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Peter van Amsterdam
Head Bioanalytics, Abbott Healthcare Products
DARQA themadag ‘When GCP meets GLP’, 30 Jan 2015, Utrecht
 The views and conclusions presented in this slide deck are
those of the author/presenter and do not necessarily reflect
the representative affiliation or company's position on the
subject.
 Exaggeration is often chosen as a style model to emphasize
the similarities or differences between various situations.
 The focus is on the bioanalytical arena
30-Jan-2015 GCP meets GLP @DARQA 2
30-Jan-2015 GCP meets GLP @DARQA 3
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
30-Jan-2015 GCP meets GLP @DARQA 4
 1965: EEC 65/65 (reaction to Thalidomide)
o No real focus on bioanalysis
 1978: 21 CFR 58
 1982: OECD 1
o Both are General GLP guidelines (preclinical safety)
o Quality system ensure the uniformity, consistency, reliability, reproducibility,
quality, and integrity pre-clinical safety tests.
 Eighties (flowing over in the Nineties)
o Increased focus on Bioequivalence studies (including paragraphs on
bioanalytical methodology to be applied)
o EU, FDA, Australia, Canada to lead
 BMV workshop – (Crystal City-I)
o < 1990 = lack of uniformity in industry wrt validation bioanalytical methods
o Crystal City-I was first international conference with focus on Bioanalytical
method validation and sample analysis
o Resulted in Shah paper (Pharm Res. 1992;9:588-592).
30-Jan-2015 GCP meets GLP @DARQA 5
30-Jan-2015 GCP meets GLP @DARQA 6
Crystal City I
Shah
2001 FDA
Guidance
CC-I CC-II CC-III
Crystal City
Conferences
Conference papers
Regulatory
Guidance
Additional white
papers
CC-IV
(ISR)
CC-IV Fast
1990 2000 2010
CC III
Viswanathan
CC II
Shah (chrom.)
Miller (LBA)
DeSilva
30-Jan-2015 GCP meets GLP @DARQA 7
20201960 1970 1980
1965:
65/65/EEC
1979:
US 58cfr21
1982:
OECD GLP
A B C
Anvisa RDC 899
HC removes ISR
1988:
Australian draft
CO6: 7581c
EMA draft
Anvisa update
Open letter to
FDA & EMA
GBC
formed
More countries or
regions likely to issue
Guidelines
D
E
1990 2000 2010
Thalidomide
A. scientist adopting home designed quality
systems
B. scientist shopping for inspiration in other areas
– peers, DIN, EPA,..
C. scientist regrouped around Shah paper
D. multiple countries issuing regulations of BA included in BE
guidelines
E. Industry increase meeting frequency (e.g. APA, EBF, CVG)
recommendation papers after (broad) internal discussions
EMA final
MHLW chrom
MHLW LBA
CFDA draft
30-Jan-2015 GCP meets GLP @DARQA 8
A bucket full of other
adjacent regulations:
21 CFR 58 (GLP), OECD-
GLP, 21 CFR 11 (CSV),
ICH-S3A (TK), ICH-E6
(GCP), ICH M3 (MIST),
MHRA GCLP, EMA GCLP,
21 CFR 320.29 (BE), …,
…, …,
 1963 FDA drafting the GMP concept
 1964 Declaration of Helsinki
 1973 New Zealand draft GLP concept
 1978 FDA GLP final
 1978 FDA GMP final
 1981 OECD GLP
 1982 MHLW GLP
 1983 EPA GLP
 1989 Revised EPA GLP
 1989 ICH global standards for Clinical Research
 1997 21 CFR 11
 1997 Revised OECD GLP
 1997 ICH GCP
 2001 EU Clinical Trials directive
 2005 EU GCP directive
 2009 MHRA GCP for laboratories
 2009 WHO GCLP
 2012 EMA 'GCLP' reflection paper
30-Jan-2015 GCP meets GLP @DARQA 9
Hmmm….
