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Stroncek DF, Zhang N, Ren J, Somerville R, Dinh A. Expanding the reach of commercial cell therapies requires changes at medical centers. J Transl Med 2024; 22:181. [PMID: 38374090 PMCID: PMC10877770 DOI: 10.1186/s12967-024-04966-6] [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: 11/14/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
The clinical application of cell therapies is becoming increasingly important for the treatment of cancer, congenital immune deficiencies, and hemoglobinopathies. These therapies have been primarily manufactured and used at academic medical centers. However, cell therapies are now increasingly being produced in centralized manufacturing facilities and shipped to medical centers for administration. Typically, these cell therapies are produced from a patient's own cells, which are the critical starting material. For these therapies to achieve their full potential, more medical centers must develop the infrastructure to collect, label, cryopreserve, test, and ship these cells to the centralized laboratories where these cell therapies are manufactured. Medical centers must also develop systems to receive, store, and infuse the finished cell therapy products. Since most cell therapies are cryopreserved for shipment and storage, medical centers using these therapies will require access to liquid nitrogen product storage tanks and develop procedures to thaw cell therapies. These services could be provided by the hospital pharmacy or transfusion service, but the latter is likely most appropriate. Another barrier to implementing these services is the variability among providers of these cell therapies in the processes related to handling cell therapies. The provision of these services by medical centers would be facilitated by establishing a national coordinating center and a network of apheresis centers to collect and cryopreserve the cells needed to begin the manufacturing process and cell therapy laboratories to store and issue the cells. In addition to organizing cell collections, the coordinating center could establish uniform practices for collecting, labeling, shipping, receiving, thawing, and infusing the cell therapy.
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Affiliation(s)
- David F Stroncek
- The Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive - MSC -1184, Building 10, Room 3C720, Bethesda, MD, 20892-1184, USA.
| | - Nan Zhang
- The Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive - MSC -1184, Building 10, Room 3C720, Bethesda, MD, 20892-1184, USA
| | - Jiaqiang Ren
- The Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive - MSC -1184, Building 10, Room 3C720, Bethesda, MD, 20892-1184, USA
| | - Rob Somerville
- The Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive - MSC -1184, Building 10, Room 3C720, Bethesda, MD, 20892-1184, USA
| | - Anh Dinh
- The Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive - MSC -1184, Building 10, Room 3C720, Bethesda, MD, 20892-1184, USA
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Dinh A, Stroncek DF. Healthcare center-based cell therapy laboratories supporting off-site manufactured cell therapies: The experiences of a single academic cell therapy laboratory. Transfusion 2024; 64:357-366. [PMID: 38173340 PMCID: PMC11132534 DOI: 10.1111/trf.17703] [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: 06/02/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Healthcare center-based cell therapy laboratories (HC CTLs) evolved from solely processing hematopoietic stem cells for transplantation to manufacturing various advanced cellular therapies. With increasing interest in cellular therapy applications, off-site manufactured products are becoming more common. HC CTLs play a critical role in supporting these products by shipping out cellular starting material (CSM) for further manufacturing and/or receiving, storing, and distributing final products. The experiences and challenges encountered by a single academic HC CTL in supporting these products are presented. METHODS All off-site manufacturing protocols supported before 2023 were reviewed. Collected data included protocol characteristics (treatment indication, product type), process logistics (shipping, receiving, storage, thawing, distribution, documentation), and product handling volumes (CSM shipping and final product infusions). RESULTS Between 2012 and 2022, 15 off-site manufactured cellular therapy early-phase, single- and multicenter clinical trials were supported. Trials were sponsored by academic/research and commercial entities. The number of protocols supported annually increased each year, with few ending. Products included cancer immunotherapies and gene therapies. Autologous CSM was collected and shipped, while autologous and allogeneic final products were received, stored, thawed, and distributed. Process differences among protocols included CSM shipping conditions, laboratory analyses, final product thaw conditions and procedures, number of treatments, and documentation. DISCUSSION HC CTLs must contend with several challenges in supporting off-site manufacturing protocols. As demand for cellular therapies increases, stakeholders should collaborate from the early phases of clinical trials to streamline processes and standardize procedures to increase value, improve safety, and reduce the burden on HC CTLs.
