Innovation in Clinical Trial Design and Product Promotion: Evolving the Patient Perspective With Regulatory and Technological Advances.

Clinical trials are evolving to innovative designs and capabilities. Clinical outcomes from pivotal trials are the backbone of good marketing practices. Novel study designs included in product labels and the uptick of innovative technology foreshadow a crescendo of patient empowerment not only in clinical trials, but also in the real-world setting. The following review will initially explore the dynamic relationship between clinical development and commercial teams. How clinical development is evolving to increase patient-focused drug development and regulatory review will then be reviewed via recent legislation; the 21st Century Cures Act is one glimpse at innovative inclusion of the patient perspective via patient experience data, related information, and real-world evidence. Trends in direct-to-consumer technology such as digital health will be also appraised. Predictions are made on how the aforementioned advances may create challenges and opportunities to promotional practices, including crosscollaboration of marketing teams and planning for the next level of patient empowerment. Finally, a hypothetical scenario is provided to illustrate marketing/commercial dynamics when planning for and promoting data from an innovative trial design with real-world evidence.

Innovation in Clinical Trial Design and Product Promotion: Evolving the Patient Perspective With Regulatory and Technological Advances.

Clinical trials are evolving to innovative designs and capabilities. Clinical outcomes from pivotal trials are the backbone of good marketing practices. Novel study designs included in product labels and the uptick of innovative technology foreshadow a crescendo of patient empowerment not only in clinical trials, but also in the real-world setting. The following review will initially explore the dynamic relationship between clinical development and commercial teams. How clinical development is evolving to increase patient-focused drug development and regulatory review will then be reviewed via recent legislation; the 21st Century Cures Act is one glimpse at innovative inclusion of the patient perspective via patient experience data, related information, and real-world evidence. Trends in direct-to-consumer technology such as digital health will be also appraised. Predictions are made on how the aforementioned advances may create challenges and opportunities to promotional practices, including cross-collaboration of marketing teams and planning for the next level of patient empowerment. Finally, a hypothetical scenario is provided to illustrate marketing/commercial dynamics when planning for and promoting data from an innovative trial design with real-world evidence.

Guanosine nucleotides inhibit different syndromes of PTHrP excess caused by human cancers in vivo.

There are two well-described syndromes caused by tumor production of parathyroid hormone-related peptide (PTHrP), namely osteolytic bone disease associated with breast cancer and humoral hypercalcemia of malignancy (HHM) that occurs with or without bone metastasis. Both syndromes have been shown experimentally to be inhibited by neutralizing antibodies to PTHrP. In a search for small-molecule inhibitors of PTHrP production or effects, we have identified guanine-nucleotide analogs as compounds that inhibit PTHrP expression by human tumor cells associated with these syndromes. We show in nude athymic murine models that these compounds reduce PTHrP-mediated osteolytic lesions associated with metastatic human breast-cancer cells as well as the degree of hypercalcemia caused by excessive PTHrP production by a squamous-cell carcinoma of the lung. These results suggest that the PTHrP gene promoter may be a suitable target for treating the skeletal effects of malignancy.