Errors are very uncommon and always result in suspension of the study.

1. Federal Food Drug, and Cosmetic Act (FD&C Act) [September 17, 2007]. 21 USC Chapter 9. http://www.fda.gov/opacom/laws/fdcact/fdctoc.htm and Amendments. http://www.fda.gov/opacom/laws/default.htm#amendments.

2. Code of Federal Regulations – Title 21, parts 50 and 56; Title 45, part 46.

3. The Belmont report: ethical principles and guidelines for the protections of human subjects Bethesda (MD): U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 1978. http://www.nih.gov/grants/oprr/humansubjects/guidance/belmont.htm. [PubMed]

4. International Conference on Harmonization. 2007. [September 17]. http://www.ich.org.

5. Murphy SB. The national impact of clinical cooperative group trials for pediatric cancer. Med Pediatr Oncol. 1995;24:279–80. [PubMed] [Google Scholar]

6. McGregor LM, Metzger ML, Sanders R, Santana VM. Pediatric cancers in the new millennium: dramatic progress, new challenges. Oncology. 2007;21(7):809–20. [PubMed] [Google Scholar]

7. http://www.fda.gov/cber/gdlns/clintrialdmc.pdf.

8. Obligations of clinical investigators 21 CFR, part 312.

9. Elements of Informed Consent 21 CFR, 50.25; 45 CFR, 46.116. http://www.fda.gov/oc/ohrt/irbs/informedconsent.html.

10. Trotti A, Colevas AD, Setser A, et al. CTCAE v3.0: development of a comprehensive system for the adverse effects of cancer treatment. Semin Radiat Oncol. 2003;13(3):176–81. [PubMed] [Google Scholar]

11. Shah S, Weitman S, Langevin AM, Bernstein M, Furman W, Pratt C. Phase I therapy trials in children with cancer. J Pediatr Hematol Oncol. 1998;20(5):431–8. [PubMed] [Google Scholar]

12. Smith M, Bernstein M, Bleyer WA, Borsi JD, Ho P, Lewis IJ, et al. Conduct of Phase I trials in children with cancer. J Clin Oncol. 1998; 16:966–78. [PubMed] [Google Scholar]

13. Lee DP, Skolnik JM, Adamson PC. Pediatric phase I trials in oncology : an analysis of study conduct efficiency. J Clin Oncol. 2005;23(33):8431–41. [PubMed] [Google Scholar]

14. Ungerleider RS, Ellenberg S Berg S. Cancer Clinical Trials: Design, Conduct, Analysis, and Reporting. In: Pizzo P, Poplack D, editors. Principles and Practice of Pediatric Oncology. 4th edition Lippincott, Williams and Wilkins; Philadelphia: 2002. p. 385. [Google Scholar]

15. Weitman S, Ochoa S, Sullivan J, Shuster J, Winick N, Pratt C, et al. Pediatric phase II cancer chemotherapy trials: a Pediatric Oncology Group study. J Pediatr Hematol Oncol. 1997;19(3):187–91. [PubMed] [Google Scholar]

16. Simon R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989;10(1):1–10. [PubMed] [Google Scholar]

17. Chen QR, Vansant G, Oades K, Pickering M, Wei JS, Song YK, et al. Diagnosis of the small round blue cell tumors using multiplex polymerase chain reaction. J Mol Diagn. 2007;9(1):80–8. [PMC free article] [PubMed] [Google Scholar]

18. Lansky SB, List MA, Lansky LL, Ritter-Sterr C, Miller DR. The measurement of performance in childhood cancer patients. Cancer. 1987; 60(7):1651–56. [PubMed] [Google Scholar]

19. Dagher R, Pazdur R. The Phase III Clinical Cancer Trial. In: Andrews P, Teicher B, editors. Anticancer Drug Development Guide: Preclinical Screening, Clinical Trials and Approval. Humana Press; Totowa: 2004. [Google Scholar]

20. Dagher RN, Pazdur R. Clinical Trial Design and Regulatory Issues. In: Abbruzzese JL, Davis D, Herbst R, editors. Antiangiogenic Cancer Therapy. Taylor and Francis; Boca Raton: 2007. [Google Scholar]

