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Committee for Advanced Therapies
Dr Monica Ensini EURORDIS
Barcelona, June 21, 2013
www.eurordis.org
2
1. Implementation of the Advanced Therapy Regulation
at the EMA:
1. the Committee for Advanced Therapies (CAT)
2. Regulatory centralised procedures for Advanced
Therapy Medicinal Products (ATMPs)
2. Role of Patients’ / Healthcare professionals’
organisations in the CAT
Content
Outline
Committee for Advanced Therapies
3
How Policy Makers and Regulators approach
Advanced Therapy Medicinal Products (ATMP)
Other EU legislations that apply to ATMP products:
• Directive 2001/83/EC (medicinal products for human use)
• Regulation (EC) No 726/2004 (procedures for the authorisation and
supervision of medicinal products for human and veterinary use and
establishing a European Medicines Agency)
• Directive 2001/20/EC (clinical trials)
• Directive 2005/28/EC (good clinical practice, manufacture and
import)
• Directive 2003/94/EC (good manufacturing practice)
• Regulation (EC) No 1901/2006 (paediatric medicines)
• Regulation (EC) 141/2000 on Orphan Drugs
Lack of harmonisation across Europe resulted in
Regulation (EC) No 1394/2007 on ATMP
Committee for Advanced Therapies
4
Regulation on Advanced Therapies
(EC) No1394/2007
Medical
Devices
Pharmaceuticals
(e.g. aspirin)
Biotech
(e.g. recombinant
insulin)
Gene TherapyCell TherapyTissue
Engineering
Advanced TherapiesScience
Legislation
Regulation on
Advanced Therapies
(EC) No1394/2007
Evaluation
CAT
expertise
CHMP
expertise
CAT
expertise
Medical
Devices Dir.
93/42/EEC
Medicinal
Products
2001/83/EC
Committee for Advanced Therapies
5
• Advanced Therapy Medicinal Products (ATMP)
• Gene Therapy Products
• Somatic Cell Therapy Products
• Tissue Engineered Products
• Combined ATMP
• Principles of existing legislation on medicines apply to
advanced therapies:
• Quality, Safety and Efficacy
• Marketing authorisation
• Post-authorisation vigilance
Regulation on Advanced Therapies
Key elements
Committee for Advanced Therapies
6 Committee for Advanced Therapies
What is a gene therapy product?
• Medicinal product that contains or consists of a recombinant gene
administred with a view to regulating, repairing, replacing, adding or
deleting a genetic sequence
• Type of gene therapy
• non-specific placement
• swap/repair a gene
• transcription regulation
• Vectors
• viral/non-viral/hybrid
• Transduction
• ex vivo / in vivo
• target cells
http://www.biochem.arizona.edu/classes/bioc471/pages/Lecture25/AMG9.11a.gif
7 Committee for Advanced Therapies
Ex vivo Gene therapy: treatment of SCID disease
http://history.nih.gov/exhibits/genetics/sect4.htm
http://athena.bioc.uvic.ca
SCID – severe combined
immunodeficiency
8 Committee for Advanced Therapies
What is a somatic cell therapy product?
• Medicinal product based on substantially manipulated cells
or tissues or of cells or tissues that are not intended to be
used for the same essential function(s) in the recipient and
the donor
• Cells / tissues from patient itself, from another human or
from animals
• Manipulated (engineered) cells / tissues (non substantial:
cutting, grinding, centrifugation, irradiation etc)
• Scope: treating, preventing or diagnosing a disease
through the pharmacological, immunological or metabolic
action of its cells or tissues
9 Committee for Advanced Therapies
Example: Cancer Cell therapy
10 Committee for Advanced Therapies
What is a
Tissue Engineered product?
