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Damerval M, Fagnoni-Legat C, Louvrier A, Fischer S, Limat S, Clairet AL, Nerich V, Madelaine I, Kroemer M. ATMP Environmental Exposure Assessment in European Healthcare Settings: A Systematic Review of the Literature. Front Med (Lausanne) 2021; 8:713047. [PMID: 34926483 PMCID: PMC8671638 DOI: 10.3389/fmed.2021.713047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022] Open
Abstract
Since 2007, a new class of biologic products for human use called "advanced therapy medicinal products (ATMP)" have been legally integrated in the European Medical Agency. They consist of recombinant nucleic acid, engineered cells, cells, or tissues. In the United States, ATMP fall under the regulatory framework of biological products and the term "cell and gene therapy product" is used in the legislative and regulatory documents. Potential clinical applications are broad, particularly, in the field of cancer, inherited genetic disease, and regenerative medicine. Indeed, the benefit conferred by CD19 chimeric antigen receptor T cells led to the first engineered cell therapy products to be approved by the Food and Drug Administration (FDA) in 2017. Gene therapy products to treat orphan diseases are also extensively developed with many clinical trials ongoing in the world. Nevertheless, the use of these therapeutic products is complex and requires careful considerations in the terms of regulatory and hospital setting requirements, such as storage, handling, administration, and disposal which justify the implementation of a secured medication circuit. Through this systematic review of the literature, the authors wanted to compile data on the assessment of environmental exposure related to the use of ATMP in healthcare setting to secure their medication circuit. A literature search was conducted on PubMed and Web of Science, and 32 publications dealing with environmental exposure assessment and ATMP were selected. In addition, marketed ATMPs were identified and data regarding the environmental concerns were extracted from product information sections from European Public Assessment Reports (EPAR). The environmental contamination assessments were mainly addressed in the reviews rather than in original articles related to the use of ATMP. Most of the product information sections from EPAR suggested precautions rather than requirements when dealing with environmental consideration following ATMP handling. Nevertheless, these precautions usually remain elusive especially concerning waste disposal and the detection of biological material on the work surfaces, and mainly relate to the genetically modified organisms (GMO) over non-GMO cellular products. Pharmaceutical oversight and adherence to the good preparation practices and good clinical practices are essential to ensure the safe use in term of environmental concern of these new therapeutic products in healthcare setting.
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Affiliation(s)
- Margaux Damerval
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
| | | | - Aurélien Louvrier
- Host-Graft Interactions Lab – Tumor - Cell and Tissue engineering (UMR 1098 INSERM/UFC/EFS), University of Franche-Comté, Besançon, France
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - Sarah Fischer
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
| | - Samuel Limat
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - Anne-Laure Clairet
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
| | - Virginie Nerich
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | | | - Marie Kroemer
- Department of Pharmacy, University Hospital of Besançon, Besançon, France
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
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Horgan D, Metspalu A, Ouillade MC, Athanasiou D, Pasi J, Adjali O, Harrison P, Hermans C, Codacci-Pisanelli G, Koeva J, Szucs T, Cursaru V, Belina I, Bernini C, Zhuang S, McMahon S, Toncheva D, Thum T. Propelling Healthcare with Advanced Therapy Medicinal Products: A Policy Discussion. Biomed Hub 2020; 5:130-152. [PMID: 33987187 DOI: 10.1159/000511678] [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: 07/31/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
Recent advances in biomedicine are opening the door to new approaches, and treatment and prevention are being transformed by novel medicines based on genetic engineering, innovative cell-based therapies and tissue-engineered products, and combinations of a medical device with embedded cell or tissue components. These advanced therapy medicinal products (ATMPs) hold one of the keys to making a reality of genuinely personalised medicine. There are an estimated 450 companies across the globe working on the development of gene therapies and more than 1,000 clinical trials underway worldwide, and some 20-30 new ATMPs filings are expected in Europe annually over the next 5 years. But challenges confront the sector, complicating the translation from research into patient access. Scientific, clinical development and regulatory issues are compounded by limited experience with clinical and commercial use, limited manufacturing know-how, high costs, and difficulties in accessing development funding