1
|
Tang MS, Shan H. Current state of gene therapy in sickle cell disease. Vox Sang 2024; 119:521-528. [PMID: 38487952 DOI: 10.1111/vox.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 06/12/2024]
Abstract
Sickle cell disease (SCD) is a type of hemoglobinopathy due to an autosomal recessive genetic defect, causing significant red cell sickling, multi-organ damage and long-term severe morbidities. Due to its complicated care and the impact on quality of life, a curative treatment for SCD is highly desirable. In recent years, gene therapy is emerging as a curative option for SCD, where autologous haematopoietic stem cells are collected from SCD patients and genetically modified ex vivo to reduce its sickling tendency before reinfusion. Although still largely investigational, a limited number of gene therapy options have been recently granted approval for SCD patients. Published data are still currently limited, but early studies have so far demonstrated the intended outcomes of less vaso-occlusive crisis and haemolysis. Nonetheless, despite its curative potential, larger clinical trials and longer follow-up period are still necessary to evaluate the safety of this treatment option, especially the risk of unintended genetic modifications. Furthermore, SCD patients frequently have limited access to specialty care; hence, the issues of affordability and accessibility to SCD gene therapy must also be addressed for it to benefit the appropriate patient population.
Collapse
Affiliation(s)
- Mei San Tang
- Department of Pathology, Stanford University School of Medicine, Palo Alto, California, USA
- Department of Pathology, Washington University, St Louis, Missouri, USA
| | - Hua Shan
- Department of Pathology, Stanford University School of Medicine, Palo Alto, California, USA
| |
Collapse
|
2
|
Britten-Jones AC, McGuinness MB, Chen FK, Grigg JR, Mack HG, Ayton LN. A multinational survey of potential participant perspectives on ocular gene therapy. Gene Ther 2024; 31:314-323. [PMID: 38565634 PMCID: PMC11090820 DOI: 10.1038/s41434-024-00450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
Amidst rapid advancements in ocular gene therapy, understanding patient perspectives is crucial for shaping future treatment choices and research directions. This international cross-sectional survey evaluated knowledge, attitudes, and perceptions of ocular genetic therapies among potential recipients with inherited retinal diseases (IRDs). Survey instruments included the Attitudes to Gene Therapy-Eye (AGT-Eye), EQ-5D-5L, National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and Patient Attitudes to Clinical Trials (PACT-22) instruments. This study included 496 participant responses (89% adults with IRDs; 11% parents/guardians/carers) from 35 countries, with most from the United States of America (USA; 69%) and the United Kingdom (11%). Most participants (90%) indicated they would likely accept gene therapy if it was available, despite only 45% agreeing that they had good knowledge of gene therapy. The main sources of information were research registries (60% of participants) and the internet (61%). Compared to data from our recently published Australian national survey of people with IRDs (n = 694), USA respondents had higher knowledge of gene therapy outcomes, and Australian respondents indicated a higher perceived value of gene therapy treatments. Addressing knowledge gaps regarding outcomes and financial implications will be central to ensuring informed consent, promoting shared decision-making, and the eventual clinical adoption of genetic therapies.