21. Kretchmar CS, Kletzel M, Murray K, Thorner P, Joshi V, Marcus R, et al. Response to paclitaxel, topotecan and topotecan-cyclophosphamide in children with untreated disseminated neuroblastoma treated in an upfront phase II investigational window: a Pediatric Oncology Group study. J Clin Oncol. 2004; 22(20):4119–26. [PubMed] [Google Scholar]

22. Pappo AS, Lyden E, Breitfeld P, Donaldson SS, Wiener E, Parham D, et al. Two consecutive phase II window trials of irinotecan alone or in combination with vincristine for the treatment of metastatic rhabdomyosarcoma: the Children's Oncology Group. J Clin Oncol. 2007; 25(4):362–9. [PubMed] [Google Scholar]

23. Walterhouse DO, Lyden ER, Breitfeld PP, Qualman SJ, Wharam MD, Meyer WH. Efficacy of topotecan and cyclophosphamide given in a phase II window trial in children with newly diagnosed metastatic rhabdomyosarcoma: a Children's Oncology Group study. J Clin Oncol. 2004;22(8):1398–1403. [PubMed] [Google Scholar]

24. Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. National Cancer Institute 2003. http://ctep.cancer.gov/forms/CTCAEv3.pdf.

25. Guidance for Industry : Reports on the Status of Postmarketing Study Commitments — Implementation of Section 130 of the Food and Drug Administration Modernization Act of 1997. Feb2006. [September 17, 2007]. http://www.fda.gov/ohrms/dockets/98fr/99n-1852-gdl0002.pdf.

26. Guidance for Industry: Qualifying for Pediatric Exclusivity Under Section 303A of the FD&C Act 1999. Sep1999. [September 17, 2007]. http://www.fda.gov/cder/guidance/2891fnl.htm.

27. Regulations Requiring Manufacturers to Assess the Safety and Effectiveness of New Drugs and Biological Products in Pediatric patients. 63 Federal Register 66631. 1998. [PubMed]

28. Pediatric Exclusivity Provision: Status Report to Congress. U.S. Food and Drug Administration. 2001.

29. Best Pharmaceutical for Children Act. Jan 4, 2002. (Public Law No. 107−109; S-1789, 107th Congress)

30. Guidance for Industry: How to Comply with the Pediatric Research Equity Act. U.S. Food and Drug Administration. Sep2005. [September 17, 2007]. http://www.fda.gov/cder/guidance/6215dft.pdf.

31. Hirschfeld S, Ho PT, Smith M, Pazdur R. Regulatory approvals of pediatric oncology drugs: previous experience and new initiatives. J Clin Oncol. 2003;21(6):1066–73. [PubMed] [Google Scholar]

32. Benjamin DK, Smith PB, Murphy D, Roberts R, Mathis L, Avant D, et al. Peer-reviewed publication of clinical trials completed for pediatric exclusivity. JAMA. 2006;296(10):1266–73. [PMC free article] [PubMed] [Google Scholar]

33. Guidance for Industry: Pediatric Oncology Studies in Response to a Written Request. U.S. Food and Drug Administration. Jun2000. [September 17, 2007]. http://www.fda.gov/cder/guidance/3756dft.htm.

34. European Medicines Agency. Medicines for children. 2007. [September 17, 2007]. http://www.emea.europa.eu/htms/human/paediatrics/introduction.htm.


Page 2

Summary of commonly referenced International Conference on Harmonization (ICH) clinical efficacy guidelines

DocumentSubjectContent
ICH E 2Adverse Event ReportingDefines terms, timeframes for AE reporting and formatting of AE reports
ICH E 6GCP Consolidated GuidelinesDefines responsibilities of sponsors, investigators, consent process monitoring and auditing procedures, and protection of human subjects
ICH E 9Statistical PrinciplesDesign and conduct of trials intended to support or establish efficacy
ICH E 10Choice of Control GroupsProperties and limitations of different kinds of control groups (active control equivalence, non-inferiority, etc.)
ICH E 11Clinical Investigations in Pediatric PopulationPrinciples of clinical investigations in children, including timing of studies and extrapolation of data relative to studies conducted in adults, consent, assent, and interventions
ICH E 14Evaluation of QT/QTc Interval ProlongationTesting the effects of new agents on the QT/QTc interval as well as cardiovascular adverse events