~1980 GLP
~2000 GCP
~2010 GCLP
 Within Pharma, bioanalytical departments are often part of
DMPK/Research.
o Basically a pre-clinical (GLP) area
o Science & technology driven
o High attrition rate
 Within CROs, bioanalytical departments are often core
business.
o Can cover all R to D area’s (GLP and)
o Science & technology driven
o Client focus, costs & timelines driven
30-Jan-2015 GCP meets GLP @DARQA 10
30-Jan-2015 GCP meets GLP @DARQA 11
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
30-Jan-2015 GCP meets GLP @DARQA 12
By design, e.g.:
 Corporate strategy
o Science in house
o Operational external
 Flexible workforce
o Cope with peaks in workload
o No redundancies in slow periods
 Excess or shortage of money
o R&D expenditures as % of sales
Improvement of deliverables, e.g.:
 Better suited then own labs
o Better equipped
o GxP compliant
o Right location
 Faster then own labs
o Larger workforce
o More instruments
o Routine power
 Specific expertise
30-Jan-2015 GCP meets GLP @DARQA 13
 CRO selection
 Oversight
 Monitoring
30-Jan-2015 GCP meets GLP @DARQA 14
30-Jan-2015 GCP meets GLP @DARQA 15
30-Jan-2015 GCP meets GLP @DARQA 16
30-Jan-2015 GCP meets GLP @DARQA 17
Sponsor
 Clinical
 QA
 Stats
 Bioanalytical
 Operations
 Trial managers
 CRAs
 Supplies
 Contracting
 Legal
 Data management
 Regulatory
 Marketing
CRO
 Project manager
 Recruitment
 CRAs
 Data management
 Pharmacokinetics
 Statistics
 Legal
 Regulatory
 QA
 Medical writers
 Archives, TMF

30-Jan-2015 GCP meets GLP @DARQA 18
Central Lab
 Project manager
 Logistics
o Kits
o Samples
 Kit building
 Safety analysis
 Data basing
 Reconciliation
 QA
 Reporting
Bioanalytical Lab(s)
 Study lead
 QA
 Management
 Sample receipt
 Archives
30-Jan-2015 GCP meets GLP @DARQA 19
30-Jan-2015 GCP meets GLP @DARQA 20
Other
 Ethical Committee
 Safety Review Board
 Health Authorities

And
 Public disclosure
 Share holders
 Senior management
 Financial analists

Clinical sites
 Investigators
 Hospital staff
 Recruitment
 Inclusion / Exclusion
 Medical history
 Dosing
 Observations
 Sampling
 Pharmacists
30-Jan-2015 GCP meets GLP @DARQA 21
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
30-Jan-2015 GCP meets GLP @DARQA 22
In the Bioanalytical (‘GLP’) Environment
BioAnalysis Man
Knows BMV Guidelines
Knows (OECD) GLP
Knows (a bit) CSV
Knows the (relevant) SOPs
Knows his science
Can handle equipment
Can perform validations
Can run samples
Can report the results
23GCP meets GLP @DARQA30-Jan-2015
In the Research (GLP) environment
BioAnalysis Man
Knows bioanalysis
Knows (OECD) GLP
Knows a bit about DMPK
Knows a bit about the study
Takes care of the PK/PD samples
Part of team
Report appendix
24GCP meets GLP @DARQA30-Jan-2015
In the Clinical (GCP) environment
2530-Jan-2015 GCP meets GLP @DARQA
BioAnalysis Man
Knows bioanalysis
Knows some GCP
Knows a bit about DMPK
Knows a bit about the study
Takes care of the PK/PD samples
May be part of sub-team
Report appendix / part of the reported data
 In the BA lab, bioanalytical objectives
o “You can do anything you want“
• Change method, amend something, redo an experiment, ….
• (as long as you follow some SOPs and QA and management rules)
 In a GLP study
o “You can mostly do what you want“
• Change method, amend something, redo an experiment, BUT …
• (as long as you follow the SOPs, protocol, SD input/agreement and QA and
management rules)
 In a GCP study
o “You can hardly do what you want“
• NO to change of method, amend something, redo an experiment, UNLESS ..
• (and follow the SOPs, protocol, sponsor input/agreement, patient rights,
and QA and management rules, ….)
30-Jan-2015 GCP meets GLP @DARQA 26
30-Jan-2015 GCP meets GLP @DARQA 27
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
30-Jan-2015 GCP meets GLP @DARQA 28
30-Jan-2015 GCP meets GLP @DARQA 29
From: Principles and Practice of ICH GLP
Rebecca Luk, Pfizer (2012)
30-Jan-2015 GCP meets GLP @DARQA 30
EMA:
EMA BMV: The validation of bioanalytical methods and the analysis of study samples for clinical
trials in humans should be performed following the principles of GCP. Further can be found in
the “Reflection Paper for Laboratories That Perform The Analysis Or Evaluation Of Clinical Trial
Samples.” (EMA/INS/GCP/532137/2010).