Collapse
Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Myra B McGuinness
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Fred K Chen
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Centre for Ophthalmology and Visual Sciences (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Royal Perth Hospital and Perth Children's Hospital, Perth, WA, Australia
| | - John R Grigg
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
- Eye Genetics Research Unit, Sydney Children's Hospitals Network, Save Sight Institute, Children's Medical Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Heather G Mack
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
| |
Collapse
|
3
|
Kostadinov K, Marinova Y, Dimitrov K, Hristova-Atanasova E, Iskrov G, Stefanov R. Navigating Gene Therapy Access: The Case of Bulgaria in the Context of the EU Regulatory Landscape. Healthcare (Basel) 2024; 12:458. [PMID: 38391833 PMCID: PMC10888421 DOI: 10.3390/healthcare12040458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
Gene therapies (GTs) have recently emerged as revolutionary personalized therapeutic options. Despite their promising potential, challenges such as uncertainty regarding long-term health benefits and safety, along with extreme price tags, pose significant obstacles to patient access. Within the EU, the European Medicines Agency plays a pivotal role with regards to GT market authorization. However, national authorities are responsible for pricing and reimbursement, which results in fragment patient access within the EU. This study aimed to provide an overview of the complex landscape of post-market authorization accessibility for GT products in Bulgaria, comparing it with neighboring EU countries. We applied a mixed-methods approach, including desk research, public data requests, and list price comparisons. As of 1 April 2023, 14 GTs had a valid market authorization at the EU level. In Bulgaria, Kymriah® was the only GT included in the Positive Drug List (PDL), with an official list price of EUR 335,636.94. Similar results were found in Romania, whereas five GTs were included in Greece's PDL. Additionally, Zolgensma® was found accessible in Bulgaria through an alternative individual access scheme at an estimated price of EUR 1,945,000.00. In conclusion, this study emphasized targeted policy interventions to address health inequalities and to ensure timely access to GTs within the EU.
Collapse
Affiliation(s)
- Kostadin Kostadinov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
| | - Yuliyana Marinova
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
| | - Kostadin Dimitrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Institute for Rare Diseases, 4023 Plovdiv, Bulgaria
| | - Eleonora Hristova-Atanasova
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
| | - Georgi Iskrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Institute for Rare Diseases, 4023 Plovdiv, Bulgaria
| | - Rumen Stefanov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Institute for Rare Diseases, 4023 Plovdiv, Bulgaria
| |
Collapse
|
4
|
Morgan G, Back E, Besser M, Hallett TB, Guzauskas GF. The value-based price of transformative gene therapy for sickle cell disease: a modeling analysis. Sci Rep 2024; 14:2739. [PMID: 38302678 PMCID: PMC10834512 DOI: 10.1038/s41598-024-53121-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/28/2024] [Indexed: 02/03/2024] Open
Abstract
Sickle cell disease (SCD) is an inherited, progressively debilitating blood disorder. Emerging gene therapies (GTx) may lead to a complete remission, the benefits of such can only be realized if GTx is affordable and accessible in the low-and middle-income countries (LMIC) with the greatest SCD burden. To estimate the health impacts and country-specific value-based prices (VBP) of a future gene therapy for SCD using a cost-utility model framework. We developed a lifetime Markov model to compare the costs and health outcomes of GTx versus standard of care for SCD. We modeled populations in seven LMICs and six high-income countries (HICs) estimating lifetime costs and disability-adjusted life-years (DALYs) in comparison to estimates of a country's cost-effectiveness threshold. Each country's unique VBP for GTx was calculated via threshold analysis. Relative to SOC treatment alone, we found that hypothetical GTx reduced the number of people symptomatic with SCD over time leading to fewer DALYs. Across countries, VBPs ranged from $3.6 million (US) to $700 (Uganda). Our results indicate a wide range of GTx prices are required if it is to be made widely available and may inform burden and affordability for 'target product profiles' of GTx in SCD.
Collapse
Affiliation(s)
- George Morgan
- Prime HCD, Mere House, Brook St, Knutsford, WA16 8GP, UK.
