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8.3 Considerations for Periodic Testing 定期检查要考虑的问题 8.4 Control of Degradation Products 8.5 Lifecycle Management 8.6 Considerations for 降解产物的控制 生命周期管理 Clinical 临床研发要考虑的问题 Development 9. DOCUMENTATION 9.1 Clinical Trial Applications 文件记录 临床试验应用 9.2 Common Technical Document (Marketing 通用技术文件（上市申报） Application) NOTES GLOSSARY REFERENCES APPENDICES 注解 术语 参考文献 附录 文案大全
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ASSESSMENT AND CONTROL OF DNA REACTIVE (MUTAGENIC) IMPURITIES
IN PHARMACEUTICALS TO LIMIT POTENTIALCARCINOGENIC RISK 为限制潜在致癌风险而对药物中DNA活性（诱变性）杂质进行的评估和控制 1. INTRODUCTION 概述
The synthesis of drug substances involves the use of reactive chemicals, reagents, solvents, catalysts, and other processing aids. As a result of chemical synthesis or subsequent degradation, impurities reside in all drug substances and associated drug products. While ICH Q3A(R2): Impurities in New Drug Substances and Q3B(R2): Impurities in New Drug Products (Ref. 1, 2) provides guidance for qualification and control for the majority of the impurities, limited guidance is provided for those impurities that are DNA reactive. The purpose of this guideline is to provide a practical framework that is applicable to the identification, categorization, qualification, and control of these mutagenic impurities to limit potential carcinogenic risk. This guideline is intended to complement ICH Q3A(R2), Q3B(R2) (Note 1), and ICH M3(R2): Nonclinical Safety Studies for the Conduct of Human Clinical Trials and Marketing Authorizations for Pharmaceuticals (Ref. 3). 原料药合成牵涉到使用活性化学物质、试剂、溶剂、催化剂和其它工艺助剂，导致在所有原料药及其制剂中会残留有化学合成或其降解产物、杂质。在ICH Q3A(R2)新原料药中的杂质和Q3B(R2)新制剂中的杂质（参考文献1、2）中提供了关于主要杂质定性和控制的指南，对DNA活性杂质给出了有限的指南。本指南的目的是提供实用框架，以应用于这些诱变杂质的鉴别、分类、定性和控制，对潜在致癌风险进行控制。本指南意在补充ICH Q3A(R2)、Q3B(R2)（注解1）和ICH M3(R2)药物人用临床试验和上市许可中的非临床安全性研究（参考文献3）。 This guideline emphasizes considerations of both safety and quality risk management in establishing levels of mutagenic impurities that are expected to pose negligible carcinogenic risk. It outlines recommendations for assessment and control of mutagenic impurities that reside or are reasonably expected to reside in final drug substance or product, taking into consideration the intended conditions of human use.
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本指南强调在建立诱变性杂质水平时考虑安全性和质量风险管理两方面，该水平应该仅表现出可忽略不计的致癌风险。指南在考虑药物在人用时的条件下，给出了对原料药或制剂中残留或可能残留的诱变性杂质评估和控制的建议。 2. SCOPE OF GUIDELINE 指南适用范围
This document is intended to provide guidance for new drug substances and new drug products during their clinical development and subsequent applications for marketing. It also applies to post-approval submissions of marketed products, and to new marketing applications for products with a drug substance that is present in a previously approved product, in both cases only where:
本指南意在给研发期间和上市申报期间的新原料药和新制剂提供指南。它也适用于已上市药物的批准后申报，以及之前已批准上市的制剂中的同样原料药生产的另一制剂新上市申报。当上述申报符合以下情形时：
— Changes to the drug substance synthesis result in new impurities
or increased acceptance criteria for existing impurities;
— 原料药合成变更，导致产生新杂质或已有杂质可接受标准增加
— Changes in the formulation, composition or manufacturing process
result in new degradation products or increased acceptance criteria for existing degradation products;
— 配方变更、组分变更或生产工艺变更，导致产生新的降解产物或已有降解
产物可接受标准增加
— Changes in indication or dosing regimen are made which
significantly affect the acceptable cancer risk level.
— 指征变更或给药方案变更，导致可接受癌症风险水平受到重大影响 Assessment of the mutagenic potential of impurities as described in this guideline is not intended for the following types of drug substances and drug products: biological/biotechnological, peptide, oligonucleotide, radiopharmaceutical,
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fermentation products, herbal products, and crude products of animal or plant origin.
