Investigator-Initiated Clinical Trials
What are investigator-initiated clinical trials?
Investigator-initiated clinical trials are clinical studies sponsored and conducted by independent investigators. After the 2003 amendment to the Japanese Pharmaceutical Affairs Law (PAL), pharmaceutical and medical device manufacturers could provide investigational products to clinician investigators to conduct a clinical trial under a Clinical Trial Notification (CTN). In these investigator-initiated clinical trials, the sponsor-investigator is responsible for designing the study and preparing the protocol as well as submitting a CTN to the Pharmaceutical and Medical Devices Agency (PMDA).
Clinical Trial Grant Program
JMACCT supports investigator initiated-clinical trials conducted under a CTN through three grant schemes under the ‘Large Scale Clinical Trial Network Project.’
What kind of clinical trials do we fund?
JMACCT’s support focuses on investigator-initiated clinical trials of new, urgently needed drugs or existing drugs with new indications for which regulatory approval is not being pursued due to a lack of financial incentives.Specifically, the grant program is designed to accelerate clinical development of medical products that are:
- Widely used as standard treatment in the US or EU but not yet approved in Japan.
- Already marketed in Japan and commonly used for off-label indications.
Through funding investigator-initiated clinical trials, JMACCT contributes to delivering those critically needed drugs to patients who will benefit from them.
For a list of awarded researches, click here.
JMACCT’s Grant Schemes
If awarded, an investigator-initiated clinical trial will be funded in stages, through three grant schemes:- Clinical Trial Planning Grant
- Clinical Trial Coordination/Management Grant
- Clinical Trial Implementation Grant
Scope
- Clinical Trial Planning Grant
This grant is designed to provide support for the finalization of the trial protocol and the preparation of other essential documents including the Investigator’s Brochure, Case Report Form and Informed Consent Form. - Clinical Trial Coordination/Management Grant
This grant is designed to provide support for establishing a research team and making other necessary arrangements for the conduct of the clinical trial. Such arrangements include selecting Coordinating Investigators and clinical sites from medical institutions registered with MNCT. - Clinical Trial Implementation Grant
This grant is designed to provide support for the trial implementation. The clinical sites selected from the MNCT member institutions will execute the trial.Calls for Research Proposals
JMACCT announces calls for research proposals by presenting a list of high priority drugs and medical devices recommended by the member societies of the Japanese Association of Medical Sciences (JAMS).
The JAMS member societies make recommendations based on the following criteria:- A new product or an existing product with new indications that is in the specialized therapeutic areas of a JAMS member society.
- Prompt regulatory approval of the new product or a new indication of the product is considered desirable so that it becomes available to Japanese patients for appropriate use.
- In principle, physical, chemical, pharmaceutical, toxicological and pharmacological studies that are relevant to the stage of clinical development of the drug or the medical device must be completed or near completion, as per the Standards for the Implementation of Clinical Trials on Pharmaceutical Products (MHW Ordinance No. 28), the Japanese GCP.
External Review
All research proposals for the Clinical Trials Grant Program are assessed by external review body: Research Evaluation Committee. The Committee meets three times a year, typically in March, July and November. Based on input from the Committee, JMACCT decides which proposals are to be funded.
Insurance for Investigator-Initiated Clinical Trials
In an investigator-initiated clinical trial, the sponsor-investigator is held responsible for ensuring that adequate insurance and other necessary arrangements are in place as required by GCP.
JMACCT, in cooperation with an insurance company, developed a new insurance package for the investigator-initiated clinical trials conducted under the Large Scale Clinical Trial Network Project to provide compensation to study participants in the chance that any negative side effects are incurred as a result of study participation.
The investigators of all clinical trials funded through the JMACCT’s grant scheme are to be included in JMACCT’s insurance policy before the commencement of clinical trials. The insurance costs will be borne by JMACCT.
JMACCT-funded Research Topics
The following are the research topics awarded under JMACCT's Grant Program.
FY2010 (April 2010-March 2011)
Investigational
ProductIndication Progress lapatinib / trastuzumab breast cancer Trial protocol under development glucarpidase conditions treated with high-dose methotrexate Trial protocol under development rituximab idiopathic thrombocytopenic purpura Trial protocol under development
FY2009 (April 2009-March 2010)
Investigational
ProductIndication Progress thalidomide Crow-Fukase syndrome CTN submitted
FY2008 (April 2008-March 2009)
Investigational
ProductIndication Progress self-expanding intracranial stent system intracranial atherosclerotic disease CTN submitted
FY2007 (April 2007-March 2008)
Investigational
ProductIndication Progress rituximab childhood refractory nephrotic syndrome CTN submitted diode laser for PDT and talaporfin sodium malignant brain tumor CTN submitted H5N1 influenza vaccine H5N1 influenza in the pediatric population Notification of Amendment to Clinical Trial Protocol submitted talc malignant pleural effusions Notification of Clinical Trial Completion submitted
FY2005 (April 2005-March 2006)
Investigational
ProductIndication Progress tegafur, gimeracil and oteracil potassium esophageal neoplasm CTN submitted H5N1 influenza vaccine H5N1 influenza Approved on
19 October 2007arginine MELAS* CTN submitted imatinib mesylate and hydroxyurea adult glioblastoma Study withdrawn**
*: Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes
**: The results of a recently completed overseas clinical trial of similar design revealed insufficient efficacy of the study drug. This made it impossible to pursue approval of the study drug in Japan, and therefore, this research project was withdrawn.
FY2004 (April 2004-March 2005)
Investigational
ProductIndication Progress irinotecan hydrochloride refractory pediatric solid tumor Notification of Clinical Trial Completion submitted phenobarbital sodium IV neonatal convulsions Approved on
16 October 2008bepridil hydrochloride hydrate persistent atrial fibrillation Approved on
16 October 2008tacrolimus hydrate interstitial pneumonitis associated with polymyositis / dermatomyositis CTN submitted leuprorelin acetate spinal and bulbar muscular atrophy (SBMA) CTN submitted
FY2003 (April 2003-March 2004)
Investigational
ProductIndication Progress imatinib mesylate Sarcoma with c-kit (CD117)
or PDGFR expression
as determined by
immunohistochemical stainingStudy terminated* fentanyl citrate Adjunct to general anesthesia in neonates and children Approved on
23 August 2007argatroban Heparin-induced thrombocytopenia (HIT) Approved
on 16 July 2008
*: The preliminary results from 25 patients participated in this study showed insufficient efficacy (preliminary response rate = 5.6%: 1 of 18 evaluable patients achieved PR as of September 2006).
Consequently, the study was closed for further accrual in October 2006 and notification of clinical trial discontinuation was submitted to PMDA in March 2007.Achievements
Some of the investigator-initiated clinical trials conducted under JMACCT’s Grant Program have already led to approval of a new vaccine and new indications of existing drugs.
Investigational
ProductIndication Approval Date fentanyl citrate Adjunct to general anesthesia in neonates and children 23 August 2007 H5N1 influenza vaccine H5N1 influenza 19 October 2007 For a summary of the progress of each clinical research project, click here. (Available in Japanese only.)