and investment. Pricing and reimbursement and market access issues are an additional challenge, particularly in Europe, where unfamiliarity with the technology and uncertainty over the use of real-world evidence induce caution among clinicians, health technology assessment bodies and payers. There is a need for a review of the suitability of the regulatory and market access framework for these products, focused development of data, public/private partnerships, and fuller collaboration governments, doctors, insurers, patients, and pharmaceutical companies. This paper makes specific recommendations for all stakeholders, ranging from early dialogue on potential products, linking of clinical data and patient registries or standardisation of control frameworks, to a comprehensive approach to evidence generation, assessment, pricing, and payment for ATMPs.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Andres Metspalu
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
| | | | | | - John Pasi
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | | | | | | | - Jasmina Koeva
- Bulgarian Alliance for Personalised and Precision Medicine, Sofia, Bulgaria
| | | | | | - Ivica Belina
- KUZ - Coalition of Association in Healthcare, Zagreb, Croatia
| | - Chiara Bernini
- European Alliance for Personalised Medicine, Brussels, Belgium
| | | | | | - Draga Toncheva
- Bulgarian Society for Genetics and Human Genomics, Sofia, Bulgaria
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
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3
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Keeler AM, Flotte TR. Recombinant Adeno-Associated Virus Gene Therapy in Light of Luxturna (and Zolgensma and Glybera): Where Are We, and How Did We Get Here? Annu Rev Virol 2019; 6:601-621. [PMID: 31283441 PMCID: PMC7123914 DOI: 10.1146/annurev-virology-092818-015530] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The recent market approvals of recombinant adeno-associated virus (rAAV) gene therapies in Europe and the United States are landmark achievements in the history of modern science. These approvals are also anticipated to herald the emergence of a new class of therapies for monogenic disorders, which had hitherto been considered untreatable. These events can be viewed as stemming from the convergence of several important historical trends: the study of basic virology, the development of genomic technologies, the imperative for translational impact of National Institutes of Health-funded research, and the development of economic models for commercialization of rare disease therapies. In this review, these historical trends are described and the key developments that have enabled clinical rAAV gene therapies are discussed, along with an overview of the current state of the field and future directions.
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Affiliation(s)
- Allison M Keeler
- Horae Gene Therapy Center and Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA;
| | - Terence R Flotte
- Horae Gene Therapy Center and Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA;
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Vella Bonanno P, Bucsics A, Simoens S, Martin AP, Oortwijn W, Gulbinovič J, Rothe C, Timoney A, Ferrario A, Gad M, Salem A, Hoxha I, Sauermann R, Kamusheva M, Dimitrova M, Petrova G, Laius O, Selke G, Kourafalos V, Yfantopoulos J, Magnusson E, Joppi R, Jakupi A, Bochenek T, Wladysiuk M, Furtado C, Marković-Peković V, Mardare I, Meshkov D, Fürst J, Tomek D, Cortadellas MO, Zara C, Haycox A, Campbell S, Godman B. Proposal for a regulation on health technology assessment in Europe - opinions of policy makers, payers and academics from the field of HTA. Expert Rev Pharmacoecon Outcomes Res 2019; 19:251-261. [PMID: 30696372 DOI: 10.1080/14737167.2019.1575730] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In January 2018 the European Commission published a Proposal for a Regulation on Health Technology Assessment (HTA): 'Proposal for a Regulation on health technology assessment and amending Directive 2011/24/EU'. A number of stakeholders, including some Member States, welcomed this initiative as it was considered to improve collaboration, reduce duplication and improve efficiency. There were however a number of concerns including its legal basis, the establishment of a single managing authority, the preservation of national jurisdiction over HTA decision-making and the voluntary/mandatory uptake of joint assessments by Member States. Areas covered: This paper presents the consolidated views and considerations on the original Proposal as set by the European Commission of a number of policy makers, payers, experts from pricing and reimbursement authorities and academics from across Europe. Expert commentary: The Proposal has since been extensively discussed at Council and while good progress has been achieved, there are still divergent positions. The European Parliament gave a number of recommendations for amendments. If the Proposal is approved, it is important that a balanced, improved outcome is achieved for all stakeholders. If not approved, the extensive contribution and progress attained should be sustained and preserved, and the best alternative solutions found.
