Guidance for Industry
Content and Format of
Investigational New Drug
Applications (INDs) for Phase 1
Studies of Drugs, Including
Well-Characterized, Therapeutic,
Biotechnology-derived Products
Center for Drug Evaluation and Research (CDER)
Center for Biologics Evaluation and Research (CBER)
November 1995
CLIN 2 TABLE OF CONTENTS
I. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
II. CURRENT REQUIREMENTS AND PRACTICES . . . . . . . . . . . . . . . . . . . . . . 2
III. CLARIFICATIONS OF PRESENT IND REGULATIONS . . . . . . . . . . . . . . . . . 2
A. Cover Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
B. Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
C. Introductory Statement and General Investigational Plan . . . . . . . . . . . 3
D. Investigator's Brochure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
E. Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
F. Chemistry, Manufacturing, and Control Information . . . . . . . . . . . . . . . . 4
G. Pharmacology and Toxicology Information . . . . . . . . . . . . . . . . . . . . . . 10
H. Previous Human Experience with the Investigational Drug . . . . . . . . . 14
I. 21 CFR 312.23(a)(10), (11) and (b), (c), (d), and (e) . . . . . . . . . . . . . . 14
IV. REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
i GUIDANCE FOR INDUSTRY 1
CONTENT AND FORMAT 
OF INVESTIGATIONAL NEW DRUG APPLICATIONS (INDs) 
FOR PHASE 1 STUDIES OF DRUGS, INCLUDING WELL-
CHARACTERIZED, THERAPEUTIC, BIOTECHNOLOGY-DERIVED 
PRODUCTS
I. INTRODUCTION
With FDA's recent successes in meeting the Prescription Drug User Fee Act of
1992 (PDUFA) review action performance goals, and the resulting significant
declines in mean and median time from submission of a marketing application to
approval for marketing, attention has turned to increasing the efficiency of other
components of the drug development process without sacrificing the long-
standing safety and efficacy standards Americans expect their drug products to
meet.  One part of IND regulation of particular interest - under active discussion
for more than two years and the subject of various degrees of attention since the
McMahon Committee - is the regulation of the initial testing of drugs in humans
(i.e., Phase 1 trials).  
This guidance clarifies requirements for data and data presentation in 21 CFR
312.22 and 312.23 related to the initial entry into human studies in the United
States of an investigational drug, including well-characterized, therapeutic,
biotechnology-derived products 2.  Present regulations allow a great deal of
          1This guidance has been prepared by the Center for Drug Evaluation and
Research (CDER) and the Center for Biologics Evaluation and Research (CBER) at
the Food and Drug Administration.  Although this guidance does not create or confer
any rights for or on any person and does not operate to bind FDA or the industry, it
does represent the agencys current thinking on data requirement issues related to the
initial entry of an unapproved drug into human studies in the United States.  For
additional copies of this guidance, contact the Consumer Affairs Branch (formerly the
Executive Secretariat Staff), HFD-210, CDER, FDA, 5600 Fishers Lane, Rockville, MD
20857 (Phone: 301-594-1012) or the Congressional and Consumer Affairs Branch
(HFM-12), CBER, FDA, 1401 Rockville Pike (STE 200N), Rockville, MD 20852-1448
(Phone:  301-594-1800 or 800-835-4709).  An electronic version of this guidance is
also available via Internet by connecting to the CDER file transfer protocol (FTP)
server (CDVS2.CDER.FDA.GOV).
     2As used throughout this guidance, the term "drugs" includes well-characterized,
therapeutic, biotechnology-derived products. flexibility in the amount and depth of various data to be submitted in an IND
depending in large part on the phase of investigation and the specific human
testing being proposed.  In some cases, the extent of that flexibility has not been
appreciated.  FDA believes clarifications of many of these requirements will help
expedite entry of new drugs into clinical testing by increasing transparency and
reducing ambiguity and inconsistencies, and by reducing the amount of
information submitted, while providing FDA with the data it needs to assess the
safety of the proposed Phase 1 study.  If the guidance specified in this
document is followed, IND submissions for Phase 1 studies should usually not
be larger than two to three, three inch, 3-ring binders ("jackets").
