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Atlas/Gene therapy/Zevaskyn/Skipped studies

Zevaskyn: genotox, carcinogenicity and repro: done or skipped?

prademagene zamikeracel · COL7A1 (RV-modified keratinocyte sheets)
Check my plan vs. these
Genotoxicity
Not conducted (integration site analysis in transduced RDEB keratinocytes instead; no clonality or oncogene preference)
“Integration site analysis (ISA) was performed on RDEB keratinocytes (n=6 donors) transduced with RVV. ISA did not indicate clonality at 6-days post-keratinocyte transduction.”
✓ VerifiedFDA summary basis for approval, p. 13Source ↗
Carcinogenicity
Not conducted (no neoplastic histology, low insertional oncogenesis risk, routine SCC screening in RDEB)
“Carcinogenicity and tumorigenicity studies of ZEVASKYN were not conducted due to absence of neoplastic features on histology, low risk of insertional oncogenesis, and frequent SCC screening recommended for all subjects with RDEB.”
✓ VerifiedFDA summary basis for approval, p. 13Source ↗
Reproductive & developmental
Not conducted (vector biodistribution confined to the implanted product)
“Developmental and reproductive toxicity (DART) studies of ZEVASKYN were not conducted due to the BD of RVV remaining confined to representative nonclinical products.”
✓ VerifiedFDA summary basis for approval, p. 13Source ↗
Safety pharmacology
Not stated in public reviews

Same question, other gene therapies

Adstiladrin

nadofaragene firadenovec · IFN-alpha2b (adenovirus, intravesical)
Not conducted for rAd-IFN; conducted for excipient Syn3 only (Ames and chromosome aberration, negative)

Beqvez

fidanacogene elaparvovec · Factor IX
Not conducted (classical); vector integration site analysis in dog and NHP liver instead

Casgevy

exagamglogene autotemcel · BCL11A enhancer (CRISPR-Cas9, ex vivo HSC)
No conventional studies; specialized on-/off-target editing (GUIDE-seq, in silico, hybrid capture) and chromosomal aberration assessments

Elevidys

delandistrogene moxeparvovec · Micro-dystrophin
Not conducted (low-frequency random AAV integration per literature)

Fayuvi

rebisufligene etisparvovec · SGSH (AAV9)
Not conducted; weight-of-evidence risk assessment used

Genglycos

pariglasgene brecaparvovec · G6PC (AAV8)
Not conducted (low AAV integration risk); vector integration assessed in germline transmission study

Glybera

alipogene tiparvovec · LPL (AAV1)
Not conducted (standard tests not relevant); integration studies (LAM-PCR, nrLAM-PCR) instead

Hemgenix

etranacogene dezaparvovec · Factor IX
Not conducted as standard battery; integration site analysis (LAM-PCR) in mouse and NHP liver showed low random integration

Imlygic

talimogene laherparepvec · GM-CSF (oncolytic HSV-1)
Not conducted (ICH S6(R1))

Itvisma

onasemnogene abeparvovec (intrathecal) · SMN1 (AAV9, intrathecal)
Not conducted (single administration, known product characteristics, class safety profile)

Kebilidi

eladocagene exuparvovec · AADC
Not conducted (agreed with CHMP; low integration risk in post-mitotic neurons)

Kresladi

marnetegragene autotemcel · ITGB2 (LVV, ex vivo HSC)
Integration site analyses only (mouse and human transduced cells); no standard genotoxicity battery

Lenmeldy

atidarsagene autotemcel · ARSA (LVV, ex vivo HSC)
Conducted: integration site analysis, in vitro immortalization assay, tumor-prone Cdkn2a-/- mouse; no insertional transformation

Luxturna

voretigene neparvovec · RPE65
Not conducted (AAV low integration frequency; limited systemic exposure)

Lyfgenia

lovotibeglogene autotemcel · HBB T87Q (LVV, ex vivo HSC)
Insertional mutagenesis assessed: in vitro immortalization (IVIM) assay and integration site analyses; low risk

Otarmeni

lunsotogene parvec · OTOF (AAV, intracochlear)
Not conducted (low AAV insertional mutagenesis risk; limited distribution beyond inner ear)

Papzimeos

zopapogene imadenovec · HPV6/11 antigens (gorilla adenovirus)
Not conducted (non-integrating, replication-incompetent adenovector; no insertional mutagenesis)

Roctavian

valoctocogene roxaparvovec · Factor VIII
Not conducted (literature on AAV); NHP liver integration site analysis: 1.55x10^-3 IS/cell, no clonal expansion

Skysona

elivaldogene autotemcel · ABCD1 (LVV, ex vivo HSC)
Standard genotox not relevant; insertional mutagenesis assessed by in vitro immortalization assay and integration site analysis

Strimvelis

autologous CD34+ cells transduced with ADA (no INN) · ADA (gamma-retroviral, ex vivo HSC)
Not conducted (conventional assays cannot detect insertional events)

Tudriqev

vusolimogene oderparepvec · GALV-GP + GM-CSF (oncolytic HSV-1)
Not conducted (not warranted based on product characteristics and safety profile)

Vyjuvek

beremagene geperpavec · COL7A1 (HSV-1, topical)
Not conducted (HSV-1 does not integrate; negligible insertional mutagenesis)

Waskyra

etuvetidigene autotemcel · WAS (LVV, ex vivo HSC)
Conventional mutagenicity not conducted; IVIM assay, vector insertion site analysis and VITA performed, no genotoxic potential

Zolgensma

onasemnogene abeparvovec · SMN1
Not conducted (low random rAAV integration per literature)

Zynteglo

betibeglogene autotemcel · HBB T87Q (LVV, ex vivo HSC)
Insertional mutagenesis assessed instead of standard genotox: in vitro immortalization assay (low potential) and integration site analysis (no clonal dominance)

Summary across all 26 gene therapies →