Pharmacology used experimental CAR T batches without lot numbers; clinical drug product lots used for insertion site and growth studies. Bridging: Per certificates of testing, nonclinical experiment batches met the clinical lot release specifications
“*Lot Nos. were not assigned for CAR T cells assessed in nonclinical studies #1-8; they were manufactured under Experiment Nos.”
✓ VerifiedFDA pharmacology/toxicology review, p. 6Source ↗
Genetically modified?
Autologous CD3+ CAR-T, lentiviral vector
“Idecabtagene vicleucel (ide-cel, bb2121) consists of autologous CD3+ T cells that are transduced using a lentiviral vector to express a BCMA-directed chimeric antigen receptor (CAR).”
✓ VerifiedFDA pharmacology/toxicology review, p. 2Source ↗
Vector and route
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
First approval
2021 (FDA)
“Summary Basis for Regulatory Action Date: March 26, 2021”
✓ VerifiedFDA summary basis for approval, p. 1Source ↗
Human eASC expanded with the manufacturing method to the clinical population doubling level, in most studies. Bridging: Same manufacturing method and population doubling level as the clinical product
No studies with the product; published data on similar murine and human tumor-derived T lymphocytes. Bridging: None; FDA noted the GEN2 process differs from the published TIL expansion methods
Nonclinical CAT19 CAR T cells from healthy donor PBMCs; clinical product from patient leukapheresate. Bridging: Constructs, including the binding domain, identical; nonclinical product judged appropriate despite minor process differences
Cryopreserved preclinical JCAR017 lots from preclinical production runs, expanded by a protocol mimicking the commercial post-transduction process. Bridging: Cells expanded according to a protocol that mimics the post-transduction manipulation process for BREYANZI
CAR T cells made with lentiviral vectors from different developmental stages; CAR identical in all cases. Bridging: CAR expressed by the CAR-T cells identical across lentiviral vector versions
Dog pharmacology study used an early 11 mm prototype device; the clinical device is 6.5 mm. Bridging: None; reviewers judged the prototype study preliminary for the pharmacology of NT-501
Pharmacology used cells transduced with UPenn/US-made research lentiviral vector; clinical studies used Oxford Biomedica vector. Bridging: No comparative in vivo studies; CHMP judged them uninformative for comparability and accepted their absence
Published rabbit study used analog fibroblasts prepared by mincing and dispase, unlike the IT process. Bridging: None; rabbit analog cell preparation did not duplicate the IT procedure
autologous cultured chondrocytes on porcine collagen membrane · Autologous chondrocytes
Analogous products: ACI-Maix membrane seeded with rabbit or horse cells. Bridging: Same ACI-Maix membrane as the clinical product, seeded with animal instead of human cells
Human bone marrow ceMSC and surrogate animal-derived ceMSC, made with an early manufacturing process. Bridging: Not bridged; reviewers concluded the studies provide limited support for RYONCIL
allogeneic cultured keratinocytes and dermal fibroblasts in murine collagen · Allogeneic keratinocytes + fibroblasts
STRATAGRAFT batches from earlier development processes that differed from the commercial process. Bridging: Differences from the commercial process were listed; the batch reflecting each change was not specified
Some in vitro pharmacology used NCI-made CAR T cells from a similar but not equivalent process; additional studies used KTE-X19-process cells. Bridging: Additional in vitro pharmacology studies with CAR T cells manufactured using the KTE-X19 process, per CHMP protocol assistance
allogeneic Treg immunotherapy with HSPC and T cells (Orca-T) · Allogeneic Treg + HSPC + Tcon
Human Tregs and Tcons manufactured similarly to intended clinical DP lots. Bridging: Manufactured similarly to clinical lots; unclear dose basis limits comparison of biological activity with clinical doses
In vitro pharmacology used CAR T cells from earlier NCI processes CLP-1.0 and CLP-2.0, not the current CLP-2.2. Bridging: NCI split-apheresis comparison of CLP-1.0 and CLP-2.0; murine surrogate CAR T cells used in vivo; repeat studies with CLP-2.2 not required
Earlier culture processes; only study ECT/2018-12-001 used the clinical process (35 mM UM171, 4F, no LDLs, 7-day culture). Bridging: No thorough non-clinical study of the final clinical culture conditions all together