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Affiliation(s)
- Anh Dinh
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland, USA
| | - David F Stroncek
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland, USA
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Rós FA, Couto SCF, Milhomens J, Ovider I, Maio KT, Jennifer V, Ramos RN, Picanço-Castro V, Kashima S, Calado RT, Barros LRC, Rocha V. A systematic review of clinical trials for gene therapies for β-hemoglobinopathy around the world. Cytotherapy 2023; 25:1300-1306. [PMID: 37318395 DOI: 10.1016/j.jcyt.2023.05.006] [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: 04/05/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AIMS Amidst the success of cell therapy for the treatment of onco-hematological diseases, the first recently Food and Drug Administration-approved gene therapy product for patients with transfusion-dependent β-thalassemia (TDT) indicates the feasibility of gene therapy as curative for genetic hematologic disorders. This work analyzed the current-world scenario of clinical trials involving gene therapy for β-hemoglobinopathies. METHODS Eighteen trials for patients with sickle cell disease (SCD) and 24 for patients with TDT were analyzed. RESULTS Most are phase 1 and 2 trials, funded by the industry and are currently recruiting volunteers. Treatment strategies for both diseases are fetal hemoglobin induction (52.4%); addition of wild-type or therapeutic β-globin gene (38.1%) and correction of mutations (9,5%). Gene editing (52.4%) and gene addition (40.5%) are the two most used techniques. The United States and France are the countries with the greatest number of clinical trials centers for SCD, with 83.1% and 4.2%, respectively. The United States (41.1%), China (26%) and Italy (6.8%) lead TDT trials centers. CONCLUSIONS Geographic trial concentration indicates the high costs of this technology, logistical issues and social challenges that need to be overcome for gene therapy to reach low- and middle-income countries where SCD and TDT are prevalent and where they most impact the patient's health.
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Affiliation(s)
- Felipe Augusto Rós
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Postgraduate program in Medical Science, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Samuel Campanelli Freitas Couto
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Fundação Pró-Sangue-Hemocentro de Sao Paulo, São Paulo, Brazil
| | - Jonathan Milhomens
- Center for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Ian Ovider
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Postgraduate program in Medical Science, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Karina Tozatto Maio
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Viviane Jennifer
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Postgraduate program in Medical Science, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Rodrigo Nalio Ramos
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Instituto D'Or de Ensino e Pesquisa, São Paulo, Brazil
| | - Virginia Picanço-Castro
- Center for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Simone Kashima
- Center for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Rodrigo T Calado
- Center for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Luciana Rodrigues Carvalho Barros
- Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vanderson Rocha
- Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Fundação Pró-Sangue-Hemocentro de Sao Paulo, São Paulo, Brazil; Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Churchill Hospital, Department of Hematology, Churchill Hospital, University of Oxford, Oxford, United Kingdom
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Okamura Y, Kano S. Comparative analysis of rule elements for transportation of cell therapy products among regulations and standards. Regen Med 2023; 18:611-622. [PMID: 37340930 DOI: 10.2217/rme-2022-0215] [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] [Indexed: 06/22/2023] Open
Abstract
Aim: This study aimed to identify the elements involved in the transportation of cell therapy products by conducting a comparative analysis of four related international standards for temperature-controlled delivery and good distribution practice (GDP). Methods: An analytical framework was constructed to cover the entire transportation process. The descriptions of each element in the Pharmaceutical Inspection Convention and Pharmaceutical Inspection Co-operation Scheme (PIC/S) GDP, International Organization for Standardization (ISO) 21973, Foundation for the Accreditation of Cellular Therapy Common Standards for Cellular Therapies and ISO 23412 were compared. Results: The study identified some elements that were present in the PIC/S GDP and other standards but were absent in ISO 21973, and vice versa. These elements are crucial in view of the increasing opportunities to transport allogeneic cells in the future. Conclusion: The study identified the necessary elements that should be included in the development of transport regulations for cell therapy products.
