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

zopapogene imadenovec · HPV6/11 antigens (gorilla adenovirus)

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
Not explicitly stated; mouse repeat-dose 1x10^10 VP gives ~5-fold safety factor over clinical 5x10^11 PU dose
“Repeat administration of a dose level approximately 5-fold higher than the intended clinical dose, assuming a 60-kilogram adult of 5x1011 PU (1x1010 VP/mouse/dose) of PRGN-2012 once weekly on Days 0, 7, and 14 was well tolerated in WT C57BL/6 mice with no safety findings reported at termination after 21 Days.”
✓ VerifiedFDA pharmacology/toxicology review, p. 4Source ↗

Longest repeat-dose systemic studies

Longest repeat-dose study and recovery
3-week mouse (C57BL/6) SC study, once weekly; non-GLP; recovery phase not stated
“Local tolerance and systemic toxicity were assessed as part of the repeat dose toxicity study of PRGN-2012 in wild type (WT) C57BL/6 mice. PRGN-2012 or GC46.empty vector was administered once weekly for three weeks at 1×1010 VP/administration.”
✓ VerifiedFDA summary basis for approval, p. 13Source ↗
Pivotal GLP studies
Single non-GLP repeat-dose SC mouse study (1x10^10 VP weekly x3, Days 0/7/14, sacrifice Day 21)
“GLP Status No”
✓ VerifiedFDA pharmacology/toxicology review, p. 12Source ↗

DART package

Species: DART
Not conducted (not warranted given product characteristics and nonclinical safety profile)
“No biodistribution (BD), genotoxicity, carcinogenicity, reproductive and developmental toxicity, juvenile, nor dedicated local tolerance studies of PRGN-2012 were conducted. These studies are not warranted based on the product characteristics and nonclinical safety profile of PRGN-2012.”
✓ VerifiedFDA pharmacology/toxicology review, p. 4Source ↗
Reproductive & developmental
Not conducted (predictable local adenovector biodistribution, species C-like vector); reviewer agreed
“This reviewer agrees with the rationale provided by the applicant for not conducting developmental and reproductive toxicology studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 13Source ↗
PPND / ePPND: when
Not conducted; reviewer agreed with the applicant's rationale
“This reviewer agrees with the rationale provided by the applicant for not conducting developmental and reproductive toxicology studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 13Source ↗

Carcinogenicity

Species: carcinogenicity
Not conducted
“No biodistribution (BD), genotoxicity, carcinogenicity, reproductive and developmental toxicity, juvenile, nor dedicated local tolerance studies of PRGN-2012 were conducted.”
✓ VerifiedFDA pharmacology/toxicology review, p. 4Source ↗
Carcinogenicity model
Not conducted (adenovectors non-integrating; insertional mutagenesis not a major concern)
“Per the applicant, studies were not conducted to evaluate carcinogenicity as adenovectors are non-integrating. Therefore, the risk for insertional mutagenesis is not a major concern.”
✓ VerifiedFDA pharmacology/toxicology review, p. 14Source ↗
Carcinogenicity timing
Not required; reviewer agreed with rationale for not conducting
“This reviewer agrees with the rationale provided by the applicant for not conducting carcinogenicity/tumorigenicity studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 14Source ↗

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

Itvisma

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

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 →