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Regulation of Cellular Therapy in the United States

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Abstract

In the United States, the Food and Drug Administration (FDA) is the jurisdictional authority for the regulation of cellular therapy products. The approach to regulatory oversight is tiered, with human cell, tissue, and cellular and tissue-based products (HCT/Ps) separated into two categories based on the risks associated with the use of the product. Products that meet the requirements for a lower level of regulatory oversight are regulated solely under Section 361 of the Public Health Services (PHS) Act, which provides the statutory authority to create and enforce regulations deemed necessary to prevent the introduction, transmission, or spread of communicable diseases. Under Section 361 of the PHS Act, HCT/Ps must comply with Title 21 of the Code of Federal Regulations 1271 [21 CFR 1271], but do not require premarket approval. HCT/Ps that do not meet the specified criteria to be regulated solely under Section 361 of the PHS are regulated as drugs, biologics, and/or devices under Section 351 of the PHS Act and the Food, Drug, and Cosmetic (FD&C) Act. These products require premarket approval and must also comply with applicable regulations under Title 21 of the CFR, including good manufacturing practices [21 CFR 210 and 211] and 21 CFR 1271. Relevant provisions in Part 1271 applicable to all HCT/Ps include donor eligibility and good tissue practices. Biological drug products must conform to the biological product regulations [21 CFR 600-680] and require a license, which is granted upon demonstration that the product meets prescribed requirements of safety, purity, and potency. In order to collect the safety and efficacy data supporting licensure, the product is studied in clinical trials under an Investigational New Drug (IND) application, in accordance with 21 CFR 312. Some cellular therapies are combined with gene therapy, which is intended to modify a patient’s genome in order to cure or treat a disease. These cell/gene therapy products are subject to the same statutory requirements as HCT/Ps regulated as drugs, biologics, and/or devices; however, the FDA has issued several guidance documents to address unique characteristics of gene therapy products. Cell and gene therapy products that meet certain criteria may be eligible for expedited development programs at the FDA, including Regenerative Medicine Advanced Therapy (RMAT) designation.

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References

  1. Food, Drug, and Cosmetic Act. (1938). 21 U.S.C. § 301 et. seq.

    Google Scholar 

  2. Public Health Services Act. (1944). 42 U.S.C.

    Google Scholar 

  3. Administrative Procedures Act. (1946). 5 U.S.C. § 551 et. seq.

    Google Scholar 

  4. U.S. Food and Drug Administration website. (2018). What is the difference between the Federal Food, Drug, and Cosmetic Act (FD&C Act), FDA regulations, and FDA guidance? Updated March 28, 2018. https://www.fda.gov/about-fda/fda-basics/what-difference-between-federal-food-drug-and-cosmetic-act-fdc-act-fda-regulations-and-fda-guidance. Last accessed 3 Jan 2021.

  5. U.S. Food and Drug Administration website. (2020). Search for FDA guidance documents. Updated December 10, 2020 https://www.fda.gov/regulatory-information/search-fda-guidance-documents. Last accessed 3 Jan 2021.

  6. U.S. Food and Drug Administration. (1993). Application of current statutory authorities to human somatic cell therapy products and gene therapy products; Notice. 58 FR 53248. Published October 14, 1993. https://tile.loc.gov/storage-services/service/ll/fedreg/fr058/fr058197/fr058197.pdf. Last accessed 3 Jan 2021.

  7. U.S. Food and Drug Administration. (1993). Human tissue intended for transplantation; Interim Rule. 58 FR 65514. Published December 14, 1993. https://tile.loc.gov/storage-services/service/ll/fedreg/fr058/fr058238/fr058238.pdf. Last accessed 3 Jan 2021.

  8. U.S. Food and Drug Administration. (1997). Human tissue intended for transplantation; Final Rule. 62 FR 40444. Published July 29, 1997. https://www.govinfo.gov/content/pkg/FR-1997-07-29/pdf/97-19819.pdf. Last accessed 3 Jan 2021.

  9. U.S. Food and Drug Administration. (1997). Proposed approach to regulation of cellular and tissue-based products; Availability and public meeting. 62 FR 9721. Published March 4, 1997. https://www.federalregister.gov/documents/1997/03/04/97-5240/proposed-approach-to-regulation-of-cellular-and-tissue-based-products-availability-and-public. Last accessed 3 Jan 2021.

  10. U.S. Food and Drug Administration. (2007). Regulation of human cells, tissues, and cellular and tissue-based products (HCT/Ps) small entity compliance guide. Guidance for Industry. August 2007. https://www.fda.gov/media/70689/download. Last accessed 3 Jan 2021.

  11. U.S. Food and Drug Administration. (2001). Human cells, tissues, and cellular and tissue-based products; Establishment registration and listing; Final Rule. 66 FR 5447. Published January 19, 2001. https://www.govinfo.gov/content/pkg/FR-2001-01-19/pdf/01-1126.pdf. Last accessed 3 Jan 2021.