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Affiliation(s)
- Patricia Vella Bonanno
- a Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK
| | - Anna Bucsics
- b Mechanism of Coordinated Access to Orphan Medicinal Products (MoCA) , Brussels , Belgium
| | - Steven Simoens
- c KU Leuven Department of Pharmaceutical and Pharmacological Sciences , Leuven , Belgium
| | - Antony P Martin
- d Health Economics Centre , University of Liverpool Management School , Liverpool , UK
| | - Wija Oortwijn
- e Department for Health Evidence , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Jolanta Gulbinovič
- f Department of Pathology, Forensic Medicine and Pharmacology , Institute of Biomedical Sciences, Faculty of Medicine, VilniusUniversity , Vilnius , Lithuania
| | - Celia Rothe
- g Department of Drug Management, Faculty of Health Sciences , Jagiellonian University Medical College , Krakow , Poland
| | - Angela Timoney
- a Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK.,h NHS Lothian , Edinburgh , UK
| | - Alessandra Ferrario
- i Division of Health Policy and Insurance Research, Department of Population Medicine , Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston , MA , USA
| | - Mohamed Gad
- j Global Health and Development Group , Imperial College , London , UK
| | | | - Iris Hoxha
- l Department of Pharmacy, Faculty of Medicine , University of Medicine , Tirana , Albania
| | - Robert Sauermann
- m Hauptverband der ÖsterreichischenSozialversicherungsträger , Vienna , Austria
| | - Maria Kamusheva
- n Department of Organization and Economics of Pharmacy, Faculty of Pharmacy , Medical University-Sofia , Bulgaria
| | - Maria Dimitrova
- n Department of Organization and Economics of Pharmacy, Faculty of Pharmacy , Medical University-Sofia , Bulgaria
| | - Guenka Petrova
- n Department of Organization and Economics of Pharmacy, Faculty of Pharmacy , Medical University-Sofia , Bulgaria
| | - Ott Laius
- o State Agency of Medicines , Tartu , Estonia
| | - Gisbert Selke
- p Wissenschaftliches Institut der AOK (WidO) , Berlin , Germany
| | - Vasilios Kourafalos
- q EOPYY-National Organization for the Provision of Healthcare Services , Athens , Greece
| | - John Yfantopoulos
- r School of Economics and Political Science , University of Athens , Athens , Greece
| | - Einar Magnusson
- s Department of Health Services , Ministry of Health , Reykjavík , Iceland
| | - Roberta Joppi
- t Pharmaceutical Drug Department , Azienda Sanitaria Locale of Verona , Verona , Italy
| | | | - Tomasz Bochenek
- g Department of Drug Management, Faculty of Health Sciences , Jagiellonian University Medical College , Krakow , Poland
| | | | | | - Vanda Marković-Peković
- x Ministry of Health and Social Welfare , Banja Luka , Republic of Srpska, Bosnia and Herzegovina.,y Department of Social Pharmacy , University of Banja Luka, Faculty of Medicine , Banja Luka , Republic of Srpska, Bosnia and Herzegovina
| | - Ileana Mardare
- z Faculty of Medicine, Public Health and Management Department , "Carol Davila" University of Medicine and Pharmacy Bucharest , Bucharest , Romania
| | - Dmitry Meshkov
- aa National Research Institution for Public Health , Moscow , Russia
| | - Jurij Fürst
- ab Health Insurance Institute , Ljubljana , Slovenia
| | - Dominik Tomek
- ac Faculty of Medicine, Slovak Medical University , Bratislava , Slovakia
| | | | - Corrine Zara
- ad Drug Territorial Action Unit , Catalan Health Service , Barcelona , Spain
| | - Alan Haycox
- d Health Economics Centre , University of Liverpool Management School , Liverpool , UK
| | - Stephen Campbell
- ae Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care , University of Manchester , Manchester , UK.,af NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences , University of Manchester , Manchester , UK
| | - Brian Godman
- a Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK.,d Health Economics Centre , University of Liverpool Management School , Liverpool , UK.,ag Division of Clinical Pharmacology , Karolinska, Karolinska Institutet , Stockholm , Sweden.,ah Department of Public Health Pharmacy and Management, School of Pharmacy , Sefako Makgatho Health Sciences University , Garankuwa , South Africa
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Gheflat S, Sadeghi A, Bandehpour M, Ramezani K, Kazemi B. Designing an Engineered Construct Gene Sensitive to Carbohydrate In-vitro and Candidate for Human Insulin Gene Therapy In-vivo. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2019; 18:2111-2116. [PMID: 32184874 PMCID: PMC7059050 DOI: 10.22037/ijpr.2019.14650.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Diabetes is a common disorder worldwide, and exhaustive efforts have been made to cure this disease. Gene therapy has been considered as a potential curative method that has had more stability in comparison with other pharmaceutical methods. However, the application of gene therapy as a definitive treatment demands further investigation. This study is aimed to prepare a suitable high- performance vector for gene therapy in diabetes mellitus. The designed vector has had prominent characteristics, such as directed replacement, which makes it a suitable method for treating or preventing other genetic disorders. The whole rDNA sequence of the human genome was scanned. The 800 bp two homology arms were digested by EcoRI, synthesized and cloned into the pGEM-B1 plasmid (prokaryotic moiety). The carbohydrate sensitive promoter, L-pyruvate kinase, and insulin gene were sub-cloned between homologous arms (eukaryotic moiety). The PGEM-B1 plasmid was digested by EcoRI, and the eukaryotic fragments were purified and transfected into Hela cell and then cultured. Afterward, the 300 µg/mL of glucose were added to the culture medium. Insulin expression in the transfected cells with 200 and 400 ng of the construct in comparison with negative control was detected using western blot and ELISA methods. Results have shown insulin expression in different glucose concentrates.