| | - Emily Back
- Prime HCD, Mere House, Brook St, Knutsford, WA16 8GP, UK
| | - Martin Besser
- Departments of Haematology, Addenbrooke's Hospital, Cambridge, UK
| | - Timothy B Hallett
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Gregory F Guzauskas
- Prime HCD, Mere House, Brook St, Knutsford, WA16 8GP, UK
- The Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle, WA, USA
| |
Collapse
|
5
|
Cornetta K, Kay S, Urio F, Minja IK, Mbugi E, Mgaya J, Mselle T, Nkya S, Alimohamed MZ, Ndaki K, Bonamino M, Koya RC, Shah LD, Mahlangu J, Drago D, Rangarajan S, Jayandharan GR. Implementation of a gene therapy education initiative by the ASGCT and Muhimbili University of Health and Allied Sciences. Mol Ther 2023; 31:2561-2565. [PMID: 37595584 PMCID: PMC10492022 DOI: 10.1016/j.ymthe.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/04/2023] [Accepted: 07/24/2023] [Indexed: 08/20/2023] Open
Abstract
There has been rapid growth in gene therapy development with an expanding list of approved clinical products. Several therapies are particularly relevant to patients in low- and middle-income countries. Moreover, investing in research and manufacturing presents an opportunity for economic development. To increase awareness of gene therapy, the American Society of Gene and Cell Therapy partnered with the Muhimbili University of Health and Allied Sciences, Tanzania, to create a certificate-bearing course. The goal was to provide faculty teaching in graduate and medical schools with the tools needed to add gene therapy to the university curriculum. The first virtual course was held in October of 2022, and 45 individuals from 9 countries in Africa completed the training. The content was new to approximately two-thirds of participants, with the remaining third indicating that the course increased their knowledge base. The program was well received and will be adapted for other under-resourced regions.
Collapse
Affiliation(s)
- Kenneth Cornetta
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Samantha Kay
- American Society of Gene and Cell Therapy, Milwaukee, WI, USA
| | - Florence Urio
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Irene Kida Minja
- SPARCo-Clinical Coordinating Center - Haematology and Blood Transfusion Department, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Erasto Mbugi
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Josephine Mgaya
- SPARCo-Clinical Coordinating Center - Haematology and Blood Transfusion Department, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Teddy Mselle
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Siana Nkya
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Mohamed Zahir Alimohamed
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Kinuma Ndaki
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, The Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS)
| | - Martín Bonamino
- Cell and Gene Therapy Program, Research Coordination, National Cancer Institute (INCA), Rio de Janeiro, Brazil; Vice-Presidency of Research and Biological Collections (VPPCB), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Richard C Koya
- Department of Gynecology and Obstetrics, University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Lesha D Shah
- New York University Grossman School of Medicine, New York, NY, USA
| | - Johnny Mahlangu
- Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Daniela Drago
- Schools of Medicine and Pharmacy, University of California, San Francisco, San Francisco, CA, USA
| | - Savita Rangarajan
- Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK; KJ Somaiya Super Speciality Hospital and Research Centre, Mumbai, India
| | - Giridhara Rao Jayandharan
- Department of Biological Sciences and Bioengineering, and Gangwal School of Medical Sciences and Technology and Mehta Family Center for Engineering in Medicine, Indian Institute of Technology Kanpur, Kanpur, UP, India
| |
Collapse
|
6
|
Gaviglio AM, Skinner MW, Lou LJ, Finkel RS, Augustine EF, Goldenberg AJ. Gene-targeted therapies: Towards equitable development, diagnosis, and access. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2023; 193:56-63. [PMID: 36688577 DOI: 10.1002/ajmg.c.32032] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/25/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
Genomic and gene-targeted therapies hold great promise in addressing the global issue of rare diseases. To achieve this promise, however, it is critical the twin goals of equity in access to testing and diagnosis, and equity in access to therapy be considered early in the life cycle of development and implementation. Rare disease researchers and clinicians must simultaneously recognize the life-altering potential of early diagnosis and administration of gene-targeted therapeutics while acknowledging that not everyone who experiences a rare disease and needs these therapies will be able to afford or access them. Achieving equity in the development of and access to gene-targeted therapies will not only require innovations in research, clinical, regulatory, and reimbursement frameworks, but will also necessitate increased attention to the ethical, legal, and social implications when establishing research paradigms and the translation of research results into novel interventions for rare genetic diseases. This article highlights and discusses the growing importance and recognition of health equity across the spectrum of rare disease research and care delivery.
