Abstract| Volume 18, ISSUE 6, SUPPLEMENT , S19, June 2016

Zoom Zoom: Genetically Modified CAR T Cells at the Point of Care

      Chimeric Antigen Receptor (CAR) T cell therapy has recently come into the spotlight due to impressive results in patients with hematological B cell malignancies. Whilst it is a paradigm shift in personalized medicine, a key unresolved issue is a large scale manufacturing. Different commercialization models have been developed, however the price of therapies is likely to remain high until sufficient scale is broadly available. My thesis examines in detail the manufacturing scale up options for both clinical trials and commercial supply and the inherent issues of regulatory environment and quality assurance. The central tenant of this thesis is to assess a point of care manufacturing option within a hospital or affiliated academic institution, where CARs are produced by GMP accredited labs. Establishing, whether current GMP qualified labs are able to service the needs of the community in providing CARs at the point of care. This will enable a sustainable and scalable solution that is not dependent on one company and allows the use of increasing numbers of new therapies from innovators. Driving the costs down as manufacturing, quality assurance, and complex logistics would not be included in the cost of overall therapy (Table I, Table II).
      Table ISummary of four hypothesis questions per country analyzed.
      Country Manufacturing Capacity QA Personnel ATMPs simultaneously
      UK 8 95% 8 340 36
      GER 7 88% 7 129 34
      CH 1 16% 1 12 1
      ITA 2 41% 2 19 3
      ESP 2 26% 2 13 4
      FRA 0 0% 0 NA 0
      NL 2 132% 2 16 9
      BEL 1 35% 1 23 3
      SWE 2 194% 2 18 11
      TUR 1 37% 1 UNK 5
      SLO 0 0% 0 NA D
      NOR 1 218% 1 7 8
      AUS 0 0 0 NA 0
      Total 27 27 579 114
      Average 21 4
      Table IICapacity from 27 labs which met manufacturing capability, represented by 13 EU countries, in comparison to European Union 27 members of state countries and Europe overall.
      Capacity %
      13 Thesis countries 46
      EU (27) members of state 32
      Europe overall 25
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