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Affiliation(s)
- Yoshihiko Okamura
- Bio-Innovation Policy Unit, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Bioscience Bldg B1-17, 5-1-5, Kashiwanoha, Kashiwa City, Chiba 8562, Japan
| | - Shingo Kano
- Bio-Innovation Policy Unit, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Bioscience Bldg B1-17, 5-1-5, Kashiwanoha, Kashiwa City, Chiba 8562, Japan
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Fehm T, Boehme P, Modak N, Talwar V, Kinscher K. The clinical supply of cell and gene therapy drugs: Challenges ahead. Drug Discov Today 2023; 28:103421. [PMID: 36309192 DOI: 10.1016/j.drudis.2022.103421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 02/03/2023]
Affiliation(s)
| | - Philip Boehme
- McKinsey Alumnus, Germany; University Witten/Herdecke, Germany
| | | | | | - Kristian Kinscher
- McKinsey & Co., Düsseldorf, Germany; University Witten/Herdecke, Germany.
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Stroncek D, Dinh A, Rai H, Zhang N, Somerville R, Panch S. The need for uniform and coordinated practices involving centrally manufactured cell therapies. J Transl Med 2022; 20:184. [PMID: 35468789 PMCID: PMC9036766 DOI: 10.1186/s12967-022-03385-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/08/2022] [Indexed: 11/12/2022] Open
Abstract
Cellular therapies have become an important part of clinical care. The treatment of patients with cell therapies often involves the collection of autologous cells at the medical center treating the patient, the shipment of these cells to a centralized manufacturing site, and the return of the cryopreserved clinical cell therapy to the medical center treating the patient for storage until infusion. As this activity grows, cell processing laboratories at many academic medical centers are involved with many different autologous products manufactured by several different centralized laboratories. The handling of these products by medical center-based cell therapy laboratories is complicated and resource-intensive since each centralized manufacturing laboratory has unique methods for labeling, storing, shipping, receiving, thawing, and infusing the cells. The field would benefit from the development of more uniform practices. The development of a coordinating center similar to those established to facilitate the collection, shipping, and transplantation of hematopoietic stem cells from unrelated donors would also be beneficial. In summary, the wide range of practices involved with labeling, shipping, freezing, thawing, and infusing centrally manufactured autologous cellular therapies lack efficiency and consistency and puts patients at risk. More uniform practices are needed.
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Affiliation(s)
- David Stroncek
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA. .,Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, 10 Center Drive, MSC-1184, Building 10, Room 1C711, Bethesda, MD, 20892-1184, USA.
| | - Anh Dinh
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Herleen Rai
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Nan Zhang
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Rob Somerville
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Sandhya Panch
- Center for Cellar Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
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Gilfanova R, Callegari A, Childs A, Yang G, Luarca M, Gutierrez AG, Medina KI, Mai J, Hui A, Kline M, Wei X, Norris PJ, Muench MO. A bioinspired and chemically defined alternative to dimethyl sulfoxide for the cryopreservation of human hematopoietic stem cells. Bone Marrow Transplant 2021; 56:2644-2650. [PMID: 34155359 PMCID: PMC8563414 DOI: 10.1038/s41409-021-01368-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023]
Abstract
The cryopreservation of hematopoietic cells using dimethyl sulfoxide (DMSO) and serum is a common procedure used in transplantation. However, DMSO has clinical and biological side effects due to its toxicity, and serum introduces variation and safety risks. Inspired by natural antifreeze proteins, a novel class of ice-interactive cryoprotectants was developed. The corresponding DMSO-, protein-, and serum-free cryopreservation media candidates were screened through a series of biological assays using human cell lines, peripheral blood cells, and bone marrow cells. XT-Thrive-A and XT-Thrive-B were identified as lead candidates to rival cryopreservation with 10% DMSO in serum based on post-thaw cell survival and short-term proliferation assays. The effectiveness of the novel cryopreservation media in freezing hematopoietic stem cells from human whole bone marrow was assessed by extreme limiting dilution analysis in immunodeficient mice. Stem cell frequencies were measured 12 weeks after transplant based on bone marrow engraftment of erythroid, myeloid, B-lymphoid, and CD34+ progenitors measured by flow cytometry. The recovered numbers of cryopreserved stem cells were similar among XT-Thrive A, XT-Thrive B, and DMSO with serum groups. These findings show that cryoprotectants developed through biomimicry of natural antifreeze proteins offers a substitute for DMSO-based media for the cryopreservation of hematopoietic stem cells.
