1
Overview of the Development Program of a Cell-Based Medicine
Arnau Pla CELLAB, Barcelona, Spain
Abstract
The success in bringing to the market a new medicine in a timely and cost-effective manner relies on a proper product development strategy. Public institutions lead the development of cell-based therapeutics up to early stage clinical trials without the resources found in biotech and pharma industries. This may explain the reduced number of cell therapies approved and their disastrous financial performance in terms of revenues. Apart from understanding the whole development process, there are a couple of basic tools (such as the target product profile) and important concepts (e.g., freedom to operate) that can help to improve the early development process in a nonpharma environment and make it sound to investors for further developments up to regulatory approval for commercialization. In this chapter, we will present and discuss the series of milestones required to make an academic achievement into an approved clinical therapy.
Keywords
Advanced therapy medicinal product; Cell-based medicine; Licensing; Product development; Product lifecycle; Target product profile
Chapter Outline
1. Introduction
The goal of pharmaceutical product development is to establish the formulation composition and define its manufacturing process to consistently deliver a drug product. This drug product has to meet appropriate quality attributes required for its intended efficacy and safety profile. In addition to basic quality requirements, the commercial success of a drug product, and by extension its lifecycle, is determined by other key parameters such as patents, market, prices competence, regulatory changes, and others that must be carefully considered during early development stages. Pharmaceutical and biopharmaceutical industries have developed systematic approaches to fulfill these complex requirements. In contrast, the newborn cell therapy industry, closely linked to academia, should develop novel approaches to address this major challenge
[1].
Although there are extensive resources and efforts devoted by many companies, to date, there are few cell therapy products licensed in Europe and in the United States (
Table 1). This fact reflects the great complexity of developing such type of treatments. However, great hopes are invested in the emerging field of regenerative medicine and the use of cells as therapeutic agents. The term advanced therapy medicinal product (ATMP) covers the following medicinal products for human use (
http://www.ema.europa.eu/ema/):
Table 1
Approved Human Cell-Based Therapeutics
| Provenge®; Autologous cellular immunotherapy | Dendreon Corporation |
| Laviv®; Autologous cultured fibroblasts | Fibrocell Technologies, Inc. |
| Carticel®; Autologous cultured chondrocytes | Genzyme BioSurgery |
| Gintuit®; Allogeneic cultured keratinocytes and fibroblasts in bovine collagen | Organogenesis, Inc. |
| Allocord®; HPC from cord blood | SSM Cardinal Glennon Children’s Medical Center |
| Hemacord®; Allogeneic HPC from cord blood | New York Blood Center |
| Ducord®; HPC from cord blood | Duke University School of Medicine |
| HPC from cord blood | Clinimmune Labs, University of Colorado Cord Blood Bank |
| HPC from cord blood | LifeSouth Community Blood Centers, Inc. |
| Chondrocelect®; Autologous cultured chondrocytes | TIGenix |
| MACI®; matrix-induced autologous chondrocyte implantation | Genzyme |
| Provenge®; Autologous cellular immunotherapy | Dendreon Corporation |
| Holoclar®; Autologous limbal stem cells | Chiesi Farmaceutici S.p.A. |
| In Canada and New Zealand [12]: |
| Prochymal®; Adult human MSC | Osiris Therapeutics, Inc. |
| JACE®; Autologous cultured epidermis | Japan Tissue Engineering Company (J-TEC) |
| JACC®; Autologous cultured cartilage | Japan Tissue Engineering Company (J-TEC) |
| Hearticellgram-AMI®; Autologous bone marrow-derived MSC | Pharmicell |
| Cartistem®; MSC for the treatment of osteoarthritis | Medipost |
With the exception of blood products, the rest include a substantial manipulation in their manufacture. Only approved human cell-based medicines were included. HPC = hematopoietic progenitor cells; MSC = mesenchymal stromal cells.
• Gene-therapy medicines: These contain genes that lead to a therapeutic effect. They work by inserting recombinant genes into cells, usually to treat a variety of diseases, including genetic disorders, cancer, or long-term diseases.
• Somatic-cell therapy medicines: These contain cells or tissues that have been manipulated to change their biological characteristics.
• Tissue-engineered medicines: These contain cells or tissues that have been modified so that they can be used to repair, regenerate, or replace tissue.
• Combined advanced therapy medicines: These are medicines that contain one or more medical devices as an integral part of the medicine.
Cell therapy-based medicinal products (CTMPs) are defined as medicinal products when there is more than minimal manipulation of the cellular component or where the intended use of the cells is different from their normal function in the body.
Much attention had been paid to the potential of novel stem cell- and tissue engineering-based therapies following a number of relevant scientific milestones and media news of potential new cures
[2,
3]. These therapies have become the focus of many biopharmaceutical developments, which face a number of major challenges in translating these scientific advances into Food and Drug Administration (FDA)/European Medicines Agency (EMA)-approved medical products. ATMPs, including cell therapy and tissue engineering products, are considered as medicines in the European Union
[4].
ATMPs are at the forefront of scientific innovation in medicine; consequently, specific regulatory framework has been developed and implemented in Europe and in the United States. In this regard, the Regulation (EC) N° 1394/2007 on ATMPs was drafted and came into force in December 2008. The Regulation laid down specific rules concerning centralized authorization and pharmacovigilance of the ATMPs. This regulatory framework has a crucial influence in the development of such ATMPs. As a consequence, the teams involved in the ATMP development must take into account the FDA/EMA scientific and regulatory guidelines that provide a detailed description of the safety, efficacy, and quality issues for CTMPs
[5,
6]. As we can see in
Box 1, cell therapy and tissue engineering products are very clearly defined by regulatory agencies.
Box 1 What are Cell Therapy and Tissue Engineering Products?
Cell therapies and tissue engineering products are considered as medicines when the following are true:
• Cell-based product:
• Substantial manipulation of cells or not intended to be used for the same essential function(s)
• Administered to human beings with a view to treating, preventing, or diagnosing a disease through the pharmacological, immunological, or metabolic action
• Tissue-engineered product:
• Substantial manipulation of tissues or not intended to be used for the same essential function(s)
• Engineered cells or tissues
• Administered to human beings with a view to regenerating, repairing, or replacing a human tissue
2. Key Pharmaceutical Factors to Consider in Early Development Stages
Several technical obstacles must be overcome during the stages of product conception and design, before cell and tissue engineering therapies move out from basic research laboratories to clinical phases of investigation. There are many challenges...