Collapse
Affiliation(s)
| | - Mark W Skinner
- Institute for Policy Advancement Ltd., Washington, DC, USA
- McMaster University, Hamilton, Ontario, Canada
| | - Lily J Lou
- University of Illinois at Chicago, Chicago, Illinois, USA
| | | | | | - Aaron J Goldenberg
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| |
Collapse
|
7
|
Landfeldt E. Gene Therapy for Neuromuscular Diseases: Health Economic Challenges and Future Perspectives. J Neuromuscul Dis 2022; 9:675-688. [DOI: 10.3233/jnd-221540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Highly efficacious, potentially curative gene therapies holds immense clinical promise, but also present complex challenges. At the time of regulatory approval and health technology assessment (HTA), evidence of efficacy and safety of gene therapies is often uncertain. In addition, research, development, and manufacturing costs, small pools of eligible patients, and the fact that many gene therapies are administered only once means that they frequently are associated with very high “one-off” price points. Although only a limited number of products have been brought to market globally, hundreds of clinical trials of gene therapies, including several of monogenetic neuromuscular diseases, are currently ongoing. Over time, as more and more conditions become amendable to gene therapy, the number of transformative, high-cost treatments is likely to increase considerably. For these reasons, concerns have been raised regarding the suitability of current health policy systems, including HTA frameworks, in ensuring appropriate access to these therapeutic innovations while simultaneously safeguarding value for taxpayers’ money, as well as affordability and sustainability. This review provides a summary overview of current challenges and future perspectives of gene therapies for neuromuscular diseases from a health economic point of view.
Collapse
|
8
|
Soliman R, Heneghan C, Bolous NS, Sidhom I, Ahmed S, Roberts N, Oke J, Elhaddad A. Systematic review of costs and cost-effectiveness of treatment for relapsed/refractory acute leukaemia in children and young adults. Expert Rev Hematol 2022; 15:345-357. [PMID: 35485262 DOI: 10.1080/17474086.2022.2069096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Survival outcomes of children with relapsed/refractory (r/r) acute leukaemia remain poor. Novel expensive treatments have been developed to improve their outcomes, yet, limited evidence exists about cost-effectiveness of alternative treatment strategies. AREAS COVERED A systematic review was conducted to summarize the health-economic evidence about costs/cost-effectiveness of treating r/r acute leukaemia in children/young adults. We searched Medline, Embase, and Cochrane databases until August 13th, 2021. Eligible articles included peer-reviewed original studies addressing r/r paediatric/young-adult acute lymphoblastic leukaemia (ALL), and acute myeloid leukaemia (AML). Quality assessment was conducted using Consolidated Health Economics Evaluation Reporting Standards (CHEERS) checklist. EXPERT OPINION The majority of papers focused on CAR-T cell therapy, which is still a novel treatment for r/r ALL, and was found to be cost-effective, yet, there remain concerns over its long-term effectiveness, affordability, and equity in access. The next best treatment option is Blinatumomab, followed by Clofarabine therapy, whereas FLA-IDA salvage chemotherapy provides least value for money. The quality of evidence is moderate to high, with limited generalizability of findings due to high variability in outcomes obtained from modelling studies. Limited studies evaluated r/r AML. We provide recommendations to deliver cost-effective treatments in real-world contexts, with implications for healthcare policy and practice.