  12. U.S. Food and Drug Administration. (2004). Eligibility determination for donors of human cells, tissues, and cellular and tissue-based products; Final rule and notice. 69 FR 29786. Published May 25, 2004. https://www.govinfo.gov/content/pkg/FR-2004-05-25/pdf/04-11245.pdf. Last accessed 3 Jan 2021.

  13. U.S. Food and Drug Administration. (2004). Current good tissue practice for human cell, tissue, and cellular and tissue based product establishments; Inspection and enforcement; Final Rule. 69 FR 68612. Issued November 24, 2004. https://www.govinfo.gov/content/pkg/FR-2004-11-24/pdf/04-25798.pdf. Last accessed 3 Jan 2021.

  14. U.S. Food and Drug Administration. (2020). Revocation of the regulations for human tissue intended for transplantation and human dura mater; Proposed Rule. 85 FR 82990. Issued December 21, 2020. https://www.govinfo.gov/content/pkg/FR-2020-12-21/pdf/2020-27828.pdf. Last accessed 3 Jan 2021.

  15. 21st Century Cures Act. (2016). H.R. 34, 114th congress. https://www.fda.gov/about-fda/jobs-and-training-fda/title-21-21st-century-cures-act-positions. Last accessed 3 Jan 2021.

  16. U.S. Food and Drug Administration website. (2019). Framework for the regulation of regenerative medicine products. Updated May 21, 2019. https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/framework-regulation-regenerative-medicine-products. Last accessed 3 Jan 2021.

  17. U.S. Food and Drug Administration website. (2020). Regenerative medicine advanced therapy designation. Updated October 5, 2020. https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/regenerative-medicine-advanced-therapy-designation. Last accessed 3 Jan 2021.

  18. U.S. Food and Drug Administration. (2020). Regulatory considerations for human cells, tissues, and cellular and tissue-based products: Minimal manipulation and homologous use. Guidance for Industry. July 2020 https://www.fda.gov/media/109176/download. Last accessed 3 Jan 2021.

  19. U.S. Food and Drug Administration. (2017). Same surgical procedure exception under 21 CFR 1271.15(b): Questions and answers regarding the scope of the exception. Guidance for Industry. November 2017. https://www.fda.gov/media/89920/download. Last accessed 3 Jan 2021.

  20. U.S. Food and Drug Administration. (2020). Compliance program guidance manual 7341.002, Inspection of human cells, tissues, and cellular and tissue-based products (HCT/Ps). https://www.fda.gov/media/73949/download. Last accessed 3 Jan 2021.

  21. U.S. Food and Drug Administration website. (2020). Frequently asked questions about combination products. Updated April 9, 2020. https://www.fda.gov/combination-products/about-combination-products/frequently-asked-questions-about-combination-products#review. Last accessed 3 Jan 2021.

  22. U.S. Food and Drug Administration website. (2020). TRG Rapid Inquiry Program (TRIP). Updated August 5, 2020. https://www.fda.gov/vaccines-blood-biologics/trg-rapid-inquiry-program-trip. Last accessed 3 Jan 2021.

  23. Center for Biologics Evaluation and Research. (2020). SOPP 8004: Tissue reference GroupVersion 5. Effective January 16, 2020. https://www.fda.gov/media/109176/download. Last accessed 3 Jan 2021.

  24. U.S. Food and Drug Administration website. (2018). Tissue reference group. Updated March 26, 2018. https://www.fda.gov/about-fda/fda-basics/what-difference-between-federal-food-drug-and-cosmetic-act-fdc-act-fda-regulations-and-fda-guidance. Last accessed 3 Jan 2021.

  25. U.S. Food and Drug Administration. (2011). How to write a request for designation (RFD). Guidance for Industry. April 2011. https://www.fda.gov/media/80495/download. Last accessed 3 Jan 2021.

  26. U.S. Food and Drug Administration. (2018). How to prepare a pre-request for designation (Pre-RFD). Guidance for Industry. February 2018 https://www.fda.gov/media/102706/download. Last accessed 3 Jan 2021.

  27. U.S. Food and Drug Administration. (2011). Current Good Tissue Practice (CGTP) and additional requirements for manufacturers of human cells, tissues, and cellular and tissue-based products (HCT/Ps). Guidance for Industry. December 2011 https://www.fda.gov/media/82724/download. Last accessed 3 Jan 2021.

  28. U.S. Food and Drug Administration. (2016). Investigating and reporting adverse reactions related to human cells, tissues, and cellular and tissue-based products (HCT/Ps) regulated solely under Section 361 of the Public Health Service Act and 21 CFR Part 1271. Guidance for Industry. March 2016 https://www.fda.gov/media/91082/download. Last accessed 3 Jan 2021.

  29. U.S. Food and Drug Administration. (2017). Deviation reporting for human cells, tissues, and cellular and tissue-based products regulated solely under Section 361 of the Public Health Service Act and 21 CFR Part 1271. Guidance for Industry. September 2017. https://www.fda.gov/media/107703/download. Last accessed 3 Jan 2021.

  30. Wilson Sonsini website. (2020). FDA delays regulatory enforcement of stem cells, other cellular and tissue products. August 5, 2020. https://www.wsgr.com/en/insights/fda-delays-regulatory-enforcement-of-stem-cells-other-cellular-and-tissue-products.html. Last accessed 3 Jan 2021.