EMA BMV: The validation of bioanalytical methods used in non-clinical pharmaco toxicological
studies that are carried out in conformity with the provisions related to Good Laboratory Practice
should be performed following the Principles of GLP.
EMA BE: The bioanalytical part of bioequivalence trials should be performed in accordance with
the principles of GLP. However, as human bioanalytical studies fall outside the scope of GLP, the
sites conducting the studies are not required to be monitored as part of a national GLP
compliance programme.
Note: OECD GLP
Draft FDA: Pre-clinical adhere to GLP (21 CFR 58), Clinical adhere to 21 CFR 320.29
ANVISA: Not addressed
MHLW: Not clearly addressed
 Availability of the clinical protocol
 Central lab between clinic and BA lab
 Lab manual
 Sample roster ≠ sample tube label
 Data base (LIMS) requirements
 Timelines
 Reporting final data before issuing final report
 Who to report what to (communication plan)
 Patients and IC
 CRFs
30-Jan-2015 GCP meets GLP @DARQA 31
30-Jan-2015 GCP meets GLP @DARQA 32
From: Unexpected Results in a Bioanalytical Laboratory – a Safety and Compliance Issue?
Silke Luedtke, Boehringer Ingelheim (2011)
30-Jan-2015 GCP meets GLP @DARQA 33
From: Unexpected Results in a Bioanalytical Laboratory – a Safety and Compliance Issue?
Silke Luedtke, Boehringer Ingelheim (2011)
Excerpt from the MHRA "Guidance for the notification of serious breaches of
GCP or the trial protocol", released 2006, update Jan 2013
 non-compliance with GCP or the protocol
If this non-compliance has a significant impact on the integrity of trial
subjects in the UK or on the scientific value of the trial, this will constitute a
serious breach. For example, widespread and uncontrolled use of protocol
waivers affecting eligibility criteria, which leads to harm to trial subjects in
the UK or which has a significant impact on the scientific value of the trial.
Another example would be an investigator repeatedly failing to reduce or
stop the dose of an IMP in response to a trigger defined in the protocol (for
example, abnormal laboratory results).
 Examples of Serious Breaches Notified to MHRA
Investigator site failed to reduce or stop trial medication, in response to
certain laboratory parameters, as required by the protocol. This occurred
with several subjects over a one year period, despite identification by the
monitor of the first two occasions. Subjects were exposed to an increased
risk of thrombosis.
30-Jan-2015 GCP meets GLP @DARQA 34
30-Jan-2015 GCP meets GLP @DARQA 35
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
 Is the bioanalytical laboratory (CRO) able to:
o Identify significant deviations from the protocol?
o Identify misdosing?
• Overdosing
• Underdosing
• Wrong medication
o Identify differences in drug clearance (a subjects ability to
metabolise or excrete an investigational drug)?
o Identify sloppy conduct at a clinical site?
o Report in a timely manner?
o Report to the right parties involved?
30-Jan-2015 GCP meets GLP @DARQA 36
 Yes, e.g. in a non-placebo controlled trial with cross-over
design some subjects had normal PK profiles for treatment
1 but hardly any profile for treatment 2
 subjects did not take medication in treatment cycle 2
 clinic did not notice as e.g. no vomiting etc was reported
 Could be a compliance issue due to misconduct
30-Jan-2015 GCP meets GLP @DARQA 37
 Yes, e.g. placebo or reference drug and active treatment
mixed-up
 may not be a safety issue for subject if the dose was
approved for the trial
 Compliance issue as it demonstrates that procedures at
the clinic are prone to error
30-Jan-2015 GCP meets GLP @DARQA 38
 Yes, e.g. some or all subjects show much higher plasma
levels than expected (e.g. from sponsor info or literature or
comparison to historic data)
 may be a safety issue for the subject(s)
 Could be a compliance and safety issue as it indicates
that the study is not executed according to protocol and
subjects may have been overdosed
30-Jan-2015 GCP meets GLP @DARQA 39
