Lemmens, Myriam, Dorsheimer, Lena, Dietz-Baum, Yasmin and Zeller, Andreas (2024) Non-clinical safety assessment of novel drug modalities: Genome safety perspectives on viral-, nuclease- and nucleotide-based gene therapies. Mutation research. Genetic toxicology and environmental mutagenesis, 896. p. 503767. ISSN 1879-3592

Abstract

Gene therapies have emerged as promising treatments for various conditions including inherited diseases as well as cancer. Ensuring their safe clinical application requires the development of appropriate safety testing strategies. Several guidelines have been provided by health authorities to address these concerns. These guidelines state that non-clinical testing should be carried out on a case-by-case basis depending on the modality. This review focuses on the genome safety assessment of frequently used gene therapy modalities, namely Adeno Associated Viruses (AAVs), Lentiviruses, designer nucleases and mRNAs. Important safety considerations for these modalities, amongst others, are vector integrations into the patient genome (insertional mutagenesis) and off-target editing. Taking into account the constraints of in vivo studies, health authorities endorse the development of novel approach methodologies (NAMs), which are innovative in vitro strategies for genotoxicity testing. This review provides an overview of NAMs applied to viral and CRISPR/Cas9 safety, including next generation sequencing-based methods for integration site analysis and off-target editing. Additionally, NAMs to evaluate the oncogenicity risk arising from unwanted genomic modifications are discussed. Thus, a range of promising techniques are available to support the safe development of gene therapies. Thorough validation, comparisons and correlations with clinical outcomes are essential to identify the most reliable safety testing strategies. By providing a comprehensive overview of these NAMs, this review aims to contribute to a better understanding of the genome safety perspectives of gene therapies.

Item Type:	Article
Keywords:	Genetic Therapy Humans Gene Editing Animals Dependovirus Genetic Vectors CRISPR-Cas Systems Lentivirus Endonucleases Mutagenicity Tests Nucleotides
Date Deposited:	16 Jul 2024 00:46
Last Modified:	16 Jul 2024 00:46
URI:	https://oak.novartis.com/id/eprint/52317