1CTClinical trials2026-07-24
FDA draft guidances on Substantial Evidence, QSP/MABEL dosing and Master Protocols, comment window closes 24 July
FDA published three draft guidances in the Federal Register on 24 June: a revised Substantial Evidence of Effectiveness draft stating that programs "can rely on one scientifically rigorous adequate and well-controlled clinical investigation with confirmatory evidence to satisfy the substantial evidence of effectiveness standard"; a QSP-based MABEL dosing draft recommending a "model-based approach that considers all available data" to set first-in-human starting doses; and a Master Protocols draft covering trial designs intended "to contribute to a demonstration of safety and substantial evidence of effectiveness." The comment windows don't line up: QSP/MABEL closes 24 July, Master Protocols 24 August, Substantial Evidence 22 September.
Why it matters
The QSP/MABEL comment window is the tightest of the three and closes first, on 24 July, sponsors with an FIH dose-selection strategy built on NOAEL should get comments in now rather than treating all three drafts as one deadline. The Substantial Evidence draft has the longest runway (22 September) but the bigger strategic stakes: it reopens how many pivotal trials a program actually needs.
What to check
Assign each draft to an owner and track its own deadline separately, QSP/MABEL (24 July), Master Protocols (24 August), Substantial Evidence (22 September). File comments while the drafts are still open; this is the cheapest moment to influence the bar you'll be held to. Have your modelling group pressure-test FIH starting doses under the QSP/MABEL approach against your current NOAEL-based method, and re-model your pivotal and confirmatory-evidence plan against the Substantial Evidence draft ahead of its later close.
Source · FDA / Federal Register ↗4CTClinical trials2026-07-08
MHRA approves nerandomilast (Jascayd) for idiopathic and progressive pulmonary fibrosis, with ongoing safety review
MHRA approved nerandomilast (Jascayd) on 8 July, granting the marketing authorisation to Boehringer Ingelheim Limited International GmbH for an 18mg tablet taken twice daily. The approval notice adds a specific line PV teams should register: "as with any medicine, the MHRA will keep the safety and effectiveness of nerandomilast under close review."
Why it matters
That close-review line is boilerplate MHRA includes on new approvals, but it is worth reading literally rather than skimming past, a twice-daily oral drug in a hard, chronic respiratory indication is exactly the profile where post-market signal detection tends to surface issues that a controlled trial population didn't. Boehringer's PV team should assume the bar for a fast, well-evidenced label update is higher than usual here, not lower.
What to check
Boehringer's PV team should have signal-detection, PSUR and RMP execution live from the 8 July approval date, not phased in, the MHRA's own language commits the agency to close review, and the MAH's monitoring should match that from day one. Other sponsors filing UK approvals in similarly hard indications should read this notice as the template for what MHRA's standard post-approval framing now looks like, and build their PV resourcing plan against it before launch, not after.
Source · MHRA ↗7CTClinical trials2026-07-07
EMA starts phased (rolling) review of daraxonrasib for metastatic pancreatic cancer, a test case for reformed EU phased reviews
EMA's CHMP started a phased review of daraxonrasib for metastatic pancreatic cancer on 7 July, based on a Phase 3 trial against chemotherapy in previously-treated patients. EMA said directly that "the review of daraxonrasib will serve as an example for some of the provisions of the reformed EU pharmaceutical legislation which is expected to strengthen the use of phased reviews", this isn't a routine rolling review, EMA named it a test case for itself.
Why it matters
EMA choosing to publicly flag one specific review as its example case means the daraxonrasib assessment will get more scrutiny of its process, not just its outcome, regulatory teams building a case for phased review on their own high-unmet-need asset should watch how EMA sequences the modules here, since that sequencing is what the reformed legislation's guidance will likely draw from.
What to check
If you're planning an EU submission for a high-unmet-need medicine, track how EMA sequences the daraxonrasib review specifically, module cadence, what triggers each phase, what CHMP asks for between modules, since EMA has said this case will inform how the reformed legislation's phased-review provisions get applied. Build your own dossier-sequencing capability now so you can deliver assessment-ready modules on a planned cadence rather than assembling one final package.
Source · EMA ↗8CTClinical trials2026-07-07
Saol Therapeutics resubmits NDA for SL1009 (sodium dichloroacetate) in pyruvate dehydrogenase complex deficiency after August 2025 Complete Response Letter
Saol Therapeutics resubmitted its NDA for SL1009 on 7 July, eleven months after an August 2025 Complete Response Letter that, per the company, "did not identify concerns related to safety or manufacturing, but requested additional evidence to support approval." The resubmission followed a Type A meeting in December and a Type C meeting in March, at which FDA "provided guidance recommending additional survival analyses to support the application", analyses Saol ran on data it already had, including two Phase 3 studies and long-term open-label extension data, rather than through a new trial.
Why it matters
The detail worth registering is what the CRL didn't say: no safety or manufacturing concerns, per Saol's own characterization. That narrowed the problem to an evidence-presentation question FDA was willing to resolve through additional analysis of an existing dataset, which is a meaningfully different, and faster, recovery path than a CRL citing safety or CMC deficiencies would allow. CT and regulatory teams facing a CRL on a rare-disease program should push for that same distinction early in their Type A meeting.
What to check
If you receive a CRL on a rare-disease program, get the Type A meeting on the calendar promptly and ask FDA directly whether the deficiency is evidentiary or a safety/manufacturing finding, Saol's sequence shows an evidentiary-only CRL can be resolved through a Type C meeting on statistical approach (survival endpoints, estimands, open-label extension handling) rather than a new trial. Before resubmitting on re-analysis, confirm your legacy trial data's traceability can withstand another round of review, since re-analysis puts the original dataset back under scrutiny.
Source · Saol Therapeutics / FDA ↗