 Yes, e.g. some or all subjects show much lower plasma
levels than expected (e.g. from sponsor info or literature or
comparison to historic data)
 may be a safety issue for the subject(s): undertreatment
of patients
 Could be a compliance and safety issue as it indicates
that the study is not executed according to protocol and
patients may have been underdosed
30-Jan-2015 GCP meets GLP @DARQA 40
 Yes, but may need help from a DMPK scientist (from the
sponsor)
e.g. profile differs significantly from others, no hint for
analytical problem like matrix effect
 Could be a safety issue
30-Jan-2015 GCP meets GLP @DARQA 41
 Yes, e.g. sample mislabeling, wrong collection tubes, wrong
matrix, large volume variations, strongly hemolyzed, …
 may not be a safety issue
 sloppiness/errors in sample collection and handling can
be indicative of bigger compliance issues
 Compliance issue as it demonstrates that procedures at
the clinic are prone to error
30-Jan-2015 GCP meets GLP @DARQA 42
 Not always but very often, i.e. for clinical trials were the
bioanalyst is unblinded and sample analysis is performed
while the trial is still ongoing
30-Jan-2015 GCP meets GLP @DARQA 43
 Yes, if there is a communication plan
 Maybe yes, with known contact details of key (sponsor)
people
 Likely not in cases of ‘thrown over the fence’
30-Jan-2015 GCP meets GLP @DARQA 44
30-Jan-2015 GCP meets GLP @DARQA 45
1. Some history lessons
2. Outsourcing
3. Perspective / Perception
4. GCP in the BA lab
5. Anomalous results
6. Case studies
In een multiple ascending dose study met een NCE worden plasma
monsters direct na de 1e en na de 7e dag geanalyseerd door een
CRO BA-lab. Gebaseerd op de PK (plasma spiegels) en de klinische
observaties wordt door de sponsor de beslissing genomen wat de
volgende (hogere) dosis gaat worden of dat de studie gestopt moet
worden.
Wanneer de sponsor de resultaten van de eerste (laagste) dosering
krijgt valt op dat er 1 subject is met 5-10x hogere plasma spiegels
dan de overige 5 subjects op drug.
 Hebben we een probleem?
 Wat had het BA lab (eerder) moeten doen?
 Wat moet de sponsor doen?
 Kan de volgende hogere dosering volgens plan plaatsvinden?
30-Jan-2015 GCP meets GLP @DARQA 46
Om een op tijd belangrijke beslissing te kunnen nemen in een
fase III programma is het gewenst dat de resultaten van een
zeer grote fase I dubbelblinde DDI studie halverwege de
bioanalyse pharmacokinetisch verwerkt en geëvalueerd
worden. Hiervoor wordt een derde onafhankelijk partij
gecontracteerd zodat de sponsor en de onderzoeker en
biometrie van de CRO blind kunnen blijven. Het lab stuurt de
data en randomisatielijst naar de 3e partij en de sponsor …
 Hebben we een probleem?
 Wat moet de sponsor doen?
 Wat moet het BA lab doen?
 Wat moet de 3e partij doen?
30-Jan-2015 GCP meets GLP @DARQA 47
Bij de pharmacokinetische verwerking en statische analyse
van een dubbelblinde PK studie blijken 3 subjects zeer
vreemde PK curves te laten zien. De sponsor wordt gevraagd
wat met deze subjects te doen. De bioanalyticus van de
sponsor ontdekt dat er bij deze 3 subjects zeer waarschijnlijk
de data van de QCs tussen de monster data is gekomen
waardoor ‘alles is opgeschoven’
Curve 1: QC-HI ipv t=0, QC-ME ipv t=1, QC-LO ipv t=2, t=0 ipv t=3 …
Curve 2: t=n-21 ipv t=02, t=n-11 ipv t=12, t1=n1 ipv t=22, t=02 ipv t=32 …
 Hebben we een probleem?
 Wat had het BA lab (eerder) moeten doen?
 Wat moet de sponsor doen?
30-Jan-2015 GCP meets GLP @DARQA 48
Na 3 succesvolle fase I studies wordt een bioanalyse methode
enigszins aangepast: ander merk HPLC kolom en wordt bij de
MS/MS overgegaan van API-CI naar ESI (zachtere ionisatie).
De methode wordt prachtig gevalideerd en toegepast bij studie
nummer 4. De chromatogrammen van vrijwel alle subject
samples laten onverwacht in meer of mindere mate een
schouder zien op de analyte piek.
 Hebben we een probleem?
 Wat moet de sponsor doen?
 Wat moet het BA lab doen?
30-Jan-2015 GCP meets GLP @DARQA 49
 DARQA for giving me the opportunity to present at their
meeting.
