Kurauchi Ryosuke, Kasai Hiroi, Ito Tatsuya
Department of Human Health Science, School of Medicine, Kyoto University, Kyoto, Japan.
School of Medicine, Hokkaido University, Sapporo, Japan.
Front Bioeng Biotechnol. 2020 Dec 23;8:606606. doi: 10.3389/fbioe.2020.606606. eCollection 2020.
Medical products comprising human cells, genes, and tissues have been developed for clinical applications worldwide, and their developmental environment has been established. These products can be imported and exported, but marketing authorization regulations are complicated among regions. This investigation was conducted to identify the characteristics of medical products comprising human cells, genes, and tissues. We used website data, books from survey companies, and reports from public agencies to conduct two investigations. We used website data to conduct a general information survey of 143 cell-therapy and gene-therapy products sold in 24 countries and public assessment reports to individually survey non-clinical and clinical developments of 18 cell-therapy and gene-therapy products developed in Japan and the European Union (EU). The first survey revealed that the numbers of products used in orthopedic surgery and dermatology have increased since 2000, and the numbers of hematological products have increased since 2011. The second investigation revealed that fewer orphaned products were developed in Japan than in the EU. The most appropriate dose was 1.2 × 10 cells per injection per adult. Clinical trials to determine the most appropriate dose were conducted in the EU but not in Japan. No non-clinical immunogenicity tests for autogenous products were conducted in Japan or the EU. Pharmacokinetics tests were not individually performed for sheet-form products. Both and pharmacological tests were more likely to be conducted in the EU, while only one or the other was conducted in Japan. Furthermore, in Japan, carcinogenicity tests were performed based on non-clinical technical guidance, while in the EU, these tests were determined according to each product's features. Fewer clinical trials were performed, and fewer subjects per product were used in Japan than in the EU. Many aspects of the clinical and non-clinical development of medical products comprising human cells, genes, and tissues differ between Japan and the EU. Analyzing these differences will enable the safe and rapid distribution of these products to clinical sites.
包含人类细胞、基因和组织的医疗产品已在全球范围内开发用于临床应用,并且其开发环境已经确立。这些产品可以进出口,但各地区的上市许可规定较为复杂。进行这项调查是为了确定包含人类细胞、基因和组织的医疗产品的特性。我们使用网站数据、调查公司的书籍以及公共机构的报告进行了两项调查。我们使用网站数据对在24个国家销售的143种细胞疗法和基因疗法产品进行了一般信息调查,并使用公共评估报告分别对在日本和欧盟(EU)开发的18种细胞疗法和基因疗法产品的非临床和临床开发情况进行了调查。第一次调查显示,自2000年以来,用于骨科手术和皮肤科的产品数量有所增加,自2011年以来,血液学产品的数量有所增加。第二次调查显示,在日本开发的孤儿产品比在欧盟少。最合适的剂量是每位成年人每次注射1.2×10个细胞。在欧盟进行了确定最合适剂量的临床试验,但在日本没有。在日本和欧盟都没有对自体产品进行非临床免疫原性测试。对于片状产品没有单独进行药代动力学测试。在欧盟更有可能同时进行安全性和药理学测试,而在日本只进行其中一项。此外,在日本,致癌性测试是根据非临床技术指南进行的,而在欧盟,这些测试是根据每种产品的特性确定的。在日本进行的临床试验较少,每个产品使用的受试者也比在欧盟少。在日本和欧盟之间,包含人类细胞、基因和组织的医疗产品的临床和非临床开发在许多方面存在差异。分析这些差异将有助于这些产品安全、快速地分发到临床场所。
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