Gupta Deven, Shaz Beth
Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC, USA.
Margolis Institute for Health Policy, Duke University, Durham, NC, USA.
J Transl Med. 2025 May 6;23(1):507. doi: 10.1186/s12967-025-06400-x.
BACKGROUND: Chimeric antigen receptor T-cell (CAR T-cell) therapies have shown significant promise in treating cancers and other diseases. However, the manufacturing processes for CAR T-cell therapies exhibit considerable variability, which can affect treatment consistency and patient outcomes. While centralized manufacturing models dominate, local decentralized approaches, including point-of-care production, are being explored to address logistical and access challenges. This study aims to evaluate the current landscape of local CAR T-cell manufacturing at academic institutions. METHODS: A comprehensive, cross-sectional survey was distributed to 130 FACT and/or JACIE accredited academic institutions globally. The survey, developed from semi-structured interviews with CAR T-cell manufacturing experts, assessed practices in cell modification methods, equipment protocols, and regulatory challenges. Data were analyzed using descriptive statistics, comparing responses across institutions and regions. RESULTS: 45 of the 130 institutions (35 from the United States and 10 internationally, from the European Union, the United Kingdom, and Australia) responded to the survey (35% response rate). Of the 45 responding institutions, 40 were actively engaged or planning to engage in CAR T-cell production, while five had no plans to initiate manufacturing. Within the 40 institutions engaged in CAR T-cell production, 63% (25/40) reported active manufacturing, while 37% (15/40) were in the process of developing manufacturing capabilities. The most commonly reported barriers to local manufacturing were cost constraints (70%, 28/40), regulatory complexities (70%, 28/40), and facility requirements (57%, 17/40). Variability in product quality was cited by 73% (29/40) of institutions. Equipment costs and the need for specialized training emerged as major challenges, particularly for international institutions. Institutions also highlighted the need for automated platforms, with 60% (24/40) using the Miltenyi CliniMACS Prodigy and 50% (20/40) using the Lonza Cocoon. CONCLUSIONS: This study highlights the widespread adoption of local CAR T-cell manufacturing and the significant variability in production processes across institutions. The findings emphasize the importance of establishing quality control benchmarks and data reporting frameworks to improve product consistency and access to CAR T-cell therapies. Addressing barriers such as cost, infrastructure, and regulatory challenges through standardization efforts and international collaboration could enhance the reproducibility, scalability, and accessibility of CAR T-cell therapies globally.
背景:嵌合抗原受体T细胞(CAR T细胞)疗法在治疗癌症和其他疾病方面显示出巨大的前景。然而,CAR T细胞疗法的制造过程存在相当大的可变性,这可能会影响治疗的一致性和患者的治疗效果。虽然集中式制造模式占主导地位,但包括即时护理生产在内的本地分散式方法正在被探索,以应对物流和可及性挑战。本研究旨在评估学术机构中本地CAR T细胞制造的现状。 方法:向全球130家获得FACT和/或JACIE认证的学术机构进行了一项全面的横断面调查。该调查基于对CAR T细胞制造专家的半结构化访谈而制定,评估了细胞改造方法、设备方案和监管挑战方面的实践。使用描述性统计分析数据,比较各机构和地区的回复情况。 结果:130家机构中有45家(35家来自美国,10家来自国际,包括欧盟、英国和澳大利亚)回复了调查(回复率为35%)。在45家回复的机构中,40家积极参与或计划参与CAR T细胞生产,而5家没有启动制造的计划。在40家从事CAR T细胞生产的机构中,63%(25/40)报告正在进行实际生产,而37%(15/40)正在发展制造能力。报告的本地制造最常见的障碍是成本限制(70%,28/40)、监管复杂性(70%,28/40)和设施要求(57%,17/40)。73%(29/40)的机构提到了产品质量的可变性。设备成本和专业培训需求成为主要挑战,特别是对于国际机构。机构还强调了对自动化平台的需求,60%(24/40)的机构使用美天旎CliniMACS Prodigy,50%(20/40)的机构使用龙沙Cocoon。 结论:本研究强调了本地CAR T细胞制造的广泛采用以及各机构生产过程中的显著可变性。研究结果强调了建立质量控制基准和数据报告框架以提高产品一致性和CAR T细胞疗法可及性的重要性。通过标准化努力和国际合作解决成本、基础设施和监管挑战等障碍,可以提高CAR T细胞疗法在全球的可重复性、可扩展性和可及性。
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