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描绘细胞治疗格局:中国临床试验与监管进展的洞见

英文原题:Mapping the cell therapy landscape: insights into clinical trials and regulatory advances in China.

PubMed 2024/10/14(内容时间) J Hematol Oncol Q1 · IF 47.8(JCR 2025)

研究概要

我们的研究结果表明,尽管中国实体瘤的疾病负担沉重且临床需求未被满足,2021 年至 2023 年间仍有超过 38% 的试验集中于以 CD19 和 BCMA 等成熟靶点为目标的血液系统恶性肿瘤。

中文摘要

近年来,细胞治疗研究和商业化进程显著加快,尤其是在美国 FDA 批准 CAR-T 治疗之后。细胞治疗目前在临床试验数量上引领肿瘤免疫学,但研发重复、靶点聚集和临床需求未满足等问题仍然存在。自 2017 年以来,中国建立了双轨制监管框架,推动细胞治疗研发管线迅速发展,目前规模位居全球第二。尽管取得进展,中国仍面临与全球类似的挑战。本研究涵盖中国已注册的 2,794 项细胞治疗临床试验,包括 2,045 项免疫细胞试验、683 项干细胞试验和 66 项其他体细胞试验。研究比较了中国、美国、欧盟和日本获批的细胞治疗产品,分析临床试验格局演变,并突出中国研究者发起试验(IIT)和企业发起试验(IST)的特点。结果显示,尽管中国实体瘤疾病负担沉重且临床需求未满足,2021 至 2023 年间仍有超过 38% 的试验聚焦血液系统恶性肿瘤,靶点主要为 CD19 和 BCMA 等已确立靶点。超过 90% 的试验属于 IIT,且 IIT 与 IST 在临床特征方面差异显著。我们建议中国监管机构制定具体指南,推动以临床价值为导向的研究,并实施更严格的监管标准以减少重复研发。此外,针对同类靶向细胞治疗产品建立基于价值的报销体系,可能进一步减少重复研发。鉴于 IIT 占比较高,明确 IIT 要求可建立加速产品开发的新路径,更好地满足中国未满足的临床需求。

展开英文摘要原文

In recent years, cell therapy research and commercialization have significantly accelerated, especially after the US FDA approved CAR-T therapy. While cell therapy now leads immuno-oncology in clinical trials, challenges such as redundant R&D, target clustering, and unmet clinical need remain. Since 2017, China has established a dual-track regulatory framework, facilitating rapid growth in its cell therapy pipeline, making it the second largest in the world. Despite this progress, China faces similar global challenges. Our study covers 2,794 registered cell therapy clinical trials in China, including 2,045 for immune cell, 683 for stem cell, and 66 for other somatic cell. It compares cell therapy products approved in China, the US, EU, and Japan, analyzes the evolving clinical trials landscape, and highlights the characteristics of investigator-initiated trials (IITs) and industry-sponsored trials (ISTs) in China. Our findings indicate that despite the high disease burden and unmet clinical needs for solid tumors in China, over 38% of trials between 2021 and 2023 focused on hematologic malignancies with established targets like CD19 and BCMA. Over 90% of trials are IITs, which show notable clinical differences from ISTs. We recommend that Chinese regulators establish specific guidelines to promote clinical-value-driven research. Stricter regulatory standards should also be implemented to minimize redundant R&D. Additionally, a value-based reimbursement system for within-class targeted cell therapy products may further reduce duplicated R&D efforts. Given the prevalence of IITs, specifying requirements for IITs could create a new pathway to accelerate product development and better address unmet clinical needs in China.

论文信息

作者
Du X、Luo X、Liu L、Cao Y、Zhang Y、Zhang Y
第一作者单位
Vanke School of Public Health, Tsinghua University, Beijing, China.China
通讯作者单位
Vanke School of Public Health, Tsinghua University, Beijing, China. yi_zhang@mail.tsinghua.edu.cn.China
文献类型
读者来信 · 综述 · 非美国政府资助研究
期刊
Journal of hematology & oncology2024 Oct 14
原文标识
PubMed 39402668 · DOI 10.1186/s13045-024-01616-8