New Approach Methodologies (NAMs) represent a paradigm shift in drug development and regulatory science, offering humanârelevant alternatives to traditional preclinical models. This miniâreview highlights recent advances in NAM development, validation, and regulatory application from FDA's Division of Applied Regulatory Science (DARS). We describe in silico NAMs including quantitative systems pharmacology (QSP) modeling for opioid overdose scenarios, (quantitative) structureâactivity relationship ((Q)SAR) modeling for toxicity prediction and drugâdrug interaction assessment, and multiâomics approaches for pharmacodynamic biomarker discovery. Additionally, we present in vitro NAMs including humanâinduced pluripotent stem cell (hiPSC)âderived neural networks for opioid pharmacology assessment, microphysiological systems (MPS) for pulmonary drug permeability, gastrointestinal models for intestinal transport, and standardized cardiac ion channel and hiPSCâCM MEA assays for proarrhythmia risk prediction. These case studies demonstrate how NAMs can reduce reliance on animal studies while improving translation to clinical outcomes. The NAMs described here range from exploratory research tools to approaches actively informing regulatory submissions review. The integration of in silico and in vitro NAMs into regulatory decisionâmaking frameworks represents a critical step toward more efficient, humanârelevant drug development and safety assessments.
Clinical Pharmacology and Therapeutics.
2026;120(5):1250-1254. doi: 10.1002/cpt.70472
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