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

azficel-T · Autologous fibroblasts

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
None: no preclinical studies; prior human experience supported initial clinical studies
“No preclinical studies were conducted by the sponsor with the clinical product, Isolagen Therapy™, or with an animal cellular analog in support of early phase to later phase clinical trials.”
✓ VerifiedFDA pharmacology/toxicology review, p. 26Source ↗
First-in-human starting dose
Not stated in public reviews
Why it's blank

The public FDA and EMA reviews of Laviv don't say how the first human dose was chosen. That rationale is in the IND, which is confidential, so it is missing for most approved products.

How it's usually set for cell therapies

FDA expects preclinical proof-of-concept and toxicology studies to identify active dose levels and support the choice of starting dose and escalation. The 2013 guidance gives no numeric formula or scaling rule for the starting dose.

“Selection of potential starting dose level, dose-escalation schedule, and dosing regimen for clinical trials.”
✓ VerifiedFDA 2013: Preclinical Assessment of Investigational Cellular and Gene Therapy…, p. 7Source ↗

Full method, every step sourced →

Longest repeat-dose systemic studies

Longest repeat-dose study and recovery
No repeat-dose study (no preclinical studies conducted)
“No preclinical studies were conducted with this product.”
✓ VerifiedFDA pharmacology/toxicology review, p. 3Source ↗
Pivotal GLP studies
None; no GLP toxicology; reliance on ~1100 treated subjects of prior commercial use
“No preclinical studies were conducted with this product.”
✓ VerifiedFDA pharmacology/toxicology review, p. 3Source ↗

DART package

Species: DART
Not conducted (autologous product, prior human experience)
“Toxicology studies as described in the International Conference on Harmonisation (ICH) Safety (‘S’) guidelines, consisting of pharmacokinetics, acute toxicology, chronic toxicology, genotoxicity, carcinogenicity, reproductive and developmental toxicity, safety pharmacology, and immunotoxicity (http://www.ich.org/cache/compo/276-254- 1.html) were not conducted by the sponsor due to the autologous nature of IT and the previous human experience.”
✓ VerifiedFDA pharmacology/toxicology review, p. 24Source ↗
Reproductive & developmental
Not conducted (autologous nature, prior human experience)
“were not conducted by the sponsor due to the autologous nature of IT and the previous human experience.”
✓ VerifiedFDA pharmacology/toxicology review, p. 24Source ↗
PPND / ePPND: when
Not conducted: autologous product with prior human experience
“reproductive and developmental toxicity, safety pharmacology, and immunotoxicity (http://www.ich.org/cache/compo/276-254- 1.html) were not conducted by the sponsor due to the autologous nature of IT and the previous human experience.”
✓ VerifiedFDA pharmacology/toxicology review, p. 24Source ↗

Carcinogenicity

Species: carcinogenicity
Not conducted (autologous product, prior human experience)
“Toxicology studies as described in the International Conference on Harmonisation (ICH) Safety (‘S’) guidelines, consisting of pharmacokinetics, acute toxicology, chronic toxicology, genotoxicity, carcinogenicity, reproductive and developmental toxicity, safety pharmacology, and immunotoxicity (http://www.ich.org/cache/compo/276-254- 1.html) were not conducted by the sponsor due to the autologous nature of IT and the previous human experience.”
✓ VerifiedFDA pharmacology/toxicology review, p. 24Source ↗
Carcinogenicity model
Not conducted; published nude-mouse study (two animals, 2 months) inconclusive for tumorigenicity
“Regarding the in vivo assessment of tumorigenic potential: 1) only two animals were used and 2) the study duration was only 2 months, therefore no conclusions can be made about this safety endpoint.”
✓ VerifiedFDA pharmacology/toxicology review, p. 12Source ↗
Carcinogenicity timing
Not required: autologous, minimally manipulated cells judged unlikely to become tumorigenic
“The pharmacology/toxicology review of the original IND submission supported the sponsor’s decision, noting that these cells are autologous, minimally manipulated, highly unlikely to change in phenotype, dedifferentiate, migrate or become tumorigenic (see Attachment I).”
✓ VerifiedFDA pharmacology/toxicology review, p. 24Source ↗

Same question, other cell therapies

Abecma

idecabtagene vicleucel · BCMA CAR-T
Country not stated; first-in-human dose-finding study in patients with relapsed/refractory multiple myeloma (CRB-401)

Carvykti

ciltacabtagene autoleucel · BCMA CAR-T
Country not stated; first clinical trial in patients with relapsed/refractory multiple myeloma (LEGEND-2)

MACI

autologous cultured chondrocytes on porcine collagen membrane · Autologous chondrocytes
Outside the United States: all clinical studies ex-US (countries not named)

Tecelra

afamitresgene autoleucel · MAGE-A4 TCR-T
Country not stated; first-in-human dose-escalation and expansion study in HLA-A*02 patients with MAGE-A4-positive advanced tumors

Yescarta

axicabtagene ciloleucel · CD19 CAR-T
Country not stated; initial dose-finding study NCI 09-C-0082 in patients with advanced B-cell malignancies

Zemcelpro

dorocubicel · UM171-expanded cord blood CD34+
Canada: dose de-escalation study (Study 001) at 2 sites in patients needing allogeneic stem cell transplant

Alofisel

darvadstrocel · Allogeneic adipose MSC
Not stated in public reviews

Amtagvi

lifileucel · TIL therapy
Not stated in public reviews

Aucatzyl

obecabtagene autoleucel · CD19 CAR-T
Not stated in public reviews

Breyanzi

lisocabtagene maraleucel · CD19 CAR-T
Not stated in public reviews

ChondroCelect

characterised viable autologous cartilage cells · Autologous chondrocytes
Not stated in public reviews

Ebvallo

tabelecleucel · EBV-specific allogeneic T cells
Not stated in public reviews

Encelto

revakinagene taroretcel · CNTF (encapsulated RPE cell implant)
Not stated in public reviews

Gintuit

allogeneic cultured keratinocytes and fibroblasts in bovine collagen · Allogeneic keratinocytes + fibroblasts
Not stated in public reviews

Holoclar

autologous corneal epithelial cells containing limbal stem cells · Autologous limbal stem cells
Not stated in public reviews

Kymriah

tisagenlecleucel · CD19 CAR-T
Not stated in public reviews

Lantidra

donislecel · Allogeneic pancreatic islets
Not stated in public reviews

Omisirge

omidubicel · Expanded cord blood HPC
Not stated in public reviews

Provenge

sipuleucel-T · PAP-GM-CSF (autologous APC)
Not stated in public reviews

Rethymic

allogeneic processed thymus tissue · Allogeneic thymus tissue
Not stated in public reviews

Ryoncil

remestemcel-L · Allogeneic BM-MSC
Not stated in public reviews

Spherox

spheroids of autologous matrix-associated chondrocytes · Autologous chondrocyte spheroids
Not stated in public reviews

StrataGraft

allogeneic cultured keratinocytes and dermal fibroblasts in murine collagen · Allogeneic keratinocytes + fibroblasts
Not stated in public reviews

Tecartus

brexucabtagene autoleucel · CD19 CAR-T
Not stated in public reviews

Tregzi

allogeneic Treg immunotherapy with HSPC and T cells (Orca-T) · Allogeneic Treg + HSPC + Tcon
Not stated in public reviews

Zalmoxis

allogeneic T cells modified with HSV-TK / dLNGFR (nalotimagene carmaleucel) · HSV-TK suicide-gene T cells
Not stated in public reviews

Summary across all 27 cell therapies →