Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T18:08:12.805Z Has data issue: false hasContentIssue false

Translating Stem Cell Research: Challenges at the Research Frontier

Published online by Cambridge University Press:  01 January 2021

Extract

There are many kinds of clinical trials. The regulatory framework within which most drug development takes place appears to be the one that is to be applied to the development of novel stem cell-based clinical trials. In the standard drug development model, appropriate pre-clinical research is conducted (largely based upon non-human animal models), and investigators or research sponsors (typically a company) submit an investigational new drug (IND) application to the Food and Drug Administration (FDA).

If approved, typical clinical trials start with Phase I, which is usually a trial (with a small number of participants) to determine the maximum tolerable dose of a drug. Phase I trials are often referred to as “safety studies” because the primary goal of Phase I research is to determine if an intervention is safe (not whether it works).

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fink, D. W., “FDA Regulation of Stem Cell-based Products,” Science 324, no. 5935 (2009): 16621663.CrossRefGoogle Scholar
DiMasi, J. A., Hansen, R. W., and Grabowski, H. G., “The Price of Innovation: New Estimates of Drug Development Costs,” Journal of Health Economics 22, no. 2 (2003): 151185.CrossRefGoogle Scholar
McKneally, M. F., “Ethical Problems in Surgery: Innovation Leading to Unforeseen Complications,” World Journal of Surgery 23 (1999): 786788; McKneally, M. F. and Daar, A. S., “Introducing New Technologies: Protecting Subjects of Surgical Innovation and Research,” World Journal of Surgery 27 (2003): 930935; Agich, G. J., “Ethics and Innovation in Medicine,” Journal of Medical Ethics 27 (2001): 295296; Reitsma, A. M. and Moreno, J. D., “Ethical Regulations for Innovative Surgery: The Last Frontier?” Journal of the American College of Surgeons 194 (2002): 792801; Reitsma, A. M. and Moreno, J. D., “Ethics of Innovative Surgery: US Surgeons' Definitions, Knowledge, and Attitudes,” Journal of the American College of Surgeons 200 (2005): 103110.CrossRefGoogle Scholar
Lindvall, O. and Hyun, I., “Medical Innovation Versus Stem Cell Tourism,” Science 324, no. 5935 (2009): 16641665.CrossRefGoogle Scholar
Cook-Deegan, R., The Gene Wars: Science, Politics and the Human Genome (New York: Norton and Co., 1996).Google Scholar
See Geron, , Geron Receives FDA Clearance to Begin World's First Human Clinical Trial of Embryonic Stem Cell-Based Therapy, Press Release, January 23, 2009.Google Scholar
Keirstead, H. S., Nistor, G., Bernal, G., Totoiu, M., Cloutier, F., Sharp, K., and Steward, O., “Human Embryonic Stem Cell-Derived Oligodendrocyte Progenitor Cell Transplants Remyelinate and Restore Locomotion after Spinal Cord Injury,” Journal of Neuroscience 25, no. 19 (2005): 4694–705.CrossRefGoogle Scholar
See Geron, , Geron and FDA Reach Agreement on Clinical Hold, Press Release, October 30, 2009.Google Scholar
Emanuel, E. J., Wendler, D., and Grady, C., “What Makes Clinical Research Ethical?” JAMA 283, no. 20 (2000): 27012711.CrossRefGoogle Scholar
Moore, F. D., “Three Ethical Revolutions: Ancient Assumptions Remodeled Under Pressure of Transplantation,” Transplantation Proceedings 20, 1 Suppl. 1 (1988): 1061–7; Moore, F. D., “The Desperate Case: CARE (Costs, Applicability, Research, Ethics),” JAMA 261, no. 10 (1989): 14831484.Google Scholar
Agrawal, M. and Emanuel, E. J., “Ethics of Phase I Oncology Studies: Reexamining the Arguments and Data,” JAMA 290, no. 8 (2003): 10751082.CrossRefGoogle Scholar
Cho, M. K. and Magnus, D., “Therapeutic Misconception and Stem Cell Research,” Nature Reports Stem Cells (2007).CrossRefGoogle Scholar
King, N. M., Henderson, G. E., Churchill, L. R., Davis, A. M., Hull, S. C., Nelson, D. K., Parham-Vetter, P.C., Rothschild, B. B., Easter, M. M., and Wilfond, B. S., “Consent Forms and the Therapeutic Misconception: The Example of Gene Transfer Research,” IRB 27 (2005): 18.CrossRefGoogle Scholar
Kimmelman, J. and Levenstadt, A., “Elements of Style: Consent Form Language and the Therapeutic Misconception in Phase I Gene Transfer Trials,” Human Gene Therapy 16, no. 4 (2005): 502508.CrossRefGoogle Scholar
See King, et al., supra note 13.Google Scholar
Please note: The author is a member of the CDHP Advisory Committee and drafted the guidelines concerning clinical trials.Google Scholar