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Affiliation(s)
| | | | | | | | | | | | | | - Justin Mai
- Vitalant Research Institute, San Francisco, CA, USA
| | - Alvin Hui
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Philip J Norris
- Vitalant Research Institute, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Marcus O Muench
- Vitalant Research Institute, San Francisco, CA, USA.
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
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9
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Mukherjee S, Reddy O, Panch S, Stroncek D. Establishment of a cell processing laboratory to support hematopoietic stem cell transplantation and chimeric antigen receptor (CAR)-T cell therapy. Transfus Apher Sci 2021; 60:103066. [PMID: 33472742 DOI: 10.1016/j.transci.2021.103066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cell processing laboratories are an important part of cancer treatment centers. Cell processing laboratories began by supporting hematopoietic stem cell (HSC) transplantation programs. These laboratories adapted closed bag systems, centrifuges, sterile connecting devices and other equipment used in transfusion services/blood banks to remove red blood cells and plasma from marrow and peripheral blood stem cells products. The success of cellular cancer immunotherapies such as Chimeric Antigen Receptor (CAR) T-cells has increased the importance of cell processing laboratories. Since many of the diseases successfully treated by CAR T-cell therapy are also treated by HSC transplantation and since HSC transplantation teams are well suited to manage patients treated with CAR T-cells, many cell processing laboratories have begun to produce CAR T-cells. The methods that have been used to process HSCs have been modified for T-cell enrichment, culture, stimulation, transduction and expansion for CAR T-cell production. While processing laboratories are well suited to manufacture CAR T-cells and other cellular therapies, producing these therapies is challenging. The manufacture of cellular therapies requires specialized facilities which are costly to build and maintain. The supplies and reagents, especially vectors, can also be expensive. Finally, highly skilled staff are required. The use of automated equipment for cell production may reduce labor requirements and the cost of facilities. The steps used to produce CAR T-cells are reviewed, as well as various strategies for establishing a laboratory to manufacture these cells.
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Affiliation(s)
- Somnath Mukherjee
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA; Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Opal Reddy
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Sandhya Panch
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - David Stroncek
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA.
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Lindgren C, Leinbach A, Annis J, Tanna J, Zhang N, Esensten JH, Hanley PJ. Processing laboratory considerations for multi-center cellular therapy clinical trials: a report from the Consortium for Pediatric Cellular Immunotherapy. Cytotherapy 2020; 23:157-164. [PMID: 33189573 DOI: 10.1016/j.jcyt.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/14/2022]
Abstract
``Cellular therapies first emerged as specialized therapies only available at a few "boutique" centers worldwide. To ensure broad access to these investigational therapies-regardless of geography, demographics and other factors-more and more academic clinical trials are becoming multi-center. Such trials are typically performed with a centralized manufacturing facility receiving the starting material and shipping the final product, either fresh or cryopreserved, to the patient's institution for infusion. As these academic multi-center trials increase in number, it is critical to have procedures and training programs in place to allow these sites that are remote from the production facility to successfully participate in these trials and satisfy regulatory compliance and patient safety best practices. Based on the collective experience of the Consortium for Pediatric Cellular Immunotherapy, the authors summarize the challenges encountered by institutions in shipping and receiving the starting material and final product as well as preparing the final product for infusion. The authors also discuss best practices implemented by each of the consortia institutions to overcome these challenges.
