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To date, what number of U.S. FDA-approved RMATs have been issued and to whom have they been awarded?
The answer is that 102 RMAT (Regenerative Medicine Advanced Therapy) designations have been publicly announced by biotech and pharma companies. However, the FDA states it has received 279 requests and issued 128, which means that a handful are not yet public knowledge. Therefore, a few companies are operating in stealth mode with regard to their RMAT designations and approximately 46% of RMAT applications get approved (128 approvals / 279 applications = 45.9%).
Thus far, Rocket Pharmaceuticals is the only company to receive four RMATs, while three other companies (AlloVir, CRISPR Therapeutics, and Humacyte) have received three RMATs to date. Additionally, 11 companies (Abeona Therapeutics, Adaptimmune, Allogene Therapeutics, Athersys, CARsgen Therapeutics, Cook MyoSite, Humacyte, Mesoblast, Ocugen, Orchard Therapeutics, and Sangamo Therapeutics) have managed to secure two RMAT designations from the U.S. FDA.
RMAT Designations by the U.S. FDA
In this article:
List of RMAT Designations
Below is a comprehensive list of publicly announced RMAT designations:
- 4DMT – 4D-150 Genetic Medicine for Intravitreal Treatment of Wet AMD (12/21/23)
- Abeona Therapeutics – EB-101 for treatment of Recessive RDEB (01/29/18)
- Abeona Therapeutics – ABO-102 for treatment of Sanfilippo Syndrome Type A (MPS IIIA) (04/23/18)
- Adaptimmune Therapeutics – ADP-A2M4 for the treatment of Synovial Sarcoma (12/03/19)
- Adaptimmune Therapeutics – ADP-A2M4CD8 for the treatment of patients with platinum resistant ovarian cancer (11/08/22)
- AffyImmune – AIC100, a CAR T-cell therapy, for the treatment anaplastic thyroid cancer.
- Allogene Therapeutics – ALLO-715 for the treatment of relapsed/refractory multiple myeloma (04/21/21)
- Allogene Therapeutics – ALLO-501A for the treatment of relapsed/refractory LBCL (06/08/22)
- Allovir – Posoleucel (Viralym-M, ALVR105) for the treatment of BK Virus-associated Hemorrhagic Cystitis after HSC Transplant (06/11/19)
- Allovir – Posoleucel (Viralym-M, ALVR105) for the treatment of adenovirus (AdV) infections post-allogeneic stem cell transplantation (01/05/22)
- Allovir – Posoleucel (Viralym-M, ALVR105) for prevention of clinically significant infections and disease from six devastating viruses that commonly impactpatients following allogeneic hematopoietic cell transplant (04/20/22)
- Angiocrine Bioscience – AB205 for the treatment of organ vascular niche injuries for the prevention of severe toxicities in lymphoma patients (11/11/20)
- Asterias Biotherapeutics (Acquired by Lineage Cell Therapeutics) – AST-OPC1 for treatment of Spinal Cord Injury (SCI) (10/02/17)
- Athersys – MultiStem for the treatment of Ischemic Stroke (10/05/17)
- Athersys – MultiStem for the treatment of Acute Respiratory Distress Syndrome (ARDS) (09/23/20)
- Atsena Therapeutics – ATSN-101, an investigational gene therapy, for patients with Leber congenital amaurosis caused by biallelic mutations in GUCY2D (11/14/23)
- Audentes Therapeutics – AT132 for the treatment of IX-linked Myotubular Myopathy (XLMTM) (08/21/18)
- Autolus Therapeutics – Obecabatagene autoleucel (obe-cel), a CD19-directed autologous CAR-T therapy, for the treatment of adult relapsed / refractory B-Acute Lymphocytic Leukemia (04/25/22).
- Aurion Biotech – AURN001, an allogeneic cell therapy candidate for the treatment of corneal edema secondary to corneal endothelial disease (06/19/24)
- AxoGen, Inc. – Avance® Nerve Graft for Peripheral Nerve Repair (10/29/18)
- BioMarin Pharmaceutical – Valoctocogene roxaparvovec, a gene therapy for adults with severe hemophilia A (03/08/21)
- Biosolution, Co., Ltd. – CartiLife for autologous cartilage implantation (08/01/23).