• Tissue Engineered Products (TEP)
 Contain/consist of engineered cells/tissues
 Administered to human to regenerate, repair or replace a
human tissue
Examples:
 Artificial skin (burn wounds)
 Cartilage repair
 Neo-organs
11 Committee for Advanced Therapies
Example: Cartilage repair
First generation 
Second/third
generation

Autologous Chondrocyte
ImplantationCI
MACI: matrix-induced autologous
chondrocyte implantation
(Combined TEP)
12 Committee for Advanced Therapies
Engineering an Organ
13 Committee for Advanced Therapies
Gene therapy medicinal product:
- recombinant nucleic acid -> to regulating, repairing, replacing, adding or
deleting a genetic sequence
Somatic cell therapy medicinal products:
-substantially manipulated cells/tissue -> to treat, prevent or diagnose a
disease (pharmacological, immunological, metabolic action)
Tissue engineered product:
-substantially manipulated cells/tissue -> to regenerate repair or replace a
human tissue
Combined ATMP:
- medical device + cell/tissue part
ATMP: summary of definitions
14 Committee for Advanced Therapies
« The Committee for Advanced Therapies (CAT) is
the committee at the European Medicines Agency
that is responsible for assessing the quality, safety
and efficacy of advanced therapy medicinal products
(ATMPs) and following scientific developments in the
field. It is a multidisciplinary committee, gathering
together some of the best available experts in
Europe.
It was established in accordance with Regulation (EC)
No 1394/2007 on ATMPs.»
http://www.ema.europa.eu
Committee for Advanced Therapies
15
CAT should cover the
scientific areas relevant to
advanced therapies,
including:
- Medical devices
- Tissue engineering
- Gene therapy
- Cell therapy
- Biotechnology
- Surgery
- Pharmacovigilance
- Risk management
- Ethics.
[Recital 9 & Art.21]
The Committee for Advances Therapies (CAT):
Composition
Committee for Advanced Therapies
16
EARLY
DEVELOPMENT
QUALITY
QUALITY
NON CLINICAL
EVALUATION
DRAFT OPINION MAA
CERTIFICATION
CLASSIFICATION
SCIENTIFIC ADVICE
QUALITY
NON CLINICAL,
CLINICAL
Role and Function of CAT
Committee for Advanced Therapies
17
►To define borderline cases
e.g. with medical device, transplant,
cosmetics.
►Incentive for applicants, not legal
requirement
►Fast procedure (max 60 days)
CLASSIFICATION
Is my product an Advanced Therapy Medicinal
Product (ATMP)?
Committee for Advanced Therapies
18
► Incentive for Small to Medium-sized
Enterprises
► Assessment of early quality and non-
clinical data
► Fast procedure (90 days), confidential
► Certificate may attract investments
CERTIFICATION
Are the data generated to date sufficient?
Committee for Advanced Therapies
19
► Scientific Advice can be given on ANY
scientific question
•Quality, non-clinical and clinical
► At any time point of development
•Post-marketing advice is also
available
► Broad advice, Conditional approval
and Exceptional circumstances
► Confidential
SCIENTIFIC
ADVICE
Advice on product development
For ATMPs the Scientific Advice Working Party (SAWP) consults the CAT
Committee for Advanced Therapies
20
EVALUATION
DRAFT OPINION MAA
►Principles of existing legislation on medicines
apply to advanced therapies
►Centralised procedure mandatory
►CAT with specific expertise to evaluate MAAs
► Risk based approach
► Risk Management Plan and follow-up of
safety and efficacy
The product development is completed
Committee for Advanced Therapies
21
CHMP Co-ordinator responsible for flow of information
between CAT & CHMP + discussion/adoption of opinion at
CHMP
ASSESSMENT
TEAM 1
ASSESSMENT
TEAM 2
CHMP Co-ordinator
(at CHMP level)
+
CAT Rapporteur
(at CAT level)
incl.
Q/S/E Experts
CHMP Co-ordinator
(at CHMP level)
+
CAT Co-Rapporteur
(at CAT level)
incl.
