Abstract
New medicines are designed to bind to receptors or enzymes and are tested in animal cells, tissues and whole organisms in a highly scientific process. Subsequently they are often administered to human subjects with tolerability as the primary objective. The process of development is considered to be linear and consecutive and passes through the famous four phases of development (Phase Iā Phase IV). This is efficient for those projects for which the uncertainty about the development is low. There is, however, an increasing number of new prototypical compounds resulting from the increased biological knowledge with a high level of uncertainty. For these prototypical drugs development has to proceed in a much more adaptive manner, using tailor-made objectives, the development of special methodology and a cyclical rather than a linear type of project management.
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Acknowledgements
I am indebted to my close colleagues at the Centre for Human Drug Research, Leiden, The Netherlands, particularly J. van Gerven and K. Burggraaf, for their input in the ideas that form the basis for this article. M. Kenter, D. Breimer and P. van Brummelen provided constructive criticism and suggestions.
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Cohen, A. Developing drug prototypes: pharmacology replaces safety and tolerability?. Nat Rev Drug Discov 9, 856ā865 (2010). https://doi.org/10.1038/nrd3227
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DOI: https://doi.org/10.1038/nrd3227
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