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Clinical development of gene- and cell-based therapies: overview of the European landscape

机译:基因和细胞疗法的临床发展:欧洲概况

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摘要

In the last decade, many clinical trials with gene- and cell-based therapies were performed and increasing interest in the development was established by (national) authorities, academic developers, and commercial companies. However, until now only eight products have received marketing authorization (MA) approval. In this study, a comprehensive overview of the clinical development of gene- and cell-based therapies in Europe is presented, with a strong focus on product-technical aspects. Public data regarding clinical trials with gene- and cell-based therapies, obtained from the European Union (EU) clinical trial database (EudraCT) between 2004 and 2014 were analyzed, including product-technical variables as potential determinants affecting development. 198 unique gene and cell therapy products were identified, which were studied in 278 clinical trials, mostly in phase 1/2 trials and with cell therapies as major group. Furthermore, most products were manufactured from autologous starting material mostly manufactured from stem cells. The majority of the trials were sponsored by academia, whereas phase 3 trials mostly by large companies. Academia dominated early-stage development by mainly using bone marrow derived products and stem cells. Conversely, commercial sponsors were more actively pursuing in vivo gene therapy medicinal product development, and cell therapies derived from differentiated tissue in later-stage development.
机译:在过去的十年中,进行了许多基于基因和细胞疗法的临床试验,并且(国家)主管部门,学术开发人员和商业公司对开发产生了越来越大的兴趣。但是,到目前为止,只有八种产品已获得营销授权(MA)批准。在这项研究中,将对欧洲基于基因和细胞的疗法的临床发展进行全面概述,并将重点放在产品技术方面。分析了2004年至2014年间从欧盟(EU)临床试验数据库(EudraCT)获得的有关基于基因和细胞疗法的临床试验的公开数据,包括产品技术变量作为影响发展的潜在决定因素。鉴定出198种独特的基因和细胞疗法产品,并在278项临床试验中进行了研究,其中大部分在1/2期试验中,并且以细胞疗法为主要组。此外,大多数产品是由自体原材料制造的,而自体原材料大多由干细胞制造。大多数试验由学术界赞助,而第3期试验则主要由大型公司赞助。学术界主要通过使用骨髓衍生产物和干细胞来控制早期发育。相反,商业赞助者更积极地追求体内基因治疗药物产品的开发,以及在后期开发中源自分化组织的细胞疗法。

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