Q/S/E Experts
Peer review by 1 CHMP
member 1 (or more) CAT
member(s)
CAT (Co)Rapp coordinate
procedure & discussions at CAT
+ prepare draft opinions and
assessment reports
Committee for Advanced Therapies
Evaluation Procedure
22 22
A medicinal product may be placed on the market
in the EU, when:
a marketing authorisation has been issued
by the EU Commission via the Centralised Procedure
(EMA)
or
it is delivered under hospital exemption, regulated by the
competent authority of an EU Member State
EU Marketing Authorisation (MA) for ATMPs
22Committee for Advanced Therapies
23 23
• 1 application to EMA  1 scientific evaluation
• Scientific Committee:
CAT + adoption by the CHMP
• Maximum legal time limit
210 days evaluation (CAT Opinion + CHMP Opinion) + EU
Commission Decision
• 1 Marketing Authorisation valid for the whole EU
• 1 Trade name and 1 Labelling (all EU languages)
Summary of Product Characteristics
User Package Leaflet
Package Labelling
Centralised Procedure for ATMPs
Committee for Advanced Therapies
24
1. Implementation of the Advanced Therapy Regulation at
the EMA:
1. the Committee for Advanced Therapies (CAT)
2. Regulatory centralised procedures for Advanced
Therapy Medicinal Products (ATMPs)
2. Role of Patients’ / Clinicians’ organisations in the CAT
Content
Outline
Committee for Advanced Therapies
25 Committee for Advanced Therapies
Clinicians’ & Patients’ organisations in the CAT
• Second Public call for expression of interest:
 closed on 1 December 2011 (2 Full Member + 2 Alternate
Member for Clinicians; 2 Full Member+2 Alternate
Member for Patients )
• Commission will review all applications and will prepare a
draft Commission Decision
• Consultation of European Parliament
• Final Commission Decision: ???
26
EMA Scientific Committees and Patients’ Contribution
• Expertise: convey a combination of specific education,
training and professional experience.
• Experience: convey practical disease knowledge obtained
from direct contact with the disease
• Advocacy: act on behalf of the affected patients in defence
of their rights; provide patient-oriented public health /
healthcare policy perspective.
• Empowerment: Access to the information necessary to
participate in the decision-making processes on behalf of all
patients.
Committee for Advanced Therapies
27
Role of Patients representatives in the
EU Centralized Procedures for ATMP
• Full members of the CAT
 Vote on products / procedures
 Stand for chair/vice-chair of CAT
 Can be Rapporteur, Co-Rapporteur, Peer reviewer
 Can take part of assessment team for:
– MAA for ATMP
– Re-registration of products legally on the market
– Certification of Quality/Non-Clinical data
 Can be Rapporteur for scientific guidelines
Committee for Advanced Therapies
28
Role of Patients representatives in the
EU Centralized Procedures for ATMP
 Representing patients’ voice
 Propose patients experts
 Bringing points of view and perspectives on Regulatory procedure
 Link outside POs useful for their specific expertise
 Points of view and real life experience of concerned patients
 Address issues that could concern lay people
 Involvement in all the Regulatory process including issues of post-
marketing access.
 Propose actions beyond the regulatory framework: e.g. proposal for a
CAT work programme addressing general issues related to ATMPs
development
Committee for Advanced Therapies
29
CAT: where we are now
http://www.ema.europa.eu/docs/e
n_GB/document_library/Work_pro
gramme/2010/11/WC500099029.pd
f
Committee for Advanced Therapies
30
CAT Objectives for the 2010-2015
► Facilitate development ATMP and submission of MAA:
understand trends in research and development, strengthen
dialogue with stakeholders, reinforce internal/external
cooperation
► Promote the use of available regulatory procedures and
introduce potential improvements
► Explore possibilities offered by the current regulatory
framework when applied to ATMP
► Contribute to foster innovation
► Promote access and availability to ATMP
Committee for Advanced Therapies
31
ATMP Regulation implemented
Clear framework for MAA for ATMP
Proactive approach to address the needs of the sector
Early dialogue between interested parties
CONCLUSION
Committee for Advanced Therapies
32 Committee for Advanced Therapies
Thank you
Thanks you for your attention!
