Mining scientific advice reports on cell-based products; insight in the
non-clinical development program.
Abstract
Aims The field of cell-based therapies for human diseases is currently
evolving from promising treatment options to established therapeutic
concepts. The design of the non-clinical development program for
cell-based products, intended to provide a rationale for treatment and
to gain insight into the safety profile, is challenging because of
limitations caused by species-specificity. The elements of the
non-clinical package for cell-based products were evaluated using advice
reports from the European Medicines Agency database from 2013-2018 to
identify the approach followed for non-clinical development of these
products. Methods The purpose of the in vivo studies was designated to
be (a combination of) pharmacology/proof-of-concept, safety,
biodistribution and/or tumourigenicity. For biodistribution and
tumourigenicity also the need for, type and design of in vitro and in
vivo studies were recorded. Results In vivo studies for cell-based
therapies were primarily aimed at proof-of-concept (75/86), followed by
addressing safety (64/86), biodistribution (49/86) or tumourigenicity
(46/86). No animal studies were performed or proposed by sponsors or
regulators for six (out of 86) products, which contained cell types that
have been studied in humans for a relatively long time. For one-third of
the products in vivo biodistribution and/or tumourigenicity studies were
not considered necessary. In vivo tumourigenicity studies were regarded
of limited value. Conclusions Compared to more conventional medicinal
products, the non-clinical development program for cell-based products
was more tailored and focussing on proof-of-concept. For tumourigenicity
an in vitro approach may suffice. Total omission of in vivo studies
appears to be possible for products with sufficient clinical experience.