Collapse
Affiliation(s)
- Ranin Soliman
- Department for Continuing Education, University of Oxford, UK.,Health Economics and Value Unit, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt
| | - Carl Heneghan
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nancy S Bolous
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, USA
| | - Iman Sidhom
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| | - Sonia Ahmed
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| | - Nia Roberts
- Oxford Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Jason Oke
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alaa Elhaddad
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| |
Collapse
|
9
|
Reiss UM, Zhang L, Ohmori T. Hemophilia gene therapy-New country initiatives. Haemophilia 2020; 27 Suppl 3:132-141. [PMID: 32638467 DOI: 10.1111/hae.14080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022]
Abstract
Gene therapy is an opportunity for haemophilia patients to receive a one-time treatment and have lasting factor levels for years or decades instead of dependence on repeated administration within short intervals and on sustained supply of drug. Great strides have been made in the development of gene therapy for haemophilia in the last decade. Adeno-associated virus (AAV) vector-mediated gene transfer in haemophilia A and B has entered the phase III trial stage. Gene transfer by lentiviral vector or gene editing technologies using factor VIII (FVIII) or IX (FIX) genes are now entering clinical evaluation. It is expected that the first FVIII and FIX gene therapy products will soon be approved and distributed in major markets. Global access to gene therapy is a critical goal. This review presents new and ongoing efforts towards this goal in countries other than North America and Europe. In Japan, researchers, regulators and funders have established a promising gene therapy development platform for multiple diseases including haemophilia. Decades of scientific and clinical research in haemophilia gene therapy in China have led to a recently registered clinical trial of AAV-mediated gene therapy for haemophilia B. Other countries are in earlier phases of building gene therapy programmes or participate in international trials. A phase 2 feasibility trial of AAV-mediated FIX gene therapy in low- and middle-income countries aims to demonstrate that gene therapy could become available in resource-constrained socio-economic settings. The different strategies for establishing gene therapy provide opportunities for closing the global gap in haemophilia care.
Collapse
Affiliation(s)
- Ulrike M Reiss
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lei Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin Key Laboratory of Blood Disease Gene Therapy, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Tsukasa Ohmori
- Department of Biochemistry, Jichi Medical University School of Medicine, Shimotsuke, Japan
| |
Collapse
|
10
|
Rittié L, Athanasopoulos T, Calero-Garcia M, Davies ML, Dow DJ, Howe SJ, Morrison A, Ricciardelli I, Saudemont A, Jespers L, Clay TM. The Landscape of Early Clinical Gene Therapies outside of Oncology. Mol Ther 2019; 27:1706-1717. [PMID: 31526597 PMCID: PMC6822232 DOI: 10.1016/j.ymthe.2019.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 08/26/2019] [Accepted: 09/01/2019] [Indexed: 02/07/2023] Open
Abstract
The field of cell and gene therapy (GT) is expanding rapidly and there is undoubtedly a wave of enthusiasm and anticipation for what these treatments could achieve next. Here we assessed the worldwide landscape of GT assets currently in early clinical development (clinical trial phase 1/2 or about to enter clinical trial). We included all gene therapies, i.e., strategies that modify an individual's protein make-up by introducing exogenous nucleic acid or nucleic acid modifiers, regardless of delivery. Unmodified cell therapies, oncology therapies (reviewed elsewhere), and vaccine programs (distinct therapeutic strategy) were not included. Using a December 31, 2018 cutoff date, we identified 336 gene therapies being developed for 138 different indications covering 165 genetic targets. In all, we found that the early clinical GT landscape comprises a very disparate group of drug candidates in terms of indications, organizations, and delivery methods. We also highlight interesting trends, revealing the evolution of the field toward in vivo therapies and adeno-associated virus vector-based delivery systems. It will be interesting to witness what proportion of this current list effectively translates into new medicines.
Collapse
Affiliation(s)
- Laure Rittié
- GSK R&D Cell and Gene Therapy Discovery Research, UP1410, 1250 S. Collegeville Road, Collegeville, PA 19426, USA.
| | - Takis Athanasopoulos
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Miguel Calero-Garcia
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Marie L Davies
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - David J Dow
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Steven J Howe
- GSK R&D Cell and Gene Therapy Process Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Alastair Morrison
- GSK R&D Worldwide Business Development, 5G104, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Ida Ricciardelli
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Aurore Saudemont
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Laurent Jespers
- GSK R&D Cell and Gene Therapy Discovery Research, 6F, Gunnels Wood Road, Stevenage, Herts SG1 2NY, UK
| | - Timothy M Clay
- GSK R&D Cell and Gene Therapy Discovery Research, UP1410, 1250 S. Collegeville Road, Collegeville, PA 19426, USA
| |
Collapse
|