Best Chemistry Practices to Support the Development of PET Drugs

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Best Chemistry Practices to Support the Development of PET Drugs June 10, 2017 8:00 16:00 Organizers and Moderators: Amy Vavere, Ph.D. Steve Zigler, Ph.D. Sponsors: Radiopharmaceutical Sciences Council Coalition for PET Drugs

Employee of Siemens-PETNET Solutions I will not discuss investigational agents, nor will I discuss indications or uses of any approved products

There are more than 150 facilities in the US that produce PET drugs Some facilities only focus on basic research Some facilities only make commercial products Many facilities are involved in production activities across the spectrum from pre-clinical studies to the production of FDA-approved products for routine clinical purposes

Traditional drug model Nationwide supply requires a relatively few number of large-scale batches Product inventory can moderate supply chain difficulties Large facilities staffed by large number of people Drug substance and product often produced separately PET drug model Nationwide supply requires a large number of small batches (1 batch = 1 vial) Product inventory not possible Small facilities with relatively small staff in a laboratory-like environment Typically not possible to isolate drug substance

Simplified View of Development Spectrum AND Discovery Preclinical Investigational Clinical Trials Commercial

PET drugs themselves are unique Short half-life affects ability to complete QC testing Ramifications for sterility testing, OOS investigations, process validation, etc. Sub-pharmacologic mass doses of the radioactive ingredient are administered in micro- to nano-molar quantities Patients typically not subjected to repeated doses Creates a unique risk profile that should inform chemistryrelated topics such as reference standards, impurities, etc.

Provide a scientific forum to share information, experiences, and best practices Help attendees understand how others deal with key chemistry practices at various stages of development and commercialization All with a focus on chemistry, manufacturing, and controls information (CMC)

Stimulate dialog and actions that lead to improved chemistry practices associated with the development and commercialization of PET drugs Where it makes sense; not meant to imply that one size fits all We need flexibility where we need flexibility We need rigor where we need rigor

$333 billion $300 million Source: US Commerce Dept Source: Personal estimate

The combined FDG market is about 25% of the 100th top-selling drug in the US (#100: Sutent by Pfizer $1.12 billion) Source: Wikipedia

PET drugs are a relatively new class of products Numerous applications and facilities for a small number of products Multiple INDs for the same investigational agent submitted by different sponsors Almost 90 ANDAs* for FDG, NaF, and ammonia More than 150 facilities Source: FDA Orange Book

Our goal is to build a bridge Between the different stages of Between different stakeholders in the development and commercialization of PET drugs

Chemists, pharmacists, scientists involved in: The development of new PET drugs Routine production and testing of PET drugs Quality assurance and regulatory affairs FDA review of applications for PET drugs

To openly participate in this scientific forum Share your experiences and ideas Help set the course for future directions

As of May 9, 2017: 10

Topics based on feedback received from various stakeholders involved in the development and manufacturing of PET drugs, including academia, industry, and the FDA We continuously need to reach out and address top issues for all stakeholders

Was it successful? Is it helpful to have furture sessions like this? Should we do it again? If so, how should it be changed to better meet your needs? Are there other avenues for us to communicate and share this information? Give us your feedback amy.vavere@stjude.org steve.zigler@petnetsolutions.com

We are in the early stages in the development and commercialization of new PET drugs many lessons learned, many more to learn Do we understand the chemistry challenges associated with the development and commercialization of PET drugs? Can we articulate these challenges to the appropriate audiences in a way that brings maximum value to the patient? Can we share ideas on the successful development and commercialization of new PET drugs?

8:00 8:30 8:30 9:00 9:00 9:30 9:30 9:45 9:45 10:15 10:15 10:45 10:45-11:30 11:30 12:30 12:30 13:00 13:00 13:30 13:30 14:00 14:00 14:15 14:15 14:45 14:45 15:15 15:15 15:45 15:45 16:00 Introduction and Overview of FDA Regulations and Guidance Documents related to PET Drug Chemistry F-18 and C-11 Chemistry Challenges Special Considerations for Tracers based on Proteins or Protein Fragments (include radiometals) Steve Zigler Siemens PETNET Peter Scott University of Michigan Serge Lyaschenko MSKCC ----- BREAK ----- ----- Field Notes #1 - Challenges behind the scenes of clinical PET tracer production Stability Studies to Support PET Drug Applications Common Deficiencies with Chemistry-Related Topics in PET Drug Applications Ashley Mishoe UCSF Danny Bingham Triad Isotopes Ravi Kasliwal CDER, FDA ----- LUNCH ----- ----- Role of USP monographs and general chapters Characterization of Active Ingredients, By-Products, Impurities, and Standards Field Notes #2 - Validation of a Quality Control method in a clinical PET tracer Steve Zigler Siemens PETNET Jeanne Link OHSU Amy Vavere St. Jude s ----- BREAK ----- ----- System suitability for Analytical Methods Transfer of Technology to Multiple Facilities - Pitfalls and Best Practices Field Notes #3 - Experience from Inspections (212 & 823) Future Directions, Moderated Discussion Mike Haka Siemens PETNET Tyler Benedum Avid Radiopharmaceuticals David Dick University of Iowa Amy Vavere & Steve Zigler