 The regulators and inspectors for stimulating us to
continuously improve our work
 Philip Timmerman (JnJ) for some of the ‘History’ slides
 Silke Lüdtke (BI) for some of the ‘Anomalous’ slides
 You, for your attention
30-Jan-2015 GCP meets GLP @DARQA 50

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GCP meets GLP in bioanalytical labs

  • 1. Peter van Amsterdam Head Bioanalytics, Abbott Healthcare Products DARQA themadag ‘When GCP meets GLP’, 30 Jan 2015, Utrecht
  • 2.  The views and conclusions presented in this slide deck are those of the author/presenter and do not necessarily reflect the representative affiliation or company's position on the subject.  Exaggeration is often chosen as a style model to emphasize the similarities or differences between various situations.  The focus is on the bioanalytical arena 30-Jan-2015 GCP meets GLP @DARQA 2
  • 3. 30-Jan-2015 GCP meets GLP @DARQA 3 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 4. 30-Jan-2015 GCP meets GLP @DARQA 4
  • 5.  1965: EEC 65/65 (reaction to Thalidomide) o No real focus on bioanalysis  1978: 21 CFR 58  1982: OECD 1 o Both are General GLP guidelines (preclinical safety) o Quality system ensure the uniformity, consistency, reliability, reproducibility, quality, and integrity pre-clinical safety tests.  Eighties (flowing over in the Nineties) o Increased focus on Bioequivalence studies (including paragraphs on bioanalytical methodology to be applied) o EU, FDA, Australia, Canada to lead  BMV workshop – (Crystal City-I) o < 1990 = lack of uniformity in industry wrt validation bioanalytical methods o Crystal City-I was first international conference with focus on Bioanalytical method validation and sample analysis o Resulted in Shah paper (Pharm Res. 1992;9:588-592). 30-Jan-2015 GCP meets GLP @DARQA 5
  • 6. 30-Jan-2015 GCP meets GLP @DARQA 6 Crystal City I Shah 2001 FDA Guidance CC-I CC-II CC-III Crystal City Conferences Conference papers Regulatory Guidance Additional white papers CC-IV (ISR) CC-IV Fast 1990 2000 2010 CC III Viswanathan CC II Shah (chrom.) Miller (LBA) DeSilva
  • 7. 30-Jan-2015 GCP meets GLP @DARQA 7 20201960 1970 1980 1965: 65/65/EEC 1979: US 58cfr21 1982: OECD GLP A B C Anvisa RDC 899 HC removes ISR 1988: Australian draft CO6: 7581c EMA draft Anvisa update Open letter to FDA & EMA GBC formed More countries or regions likely to issue Guidelines D E 1990 2000 2010 Thalidomide A. scientist adopting home designed quality systems B. scientist shopping for inspiration in other areas – peers, DIN, EPA,.. C. scientist regrouped around Shah paper D. multiple countries issuing regulations of BA included in BE guidelines E. Industry increase meeting frequency (e.g. APA, EBF, CVG) recommendation papers after (broad) internal discussions EMA final MHLW chrom MHLW LBA CFDA draft
  • 8. 30-Jan-2015 GCP meets GLP @DARQA 8 A bucket full of other adjacent regulations: 21 CFR 58 (GLP), OECD- GLP, 21 CFR 11 (CSV), ICH-S3A (TK), ICH-E6 (GCP), ICH M3 (MIST), MHRA GCLP, EMA GCLP, 21 CFR 320.29 (BE), …, …, …,
  • 9.  1963 FDA drafting the GMP concept  1964 Declaration of Helsinki  1973 New Zealand draft GLP concept  1978 FDA GLP final  1978 FDA GMP final  1981 OECD GLP  1982 MHLW GLP  1983 EPA GLP  1989 Revised EPA GLP  1989 ICH global standards for Clinical Research  1997 21 CFR 11  1997 Revised OECD GLP  1997 ICH GCP  2001 EU Clinical Trials directive  2005 EU GCP directive  2009 MHRA GCP for laboratories  2009 WHO GCLP  2012 EMA 'GCLP' reflection paper 30-Jan-2015 GCP meets GLP @DARQA 9 Hmmm…. ~1980 GLP ~2000 GCP ~2010 GCLP
  • 10.  Within Pharma, bioanalytical departments are often part of DMPK/Research. o Basically a pre-clinical (GLP) area o Science & technology driven o High attrition rate  Within CROs, bioanalytical departments are often core business. o Can cover all R to D area’s (GLP and) o Science & technology driven o Client focus, costs & timelines driven 30-Jan-2015 GCP meets GLP @DARQA 10
  • 11. 30-Jan-2015 GCP meets GLP @DARQA 11 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 12. 30-Jan-2015 GCP meets GLP @DARQA 12
