Journal Article

Pre-clinical animal models are poor predictors of human toxicities in phase 1 oncology clinical trials

George, Goldy C., Khozin, Sean, Marcelo-Lewis, Kathrina L., Borthakur, Gautam, Yuan, Ying, LoRusso, Patricia, Atkins, Johnique T., Hess, Kenneth, Hong, David S.

2020

Overview

Background Our objective was to determine the correlation between preclinical toxicity found in animal models (mouse, rat, dog and monkey) and clinical toxicity reported in patients participating in Phase 1 oncology clinical trials. Methods We obtained from two major early-Phase clinical trial centres, preclinical toxicities from investigational brochures and clinical toxicities from published Phase 1 trials for 108 drugs, including small molecules, biologics and conjugates. Toxicities were categorised according to Common Terminology Criteria for Adverse Events version 4.0. Human toxicities were also categorised based on their reported clinical grade (severity). Positive predictive values (PPV) and negative predictive values (NPV) were calculated to determine the probability that clinical studies would/would not show a particular toxicity category given that it was seen in preclinical toxicology analysis. Statistical analyses also included kappa statistics, and Matthews (MCC) and Spearman correlation coefficients. Results Overall, animal toxicity did not show strong correlation with human toxicity, with a median PPV of 0.65 and NPV of 0.50. Similar results were obtained based on kappa statistics and MCC. Conclusions There is an urgent need to assess more novel approaches to the type and conduct of preclinical toxicity studies in an effort to provide better predictive value for human investigation.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/1807/4024 / 692/4028 / Animal models / Animals / Antineoplastic Agents - administration & dosage / Antineoplastic Agents - adverse effects / Biomedical and Life Sciences / Biomedicine / Cancer Research / Clinical trials / Clinical Trials, Phase I as Topic - standards / Clinical Trials, Phase I as Topic - statistics & numerical data / Disease Models, Animal / Dogs / Drug Evaluation, Preclinical - standards / Drug Evaluation, Preclinical - statistics & numerical data / Drug Resistance / Drug-Related Side Effects and Adverse Reactions - diagnosis / Drug-Related Side Effects and Adverse Reactions - epidemiology / Epidemiology / Haplorhini / Humans / Mice / Molecular Medicine / Neoplasms - drug therapy / Neoplasms - epidemiology / Neoplasms - pathology / Oncology / Prognosis / Rats / Statistical analysis / Terminology / Toxicity