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At least 19 recordsLinked to original sources
PubMed2026

Understanding FDA's reasons for nonapproval: A systematic review of complete response letters in cell and gene therapy.

BACKGROUND AIMS: Cell and gene therapy products face unique regulatory challenges due to their biological complexity and the stringent expectations for manufacturing control, analytical testing, and clinical assessment. As the pipeline grows, understanding the drivers of FDA non‑approval is increasingly important for improving first‑cycle success and reducing development delays. In this study, we aimed to characterize the frequency and impact of refuse‑to‑file actions, major amendments, and complete response letters issued for biologics licensing applications; and to identify recurring patterns of deficiencies contributing to delayed approval. METHODS: Publicly available documents were extracted from the FDA website. Data from each approved cell and gene therapy product's regulatory history-including complete responses, major amendments, inspection timing, and cited deficiencies-were compiled and categorized across clinical, quality, and labeling domains. RESULTS: Analysis showed that informational deficiencies were common across modalities. Major amendments occurred in roughly half of applications, and complete responses had the most significant impact. Quality deficiencies appeared in all complete responses and were the predominant barrier, while clinical and labeling issues were less frequent but meaningful when present. CONCLUSION: Overall, these findings highlight the need for proactive FDA engagement, comprehensive readiness, and early inspection preparation to reduce regulatory risk and improve first cycle approval outcomes.

Humans↗
PubMed2025

Gene regulation technologies for gene and cell therapy.

Gene therapy stands at the forefront of medical innovation, offering unique potential to treat the underlying causes of genetic disorders and broadly enable regenerative medicine. However, unregulated production of therapeutic genes can lead to decreased clinical utility due to various complications. Thus, many technologies for controlled gene expression are under development, including regulated transgenes, modulation of endogenous genes to leverage native biological regulation, mapping and repurposing of transcriptional regulatory networks, and engineered systems that dynamically react to cell state changes. Transformative therapies enabled by advances in tissue-specific promoters, inducible systems, and targeted delivery have already entered clinical testing and demonstrated significantly improved specificity and efficacy. This review highlights next-generation technologies under development to expand the reach of gene therapies by enabling precise modulation of gene expression. These technologies, including epigenome editing, antisense oligonucleotides, RNA editing, transcription factor-mediated reprogramming, and synthetic genetic circuits, have the potential to provide powerful control over cellular functions. Despite these remarkable achievements, challenges remain in optimizing delivery, minimizing off-target effects, and addressing regulatory hurdles. However, the ongoing integration of biological insights with engineering innovations promises to expand the potential for gene therapy, offering hope for treating not only rare genetic disorders but also complex multifactorial diseases.

Humans↗
PubMed2026

Directing fratricide within T cell products using an anti-uPAR chimeric antigen receptor to drive the production of potent therapeutic cells.

Cell therapy manufacturing of primary T cells often results in heterogeneous cell populations in the final product, with many cells lacking desired receptor expression or exhausted and other dysfunctional phenotypes. Here, we design a novel cell-intrinsic strategy to genetically reprogram primary human T cells to autonomously detect and eliminate dysfunctional cells. This integrated detection and elimination process, known as directed fratricide, is programmed via non-viral CRISPR genome editing to eliminate the T cell receptor (TCR) alpha chain (TRAC gene knockout) and integrate a chimeric antigen receptor (CAR) against the urokinase-type plasminogen activator receptor (uPAR), also known as CD87. In these cell products, strong T cell stimulation or activation during manufacturing causes a small subset of cells to express uPAR, which triggers CAR-mediated killing within the product. This fratricide induces proliferation in the desired cells and destroys undesired cells, a process that could be modeled computationally and controlled robustly via supplements to the culture media. The strategy enabled enrichment of anti-uPAR and anti-disialoganglioside (GD2) CAR-T cell products up to ≥99% CAR+/TCR-, favoring a memory-like phenotype. Understanding growth dynamics among T cell subsets and reprogramming them via CRISPR could accelerate the biomanufacturing of potent cell products without extensive selection methods.

Humans↗
PubMed2025

Pre-clinical safety and efficacy of human induced pluripotent stem cell-derived products for autologous cell therapy in Parkinson's disease.

Human induced pluripotent stem cell (hiPSC)-derived midbrain dopaminergic cells (mDACs) represent a promising source for autologous cell therapy in Parkinson's disease (PD), but standardized regulatory criteria are essential for clinical translation. In this pre-clinical study, we generated multiple clinical-grade hiPSC lines from freshly biopsied fibroblasts of four sporadic PD patients using episomal reprogramming and differentiated them into mDACs using a refined 21-day protocol. Rigorous evaluations included whole-genome/exome sequencing, RNA sequencing, and in vivo studies, including a 39-week Good Laboratory Practice-compliant mouse safety study. While mDACs from all lines met safety criteria, mDACs from one patient failed to improve rodent behavioral outcomes, underscoring inter-individual variability. Importantly, in vitro assessments did not reliably predict in vivo efficacy, identifying dopaminergic fiber density as a key efficacy criterion. These findings support comprehensive quality control guidelines for autologous cell therapy and pave the way for a clinical trial with eight sporadic PD patients, scheduled to commence in 2025.

Humans↗
PubMed1978

Chronic experimental allergic encephalomyelitis in rhesus monkeys and its modification by treatment.

Rhesus monkeys were immunized with low doses of encephalitogenic mixture. Twenty two of 24 monkeys developed experimental allergic encephalomyelitis (EAE) lasting from 3 to 252 days. Fifteen of 22 monkeys developed chronic progressive EAE with remissions and relapses. In the early stages of EAE multiple perivascular foci of demyelination and lymphoid histiocytic infiltration were found within the central nervous system (CNS). In advanced disease these foci became confluent, developing foci of plaque type with demyelination and gliofibrosis. Eight affected monkeys received an emulsion of spinal cord with incomplete adjuvant; 6 of them showed a good therapeutic response. In the CNS of those monkeys 514 to 667 days later plaques of demyelination and gliofibrosis and minimal inflammatory lesions were detected. Two monkeys without clinical evidence of EAE had plaques of demyelination and gliofibrosis in the CNS 2 years after immunization. It is suggested that chronic EAE in monkeys may be considered an adequate model for multiple sclerosis (MS).

Acute Disease↗
PubMed1976

[Embolisation of malignant renal tumours (author's transl)].

We have carried out embolisation of malignant renal tumours using homogenised muscle in a number of patients. Since October 1974, this has been done 22 times; in six cases the tumour was inoperable. Pre-operative embolisation of resectable renal tumours makes the operative procedures easier and reduces operative risks in older patients. Haematuria, which can cause bladder obstruction, is considered a particular indication in the presence of an inoperable tumour. Tumour growth can be reduced or there may even be regression. There were no significant complications as a result of embolisation of renal tumours with autologous homogenised muscle.

Adenocarcinoma↗
PubMed1978

[Clinical and laboratory evaluation of the results of treating trophic ulcers of the lower extremities with a catgut dressing].

To assess the effect of the catgut dressing in trophic ulcers of the lower extremities upon the dynamics of non-specific immunological reactivity the authors defined the complementary activity of the serum, concentration of the serumal lysozyme and contents of thermolabile inhibitors of the serum. The clinical and laboratory findings prove that the use of the cargut dressing in trophic ulcers of the lower extremities increases the level of non-specific immunological reactivity of an organism. The use of catgut for the therapeutic purposes stimulates the condition of natural immunity which constitutes one of the causes contributing to a favourable course of the healing processes.

Catgut↗