Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland.
Fraunhofer ISC - Translational Center Regenerative Therapies, Würzburg, Germany.
Cytotherapy. 2023 May;25(5):548-558. doi: 10.1016/j.jcyt.2023.01.003. Epub 2023 Mar 7.
The development of medicinal products often continues throughout the different phases of a clinical study and may require challenging changes in raw and starting materials at later stages. Comparability between the product properties pre- and post-change thus needs to be ensured. Here, we describe and validate the regulatory compliant change of a raw material using the example of a nasal chondrocyte tissue-engineered cartilage (N-TEC) product, initially developed for treatment of confined knee cartilage lesions. Scaling up the size of N-TEC as required for the treatment of larger osteoarthritis defects required the substitution of autologous serum with a clinical-grade human platelet lysate (hPL) to achieve greater cell numbers necessary for the manufacturing of larger size grafts. A risk-based approach was performed to fulfill regulatory requirements and demonstrate comparability of the products manufactured with the standard process (autologous serum) already applied in clinical indications and the modified process (hPL). Critical attributes with regard to quality, purity, efficacy, safety and stability of the product as well as associated test methods and acceptance criteria were defined. Results showed that hPL added during the expansion phase of nasal chondrocytes enhances proliferation rate, population doublings and cell numbers at passage 2 without promoting the overgrowth of potentially contaminant perichondrial cells. N-TEC generated with the modified versus standard process contained similar content of DNA and cartilaginous matrix proteins with even greater expression levels of chondrogenic genes. The increased risk for tumorigenicity potentially associated with the use of hPL was assessed through karyotyping of chondrocytes at passage 4, revealing no chromosomal changes. Moreover, the shelf-life of N-TEC established for the standard process could be confirmed with the modified process. In conclusion, we demonstrated the introduction of hPL in the manufacturing process of a tissue engineered product, already used in a late-stage clinical trial. Based on this study, the national competent authorities in Switzerland and Germany accepted the modified process which is now applied for ongoing clinical tests of N-TEC. The described activities can thus be taken as a paradigm for successful and regulatory compliant demonstration of comparability in advanced therapy medicinal products manufacturing.
药品的开发通常在临床研究的不同阶段持续进行,并且可能需要在后期阶段对原材料和起始物料进行具有挑战性的变更。因此,需要确保变更前后产品特性的可比性。在这里,我们以最初为治疗局限性膝关节软骨损伤而开发的鼻软骨细胞组织工程软骨(N-TEC)产品为例,描述并验证了原材料的法规合规变更。为了治疗更大的骨关节炎缺损,需要按要求扩大 N-TEC 的规模,这就需要用临床级人血小板裂解液(hPL)替代自体血清,以获得制造更大尺寸移植物所需的更多细胞数量。采用基于风险的方法来满足监管要求,并证明已在临床适应症中应用的标准工艺(自体血清)和已修改的工艺(hPL)制造的产品具有可比性。定义了与产品质量、纯度、功效、安全性和稳定性相关的关键属性,以及相关的测试方法和验收标准。结果表明,在鼻软骨细胞的扩增阶段添加 hPL 可提高传代 2 时的增殖率、倍增次数和细胞数量,而不会促进潜在污染物软骨膜细胞的过度生长。与标准工艺相比,用修改后的工艺生成的 N-TEC 含有相似含量的 DNA 和软骨基质蛋白,并且软骨形成基因的表达水平更高。通过对第 4 代软骨细胞进行染色体核型分析,评估了与使用 hPL 相关的潜在致瘤风险,结果未发现染色体变化。此外,还可以用修改后的工艺确认为标准工艺建立的 N-TEC 的保质期。总之,我们证明了在已经用于后期临床试验的组织工程产品的制造过程中引入 hPL。基于这项研究,瑞士和德国的国家主管当局接受了修改后的工艺,现在正在对 N-TEC 的正在进行的临床测试应用该工艺。因此,所描述的活动可以作为在先进治疗药物产品制造中成功进行法规合规性可比性证明的范例。