Minutes of 29th Apex Committee

26 Pages·2016·0.57 MB·English

Minutes of 32nd Apex Committee 03.11.2016

MINUTES OF THE 32nd MEETING OF THE APEX COMMITTEE HELD ON
03.11.2016 UNDER THE CHAIRMANSHIP OF SECRETARY, (H&FW) FOR
SUPERVISING CLINICAL TRIALS ON NEW CHEMICAL ENTITIES
Present:
1. SHRI C.K. MISHRA
Secretary
Department of Health and Family Welfare
Ministry of Health and Family Welfare &
Chairman, Apex Committee
2. Dr. SOUMYA SWAMINATHAN
Secretary, DHR & DG ICMR
3. Dr. JAGDISH PRASAD
DGHS
4. SHRI K. L. SHARMA
Joint Secretary
Department of Health and Family Welfare
Special Invitees:
1. SHRI K. B. AGGARWAL
Addl. Secretary (F&D)
Ministry of Health and Family Welfare
2. Dr. G. N. SINGH
DCG (I), FDA Bhavan, New Delhi

Initiating the discussion, Chairman, Apex Committee welcomed the members of
the Committee and special invitees to the meeting. Thereafter, the Committee
deliberated upon each of the agenda items and recommended as following:

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Minutes of 32nd Apex Committee 03.11.2016

ITEM No. 01

Proposals of Clinical Trials related to New Chemical Entities (NCEs)
recommended by Technical Committee:
Proposal No.01:
A trial investigating the cardiovascular safety of oral Semaglutide in subjects
with Type 2 diabetes
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study
subject to verification of conduct of Phase II Clinical trial. (Details at Annexure-I).
Proposal No.02:
A Phase III, multicentre, multinational, randomized, open-label, parallel-arm study
of Avelumab plus best supportive care versus best supportive care alone as a
maintenance treatment in patients with locally advanced or metastatic urothelial
cancer whose disease did not progress after completion of first line Platinum-
containing chemotherapy.
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study
subject to verification of conduct of Phase II Clinical trial. (Details at Annexure-I).
Proposal No.03:
A Randomized, Double-Blind, Placebo-Controlled, Six-Month Study to Evaluate
the Efficacy, Safety and Tolerability of Sarizotan in Patients with Rett Syndrome
with Respiratory Symptoms.
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study
(Details at Annexure-I).

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Minutes of 32nd Apex Committee 03.11.2016

ITEM No. 02
Proposal No.04:
A Randomized, Double-Blind, Placebo-Controlled, Phase III Study to Compare
NSAI plus Abemaciclib, a CDK4 and CDK6 Inhibitor, or plus Placebo and to
Compare Fulvestrant plus Abemaciclib or plus Placebo in Postmenopausal
Women with Hormone Receptor-Positive, HER2-Negative Loco regionally
Recurrent or Metastatic Breast Cancer.
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study
subject to verification of conduct of Phase II Clinical trial. (Details at Annexure-I).
Proposals of Clinical Trials related to IND’s recommended by IND/CBBTDEC Committee:
Proposal No.01:
A multi-centre, non-randomized, open label, single arm trial to determine the
efficacy, safety and tolerability of Tissue Engineered Xenografts (Bovine
Pericardium, Bovine Jugular Vein and Porcein Pulmonary Artery) in patients with
Structural Heart Disease and Pulmonary Stenosis” in patients of 100, 25, 25
respectively
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study.
Proposal No.02:
A Prospective, randomized, multi-centric, comparative, open label, double arm
controlled clinical study to evaluate the safety and efficacy of UCMSCs in
subjects with recently diagnostic Type I diabetes.
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study

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Minutes of 32nd Apex Committee 03.11.2016

Proposal No.03:
Prospective, randomized, open label, double arm, dose finding clinical study of R-HSC-
008 as an adjunct cell based therapy as a prophylaxis for aGvHD after allogenic
Hematopoietic stem cell Transplantation–Phase I/II”.
The Committee, after detailed deliberations, concurred with the recommendations of
the Technical Committee for approval of clinical trial protocol for conduct of the study
subject to condition that outcome of Phase I shall be submitted to CBBTDEC.
Proposal No.04:
Prospective, multicentric, open label, two arm, parallel group, comparative dose
escalation clinical study to evaluate the safety and efficacy of R-HSC-
002(Autologous bone marrow derived MSCs) and R-HSC-003(Allogenic cord
derived MSCs) dosage as an adjunct cell based therapy in the treatment of
patients with ischemic limb disease.
The committee after detailed deliberations, concurred with the recommendations of the
Technical Committee for approval of clinical trial protocol for conduct of the study
subject to justification of two arm study to be verified by CDSCO.
ITEM No. 03
Proposals for Clinical Trial Waiver in Indian population for approval of new drugs
falling under the category of drugs, which have already been approved outside
India
Proposal No.01:
Hydralazine tablet 25 mg/50 mg.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.02:
Dengue Tetravalent Vaccine (Live, Attenuated).
The proposal is deferred.
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Minutes of 32nd Apex Committee 03.11.2016