  
The most significant clarifications are: 1) the explicit willingness to accept  an
integrated summary report of toxicology findings based upon the unaudited draft
toxicologic reports of completed animal studies as initial support for human
studies, and 2) specific manufacturing data appropriate for a Phase 1
investigation.   For products not covered by this Guidance, other FDA guidance
documents should be consulted.  In addition, the Center responsible for the
product may be contacted for guidance.
Because of the manufacturing and toxicologic differences between well-
characterized, therapeutic, biotechnology-derived products and other biologic
products, this Guidance only applies to drugs and well-characterized,
therapeutic, biotechnology-derived products.  For products not covered by this
Guidance, the Center responsible for the product should be contacted for
guidance.
This guidance applies equally to both commercial and individual investigator
sponsored INDs.  
II. CURRENT REQUIREMENTS AND PRACTICES
Under current regulations, any use in the United States of a drug product not
previously authorized for marketing in the United States first requires
submission of an IND to the FDA.  Current regulations at 21 CFR 312.22 and
312.23 contain the general principles underlying the IND submission and the
general requirements for an IND's content and format. 
III. CLARIFICATIONS OF PRESENT IND REGULATIONS
An IND submission for Phase 1 studies is required by regulation to contain the
sections enumerated below.  Clarifications are described when appropriate
beneath each section heading.
2 A. Cover Sheet (FDA Form-1571) [21 CFR 312.23(a)(1)]:
No clarifications.
B. Table of Contents [21 CFR 312.23(a)(2)]:
No clarifications.
C. Introductory Statement and General Investigational Plan [21 CFR
312.23(a)(3)]:
Regulations repeatedly describe this section as brief.  Ordinarily, two to
three pages should suffice.  The information requested here is intended
to place the developmental plan for the drug into perspective and to help
FDA anticipate sponsor needs.  Often a sponsor in the first human
studies is simply attempting to determine early pharmacokinetic and
perhaps early pharmacodynamic properties of the drug.  Detailed
developmental plans are contingent on the outcomes of such studies.  In
that case, sponsors should simply state this in this section and not
attempt to develop and write detailed developmental plans that will, in all
likelihood, change considerably should the product proceed to further
development.  
D. Investigator's Brochure [21 CFR 312.23(a)(5)]:
Under the auspices of the International Conference on Harmonization
(ICH), a document that provides general guidance on the Investigator's
Brochure has been developed and will soon be published in the  Federal
Register (Good Clinical Practice: Guideline for the Investigator's
Brochure).  Sponsors are referred to this document for further information
on recommended elements of an Investigator's Brochure.
E. Protocols [21 CFR 312.23(a)(6)]:
The regulation requires submission of a copy of the protocol for the
conduct of each proposed clinical trial.  Sponsors are reminded that the
regulations were changed in 1987 specifically to allow Phase 1 study
protocols to be less detailed and more flexible than protocols for Phase 2
or 3 studies.  This change recognized that these protocols are part of an
early learning process and should be adaptable as information is
obtained, and that the principal concern at this stage of development is
that the study be conducted safely.  The regulations state that Phase 1
protocols should be directed primarily at providing  an outline  of the
3 investigation:  an estimate of the number of subjects to be included; a
description of safety exclusions; and a description of the dosing plan,
including duration, dose, or method to be used in determining dose.  In
addition, such protocols should specify in detail  only those elements of
the study that are critical to subject safety, such as:  1) necessary
monitoring of vital signs and blood chemistries and 2) toxicity-based
stopping or dose adjustment rules.  In addition, the regulations state that
modifications of the experimental design of Phase 1 studies that do not
affect critical safety assessments are required to be reported to FDA
only in the IND annual report.  
F. Chemistry, Manufacturing, and Control Information [21 CFR
312.23(a)(7)]:
The regulations at 312.23(a)(7)(i) emphasize the graded nature of
manufacturing and controls information.  Although in each phase of the
investigation sufficient information should be submitted to assure the
proper identification, quality, purity, and strength of the investigational
drug, the amount of information needed to make that assurance will vary
with the phase of the investigation, the proposed duration of the
investigation, the dosage form, and the amount of information otherwise
available.  For example, although stability data are required in all phases
of the IND to demonstrate that the new drug substance and drug product
are within acceptable chemical and physical limits for the planned
duration of the proposed clinical investigation, if very short-term tests are
proposed, the supporting stability data can be correspondingly very
limited.  