本指南中描述的杂质潜在诱变性评估不适用于以下类型的原料药和制剂：生物/生物技术制品、肽类、寡核苷酸、放射药物、发酵产品、草药制品和动物或植物来源的粗品。 This guideline does not apply to drug substances and drug products intended for advanced cancer indications as defined in the scope of ICH S9 (Ref. 4). Additionally, there may be some cases where a drug substance intended for other indications is itself genotoxic at therapeutic concentrations and may be expected to be associated with an increased cancer risk. Exposure to a mutagenic impurity in these cases would not significantly add to the cancer risk of the drug substance. Therefore, impurities could be controlled at acceptable levels for non-mutagenic impurities. 本指南不适用于ICH S9（参考文献4）中所定义的晚期癌症指征用原料药和制剂。另外，可能会有些情况下，制剂用于其它治疗，而其自己本身在治疗浓度下就具有基因毒性，已知其会使癌症风险增加。这些情况下，暴露在具有诱变性的杂质下，不会显著增加原料药的癌症风险。因此，杂质可以被控制在非诱变性杂质的可接受水平。
Assessment of the mutagenic potential of impurities as described in this guideline is not intended for excipients used in existing marketed products, flavoring agents, colorants, and perfumes. Application of this guideline to leachables associated with drug product packaging is not intended, but the safety risk assessment principles outlined in this guideline for limiting potential carcinogenic risk can be used if warranted. The safety risk assessment principles of this guideline can be used if warranted for impurities in excipients that are used for the first time in a drug product and are chemically synthesized.
在本指南中所描述的对杂质潜在诱变性的评估不适用于已上市药物中使用的辅料、调味剂、着色剂和香料。本指南不适用于药物包材中的可浸出杂质，但指南中限制潜在致癌风险的安全风险评估原则在一定情况下是可以使用的。如果辅料是首次用于药物中，且是化学合成的，则本指南的安全风险评估原则可以适用于辅料中的杂质。 3. GENERAL PRINCIPLES 通用原则
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The focus of this guideline is on DNA reactive substances that have a potential to directly cause DNA damage when present at low levels leading to mutations and therefore, potentially causing cancer. This type of mutagenic carcinogen is usually detected in a bacterial reverse mutation (mutagenicity) assay. Other types of genotoxicants that are non-mutagenic typically have threshold mechanisms and usually do not pose carcinogenic risk in humans at the level ordinarily present as impurities. Therefore to limit a possible human cancer risk associated with the exposure to potentially mutagenic impurities, the bacterial mutagenicity assay is used to assess the mutagenic potential and the need for controls. Structure-based assessments are useful for predicting bacterial mutagenicity outcomes based upon the established knowledge. There are a variety of approaches to conduct this evaluation including a review of the available literature, and/or computational toxicology assessment.
本指南关注的焦点为可与DNA反应的物质，这些物质在较低水平时也可能会直接引起DNA损伤，导致DNA诱变，从而引发癌症。这类诱变性致癌作用常被细菌逆式突变（诱变）含量检出。其它类型不具有典型诱变性的基因毒性物质则有阈值进行控制，一般以常规水平杂质出现时对人类不具有致癌风险。因此，为了限制暴露于潜在诱变性杂质可能带来的人类癌症风险，我们使用细菌诱变含量来评估诱变可能性及控制的必要性。基于结构进行的评估有助于根据已有的知识来预测细菌诱变性测试结果。有很多方法可以用于实施该评估，包括对可获得的文献资料进行审核，和/或采用计算方式进行毒性评估。
A Threshold of Toxicological Concern (TTC) concept was developed to define an acceptable intake for any unstudied chemical that poses a negligible risk of carcinogenicity or other toxic effects. The methods upon which the TTC is based are generally considered to be very conservative since they involve a simple linear extrapolation from the dose giving a 50% tumor incidence (TD50) to a 1 in 106incidence, using TD50 data for the most sensitive species and most sensitive site of tumor induction. For application of a TTC in the assessment of acceptable limits of mutagenic impurities in drug substances and drug products, a value of 1.5 μg/day corresponding to a theoretical 10-5 excess lifetime risk of cancer, can be
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ICHM7(step4)基因毒性杂质评估和控制中英
