Leukemia
in gene therapy trials: a question of vectors, inserts and dosage?»
Before moving on to human trials, they will need to study all instances of «off - target» effects: Years before Crispr, the viruses employed to deliver DNA
in gene therapy trials occasionally damaged the whole system, causing cancer.
Some on the panel suggested they were particularly sensitive about such concerns given that it was at UPenn in 1999 that a young man, Jessie Gelsinger, died
in a gene therapy trial, setting the field back for years.
A few years ago, a retrovirus triggered leukemia in three children
in a gene therapy trial in France (ScienceNOW, 14 January 2003).
Health authorities in several countries are responding to a serious adverse event
in a gene therapy trial.
Gene therapy experts are heartened by the new results, which may counteract a wave of negative publicity after the death last year of a volunteer
in a gene therapy trial at the University of Pennsylvania (ScienceNOW, 9 December 1999).
The patient was the first
in a gene therapy trial to die of the therapy itself; his death is the latest blow to a field that has been struggling to live up to the promise and hype surrounding the first gene therapy trials a decade ago.
Not exact matches
To date, no
gene therapies have yet been approved
in the US, though one to treat another form of LCA has had promising results
in late - stage
trials.
Katherine High, Spark's president and chief scientific officer, expressed her enthusiasm for the early clinical data related to SPK - 8011: «The encouraging start of our SPK - 8011 clinical
trial reinforces the strength of our
gene therapy platform, delivers human proof - of - concept
in a second liver - mediated disease — a significant achievement
in the
gene therapy field — and positions us well to potentially transform the current treatment approach for this life - altering disease with a one - time intervention.»
He and his lab, for example, along with the company Neurologix based
in Fort Lee, N.J., are conducting a clinical
trial to test a similar
gene -
therapy treatment for Parkinson's disease.
But he contends that other
gene therapies already
in clinical
trials suggest that the treatment could work.
These allusions to the past aren't surprising considering how drastically the clinical
trial changed
gene therapy and, in particular, the career of James M. Wilson, the medical geneticist who headed Penn's Institute for Human Gene Therapy, where the test took pl
gene therapy and, in particular, the career of James M. Wilson, the medical geneticist who headed Penn's Institute for Human Gene Therapy, where the test took
therapy and,
in particular, the career of James M. Wilson, the medical geneticist who headed Penn's Institute for Human
Gene Therapy, where the test took pl
Gene Therapy, where the test took
Therapy, where the test took place.
Scientists believe that is what happened during a 1999 French
gene therapy trial on a group of 10 young children with X-SCID, an immune deficiency disorder known as boy -
in - the - bubble syndrome.
«My team at Nationwide Children's has worked with commitment and dedication to develop a
therapy that may subsequently be shown through future clinical trials to potentially alter the course of this unforgiving condition and provide a therapeutic option for the families and infants with SMA1,» says Jerry Mendell, MD, principal investigator in the Center for Gene Therapy at Nationwide Chil
therapy that may subsequently be shown through future clinical
trials to potentially alter the course of this unforgiving condition and provide a therapeutic option for the families and infants with SMA1,» says Jerry Mendell, MD, principal investigator
in the Center for
Gene Therapy at Nationwide Chil
Therapy at Nationwide Children's.
Although
gene therapy research has made great strides
in recent years, it has yet to be widely deployed, and no CRISPR - edited
genes have yet been tested for safety or efficacy
in human clinical
trials.
Several SMA treatment
trials are
in progress, but the community is especially tracking a single - dose
gene therapy that, if approved, would have its own cost and treatment implications.
AAV is
in use
in many late - stage clinical
trials in the United States, and has already been approved for use
in one
gene therapy drug
in the European Union.
This study represents a significant step towards the development of clinical
trials in gene therapy for the curative treatment of hereditary deafness and balance loss
in humans.
Although some
gene therapy trials have seen limited success, many have produced adverse reactions
in volunteers.
AveXis, Inc., a clinical - stage
gene therapy company developing treatments for patients suffering from rare and life - threatening neurological genetic diseases, announced in July 2016 that the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation for the treatment based on preliminary clinical results from the trial of AVXS
therapy company developing treatments for patients suffering from rare and life - threatening neurological genetic diseases, announced
in July 2016 that the U.S. Food and Drug Administration (FDA) granted Breakthrough
Therapy Designation for the treatment based on preliminary clinical results from the trial of AVXS
Therapy Designation for the treatment based on preliminary clinical results from the
trial of AVXS - 101.
The
trial he conducted tested the safety of a
therapy for ornithine transcarbamylase (OTC) deficiency, a rare disorder
in which the liver lacks a functional copy of the OTC
gene.
A one - time intravenous infusion of the high dose of
gene therapy extended the survival of patients with spinal muscular atrophy type 1 (SMA1)
in a Phase 1 clinical
trial, according to a study published
in the New England Journal of Medicine.
«Fibroblast growth factor receptor inhibitors are new
therapies being developed
in clinical
trials for patients whose cancer cells have genetic alterations
in this family of
genes,» says Roychowdhury, a member of the OSUCCC — James Translational Therapeutics Program.
