细胞和基因治疗试验的临床支持:风险,影响和经验教训
Carolyn A Wills1, Daniela Drago2,3, Robert G Pietrusko1,3
1Vor Biopharma, Cambridge, MA 02140, USA.
Molecular therapy. Methods & clinical development
|October 27, 2023
概括
大多数FDA对细胞和基因疗法的临床禁令都在几个月内解除,通常是由于不良事件. 公司可以通过使用FDA资源和积极的安全规划来减轻保留.
科学领域:
- 生物技术是生物技术.
- 监管科学 监管科学
- 临床试验 临床试验
背景情况:
- 细胞和基因疗法的发展激增,导致FDA授权的临床持有率上升.
- 临床持有对生物技术公司产生重大影响,需要了解其原因和后果.
研究的目的:
- 分析FDA临床对细胞和基因疗法的原因和影响.
- 确定临床停摆的常见触发因素和有效的解决策略.
主要方法:
- 在2020年1月至2022年12月期间,对33项公开宣布的细胞和基因疗法临床试验进行分析.
- 按治疗类型 (CAR T,lentiviral,基于AV的基因疗法) 分类持有,并确定常见原因和解决方案.
主要成果:
- 大约80%的临床持有被平均在6.2个月内解除.
- 副作用或患者死亡是最常见的暂停的触发因素.
- 协议修正案是FDA最常见的要求解决方案,以解除托架.
- 基于CAR T,Lentiviral和AAV的基因疗法占分析的大部分持有率.
结论:
- 虽然由于不可预见的不良事件,一些临床停留是不可避免的,但许多缺陷可以预防.
- 积极的风险评估,FDA监管资源的利用和外部安全监测可以帮助预防或缩短临床停留时间.
- 几种疗法在暂停后取得了临床成功,这表明暂停不一定排除未来的疗效.
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