And a very special thank to
Dr Patrick Celis EMA-CAT Scientific
Secretariat ,
Dr. Michele Lipucci di Paola (EMA-
CAT/EURORDIS) and
Dr. Fabrizia Bignami
who heavily contributed to this
presentation

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Committee for Advanced Therapies

  • 1. Committee for Advanced Therapies Dr Monica Ensini EURORDIS Barcelona, June 21, 2013 www.eurordis.org
  • 2. 2 1. Implementation of the Advanced Therapy Regulation at the EMA: 1. the Committee for Advanced Therapies (CAT) 2. Regulatory centralised procedures for Advanced Therapy Medicinal Products (ATMPs) 2. Role of Patients’ / Healthcare professionals’ organisations in the CAT Content Outline Committee for Advanced Therapies
  • 3. 3 How Policy Makers and Regulators approach Advanced Therapy Medicinal Products (ATMP) Other EU legislations that apply to ATMP products: • Directive 2001/83/EC (medicinal products for human use) • Regulation (EC) No 726/2004 (procedures for the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency) • Directive 2001/20/EC (clinical trials) • Directive 2005/28/EC (good clinical practice, manufacture and import) • Directive 2003/94/EC (good manufacturing practice) • Regulation (EC) No 1901/2006 (paediatric medicines) • Regulation (EC) 141/2000 on Orphan Drugs Lack of harmonisation across Europe resulted in Regulation (EC) No 1394/2007 on ATMP Committee for Advanced Therapies
  • 4. 4 Regulation on Advanced Therapies (EC) No1394/2007 Medical Devices Pharmaceuticals (e.g. aspirin) Biotech (e.g. recombinant insulin) Gene TherapyCell TherapyTissue Engineering Advanced TherapiesScience Legislation Regulation on Advanced Therapies (EC) No1394/2007 Evaluation CAT expertise CHMP expertise CAT expertise Medical Devices Dir. 93/42/EEC Medicinal Products 2001/83/EC Committee for Advanced Therapies
  • 5. 5 • Advanced Therapy Medicinal Products (ATMP) • Gene Therapy Products • Somatic Cell Therapy Products • Tissue Engineered Products • Combined ATMP • Principles of existing legislation on medicines apply to advanced therapies: • Quality, Safety and Efficacy • Marketing authorisation • Post-authorisation vigilance Regulation on Advanced Therapies Key elements Committee for Advanced Therapies
  • 6. 6 Committee for Advanced Therapies What is a gene therapy product? • Medicinal product that contains or consists of a recombinant gene administred with a view to regulating, repairing, replacing, adding or deleting a genetic sequence • Type of gene therapy • non-specific placement • swap/repair a gene • transcription regulation • Vectors • viral/non-viral/hybrid • Transduction • ex vivo / in vivo • target cells http://www.biochem.arizona.edu/classes/bioc471/pages/Lecture25/AMG9.11a.gif
  • 7. 7 Committee for Advanced Therapies Ex vivo Gene therapy: treatment of SCID disease http://history.nih.gov/exhibits/genetics/sect4.htm http://athena.bioc.uvic.ca SCID – severe combined immunodeficiency
  • 8. 8 Committee for Advanced Therapies What is a somatic cell therapy product? • Medicinal product based on substantially manipulated cells or tissues or of cells or tissues that are not intended to be used for the same essential function(s) in the recipient and the donor • Cells / tissues from patient itself, from another human or from animals • Manipulated (engineered) cells / tissues (non substantial: cutting, grinding, centrifugation, irradiation etc) • Scope: treating, preventing or diagnosing a disease through the pharmacological, immunological or metabolic action of its cells or tissues
  • 9. 9 Committee for Advanced Therapies Example: Cancer Cell therapy
  • 10. 10 Committee for Advanced Therapies What is a Tissue Engineered product? • Tissue Engineered Products (TEP)  Contain/consist of engineered cells/tissues  Administered to human to regenerate, repair or replace a human tissue Examples:  Artificial skin (burn wounds)  Cartilage repair  Neo-organs
  • 11. 11 Committee for Advanced Therapies Example: Cartilage repair First generation  Second/third generation  Autologous Chondrocyte ImplantationCI MACI: matrix-induced autologous chondrocyte implantation (Combined TEP)