  • 13. By design, e.g.:  Corporate strategy o Science in house o Operational external  Flexible workforce o Cope with peaks in workload o No redundancies in slow periods  Excess or shortage of money o R&D expenditures as % of sales Improvement of deliverables, e.g.:  Better suited then own labs o Better equipped o GxP compliant o Right location  Faster then own labs o Larger workforce o More instruments o Routine power  Specific expertise 30-Jan-2015 GCP meets GLP @DARQA 13
  • 14.  CRO selection  Oversight  Monitoring 30-Jan-2015 GCP meets GLP @DARQA 14
  • 15. 30-Jan-2015 GCP meets GLP @DARQA 15
  • 16. 30-Jan-2015 GCP meets GLP @DARQA 16
  • 17. 30-Jan-2015 GCP meets GLP @DARQA 17
  • 18. Sponsor  Clinical  QA  Stats  Bioanalytical  Operations  Trial managers  CRAs  Supplies  Contracting  Legal  Data management  Regulatory  Marketing CRO  Project manager  Recruitment  CRAs  Data management  Pharmacokinetics  Statistics  Legal  Regulatory  QA  Medical writers  Archives, TMF  30-Jan-2015 GCP meets GLP @DARQA 18
  • 19. Central Lab  Project manager  Logistics o Kits o Samples  Kit building  Safety analysis  Data basing  Reconciliation  QA  Reporting Bioanalytical Lab(s)  Study lead  QA  Management  Sample receipt  Archives 30-Jan-2015 GCP meets GLP @DARQA 19
  • 20. 30-Jan-2015 GCP meets GLP @DARQA 20 Other  Ethical Committee  Safety Review Board  Health Authorities  And  Public disclosure  Share holders  Senior management  Financial analists  Clinical sites  Investigators  Hospital staff  Recruitment  Inclusion / Exclusion  Medical history  Dosing  Observations  Sampling  Pharmacists
  • 21. 30-Jan-2015 GCP meets GLP @DARQA 21 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 22. 30-Jan-2015 GCP meets GLP @DARQA 22
  • 23. In the Bioanalytical (‘GLP’) Environment BioAnalysis Man Knows BMV Guidelines Knows (OECD) GLP Knows (a bit) CSV Knows the (relevant) SOPs Knows his science Can handle equipment Can perform validations Can run samples Can report the results 23GCP meets GLP @DARQA30-Jan-2015
  • 24. In the Research (GLP) environment BioAnalysis Man Knows bioanalysis Knows (OECD) GLP Knows a bit about DMPK Knows a bit about the study Takes care of the PK/PD samples Part of team Report appendix 24GCP meets GLP @DARQA30-Jan-2015
  • 25. In the Clinical (GCP) environment 2530-Jan-2015 GCP meets GLP @DARQA BioAnalysis Man Knows bioanalysis Knows some GCP Knows a bit about DMPK Knows a bit about the study Takes care of the PK/PD samples May be part of sub-team Report appendix / part of the reported data
  • 26.  In the BA lab, bioanalytical objectives o “You can do anything you want“ • Change method, amend something, redo an experiment, …. • (as long as you follow some SOPs and QA and management rules)  In a GLP study o “You can mostly do what you want“ • Change method, amend something, redo an experiment, BUT … • (as long as you follow the SOPs, protocol, SD input/agreement and QA and management rules)  In a GCP study o “You can hardly do what you want“ • NO to change of method, amend something, redo an experiment, UNLESS .. • (and follow the SOPs, protocol, sponsor input/agreement, patient rights, and QA and management rules, ….) 30-Jan-2015 GCP meets GLP @DARQA 26
  • 27. 30-Jan-2015 GCP meets GLP @DARQA 27 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 28. 30-Jan-2015 GCP meets GLP @DARQA 28
  • 29. 30-Jan-2015 GCP meets GLP @DARQA 29 From: Principles and Practice of ICH GLP Rebecca Luk, Pfizer (2012)
  • 30. 30-Jan-2015 GCP meets GLP @DARQA 30 EMA: EMA BMV: The validation of bioanalytical methods and the analysis of study samples for clinical trials in humans should be performed following the principles of GCP. Further can be found in the “Reflection Paper for Laboratories That Perform The Analysis Or Evaluation Of Clinical Trial Samples.” (EMA/INS/GCP/532137/2010). EMA BMV: The validation of bioanalytical methods used in non-clinical pharmaco toxicological studies that are carried out in conformity with the provisions related to Good Laboratory Practice should be performed following the Principles of GLP. EMA BE: The bioanalytical part of bioequivalence trials should be performed in accordance with the principles of GLP. However, as human bioanalytical studies fall outside the scope of GLP, the sites conducting the studies are not required to be monitored as part of a national GLP compliance programme. Note: OECD GLP Draft FDA: Pre-clinical adhere to GLP (21 CFR 58), Clinical adhere to 21 CFR 320.29 ANVISA: Not addressed MHLW: Not clearly addressed