It is recognized that modifications to the method of preparation of the new
drug substance and dosage form, and even changes in the dosage form
itself, are likely as the investigation progresses. The emphasis in an initial
Phase 1 CMC submission should, therefore, generally be placed on
providing information that will allow evaluation of the safety of subjects in
the proposed study.  The identification of a safety concern or insufficient
data to make an evaluation of safety is the only basis for a clinical hold
based on the CMC section.
Reasons for concern may include, for example:  1) a product made with
unknown or impure components; 2) a product possessing chemical
structures of known or highly likely toxicity; 3) a product that cannot
remain chemically stable throughout the testing program proposed; or 4)
a product with an impurity profile indicative of a potential health hazard or
an impurity profile insufficiently defined to assess a potential health
4 hazard; or 5) a poorly characterized master or working cell bank.
In addition, for pre-clinical studies to be useful in assuring the safety of
human studies, sponsors should be able to relate the drug product being
proposed for use in a clinical study to the drug product used in the animal
toxicology studies that support the safety of the proposed human study.
The information discussed in the following numbered paragraphs should
usually suffice for a meaningful review of the manufacturing procedures
for drug products used in Phase 1 clinical studies.  Additional information
should ordinarily be submitted for review of the larger-scale
manufacturing procedures used to produce drug products for Phase 2 or
Phase 3 clinical trials or as part of the manufacturing section of a
marketing application.  Any questions sponsors have about potential
large scale IND clinical trials or potential marketing application
manufacturing requirements or specifications should be directed to the
appropriate division in the CDER Office of New Drug Chemistry, or the
appropriate CBER division with responsibility for the product, for
clarification and discussion.  As clinical development of a drug product
proceeds, sponsors should discuss the manufacturing data that will be
needed to support the safe use of their products in Phase 2 and 3 trials
with the appropriate division in the CDER Office of New Drug Chemistry,
or the appropriate CBER division with responsibility for the product. 
1. Chemistry and Manufacturing Introduction:
At the beginning of this section, the sponsor should state whether
it believes:  1) the chemistry of either the drug substance or the
drug product, or 2) the manufacturing of either the drug substance
or the drug product, presents any signals of potential human risk. 
If so, these signals of potential risks should be discussed, and the
steps proposed to monitor for such risk(s) should be described, or
the reason(s) why the  signal(s) should be dismissed should be
discussed. 
In addition, sponsors should describe any chemistry and
manufacturing differences between the drug product proposed for
clinical use and the drug product used in the animal toxicology
trials that formed the basis for the sponsor's conclusion that it was
safe to proceed with the proposed clinical study.  How these
differences might affect the safety profile of the drug product
should be discussed.  If there are no differences in the products,
that should be stated.
5 2. Drug Substance [312.23 (a)(7)(iv)(a)]:
Sponsors are reminded that, under present regulations, references
to the current edition of the USP-NF may be used to satisfy some
of the requirements, when applicable.  
Information on the drug substance should be submitted in a
summary report containing the following items.
a. A description of the drug substance, including its
physical, chemical, or biological characteristics:
A brief description of the drug substance and some
evidence to support its proposed chemical structure should
be submitted.  It is understood that the amount of structure
information will be  limited in the early stage of drug
development.
b. The name and address of its manufacturer:  
The full street address of the manufacturer of the clinical
trial drug substance should be submitted.
c. The general method of preparation of the drug
substance:
  
A brief description of the manufacturing process, including a
list of the reagents, solvents, and catalysts used, should be
submitted.  A detailed flow diagram is suggested as the
usual, most effective,  presentation of this information. 
More information may be needed to assess the safety of
biotechnology-derived drugs or drugs extracted from human
or animal sources.
d. The acceptable limits and analytical methods used to
assure the identity, strength, quality, and purity of
the drug substance:  
A brief description of the test methods used should be
submitted.  Proposed acceptable limits supported by simple
analytical data, (e.g., IR spectrum to prove the identity, and
HPLC chromatograms to support the purity level and
impurities profile) of the clinical trials material should be
6 provided.  Submission of a copy of the certificate of analysis
is also suggested.  The specific methods will depend on the
source and type of drug substance ( e.g., animal source,
plant extract, radiopharmaceutic, other biotechnology-
derived products).  Validation data and established
specifications ordinarily need not be submitted at the initial
stage of drug development.  However, for some well-
characterized, therapeutic biotechnology-derived products,
preliminary specifications and additional validation data may
be needed in certain circumstances to ensure safety in
Phase 1. 
e. Information to support the stability of the drug
substance during the toxicologic studies and the
proposed clinical study(ies):
A brief description of the stability study and the test methods
used to monitor the stability of the drug substance should be
submitted.  Preliminary tabular data based on
representative material may be submitted.   Neither detailed
stability data nor the stability protocol should be submitted.