Secretary, DHR may take a presentation from the applicant along with DGHS and the
outcome should be submitted to the Apex Committee for consideration.
Proposal No.03:
Idarucizumab (Praxiband).
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.04:
Riboflavin Ophthalmic Solution 0.1%
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.05:
Eliglustat 84 mg Capsules.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.06:
Alectinib Capsules 150 mg.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.07:
Tranexamic Acid Film Coated Tablet 1000mg (Additional Strength)
The Committee noted that proposed formulation is higher dose of approved drug which
is within the recommended dose. After detailed deliberations, the Apex Committee
concurred with the recommendations of the Technical Committee for waiver of local
clinical trial (Details at Annexure-II)
Proposal No.08:
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Minutes of 32nd Apex Committee 03.11.2016

Bendamustine Hydrochloride 100mg /vial (Additional Indication).
The Apex Committee, after detailed deliberations, concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.09:
Insulin Glargine solution for Injection 300 IU/mL [Additional Strength].
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.10:
Trametinib 0.5 mg & 2 mg Tablets and Trametinib in combination with Dabrafenib
as 50mg/75mg Capsules.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.11:
Daratumumab Concentrate for solution for infusion 100 mg and 400 mg.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).
Proposal No.12:
Bone allograft products derived from human donor musculo skeletal donor
tissue - R-HSC-003(Allogenic cord derived MSCs) and R-HSC-003(Allogenic cord
derived MSCs) Musculoskeletal Donor Tissue.
The Apex Committee, after detailed deliberations concurred with the recommendations
of the Technical Committee for waiver of local clinical trial (Details at Annexure-II).

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Minutes of 32nd Apex Committee 03.11.2016

OTHERS:
ITEM NO. 01
1. Compliance report on the recommendation of the 30th Apex Committee
regarding the clinical trial proposal of M/s Pharmazz.
The Committee noted that DG, ICMR has reviewed the revised protocol after
incorporating amendments recommended by the IND Committee. The Apex
Committee recommended for approval of clinical trial protocol for conduct of the
study
2. Discussion on the proposal of M/s APAC Biotech Pvt. Ltd, Gurgaon for
Marketing Authorization of APCEDEN™ [Dendritic Cell (DC) product].
The Committee recommended for the conduct of Phase III clinical trial on suitable
number of subjects. Further, it was decided that DCG (I) may constitute an expert
Committee for verifying the compliance of M/s APAC Biotech to the provisions of
Drugs and Cosmetics Act, 1940 and Rules, 1945.
3. The Committee decided that the disposal of applications of Clinical Trials/New
Drugs shall be carried out keeping in view the first in first out basis, the Committee
also directed that the pendency of existing applications brought down so that all
applications are disposed of within the prescribed timelines.
ITEM NO. 02
(i) The decision of the Apex Committee taken in its meeting held in first
week of July 2016, that “the drugs (including Cosmetics and Medical
Devices) approved by ICH regulators, with no adverse events, did not
require Phase III “, may be implemented.
(ii) In future, cases of waivers need not be brought to Technical Committee
and Apex Committee and these should be considered and disposed of
by the Central Licencing Authority as per provisions of Drugs and
Cosmetics Act, Rules and Guidelines issued by the Government from
time to time and Technical Committee will act as Appellate Committee in
cases of disputes.
The meeting ended with vote of thanks to and from the Chairman.

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Minutes of 32nd Apex Committee 03.11.2016

Annexure-I
Proposal of clinical trial of NCEs along with their evaluations and recommendations of the
Technical Committee in its 35th and 36th Meeting held on 21.09.2016 and 20.10.2016 respectively.
Proposal Details of the proposal Assessment of the Proposal vis – Recommendation
No a vis specified Parameters 1. Subject Expert

Committee
2. Technical Committee
1. Name of the Drug: Risk versus benefit to the 1. The proposal was
Oral Semaglutide patients- The safety profile of deliberated in SEC
the test drug from preclinical (Endocrinology) held on
Date of Application:
toxicity studies including 14/06/2016.
19/04/2016 repeat dose toxicity,
After the detailed
genotoxicity, carcinogenicity
deliberation the committee
Protocol No: NN9924- study and clinical phase I, II
recommended the conduct
4221 studies justify the conduct of
of the trial subject to the
the study.
following condition
Phase of the trial: IIIa
Innovation vis-a-vis existing
i. Primary responsibility
therapeutic option The
for the Standard of
Name of the
purpose of study is to Care should be with
Applicant: Novo
investigate the cardiovascular the trial investigator
Nordisk India Private
safety of oral Semaglutide in
ii. The HbA1c at
Ltd, Plot No. 32, 47 -
subjects with type 2 diabetes. inclusion must be
50, EPIP Area,
between 7 to 10 %
Unmet need in the country-
Whitefield, Bangalore -
The test drug may be an iii. The hypoglycemic
560 066, Karnataka,
criteria and rescue
alternative treatment option in
India
medication should be
subjects with type-2 diabetes at
clearly defined under
Name of the Sponsor: high risk of cardiovascular
the protocol.
Novo Nordisk India events.
iv. The OADs be
Private Ltd, Plot No.
provided free of cost.
32, 47 - 50, EPIP Area,