  • 12. 12 Committee for Advanced Therapies Engineering an Organ
  • 13. 13 Committee for Advanced Therapies Gene therapy medicinal product: - recombinant nucleic acid -> to regulating, repairing, replacing, adding or deleting a genetic sequence Somatic cell therapy medicinal products: -substantially manipulated cells/tissue -> to treat, prevent or diagnose a disease (pharmacological, immunological, metabolic action) Tissue engineered product: -substantially manipulated cells/tissue -> to regenerate repair or replace a human tissue Combined ATMP: - medical device + cell/tissue part ATMP: summary of definitions
  • 14. 14 Committee for Advanced Therapies « The Committee for Advanced Therapies (CAT) is the committee at the European Medicines Agency that is responsible for assessing the quality, safety and efficacy of advanced therapy medicinal products (ATMPs) and following scientific developments in the field. It is a multidisciplinary committee, gathering together some of the best available experts in Europe. It was established in accordance with Regulation (EC) No 1394/2007 on ATMPs.» http://www.ema.europa.eu Committee for Advanced Therapies
  • 15. 15 CAT should cover the scientific areas relevant to advanced therapies, including: - Medical devices - Tissue engineering - Gene therapy - Cell therapy - Biotechnology - Surgery - Pharmacovigilance - Risk management - Ethics. [Recital 9 & Art.21] The Committee for Advances Therapies (CAT): Composition Committee for Advanced Therapies
  • 16. 16 EARLY DEVELOPMENT QUALITY QUALITY NON CLINICAL EVALUATION DRAFT OPINION MAA CERTIFICATION CLASSIFICATION SCIENTIFIC ADVICE QUALITY NON CLINICAL, CLINICAL Role and Function of CAT Committee for Advanced Therapies
  • 17. 17 ►To define borderline cases e.g. with medical device, transplant, cosmetics. ►Incentive for applicants, not legal requirement ►Fast procedure (max 60 days) CLASSIFICATION Is my product an Advanced Therapy Medicinal Product (ATMP)? Committee for Advanced Therapies
  • 18. 18 ► Incentive for Small to Medium-sized Enterprises ► Assessment of early quality and non- clinical data ► Fast procedure (90 days), confidential ► Certificate may attract investments CERTIFICATION Are the data generated to date sufficient? Committee for Advanced Therapies
  • 19. 19 ► Scientific Advice can be given on ANY scientific question •Quality, non-clinical and clinical ► At any time point of development •Post-marketing advice is also available ► Broad advice, Conditional approval and Exceptional circumstances ► Confidential SCIENTIFIC ADVICE Advice on product development For ATMPs the Scientific Advice Working Party (SAWP) consults the CAT Committee for Advanced Therapies
  • 20. 20 EVALUATION DRAFT OPINION MAA ►Principles of existing legislation on medicines apply to advanced therapies ►Centralised procedure mandatory ►CAT with specific expertise to evaluate MAAs ► Risk based approach ► Risk Management Plan and follow-up of safety and efficacy The product development is completed Committee for Advanced Therapies
  • 21. 21 CHMP Co-ordinator responsible for flow of information between CAT & CHMP + discussion/adoption of opinion at CHMP ASSESSMENT TEAM 1 ASSESSMENT TEAM 2 CHMP Co-ordinator (at CHMP level) + CAT Rapporteur (at CAT level) incl. Q/S/E Experts CHMP Co-ordinator (at CHMP level) + CAT Co-Rapporteur (at CAT level) incl. Q/S/E Experts Peer review by 1 CHMP member 1 (or more) CAT member(s) CAT (Co)Rapp coordinate procedure & discussions at CAT + prepare draft opinions and assessment reports Committee for Advanced Therapies Evaluation Procedure
  • 22. 22 22 A medicinal product may be placed on the market in the EU, when: a marketing authorisation has been issued by the EU Commission via the Centralised Procedure (EMA) or it is delivered under hospital exemption, regulated by the competent authority of an EU Member State EU Marketing Authorisation (MA) for ATMPs 22Committee for Advanced Therapies