3. Drug Product [21 CFR 312.23 (a)(7)(iv)(b)]:
Sponsors are reminded that, under present regulations, references
to the current edition of the USP-NF may be used to satisfy some
of these requirements, when applicable.
Information on the drug product should be submitted in a summary
report containing the following items:
a. A list of all components, which may include
reasonable alternatives for inactive compounds, used
in the manufacture of the investigational drug
product, including both those components intended
to appear in the drug product and those which may
not appear, but which are used in the manufacturing
process:
A list of usually no more than one or two pages of written
information should be submitted.  The quality ( e.g., NF,
ACS) of the inactive ingredients should be cited.  For novel
excipients, additional manufacturing information may be
7 necessary.
b. Where applicable, the quantitative composition of the
investigational new drug product, including any
reasonable variations that may be expected during
the investigational stage:
A brief summary of the composition of the investigational
new drug product should be submitted.  In most cases,
information on component ranges is not necessary.  
c. The name and address of the drug product
manufacturer:   
The full street address(es) of the manufacturer(s) of the
clinical trial drug product should be submitted.
d. A brief, general description of the method of
manufacturing and packaging procedures as
appropriate for the product:
A diagrammatic presentation and a brief written description
of the manufacturing process should be submitted, including
sterilization process for sterile products.   Flow diagrams are
suggested as the usual, most effective, presentations of this
information.
e. The acceptable limits and analytical methods used to
assure the identity, strength, quality, and purity of
the drug product:
A brief description of the proposed acceptable limits and the
test methods used should be submitted.  Tests that should
be submitted will vary according to the dosage form.  For
example, for sterile products, sterility and non-pyrogenicity
tests should be submitted.  Submission of a copy of the
certificate of analysis of the clinical batch is also suggested. 
Validation data and established specifications need not be
submitted at the initial stage of drug development.  For well-
characterized, therapeutic, biotechnology-derived products,
adeaute assessment of bioactivity and preliminary
specifications should be available.
8 f. Information to support the stability of the drug
substance during the toxicologic studies and the
proposed clinical study(ies):
A brief description of the stability study and the test methods
used to monitor the stability of the drug product packaged in
the proposed container/closure system and storage
conditions should be submitted.  Preliminary tabular data
based on representative material may be submitted. 
Neither detailed stability data nor the stability protocol
should be submitted.  
4. A brief general description of the composition,
manufacture, and control of any placebo to be used in the
proposed clinical trial(s) [21 CFR 312.23(a)(7)(iv)(c)]:
Diagrammatic, tabular, and brief written information should be
submitted.  
5. A copy of all labels and labeling to be provided to each
investigator [21 CFR 312.23(a)(7)(iv)(d)]:
A mock-up or printed representation of the proposed labeling that
will be provided to investigator(s) in the proposed clinical trial
should be submitted.  Investigational labels must carry a "caution"
statement as required by 21 CFR 312.6(a).  That statement reads:
"Caution: New Drug - Limited by Federal (or United States) law to
investigational use." 
6. A claim for categorical exclusion from or submission of an
environmental assessment [21 CFR 312.23(a)(7)(iv)(e)]:
FDA believes the great majority of products should qualify for a
categorical exclusion.  Sponsors who believe their investigational
product meets the exclusion categories under 21 CFR 25.24
should submit a statement certifying that their product meets the
exclusion requirements and requesting a categorical exclusion on
that basis.  (For INDs submitted to CDER, see  Guidance for
Industry for the Submission of Environmental Assessments for
Human Drug Applications and Supplements , November, 1995.)
9 G. Pharmacology and Toxicology Information [21 CFR 312.23(a)(8)]:
[The following pharmacology and toxicology guidance is applicable to all
phases of IND development of products covered by this guidance.]