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Affiliation(s)
- Shivasadat Gheflat
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abdolrahim Sadeghi
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mojgan Bandehpour
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Keyvan Ramezani
- Departement of Parasitology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Bahram Kazemi
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Departement of Parasitology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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6
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Langhof H, Chin WWL, Wieschowski S, Federico C, Kimmelman J, Strech D. Preclinical efficacy in therapeutic area guidelines from the U.S. Food and Drug Administration and the European Medicines Agency: a cross-sectional study. Br J Pharmacol 2018; 175:4229-4238. [PMID: 30153701 DOI: 10.1111/bph.14485] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/28/2018] [Accepted: 08/06/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND PURPOSE Therapeutic area guidelines (TAGs) published by the EMA and the FDA offer guidance in planning the launch of a trial in a certain indication. We assessed and compared the guidance on preclinical efficacy of all available TAGs from EMA and FDA. EXPERIMENTAL APPROACH EMA and FDA websites and databases were searched for all TAGs. A mixed deductive and inductive approach was applied to analyse and cluster content for preclinical efficacy. KEY RESULTS A total of 114 EMA and 120 FDA TAGs were identified, covering 126 indications. Our core finding is that 75% of EMA TAGs and 58% from the FDA TAGs do not offer any guidance on preclinical efficacy. TAGs varied widely on the extent, nature and detail of guidance. CONCLUSIONS AND IMPLICATIONS Guidance on preclinical efficacy in a consistent, comprehensive and explicit way that still allows for justified deviations is an important but neglected aspect of transparency for drug development. This transparency would help sponsors in designing preclinical studies and in negotiating more efficiently with regulators.
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Affiliation(s)
- Holger Langhof
- Charité - University Medicine Berlin, QUEST - Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Berlin, Germany.,Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - William Wei Lim Chin
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Susanne Wieschowski
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Carole Federico
- STREAM (Studies of Translation, Ethics and Medicine), Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Jonathan Kimmelman
- STREAM (Studies of Translation, Ethics and Medicine), Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Daniel Strech
- Charité - University Medicine Berlin, QUEST - Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Berlin, Germany.,Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
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7
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In vitro and in vivo delivery of siRNA via VIPER polymer system to lung cells. J Control Release 2018; 276:50-58. [PMID: 29474962 DOI: 10.1016/j.jconrel.2018.02.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 02/11/2018] [Accepted: 02/12/2018] [Indexed: 12/17/2022]
Abstract
The block copolymer VIPER (virus-inspired polymer for endosomal release) has been reported to be a promising novel delivery system of DNA plasmids both in vitro and in vivo. VIPER is comprised of a polycation segment for condensation of nucleic acids as well as a pH-sensitive segment that exposes the membrane lytic peptide melittin in acidic environments to facilitate endosomal escape. The objective of this study was to investigate VIPER/siRNA polyplex characteristics, and compare their in vitro and in vivo performance with commercially available transfection reagents and a control version of VIPER lacking melittin. VIPER/siRNA polyplexes were formulated and characterized at various charge ratios and shown to be efficiently internalized in cultured cells. Target mRNA knockdown was confirmed by both flow cytometry and qRT-PCR and the kinetics of knockdown was monitored by live cell spinning disk microscopy, revealing knockdown starting by 4 h post-delivery. Intratracheal instillation of VIPER particles formulated with sequence specific siRNA to the lung of mice resulted in a significantly more efficient knockdown of GAPDH compared to treatment with VIPER particles formulated with scrambled sequence siRNA. We also demonstrated using pH-sensitive labels that VIPER particles experience less acidic environments compared to control polyplexes. In summary, VIPER/siRNA polyplexes efficiently deliver siRNA in vivo resulting in robust gene silencing (>75% knockdown) within the lung.