  • 31.  Availability of the clinical protocol  Central lab between clinic and BA lab  Lab manual  Sample roster ≠ sample tube label  Data base (LIMS) requirements  Timelines  Reporting final data before issuing final report  Who to report what to (communication plan)  Patients and IC  CRFs 30-Jan-2015 GCP meets GLP @DARQA 31
  • 32. 30-Jan-2015 GCP meets GLP @DARQA 32 From: Unexpected Results in a Bioanalytical Laboratory – a Safety and Compliance Issue? Silke Luedtke, Boehringer Ingelheim (2011)
  • 33. 30-Jan-2015 GCP meets GLP @DARQA 33 From: Unexpected Results in a Bioanalytical Laboratory – a Safety and Compliance Issue? Silke Luedtke, Boehringer Ingelheim (2011)
  • 34. Excerpt from the MHRA "Guidance for the notification of serious breaches of GCP or the trial protocol", released 2006, update Jan 2013  non-compliance with GCP or the protocol If this non-compliance has a significant impact on the integrity of trial subjects in the UK or on the scientific value of the trial, this will constitute a serious breach. For example, widespread and uncontrolled use of protocol waivers affecting eligibility criteria, which leads to harm to trial subjects in the UK or which has a significant impact on the scientific value of the trial. Another example would be an investigator repeatedly failing to reduce or stop the dose of an IMP in response to a trigger defined in the protocol (for example, abnormal laboratory results).  Examples of Serious Breaches Notified to MHRA Investigator site failed to reduce or stop trial medication, in response to certain laboratory parameters, as required by the protocol. This occurred with several subjects over a one year period, despite identification by the monitor of the first two occasions. Subjects were exposed to an increased risk of thrombosis. 30-Jan-2015 GCP meets GLP @DARQA 34
  • 35. 30-Jan-2015 GCP meets GLP @DARQA 35 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 36.  Is the bioanalytical laboratory (CRO) able to: o Identify significant deviations from the protocol? o Identify misdosing? • Overdosing • Underdosing • Wrong medication o Identify differences in drug clearance (a subjects ability to metabolise or excrete an investigational drug)? o Identify sloppy conduct at a clinical site? o Report in a timely manner? o Report to the right parties involved? 30-Jan-2015 GCP meets GLP @DARQA 36
  • 37.  Yes, e.g. in a non-placebo controlled trial with cross-over design some subjects had normal PK profiles for treatment 1 but hardly any profile for treatment 2  subjects did not take medication in treatment cycle 2  clinic did not notice as e.g. no vomiting etc was reported  Could be a compliance issue due to misconduct 30-Jan-2015 GCP meets GLP @DARQA 37
  • 38.  Yes, e.g. placebo or reference drug and active treatment mixed-up  may not be a safety issue for subject if the dose was approved for the trial  Compliance issue as it demonstrates that procedures at the clinic are prone to error 30-Jan-2015 GCP meets GLP @DARQA 38
  • 39.  Yes, e.g. some or all subjects show much higher plasma levels than expected (e.g. from sponsor info or literature or comparison to historic data)  may be a safety issue for the subject(s)  Could be a compliance and safety issue as it indicates that the study is not executed according to protocol and subjects may have been overdosed 30-Jan-2015 GCP meets GLP @DARQA 39
  • 40.  Yes, e.g. some or all subjects show much lower plasma levels than expected (e.g. from sponsor info or literature or comparison to historic data)  may be a safety issue for the subject(s): undertreatment of patients  Could be a compliance and safety issue as it indicates that the study is not executed according to protocol and patients may have been underdosed 30-Jan-2015 GCP meets GLP @DARQA 40
