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Itvisma: what was done before first-in-human, and what came after?

onasemnogene abeparvovec (intrathecal) · SMN1 (AAV9, intrathecal)

Before first-in-human

First-in-human: where
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.
Repeat-dose tox before first-in-human
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-in-human starting dose
NHP-tolerated 1.2x10^13 vg/animal scaled 10-fold by CSF volume to human starting dose 1.2x10^14 vg/patient
“In vivo toxicology/safety studies conducted in NHPs utilized a single IT administration of OAV101 at 1.2 x 1013 vg/animal, considered equivalent to the proposed starting clinical dose level for ITVISMA of 1.2x1014 vg/patient based on a 10-fold difference in CSF volume between NHP and human.”
✓ VerifiedFDA summary basis for approval, p. 15Source ↗

Longest repeat-dose systemic studies

Longest repeat-dose study and recovery
No repeat-dose study (single administration)
“No carcinogenicity, genotoxicity, or repeat dosing were conducted for OAV101B. These studies are not necessary based on the intended ROA, dosing regimen (i.e., single infusion), known product characteristics, and overall safety profile for this class of product.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗
Pivotal GLP studies
Single-dose IT NHP study (1.2, 3.0, 6.0 x10^13 vg/animal) to 12 months; mouse ICV studies; IV mouse FEED and EFD
“A single IT dose of onasemnogene abeparvovec was administered at three dose levels: 1.20 × 10 13 vg/animal (equivalent to the clinical therapeutic dose), 3.0 × 10 13 vg/animal, and 6.0 × 10 13 vg/animal.”
✓ VerifiedUS prescribing informationSource ↗

DART package

Species: DART
Mouse (FVB; fertility and early embryonic development, single IV dose)
“Fertility and early embryonic development (FEED) studies were conducted in healthy male and female FVB mice administered a single intravenous injection of OAV101B.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗
Reproductive & developmental
Mouse FEED (single IV OAV101B): no fertility effects, no germline transmission; mouse EFD NOAEL 1.1x10^14 vg/kg
“Fertility and early embryonic development (FEED) studies were conducted in healthy male and female FVB mice administered a single intravenous injection of OAV101B. There were no reported adverse effects on fertility, fecundity, or mating behaviors in either sex.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗
PPND / ePPND: when
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.

Carcinogenicity

Species: carcinogenicity
Not conducted
“No carcinogenicity, genotoxicity, or repeat dosing were conducted for OAV101B.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗
Carcinogenicity model
Not conducted; not necessary given single infusion, known product characteristics and class safety profile
“No carcinogenicity, genotoxicity, or repeat dosing were conducted for OAV101B. These studies are not necessary based on the intended ROA, dosing regimen (i.e., single infusion), known product characteristics, and overall safety profile for this class of product.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗
Carcinogenicity timing
Not conducted: not necessary (single infusion, known product characteristics, class safety profile)
“No carcinogenicity, genotoxicity, or repeat dosing were conducted for OAV101B. These studies are not necessary based on the intended ROA, dosing regimen (i.e., single infusion), known product characteristics, and overall safety profile for this class of product.”
✓ VerifiedFDA summary basis for approval, p. 16Source ↗

Same question, other gene therapies

Adstiladrin

nadofaragene firadenovec · IFN-alpha2b (adenovirus, intravesical)
US: all clinical studies, including first-in-human in patients with BCG-unresponsive NMIBC, conducted in the US

Kebilidi

eladocagene exuparvovec · AADC
Country not stated; the vector (rAAV2-hAADC) was first tested in humans in Parkinson's disease patients by bilateral intraputaminal dosing

Otarmeni

lunsotogene parvec · OTOF (AAV, intracochlear)
United States and unnamed ex-US sites: DB-OTO-001 (7 US, 4 ex-US sites), the only clinical study

Roctavian

valoctocogene roxaparvovec · Factor VIII
Country not stated; first-in-human dose-escalation study 270-201 in patients with severe hemophilia A

Strimvelis

autologous CD34+ cells transduced with ADA (no INN) · ADA (gamma-retroviral, ex vivo HSC)
Israel: first administered in 2000 to one ADA-SCID patient at Hadassah University, Jerusalem (pilot study)

Zolgensma

onasemnogene abeparvovec · SMN1
United States: single-site trial in 15 infants with SMA

Beqvez

fidanacogene elaparvovec · Factor IX
Not stated in public reviews

Casgevy

exagamglogene autotemcel · BCL11A enhancer (CRISPR-Cas9, ex vivo HSC)
Not stated in public reviews

Elevidys

delandistrogene moxeparvovec · Micro-dystrophin
Not stated in public reviews

Fayuvi

rebisufligene etisparvovec · SGSH (AAV9)
Not stated in public reviews

Genglycos

pariglasgene brecaparvovec · G6PC (AAV8)
Not stated in public reviews

Glybera

alipogene tiparvovec · LPL (AAV1)
Not stated in public reviews

Hemgenix

etranacogene dezaparvovec · Factor IX
Not stated in public reviews

Imlygic

talimogene laherparepvec · GM-CSF (oncolytic HSV-1)
Not stated in public reviews

Kresladi

marnetegragene autotemcel · ITGB2 (LVV, ex vivo HSC)
Not stated in public reviews

Lenmeldy

atidarsagene autotemcel · ARSA (LVV, ex vivo HSC)
Not stated in public reviews

Luxturna

voretigene neparvovec · RPE65
Not stated in public reviews

Lyfgenia

lovotibeglogene autotemcel · HBB T87Q (LVV, ex vivo HSC)
Not stated in public reviews

Papzimeos

zopapogene imadenovec · HPV6/11 antigens (gorilla adenovirus)
Not stated in public reviews

Skysona

elivaldogene autotemcel · ABCD1 (LVV, ex vivo HSC)
Not stated in public reviews

Tudriqev

vusolimogene oderparepvec · GALV-GP + GM-CSF (oncolytic HSV-1)
Not stated in public reviews

Vyjuvek

beremagene geperpavec · COL7A1 (HSV-1, topical)
Not stated in public reviews

Waskyra

etuvetidigene autotemcel · WAS (LVV, ex vivo HSC)
Not stated in public reviews

Zevaskyn

prademagene zamikeracel · COL7A1 (RV-modified keratinocyte sheets)
Not stated in public reviews

Zynteglo

betibeglogene autotemcel · HBB T87Q (LVV, ex vivo HSC)
Not stated in public reviews

Summary across all 26 gene therapies →