Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Centro de investigación Lascaray ikergunea, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.
Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, Italy.
Adv Biochem Eng Biotechnol. 2020;171:321-368. doi: 10.1007/10_2019_109.
Gene therapy medicinal products (GTMPs) are one of the most promising biopharmaceuticals, which are beginning to show encouraging results. The broad clinical research activity has been addressed mainly to cancer, primarily to those cancers that do not respond well to conventional treatment. GTMPs to treat rare disorders caused by single-gene mutations have also made important advancements toward market availability, with eye and hematopoietic system diseases as the main applications.Nucleic acid-marketed products are based on both in vivo and ex vivo strategies. Apart from DNA-based therapies, antisense oligonucleotides, small interfering RNA, and, recently, T-cell-based therapies have been also marketed. Moreover, the gene-editing tool CRISPR is boosting the development of new gene therapy-based medicines, and it is expected to have a substantial impact on the gene therapy biopharmaceutical market in the near future.However, despite the important advancements of gene therapy, many challenges have still to be overcome, which are discussed in this book chapter. Issues such as efficacy and safety of the gene delivery systems and manufacturing capacity of biotechnological companies to produce viral vectors are usually considered, but problems related to cost and patient affordability must be also faced to ensure the success of this emerging therapy. Graphical Abstract.
基因治疗药物(GTMPs)是最有前途的生物制药之一,已开始显示出令人鼓舞的效果。广泛的临床研究活动主要针对癌症,主要针对那些对常规治疗反应不佳的癌症。用于治疗单基因突变引起的罕见疾病的 GTMP 也在推向市场方面取得了重要进展,眼部和造血系统疾病是主要应用领域。核酸上市产品基于体内和体外策略。除了基于 DNA 的疗法外,反义寡核苷酸、小干扰 RNA,最近还有基于 T 细胞的疗法也已上市。此外,基因编辑工具 CRISPR 正在推动新的基于基因治疗的药物的开发,预计在不久的将来将对基因治疗生物制药市场产生重大影响。然而,尽管基因治疗取得了重要进展,但仍有许多挑战有待克服,本书章节对此进行了讨论。通常会考虑基因传递系统的疗效和安全性以及生物技术公司生产病毒载体的制造能力等问题,但为确保这种新兴疗法的成功,还必须面对与成本和患者承受能力相关的问题。