  • 41.  Yes, but may need help from a DMPK scientist (from the sponsor) e.g. profile differs significantly from others, no hint for analytical problem like matrix effect  Could be a safety issue 30-Jan-2015 GCP meets GLP @DARQA 41
  • 42.  Yes, e.g. sample mislabeling, wrong collection tubes, wrong matrix, large volume variations, strongly hemolyzed, …  may not be a safety issue  sloppiness/errors in sample collection and handling can be indicative of bigger compliance issues  Compliance issue as it demonstrates that procedures at the clinic are prone to error 30-Jan-2015 GCP meets GLP @DARQA 42
  • 43.  Not always but very often, i.e. for clinical trials were the bioanalyst is unblinded and sample analysis is performed while the trial is still ongoing 30-Jan-2015 GCP meets GLP @DARQA 43
  • 44.  Yes, if there is a communication plan  Maybe yes, with known contact details of key (sponsor) people  Likely not in cases of ‘thrown over the fence’ 30-Jan-2015 GCP meets GLP @DARQA 44
  • 45. 30-Jan-2015 GCP meets GLP @DARQA 45 1. Some history lessons 2. Outsourcing 3. Perspective / Perception 4. GCP in the BA lab 5. Anomalous results 6. Case studies
  • 46. In een multiple ascending dose study met een NCE worden plasma monsters direct na de 1e en na de 7e dag geanalyseerd door een CRO BA-lab. Gebaseerd op de PK (plasma spiegels) en de klinische observaties wordt door de sponsor de beslissing genomen wat de volgende (hogere) dosis gaat worden of dat de studie gestopt moet worden. Wanneer de sponsor de resultaten van de eerste (laagste) dosering krijgt valt op dat er 1 subject is met 5-10x hogere plasma spiegels dan de overige 5 subjects op drug.  Hebben we een probleem?  Wat had het BA lab (eerder) moeten doen?  Wat moet de sponsor doen?  Kan de volgende hogere dosering volgens plan plaatsvinden? 30-Jan-2015 GCP meets GLP @DARQA 46
  • 47. Om een op tijd belangrijke beslissing te kunnen nemen in een fase III programma is het gewenst dat de resultaten van een zeer grote fase I dubbelblinde DDI studie halverwege de bioanalyse pharmacokinetisch verwerkt en geëvalueerd worden. Hiervoor wordt een derde onafhankelijk partij gecontracteerd zodat de sponsor en de onderzoeker en biometrie van de CRO blind kunnen blijven. Het lab stuurt de data en randomisatielijst naar de 3e partij en de sponsor …  Hebben we een probleem?  Wat moet de sponsor doen?  Wat moet het BA lab doen?  Wat moet de 3e partij doen? 30-Jan-2015 GCP meets GLP @DARQA 47
  • 48. Bij de pharmacokinetische verwerking en statische analyse van een dubbelblinde PK studie blijken 3 subjects zeer vreemde PK curves te laten zien. De sponsor wordt gevraagd wat met deze subjects te doen. De bioanalyticus van de sponsor ontdekt dat er bij deze 3 subjects zeer waarschijnlijk de data van de QCs tussen de monster data is gekomen waardoor ‘alles is opgeschoven’ Curve 1: QC-HI ipv t=0, QC-ME ipv t=1, QC-LO ipv t=2, t=0 ipv t=3 … Curve 2: t=n-21 ipv t=02, t=n-11 ipv t=12, t1=n1 ipv t=22, t=02 ipv t=32 …  Hebben we een probleem?  Wat had het BA lab (eerder) moeten doen?  Wat moet de sponsor doen? 30-Jan-2015 GCP meets GLP @DARQA 48
  • 49. Na 3 succesvolle fase I studies wordt een bioanalyse methode enigszins aangepast: ander merk HPLC kolom en wordt bij de MS/MS overgegaan van API-CI naar ESI (zachtere ionisatie). De methode wordt prachtig gevalideerd en toegepast bij studie nummer 4. De chromatogrammen van vrijwel alle subject samples laten onverwacht in meer of mindere mate een schouder zien op de analyte piek.  Hebben we een probleem?  Wat moet de sponsor doen?  Wat moet het BA lab doen? 30-Jan-2015 GCP meets GLP @DARQA 49
  • 50.  DARQA for giving me the opportunity to present at their meeting.  The regulators and inspectors for stimulating us to continuously improve our work  Philip Timmerman (JnJ) for some of the ‘History’ slides  Silke Lüdtke (BI) for some of the ‘Anomalous’ slides  You, for your attention 30-Jan-2015 GCP meets GLP @DARQA 50