  31. U.S. Food and Drug Administration. (2010). Compliance program guidance manual 7345.848, Chapter 45 Biological drug products inspection of biological drug products (CBER). October 1, 2010. https://www.fda.gov/media/73834/download. Last accessed 3 Jan 2021.

  32. U.S. Food and Drug Administration website. (2020). Device advice: Comprehensive regulatory assistance. Updated August 2020. https://www.fda.gov/medical-devices/device-advice-comprehensive-regulatory-assistance. Last accessed 3 Jan 2021.

  33. U.S. Food and Drug Administration website. (2020). FDA website Biologics License Applications (BLA) process (CBER). Updated November 20, 2020. https://www.fda.gov/vaccines-blood-biologics/development-approval-process-cber/biologics-license-applications-bla-process-cber. Last accessed 3 Jan 2021.

  34. U.S. Food and Drug Administration website. (2015). IND application procedures: Clinical hold. Updated October 9, 2015. https://www.fda.gov/drugs/investigational-new-drug-ind-application/ind-application-procedures-clinical-hold. Last accessed 3 Jan 2021.

  35. U.S. Food and Drug Administration. (2000). Submitting and reviewing complete responses to clinical holds. Guidance for Industry. October 2000. https://www.fda.gov/media/72548/download. Last accessed 3 Jan 2021.

  36. U.S. Food and Drug Administration website. (2019). Tissue establishment registration. Updated November 5, 2019. https://www.fda.gov/vaccines-blood-biologics/biologics-establishment-registration/tissue-establishment-registration. Last accessed 3 Jan 2021.

  37. U.S. Food and Drug Administration. (2004). Sterile drug products produced by Aseptic Processing – Current good manufacturing practice. Guidance for Industry. September 2004. https://www.fda.gov/media/71026/download. Last accessed 3 Jan 2021.

  38. U.S. Food and Drug Administration. (2002). Validation of procedures for processing of human tissues intended for transplantation. Guidance for Industry. March 2002. https://www.fda.gov/media/73242/download. Last accessed 3 Jan 2021.

  39. U.S. Food and Drug Administration. (2011). Process validation: General principles and practices. Guidance for Industry. January 2011. https://www.fda.gov/files/drugs/published/Process-Validation%2D%2DGeneral-Principles-and-Practices.pdf. Last accessed 3 Jan 2021.

  40. U.S. Food and Drug Administration. (2007). Eligibility determination for donors of human cells, tissues, and cellular and tissue-based products (HCT/Ps). Guidance for Industry. August 2007. https://www.fda.gov/media/73072/download. Last accessed 3 Jan 2021.

  41. U.S. Food and Drug Administration website. (2019). Testing donors of human cells, tissues, and cellular and tissue-based products (HCT/P): Specific requirements. Updated May 3, 2019. https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/testing-donors-human-cells-tissues-and-cellular-and-tissue-based-products-hctp-specific-requirements. Last accessed 3 Jan 2021.

  42. U.S. Food and Drug Administration. (2014). Biologics license applications for minimally manipulated, unrelated allogeneic placental/umbilical cord blood intended for hematopoietic and immunologic reconstitution in patients with disorders affecting the hematopoietic system. Guidance for Industry. March 2014. https://www.fda.gov/media/86387/download. Last accessed 3 Jan 2021.

  43. U.S. Food and Drug Administration. (2014). Investigational new drug applications for minimally manipulated, unrelated allogeneic placental/umbilical cord blood intended for hematopoietic and immunologic reconstitution in patients with disorders affecting the hematopoietic system. Guidance for Industry. March 2014. https://www.fda.gov/media/89441/download. Last accessed 3 Jan 2021.

  44. U.S. Food and Drug Administration website. (2018). What is gene therapy? Updated July 25, 2018. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/expedited-programs-regenerative-medicine-therapies-serious-conditions. Last accessed 3 Jan 2021.

  45. U.S. Food and Drug Administration. (2020). Long term follow-up after administration of human gene therapy products. Guidance for Industry. January 2020. https://www.fda.gov/media/113768/download. Last accessed 3 Jan 2021.

  46. U.S. Food and Drug Administration. (2020). Testing of retroviral vector-based human gene therapy products for replication competent retrovirus during product manufacture and patient follow-up. Guidance for Industry. January 2020. https://www.fda.gov/media/113790/download. Last accessed 3 Jan 2021.

  47. U.S. Food and Drug Administration. (2019). Expedited programs for regenerative medicine therapies for serious conditions. Guidance for Industry. February 2019. https://www.fda.gov/media/120267/download. Last accessed 3 Jan 2021.

  48. U.S. Food and Drug Administration. (2014). Expedited programs for serious conditions–Drugs and biologics. Guidance for Industry. May 2014. https://www.fda.gov/media/86377/download. Last accessed 3 Jan 2021.

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Fisher, N., Ibenana, L., El Fiky, A., Anderson, R. (2022). Regulation of Cellular Therapy in the United States. In: Gee, A.P. (eds) Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-75537-9_1

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