 
number 0910-0338. The collections of information in 21 CFR part 812 
relating to investigational device exemption applications have been 
approved under OMB control number 0910-0078.

III. Electronic Access

    Persons with access to the internet may obtain the draft guidance 
at https://www.regulations.gov, 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, or https://www.fda.gov/regulatory-information/search-fda-guidance-documents.

Grace R. Graham,
Deputy Commissioner for Policy, Legislation, and International Affairs.
[FR Doc. 2025-18897 Filed 9-29-25; 8:45 am]
BILLING CODE 4164-01-P