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Review
.2021 Nov;23(11):2057-2066.
doi: 10.1038/s41436-021-01245-3. Epub 2021 Jul 7.

Ethical challenges for a new generation of early-phase pediatric gene therapy trials

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Free article
Review

Ethical challenges for a new generation of early-phase pediatric gene therapy trials

Alexander A Iyer et al. Genet Med.2021 Nov.
Free article

Abstract

After decades of setbacks, gene therapy (GT) is experiencing major breakthroughs. Five GTs have received US regulatory approval since 2017, and over 900 others are currently in development. Many of these GTs target rare pediatric diseases that are severely life-limiting, given a lack of effective treatments. As these GTs enter early-phase clinical trials, specific ethical challenges remain unresolved in three domains: evaluating risks and potential benefits, selecting participants fairly, and engaging with patient communities. Drawing on our experience as clinical investigators, basic scientists, and bioethicists involved in a first-in-human GT trial for an ultrarare pediatric disease, we analyze these ethical challenges and offer points to consider for future GT trials.

© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

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References

    1. Dunbar CE, High KA, Joung JK, Kohn DB, Ozawa K, Sadelain M. Gene therapy comes of age. Science. 2018;359:eaan4672.
    1. US Food and Drug Administration. FDA continues strong support of innovation in development of gene therapy products. 2020.https://www.fda.gov/news-events/press-announcements/fda-continues-strong... . Accessed 29 June 2020.
    1. US Food and Drug Administration. FDA approves first cell-based gene therapy for adult patients with relapsed or refractory MCL. 2020.https://www.fda.gov/news-events/press-announcements/fda-approves-first-c... . Accessed 26 January 2021.
    1. American Society of Gene & Cell Therapy. Glossary.https://www.asgct.org/education/more-resources/glossary . Accessed 10 December 2020.
    1. Kuzmin DA et al. The clinical landscape for AAV gene therapies. Nat Rev Drug Discov. 2021.https://doi.org/10.1038/d41573-021-00017-7 . Accessed 22 March 2021.

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