- bluebird bio – Lyfgenia (lovo-cel) for the treatment of Severe Sickle Cell Disease (10/01/17)
- BlueRock Therapeutics, a subsidiary of Bayer – Bemdaneprocel, previously known as BRT-DA01, for the treatment of Parkinson’s disease (06/03/24)
- Bristol-Myers Squibb – Liso-cel, an autologous anti-CD19 CAR-T cell therapy for the treatment of adult patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) (12/18/19)
- Caladrius Biosciences – CLBS14 (CD34+ cell therapy program) for the treatment of Refractory Angina (10/01/17)
- Capricor Therapeutics – CAP-1002 for the treatment of Duchenne Muscular Dystrophy (02/05/18)
- Caribou Biosciences – CB-010, an allogeneic anti-CD19 CAR-T cell therapy for relapsed or refractory large B cell lymphoma (11/29/22)
- CARsgen Therapeutics – CT053 (CAR-T therapy) for the treatment of Relapsed or Refractory Multiple Myeloma (10/28/19)
- CARsgen Therapeutics– CT041 for patients with advanced gastric or gastroesophageal junction adenocarcinoma (GC/GEJ) with Claudin18.2-positive tumor (01/10/22)
- Cartesian Therapeutics – Descartes-08, an autologous mRNA CAR-T directed against the B cell maturation antigen (BCMA), for the treatment of myasthenia gravis (05/22/24)
- Cellerant Therapeutics – Romyelocel-L for prevention of Infections During Neutropenia (07/02/18)
- Cellular Biomedicine Group Inc (CBMG) – C-CAR039 for use in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) (01/12/22).
- Cook Myosite – Iltamiocel (autologous muscle cells) for treatment of stress urinary incontinence (SUI) following surgical treatment (12/17/20)
- Cook Myosite – Iltamiocel for the treatment of adult females with chronic fecal incontinence (06/01/22)
- CRISPR Therapeutics – CTX001™ for the treatment of Severe Hemoglobinopathies (05/11/20)
- CRISPR Therapeutics – CTX110™, an allogeneic CAR-T cell therapy targeting CD19+ B-cell malignancies (11/22/21)
- CRISPR Therapeutics – CTX130™, an allogeneic CAR T cell therapy targeting CD70, for the treatment of Mycosis Fungoides and Sézary Syndrome (09/28/2022)
- Deverra Therapeutics – DVX101 (Dilanubicel) for the treatment of Acute Myeloid Leukemia (03/19/24)
- Direct Biologics – Exoflo, an extracellular vesicle (EV) drug product, to treat Covid-19-linked acute respiratory distress syndrome (04/12/22)
- DiscGenics – Injectable Disc Cell Therapy (IDCT or rebonuputemcel), an injectable, allogeneic discogenic progenitor cell therapy for the treatment of symptomatic lumbar degenerative disc disease (DDD) (01/26/23)
- Editas Medicine, Inc. – EDIT-301, an investigational, gene editing medicine for the treatment of severe sickle cell disease (10/16/23).
- Enzyvant – Rethymic (originally RVT-802) for the treatment of DiGeorge Syndrome (04/17/17)
- ExCellThera – ECT-001 for the treatment of Hematologic Malignancies (04/23/19)
- Fate Therapeutics – FT516, a gene-edited iPSC-derived NK cell therapy, for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) (12/13/21)
- Fibrocell – FCX-007 for the treatment of Recessive Dystrophic Epidermolysis Bullosa (05/29/19)
- Fortress Biotech (Subsidiary Cellvation Inc.) – EVA101 for the treatment of Traumatic Brain Injury (11/08/17)
- Helixmith Co., Ltd. (Previously ViroMed) – VM-202 for the treatment of Diabetic Peripheral Neuropathy (05/30/18)
- Humacyte – Humacyl for Vascular Access for Hemodialysis (03/20/17)
- Humacyte – Acellular Tissue Engineered Vessel (previously Human Acellular Vessel) for urgent arterial repair following extremity vascular trauma (05/04/23)
- Humacyte – Acellular Tissue Engineered Vessel (ATEV) for advanced peripheral artery disease (PAD) (07/01/24)
- IASO Biotherapeutics – BCMA CAR-T CT103A (Equecabtagene Autoleucel) for relapsed/refractory multiple myeloma (02/12/23)
- Immatics N.V. – IMA203, a TCR-T cell therapy, for multiple relapsed and/or refractory HLA-A*02:01-positive and PRAME-expressing cancers, including cutaneous melanoma, uveal melanoma, endometrial carcinoma, synovial sarcoma, and ovarian cancer (10/24/23).