  • 23. 23 23 • 1 application to EMA  1 scientific evaluation • Scientific Committee: CAT + adoption by the CHMP • Maximum legal time limit 210 days evaluation (CAT Opinion + CHMP Opinion) + EU Commission Decision • 1 Marketing Authorisation valid for the whole EU • 1 Trade name and 1 Labelling (all EU languages) Summary of Product Characteristics User Package Leaflet Package Labelling Centralised Procedure for ATMPs Committee for Advanced Therapies
  • 24. 24 1. Implementation of the Advanced Therapy Regulation at the EMA: 1. the Committee for Advanced Therapies (CAT) 2. Regulatory centralised procedures for Advanced Therapy Medicinal Products (ATMPs) 2. Role of Patients’ / Clinicians’ organisations in the CAT Content Outline Committee for Advanced Therapies
  • 25. 25 Committee for Advanced Therapies Clinicians’ & Patients’ organisations in the CAT • Second Public call for expression of interest:  closed on 1 December 2011 (2 Full Member + 2 Alternate Member for Clinicians; 2 Full Member+2 Alternate Member for Patients ) • Commission will review all applications and will prepare a draft Commission Decision • Consultation of European Parliament • Final Commission Decision: ???
  • 26. 26 EMA Scientific Committees and Patients’ Contribution • Expertise: convey a combination of specific education, training and professional experience. • Experience: convey practical disease knowledge obtained from direct contact with the disease • Advocacy: act on behalf of the affected patients in defence of their rights; provide patient-oriented public health / healthcare policy perspective. • Empowerment: Access to the information necessary to participate in the decision-making processes on behalf of all patients. Committee for Advanced Therapies
  • 27. 27 Role of Patients representatives in the EU Centralized Procedures for ATMP • Full members of the CAT  Vote on products / procedures  Stand for chair/vice-chair of CAT  Can be Rapporteur, Co-Rapporteur, Peer reviewer  Can take part of assessment team for: – MAA for ATMP – Re-registration of products legally on the market – Certification of Quality/Non-Clinical data  Can be Rapporteur for scientific guidelines Committee for Advanced Therapies
  • 28. 28 Role of Patients representatives in the EU Centralized Procedures for ATMP  Representing patients’ voice  Propose patients experts  Bringing points of view and perspectives on Regulatory procedure  Link outside POs useful for their specific expertise  Points of view and real life experience of concerned patients  Address issues that could concern lay people  Involvement in all the Regulatory process including issues of post- marketing access.  Propose actions beyond the regulatory framework: e.g. proposal for a CAT work programme addressing general issues related to ATMPs development Committee for Advanced Therapies
  • 29. 29 CAT: where we are now http://www.ema.europa.eu/docs/e n_GB/document_library/Work_pro gramme/2010/11/WC500099029.pd f Committee for Advanced Therapies
  • 30. 30 CAT Objectives for the 2010-2015 ► Facilitate development ATMP and submission of MAA: understand trends in research and development, strengthen dialogue with stakeholders, reinforce internal/external cooperation ► Promote the use of available regulatory procedures and introduce potential improvements ► Explore possibilities offered by the current regulatory framework when applied to ATMP ► Contribute to foster innovation ► Promote access and availability to ATMP Committee for Advanced Therapies
  • 31. 31 ATMP Regulation implemented Clear framework for MAA for ATMP Proactive approach to address the needs of the sector Early dialogue between interested parties CONCLUSION Committee for Advanced Therapies
  • 32. 32 Committee for Advanced Therapies Thank you Thanks you for your attention! And a very special thank to Dr Patrick Celis EMA-CAT Scientific Secretariat , Dr. Michele Lipucci di Paola (EMA- CAT/EURORDIS) and Dr. Fabrizia Bignami who heavily contributed to this presentation