1. Pharmacology and Drug Distribution [21 CFR
312.23(a)(8)(i)]:
This section should contain, if known:  1) a description of the
pharmacologic effects and mechanism(s) of actions of the drug in
animals, and 2) information on the absorption, distribution,
metabolism, and excretions of the drug.  The regulations do not
further describe the presentation of these data, in contrast to the
more detailed description of how to submit toxicologic data.  A
summary report, without individual animal records or individual
study results, usually suffices.  In most circumstances, five pages
or less should suffice for this summary.  If this information is not
known, it should simply be so stated.  
To the extent that such studies may be important to address safety
issues, or to assist in evaluation of toxicology data, they may be
necessary; however, lack of this potential effectiveness information
should not generally be a reason for a Phase 1 IND to be placed
on clinical hold. 
2. Toxicology:  Integrated Summary [21 CFR
312.23(a)(8)(ii)(a)]
Present regulations require an integrated summary of the
toxicologic effects of the drug in animals and  in vitro.  The
particular studies needed depend on the nature of the drug and the
phase of human investigation.  When species specificity,
immunogenicity, or other considerations appear to make many or
all toxicological models irrelevant, sponsors are encouraged to
contact the agency to discuss toxicological testing.
The regulations are not specific as to the nature of the report of
toxicology data needed in an IND submission and the nature of the
study reports upon which the report submitted to the IND is based. 
The regulations are silent on whether the submitted material
should be based on:  1) "final fully quality-assured" individual study
reports, or  2) earlier, unaudited draft toxicologic  reports of the
completed study(ies).  Most sponsors have concluded that a
10 submission based on final fully quality-assured individual study
reports is required, and a substantial delay in submission of an
IND for several  months is often encountered to complete such
final fully quality-assured individual reports from the time the
unaudited draft toxicologic reports of the completed studies are
prepared.
Moreover, although the regulation does not specifically require
individual toxicology study reports to be submitted, referring only to
an integrated summary of the toxicologic findings, the requirement
at 21 CFR 312.23(a)(8)(ii)(b) for a full tabulation of data from each
study suitable for detailed review has led most sponsors to provide
detailed reports of each study.  
Although the GLP and quality assurance processes and principles
are critical for the maintenance of a toxicology study system that is
valid and credible, it is unusual, as far as FDA is aware, for
findings in the unaudited draft toxicologic report of the completed
studies to change during the production of the "final," quality-
assured individual study reports in ways important to determining
whether use in humans is safe.
 
Therefore, if final, fully quality-assured individual study reports are
not available at the time of IND submission, an integrated
summary report of toxicologic findings based on the unaudited
draft toxicologic reports of the completed animal studies may be
submitted.   This integrated summary report should represent the
sponsor's evaluation of the animal studies that formed the basis for
the sponsor's decision that the proposed human studies are safe. 
It is expected that the unaudited draft reports that formed the basis
of this decision might undergo minor modifications during final
review and quality assurance auditing.  Full toxicology department
individual study reports should be available to FDA, upon request,
and individual study reports should be available to FDA, upon
request, as final, fully quality-assured documents within 120 days
of the start of the human study for which the animal study formed
part of the safety conclusion basis.   These final reports should
contain in the introduction any changes from those reported in the
integrated summary.  If there are no changes, that should be so
stated clearly at the beginning of the final, fully quality-assured
report.
If the integrated summary is based upon unaudited draft reports,
11 sponsors should submit an update to their integrated summary by
120 days after the start of the human study(ies) identifying any
differences found in the preparation of the final fully quality-
assured study reports and the information submitted in the initial
integrated summary.  If there were no differences found, that
should be stated in the integrated summary update.
.
In addition, any new finding discovered during the preparation of
the final, fully quality-assured individual study reports that could
affect subject safety must be reported to FDA under 21 CFR
312.32. 
Usually, 10 to 15 pages of text with additional tables (as needed)
should suffice for the integrated summary.  It should represent the
sponsor's perspective on the completed animal studies at the time
the sponsor decided human trials were appropriate.   Use of visual
data displays (e.g., box plots, stem and leaf displays, histograms
or distributions of lab results over time) will facilitate description of
the findings of these trials.