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Affiliation(s)
| | - Ashley Leinbach
- University of California San Francisco, San Francisco, California, USA
| | - Julie Annis
- Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jay Tanna
- Center for Cancer and Immunology Research, Center for Cancer and Blood Disorders, Children's National Hospital, Washington, DC, USA
| | - Nan Zhang
- Center for Cancer and Immunology Research, Center for Cancer and Blood Disorders, Children's National Hospital, Washington, DC, USA
| | | | - Patrick J Hanley
- Center for Cancer and Immunology Research, Center for Cancer and Blood Disorders, Children's National Hospital, Washington, DC, USA; The George Washington University, Washington, DC, USA.
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Fontaine MJ, Selogie E, Stroncek D, McKenna D, Szczepiorkowski ZM, Takanashi M, Garritsen H, Girdlestone J, Reems JA. Variations in novel cellular therapy products manufacturing. Cytotherapy 2020; 22:337-342. [PMID: 32223996 DOI: 10.1016/j.jcyt.2020.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AIMS At the frontier of transfusion medicine and transplantation, the field of cellular therapy is emerging. Most novel cellular therapy products are produced under investigational protocols with no clear standardization across cell processing centers. Thus, the purpose of this study was to uncover any variations in manufacturing practices for similar cellular therapy products across different cell processing laboratories worldwide. METHODS An exploratory survey that was designed to identify variations in manufacturing practices in novel cellular therapy products was sent to cell processing laboratory directors worldwide. The questionnaire focused on the manufacturing life cycle of different cell therapies (i.e., collection, purification, in vitro expansion, freezing and storage, and thawing and washing), as well as the level of regulations followed to process each product type. RESULTS The majority of the centers processed hematopoietic progenitor cells (HPCs) from peripheral blood (n = 18), bone marrow (n = 16) or cord blood (n = 19), making HPCs the most commonly processed cells. The next most commonly produced cellular therapies were lymphocytes (n = 19) followed by mesenchymal stromal cells (n = 14), dendritic cells (n = 9) and natural killer (NK) cells (n = 9). A minority of centers (<5) processed pancreatic islet cells (n = 4), neural cells (n = 3) and induced-pluripotent stem cells (n = 3). Thirty-two laboratories processed products under an investigational status, for either phase I/II (n = 27) or phase III (n = 17) clinical trials. If purification methods were used, these varied for the type of product processed and by institution. Environmental monitoring methods also varied by product type and institution. CONCLUSION This exploratory survey shows a wide variation in cellular therapy manufacturing practices across different cell processing laboratories. A better understanding of the effect of these variations on the quality of these cell-based therapies will be important to assess for further process evaluation and development.
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Affiliation(s)
- Magali J Fontaine
- University of Maryland School of Medicine, Baltimore, Maryland, USA; Biomedical Excellence for Safer Transfusion (BEST).
| | | | - David Stroncek
- Biomedical Excellence for Safer Transfusion (BEST); Center for Cellular Engineering, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - David McKenna
- Biomedical Excellence for Safer Transfusion (BEST); Molecular and Cellular Therapeutics, University of Minnesota, Saint Paul, Minnesota, USA
| | - Zbigniew M Szczepiorkowski
- Biomedical Excellence for Safer Transfusion (BEST); Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Minoko Takanashi
- Biomedical Excellence for Safer Transfusion (BEST); Japanese Red Cross Society Blood Service Headquarters, Tokyo, Japan
| | - Henk Garritsen
- Biomedical Excellence for Safer Transfusion (BEST); Institut für Klinische Transfusionsmedizin, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany
| | - John Girdlestone
- Biomedical Excellence for Safer Transfusion (BEST); NHS Blood and Transplant, The John Radcliffe Hospital, Oxford, UK
| | - Jo-Anna Reems
- Biomedical Excellence for Safer Transfusion (BEST); University of Utah, Salt Lake City, Utah, USA
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