Now Aubourg and his team have showed
in a preliminary
trial that
gene therapy stopped ALD
in two boys for whom they could not find matching bone marrow donors.
One clinical
trial involves the drug CGF166, a one - time
gene therapy, which, if proven successful
in humans, could regenerate new hair cells within the cochlea that can signal the part of the brain that processes sound.
Another candidate, AVXS - 101 (AveXis), is a
gene therapy approach to increase SMN levels, which is
in Phase I clinical
trials.
A U.K. team is designing a clinical
trial even more radical than prenatal stem cell
therapy: the first ever test of
gene therapy in pregnancy.
Two of 10 children treated with
gene therapy for SCID
in a French
trial develop leukemia, researchers announced
in 2002, and it is discovered that the virus had inserted
genes in several unexpected places around the genome, leading the cells to become cancerous.
After this incident, and the death
in 1999 of a young man
in a clinical
trial, apparently because of an immune reaction to the treatment,
gene therapy research grounds nearly to a halt.
The tragic death of 18 - year - old Jesse Gelsinger
in a
trial last year marked a low point
in the history of
gene therapy.
Many point to the Jesse Gelsinger case,
in which a teenager died during a
gene therapy clinical
trial.
Regulators
in the US could soon be asked to approve a human
trial of
gene therapy for cystic fibrosis that uses a hybrid of the HIV and Ebola viruses.
AAV1 is considered safe as a viral vector and is already
in use
in human
gene therapy trials for blindness, heart disease, muscular dystrophy and other conditions.
«Our
gene therapy protocol is not yet ready for clinical
trials — we need to tweak it a bit more — but
in the not - too - distant future we think it could be developed for therapeutic use
in humans,» says Jeffrey Holt, PhD, a scientist
in the Department of Otolaryngology and F.M. Kirby Neurobiology Center at Boston Children's and an associate professor of Otolaryngology at Harvard Medical School.
It showed effectiveness against liver cancer
in a phase II clinical
trial and will move into a phase III
trial later this year, David Kirn, an oncologist and the company's president and chief executive officer, said at a recent meeting of the American Society for
Gene & Cell
Therapy in Washington, D.C..
The proposed clinical
trial,
in which researchers would use CRISPR to engineer immune cells to fight cancer, won approval from the Recombinant DNA Advisory Committee (RAC) at the U.S. National Institutes of Health, a panel that has traditionally vetted the safety and ethics of
gene therapy trials funded by the U.S. government and others.
IN TWO months» time, a group of profoundly deaf people could be able to hear again, thanks to the world's first
gene therapy trial for deafness.
Scientists believe that's what happened during a 1999 French
gene therapy trial on a group of 10 infants with X-SCID, an immune deficiency disorder known as boy -
in - the - bubble syndrome.
«The good news is that this finding predicts that patients missing either
gene should be sensitive to new
therapies targeting focal adhesion enzymes, which are currently being tested
in early - stage clinical
trials,» says Shaw, who is also a member of the Moores Cancer Center and an adjunct professor at the University of California, San Diego.
A
therapy that replaces the faulty
gene responsible for cystic fibrosis
in patients» lungs has produced encouraging results
in a major UK
trial.
(
In the early 2000s, five children who participated in a retrovirus - based gene therapy trial for severe combined immunodeficiency developed leukemia
In the early 2000s, five children who participated
in a retrovirus - based gene therapy trial for severe combined immunodeficiency developed leukemia
in a retrovirus - based
gene therapy trial for severe combined immunodeficiency developed leukemia.)
Dr. Levine directs the Clinical Cell and Vaccine Production Facility (CVPF), which develops, manufactures, and tests novel cell and
gene therapies in clinical
trials at Penn and collaborating institutions.
One early success story is cystic fibrosis: since the
gene was identified
in 1989, exceptional progress has been made
in devising new experimental treatments, including
gene therapy trials.
(Adeno - associated virus or AAV has been approved
in Europe as a vector for
gene therapy, and is being explored
in the United States for clinical
trials.)
The team envisions that
in the future, deaf people might benefit from
gene therapy similar to the approaches currently being tested
in clinical
trials for other diseases.
What's more, none of the patients experienced macrophage activate syndrome or cytokine release syndrome, an infusion reaction observed
in other
gene therapy trials characterized by fever, nausea, chills, hypotension or a rash.
«A clinical
trial in both type 1 and type 2 diabetics
in the immediate foreseeable future is quite realistic, given the impressive nature of the reversal of the diabetes, along with the feasibility
in patients to do AAV
gene therapy.»
Although several experimental
trials of
gene therapy are under way, some of them for more than a decade, uniQure is the first
in the West to win regulatory approval for a commercial treatment.
As a new generation of
gene therapy clinical
trials shows promise to cure or halt the progression of several rare diseases, the time has come to explore ways to pay for the cutting edge treatments, a pediatric hematologist - oncologist from Dana - Farber / Boston Children's Cancer and Blood Disorders Center argues
in a commentary published by the journal Science.
As for worries about harmful effects, researchers say AAV8 isn't likely to disrupt healthy
genes, a side effect that stalled a promising
gene -
therapy trial for an immune - deficiency disorder
in 2002.