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Baruteau J, Waddington SN, Alexander IE, Gissen P. Gene therapy for monogenic liver diseases: clinical successes, current challenges and future prospects. J Inherit Metab Dis 2017; 40:497-517. [PMID: 28567541 PMCID: PMC5500673 DOI: 10.1007/s10545-017-0053-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 02/08/2023]
Abstract
Over the last decade, pioneering liver-directed gene therapy trials for haemophilia B have achieved sustained clinical improvement after a single systemic injection of adeno-associated virus (AAV) derived vectors encoding the human factor IX cDNA. These trials demonstrate the potential of AAV technology to provide long-lasting clinical benefit in the treatment of monogenic liver disorders. Indeed, with more than ten ongoing or planned clinical trials for haemophilia A and B and dozens of trials planned for other inherited genetic/metabolic liver diseases, clinical translation is expanding rapidly. Gene therapy is likely to become an option for routine care of a subset of severe inherited genetic/metabolic liver diseases in the relatively near term. In this review, we aim to summarise the milestones in the development of gene therapy, present the different vector tools and their clinical applications for liver-directed gene therapy. AAV-derived vectors are emerging as the leading candidates for clinical translation of gene delivery to the liver. Therefore, we focus on clinical applications of AAV vectors in providing the most recent update on clinical outcomes of completed and ongoing gene therapy trials and comment on the current challenges that the field is facing for large-scale clinical translation. There is clearly an urgent need for more efficient therapies in many severe monogenic liver disorders, which will require careful risk-benefit analysis for each indication, especially in paediatrics.
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Affiliation(s)
- Julien Baruteau
- Genetics and Genomic Medicine Programme, Great Ormond Street Institute of Child Health, University College London, London, UK.
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
- Gene Transfer Technology Group, Institute for Women's Health, University College London, London, UK.
| | - Simon N Waddington
- Gene Transfer Technology Group, Institute for Women's Health, University College London, London, UK
- Wits/SAMRC Antiviral Gene Therapy Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ian E Alexander
- Gene Therapy Research Unit, The Children's Hospital at Westmead and Children's Medical Research Institute, Westmead, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
| | - Paul Gissen
- Genetics and Genomic Medicine Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
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9
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Abstract
For decades, effective cancer gene therapy has been a tantalising prospect; for a therapeutic modality potentially able to elicit highly effective and selective responses, definitive efficacy outcomes have often seemed out of reach. However, steady progress in vector development and accumulated experience from previous clinical studies has finally led the field to its first licensed therapy. Following a pivotal phase III trial, Imlygic (talimogene laherparepvec/T-Vec) received US approval as a treatment for cutaneous and subcutaneous melanoma in October 2015, followed several weeks later by its European authorisation. These represent the first approvals for an oncolytic virotherapy. Imlygic is an advanced-generation herpesvirus-based vector optimised for oncolytic and immunomodulatory activities. Many other oncolytic agents currently remain in development, providing hope that current success will be followed by other diverse vectors that may ultimately come to constitute a new class of clinical anti-cancer agents. In this review, we discuss some of the key oncolytic viral agents developed in the adenovirus and herpesvirus classes, and the prospects for further enhancing their efficacy by combining them with novel immunotherapeutic approaches.
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Affiliation(s)
- Alan E. Bilsland
- Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Glasgow, G61 1QH, UK
| | | | - T. R. Jeffry Evans
- Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Glasgow, G61 1QH, UK
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10
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Flotte TR. Ethical Implications of the Cost of Molecularly Targeted Therapies. Hum Gene Ther 2016; 26:573-4. [PMID: 26355414 DOI: 10.1089/hum.2015.29010.trf] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Tedesco FS. Human artificial chromosomes for Duchenne muscular dystrophy and beyond: challenges and hopes. Chromosome Res 2015; 23:135-41. [PMID: 25596829 DOI: 10.1007/s10577-014-9460-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Safe and efficacious vectors able to carry large or several transgenes are of key importance for gene therapy. Human artificial chromosomes can fulfil this essential requirement; moreover, they do not integrate into the host genome. However, drawbacks such as the low efficiency of chromosome transfer and their relatively complex engineering still limit their widespread use. In this article, I summarise the key steps that brought human artificial chromosomes into preclinical research for Duchenne muscular dystrophy, an X-linked, monogenic disorder. I will also review possible future pre-clinical and clinical perspectives for this technology.
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Affiliation(s)
- Francesco Saverio Tedesco
- Department of Cell and Developmental Biology, University College London, 21 University Street, London, WC1E 6DE, UK,
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12
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Abstract
Since the approval of insulin as the first recombinant therapeutic protein, the prominence of biologic therapies in drug development has grown significantly. Many modalities beyond traditional biologics are now being developed or explored for various indications with significant unmet medical needs. From early traditional replacement proteins to more recent, highly engineered antibodies, oligonucleotides, fusion proteins, and gene constructs, biologic agents have delivered life-changing therapies, despite often having scientifically and technically challenging development programs. This brief review outlines some of the major biotherapeutic classes and identifies the advantages and challenges with the development of these products.
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