Whitefield, Bangalore -
560 066, Karnataka, The proposal was Re-
India. deliberated in SEC
(Endocrinology) held on
Name of the
22/08/2016.
Manufacturer: Novo
Nordisk A/S, Novo After detailed deliberation
AlléDK-2880, the committee approved
Bagsværd, Denmark the study as the points
raised earlier have been
Title: A trial
complied with. The firm
investigating the
further clarified that the
cardiovascular safety of
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Minutes of 32nd Apex Committee 03.11.2016

Oral Semaglutide in patients with Type 2
subjects with Type 2 diabetes with HbA1C
diabetes. ≥10.0 % will receive
standard of care along with
Insulin and the study
medication.
SEC Expert List:
1. Dr. Rajesh Rajput, Senior
Professor & Head, Dept.
of Endocrinology, PGIMS,
Medical Road, Rohtak-
124001
2. Dr. Anil Bhansali,
Additional Prof. & HOD,
Endocrinology, PGIMER,
Sector-12, Chandigarh.
3. Dr. Richa Dewan, Director
and Professor, Dept. of
Medicine, MAMC, New
Delhi.
4. Dr. Lalit Kumar Gupta,
Professor Dept. of
Pharmacology, Lady
Harding Medical College,
New Delhi.
2. Recommendation of
the Technical
Committee on
21.09.2016:
After detailed deliberation,
the committee agreed with
the recommendation of the
SEC and recommended the
approval of the study.
02 Name of the Drug: Assessment of Risk vs. 1. The proposal was
Avelumab is the Benefit to the patients: The deliberated in SEC
proposed International safety profile of the study (Oncology) held on
Non-proprietary Name drugs from preclinical safety 27/09/2016.
(INN) for the anti-PD- pharmacology and toxicology
After detailed deliberation
L1 monoclonal studies and clinical studies
the committee
antibody, justify the conduct of the trial.
recommended the conduct
MSB0010718C.
Innovation vis-avis Existing of the study.
Therapeutic Option: To
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Minutes of 32nd Apex Committee 03.11.2016

Date of Application: demonstrate the benefit of SEC Expert List:
maintenance treatment with
25/06/2016
1. Dr. Sameer Bakshi,
Avelumab plus BSC vs BSC
Professor, dept. of Medical
Protocol No:
alone in prolonging overall
Oncology, AIIMS, New
B9991001 survival (OS) in patients with Delhi.
unresectable locally advanced 2. Dr. C.K. Bose, Assistant
Phase of the trial: III or metastatic US whose Professor, Netaji Subhash
Chandra Bose Cancer
disease did not progress on or
Research Institute,
Name of the
following completion of first-
Kolkata.
Applicant: M/s Pfizer
line platinum-containing
3. Dr. Sanjay Kumar Singh,
Limited, The Capital,
chemotherapy in each co-
Dept. of Medical
1802/1901, Plot No. C-
primary UC patient population: Oncology, Gajara Raja
70, G Block, Bandra 1) patients determined to have Medical College, Veer
Kurla Complex, Bandra Savarkar Marg, Gwalior-
PD-L1-positive tumors
474009 Gwalior.
(East), Mumbai
(including infiltrating immune
400051, Maharashtra, 4. Dr. Prantar Chakroborty,
cell) by a verified GMP PD-L1
Dept. of Hematology, NRS
India
1HC test, and 2) all
Medical College, Kolkata
randomized patients. 700014.
Name of the Sponsor:
M/s Pfizer Inc., 235 Unmet Medical Need in the 5. Dr. Renu Saxena, Prof. and
Head, Dept. of
East 42nd Street, Country: The test drug may
Hematology, AIIMS, New
New York, NY 10017, potentially provide alternative
Delhi.
USA treatment of subjects with
6. Dr. Bikash Medhi,
locally advanced or metastatic
Pharmacology, PGIMER,
Name of the
urothelial cancer. Sector 12, Chandigarh.
Manufacturer: M/s
7. Dr. K.V. Anand, HOD,
Merck Serono S.A.,
Dept. of Vascular Surgery,
Succursale d’Aubonne, Army Hospital, R & R,
Zone Industrielle New Delhi.

del’Ouriettaz, CH-1170

Aubonne, Switzerland
2. Recommendation of
Title: A Phase 3, the Technical
multicentre, Committee on
multinational, 20.10.2016:
randomized, open-label,
After detailed deliberation,
parallel-arm study of
the committee agreed with
avelumab plus best
the recommendation of the
supportive care versus
SEC and recommended the
best supportive care
approval of the study.
alone as a maintenance
treatment in patients
with locally advanced
or metastatic urothelial
cancer whose disease
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