The summary document should be accurate contemporaneously
with the IND submission (i.e., it should be updated so that if new
information or findings from the completed animal studies have
become known since the sponsor's decision that the proposed
human study is safe, such new information should also be included
in the submitted summary).
The integrated summary of the toxicologic findings of the
completed animal studies to support the safety of the proposed
human investigation should ordinarily contain the following
information:
a. A brief description of the design of the trials and any
deviations from the design in the conduct of the trials.  In
addition, the dates of the performance of the trials should be
included.  Reference to the study protocol and protocol
amendments may suffice for some of this information.
b. A systematic presentation of the findings from the animal
toxicology and toxicokinetic studies.  Those findings that an
informed and experienced expert would reasonably
consider as possible signals of human risk should be
highlighted.   The format of this part of the summary may be
12 approached from a "systems review" perspective: ( e.g.,
CNS, cardiovascular, pulmonary, gastrointestinal, renal,
hepatic, genitourinary, hematopoietic and immunologic, and
dermal).  If a product's effects on a particular body system
have not been assessed, that should be so noted.  If any
well-documented toxicological "signal" is not considered
evidence of human risk, the reason should be given.  In
addition, the sponsor should note whether these findings
are discussed in the investigator's brochure.
c. Identification and qualifications of the individual(s) who
evaluated the animal safety data and concluded that it is
reasonably safe to begin the proposed human study.  This
person(s) should sign the summary attesting that the
summary accurately reflects the animal toxicology data from
the completed studies.
d. A statement of where the animal studies were conducted
and where the records of the studies are available for
inspection, should an inspection occur.  
e. As required under 21 CFR 312.23(a)(8)(iii), a declaration
that each study subject to good laboratory practices (GLP)
regulations was performed in full compliance with GLPs or,
if the study was not conducted in compliance with those
regulations, a brief statement of the reason for the
noncompliance and the sponsor's view on how such non-
compliance might affect the interpretations of the findings.
NOTE:  The information described in paragraphs "c", "d", and "e"
may be supplied as part of the integrated summary or as part of
the full data tabulations described below.
3. Toxicology - Full Data Tabulation [21 CFR
312.23(a)(8)(ii)(b)]:
The sponsor should submit, for each animal toxicology study that
is intended to support the safety of the proposed clinical
investigation, a full tabulation of data suitable for detailed review. 
This should consist of line listings of the individual data points,
including laboratory data points, for each animal in these trials
along with summary tabulations of these data points.    To allow
interpretation of the line listings, accompanying the line listings
13 should be either:  1) a brief (usually a few pages) description ( i.e.,
a technical report or abstract including a methods description
section) of the study or 2) a copy of the study protocol and
amendments.  
4. Toxicology - GLP Certification [21 CFR 312.23(a)(8)(iii)]:
See section III.G.2.e. above.
5. Monitoring of Effects of these Clarifications:
At the end of the first two to three years of this new procedure,
FDA will assemble and examine the instances in which the early
and later animal study individual reports differed to determine if
such differences made a material difference in the safe conduct of
human trials.  Depending on the outcomes, the acceptability of this
approach to reporting toxicology studies to INDs may be re-
examined. 
H. Previous Human Experience with the Investigational Drug [21
CFR 312.23(a)(9)]:
Present regulations require this information only if there has been
previous human experience with the investigational drug.  If there has
been no previous human experience, the submission should so state.  
When there has been previous human experience, such experience may
be presented in an integrated summary report.  Individual study reports
should not be routinely submitted.
I. 21 CFR 312.23(a)(10), (11) and (b), (c), (d), and (e) :
No clarifications.
IV. REFERENCES
A. Food and Drug Administration, Center for Drug Evaluation and Research,
"IND Process and Review Procedures" (MAPP xxxx.x),  Manual of
Policies and Procedures, November, 1995.
B. International Conference on Harmonization:  Good Clinical Practice:
Guideline for the Investigator's Brochure .
14 Submitted by:
____________________________________
Murray Lumpkin, M.D.
Deputy Director for Review Management
Center for Drug Evaluation and Research
Approved by:
____________________________________
Janet Woodcock, M.D.
Director, Center for Drug Evaluation and Research
____________________________________
Kathryn Zoon, Ph.D.
Director, Center for Biologics Evaluation and Research
15