H.R. 5416 – Give Kids a Chance Act

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Updated February 8, 2026 at 7:03 AM UTC

The Give Kids a Chance Act amends the Federal Food, Drug, and Cosmetic Act to give the FDA new authority to require and oversee pediatric studies of molecularly targeted cancer drugs, including drug combinations. It aims to generate pediatric dosing, safety, and efficacy data and to inform pediatric labeling. The law also lets the FDA require limited pre‑clinical work to assess whether adult cancer drugs are relevant to children’s cancers. It applies to drug manufacturers and sponsors seeking FDA approval or investigational exemptions.

Key Provisions

Redefines “molecularly targeted pediatric cancer investigation” to cover single drugs and combinations of active ingredients for pediatric cancer studies.
Requires such investigations to produce clinically meaningful pediatric data on dosing, safety, and preliminary efficacy using age‑appropriate formulations.
Specifies that single‑drug studies must inform pediatric labeling, while combination studies must help determine the relevance of the molecular target to pediatric cancer growth.
Mandates inclusion of all pre‑clinical study results that justified launching the pediatric investigation.
Allows the FDA to require up to two pre‑clinical studies on adult cancer drugs to assess pediatric relevance before granting an investigational‑use exemption.
Extends these requirements to any relevant FDA application submitted after a three‑year period following the law’s enactment.

Legislative Activity

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2 earlier actions

HouseCommittee Latest Action

Referred to the Subcommittee on Health.

Health Subcommittee

September 30, 2021

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HouseIntro Referral

Introduced in House

September 29, 2021

HouseIntro Referral

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

September 29, 2021

HouseCommittee

Referred to the Subcommittee on Health.

Health Subcommittee

September 30, 2021

Bill Text

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Introduced in HouseIssued September 29, 2021

I

117th CONGRESS

1st Session

H. R. 5416

IN THE HOUSE OF REPRESENTATIVES

September 29, 2021

Mr. Butterfield (for himself, Mr. McCaul, and Ms. Wild) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To amend the Federal Food, Drug, and Cosmetic Act to establish additional authorities of the Food and Drug Administration regarding the conduct of pediatric investigations of molecularly targeted drugs to treat cancer, and for other purposes.

1.

Short title

This Act may be cited as the Give Kids a Chance Act.

2.

Research into pediatric uses of drugs; additional authorities of Food and Drug Administration regarding molecularly targeted cancer drugs

(a)

In general

(1)

Authority regarding investigation of combination of active ingredients

Section 505B(a)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)(3)) is amended—

(A)

by redesignating subparagraphs (B) and (C) as subparagraphs (C) and (D), respectively; and

(B)

by striking subparagraph (A) and inserting the following:

(A)

In general

For purposes of paragraph (1)(B), the investigation described in this paragraph is (as determined by the Secretary) a molecularly targeted pediatric cancer investigation of—

(i)

the drug or biological product for which the application referred to in such paragraph is submitted; or

(ii)

the active ingredient or ingredients of such drug or biological product in combination with—

(I)

an active ingredient of a drug or biological product for which there is in effect an exemption for investigational use under section 505(i) that was submitted by the person submitting the application referred to in paragraph (1)(B); or

(II)

an active ingredient of a drug for which an approval under section 505 is in effect, or an active ingredient of a biological product for which an approval under section 351 of the Public Health Service Act is in effect.

(B)

Additional requirements

(i)

Design of investigation

A molecularly targeted pediatric cancer investigation referred to in subparagraph (A) shall be designed to yield clinically meaningful pediatric study data, gathered using appropriate formulations for each age group for which the study is required, regarding dosing, safety, and preliminary efficacy.

(ii)

Purpose of investigation

The purpose of a molecularly targeted pediatric cancer investigation referred to in subparagraph (A) shall be—

(I)

in the case of such an investigation conducted with respect to a drug or biological product referred to in clause (i) of such subparagraph, to inform potential pediatric labeling of the drug or biological product involved; and

(II)

in the case of such an investigation conducted with respect to a combination of active ingredients described to in clause (ii) of such subparagraph, to assist in determining the relevance of its molecular target to the growth or progression of a pediatric cancer.

(iii)

Preclinical data

The reports on an investigation required in paragraph (1)(B) shall include the results of all preclinical studies on which the decision to conduct such investigation was based.

(iv)

Rule of construction regarding inactive ingredients

With respect to a combination of active ingredients referred to in subparagraph (A)(ii), such subparagraph may not be construed as addressing the use of inactive ingredients with such combination. For purposes of such subparagraph, the Secretary may establish such requirements with respect to inactive ingredients as the Secretary determines to be appropriate.

.

(2)

Clarifying applicability of certain provisions

Section 505B(a)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)(3)), as amended by paragraph (1), is amended by adding at the end the following:

(E)

Internal committee review; labeling changes; dissemination of information; adverse events; scope of authority

Subsections (f) through (j) shall apply with respect to investigations described in this paragraph to the same extent and in the same manner as such subsections apply with respect to the assessments required under paragraph (1)(A), except that subsection (g) does not apply with respect to an investigation referred to in subparagraph (A)(ii).

.

(3)

Conforming amendments

Section 505B(a) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)) is amended—

(A)

in paragraph (3)(C), as redesignated by paragraph (1)(A) of this subsection, by striking investigations described in this paragraph and inserting investigations referred to in subparagraph (A)(i);

(B)

in paragraph (3)(D), as redesignated by paragraph (1)(A) of this subsection, by striking the assessments under paragraph (2)(B) and inserting the assessments required under paragraph (1)(A); and

(C)

in paragraph (5)(D), by inserting before the period at the end the following: , except this subparagraph is not applicable to a drug or biological product that is the subject of an investigation referred to in paragraph (3)(A)(ii).

(b)

Authority regarding preclinical studies

Section 505B(a)(1) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)(1)), as amended by subsection (b)(1), is further amended by adding at the end the following:

(D)

Preclinical studies generally

(i)

In general

With respect to an application for an exemption for investigational use under section 505(i) for a drug or biological product that is intended for the treatment of an adult cancer, the Secretary may require, as a condition of permitting the exemption to go into effect, that the sponsor involved enter into an agreement with the Secretary to conduct not more than two preclinical studies of the drug or biological product in order to assist in determining the relevance of its molecular target to the growth or progression of a pediatric cancer.

(ii)

Timeframe for preclinical studies

With respect to the drug or biological product involved, an agreement under clause (i) for a preclinical study shall specify the date by which an initial plan for the study will be submitted to the Secretary. The results of the preclinical study shall be submitted to the Secretary in accordance with a timeframe to which the Secretary and the sponsor involved have agreed.

.

(c)

Applicability

The amendments made by this section apply with respect to any application under section 505(i) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(i)), any application under section 505 of such Act (21 U.S.C. 355), and any application under section 351(a) of the Public Health Service Act (42 U.S.C. 262), that is submitted on or after the expiration of the 3-year period beginning on the date of the enactment of this Act.