Development and Clinical Translation of Approved Gene Therapy Products for Genetic Disorders

Abstract

The field of gene therapy is striving more than ever to define a path to the clinic and the market. Twenty gene therapy products have already been approved and over two thousand human gene therapy clinical trials have been reported worldwide. These advances raise great hope to treat devastating rare and inherited diseases as well as incurable illnesses. Understanding of the precise pathomechanisms of diseases as well as the development of efficient and specific gene targeting and delivery tools are revolutionizing the global market. Currently, human cancers and monogenic disorders are indications number one. The elevated prevalence of genetic disorders and cancers, clear gene manipulation guidelines and increasing financial support for gene therapy in clinical trials are major trends. Gene therapy is presently starting to become commercially profitable as a number of gene and cell-based gene therapy products have entered the market and the clinic. This article reviews the history and development of twenty approved human gene and cell-based gene therapy products that have been approved up-to-now in clinic and markets of mainly North America, Europe and Asia.

Keywords: cell-based gene therapy; clinic; drug; gene therapy; genetic disease.

Figure 1

Approved human gene and cell-based gene therapy products. (A) In vivo approved gene therapy drugs such as Neovasculgen, Glybera, Defitelio, Rexin-G, Onpattro, Eteplirsen, Spinraza, Kynamro, Imlygic, Oncorine, Luxturna, Macugen, Gendicine, Vitravene as well as Zolgensma directly injected into their target tissue or organ. (B) Ex vivo gene therapy drugs include Zalmoxis as allogenic T cells, Invossaas allogenic chondrocytes, Yeskarta and Kymriahas autologous T cells (CAR T cell therapy), Strimvelisas autologous hematopoitic stem cells.

Figure 2

Distribution countries of approval gene therapy drugs (A) and timeline of gene therapy development (B). As it is shown the North America and Europe are main parts of the gene therapy development and market (A). Gene therapy market began with approval of Vitravene drug in 1998, and it was continued with approval of Zolgensma drug in 24 May, 2019. 2016 and 2017 years were promising points in gene therapy market since near 10 gene therapy products such as Imlygic, Defibrotide, Spinraza, Zalmoxis, Exondys51, Strimvelis, Invossa, Yeskarta and Kymriah were approved by relevant authority (B).