- Immunicum AB – Ilixadencel, activated allogeneic dendritic cells that act as an immune primer for the treatment of metastatic Renal Cell Carcinoma (05/06/20)
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Intellia Therapeutics – NTLA-2002, an in vivo CRISPR-based investigational therapy, for the treatment of Hereditary Angioedema (03/21/23)
- Iovance – Lifileucel for the treatment of Advanced Melanoma (10/11/18)
- jCyte – jCell for the treatment of Retinitis Pigmentosa (05/02/17)
- Juno Therapeutics (with Celgene Corp) – JCAR017 for the treatment of Lymphoma (large B cell NHL) (11/01/17)
- Kiadis Pharma – ATIR101 for the treatment of Leukemia (9/20/17)
- Longeveron – Lomecel-B™ for the treatment of Mild Alzheimer’s Disease (07/10/24)
- Krystal Biotech – KB103 for wound closure for RDEB Patients (06/24/19)
- Kyverna Therapeutics – KYV-101, an autologous, human CD19 CAR T-cell product candidate, for the treatment of patients suffering from refractory stiff-person syndrome (07/15/24)
- Magenta Therapeutics – MGTA-456 for Multiple Inherited Metabolic Disorders, including Cerebral Adrenoleukodystrophy (09/04/19)
- Mallinckrodt Pharmaceuticals – Stratagraft for Thermal Burns (07/18/17)
- Medeor Therapeutics – MDR-101 to prevent kidney transplant rejection without chronic use of immunosuppressive drugs (09/22/20)
- Mesoblast – MPC-150-IM for Heart Failure (12/21/17)
- Mesoblast – Rexlemestrocel-L in the treatment of chronic low back pain (CLBP) associated with disc degeneration (02/08/23)
- MiMedx Group – AmnioFix® Injectable for Knee Osteoarthritis (03/09/18)
- Mustang Bio (St. Judes)– MB-107 for X-linked Severe Combined Immunodeficiency (“Bubble Boy” Disease) (08/22/19)
- Myrtelle Inc. – rAAV-Olig001-ASPA for the treatment of Canavan disease (CD) (04/02/24)
- Neurona Therapeutics – NRTX-1001 for the treatment of Focal Epilepsy (06/18/24)
- Nightstar Therapeutics – NSR-REP1 for Choroideremia (progressive vision loss) (06/14/18)
- Novartis – Kymriah® for patients with relapsed or refractory (r/r) follicular lymphoma (04/22/20)
- Ocugen – NeoCart® for the repair of full-thickness lesions of the knee cartilage in adults (05/24/22)
- Ocugen – OCU400 for teatment of Retinitis Pigmentosa associated with RHO mutations (12/19/23)
- Orca Bio – Orca-T, an experimental allogeneic cell therapy for patients with blood cancers who are eligible for a hematopoietic stem cell transplant (10/15/20).
- Orchard Therapeutics – OTL-103 for Wiskott-Aldrich Syndrome (07/29/19)
- Orchard Therapeutics – OTL-200 for Metachromatic Leukodystrophy (MLD) (01/14/21)
- Organogenesis – ReNu® for Knee Osteoarthritis (01/11/21)
- Pacira BioSciences – PCRX-201 for treatment of Osteoarthritis of the Knee (03/13/24)
- PolarityTE – SkinTE® for a chronic cutaneous ulcers and skin conditions (05/13/2022)
- Poseida Therapeutics – P-BCMA-101 for Relapsed/Refractory Multiple Myeloma (11/05/18)
- ProKidney – REACT® (Renal Autologous Cell Therapy) for slowing the progression of Chronic Kidney Disease (CKD) and improving kidney function (01/18/22)
- Regenxbio – RGX-121, an investigational gene therapy for Hunter syndrome (05/24/2023)
- Rocket Pharmaceuticals – RP-L102 for Fanconi Anemia (11/27/18)
- Rocket Pharmaceuticals – RP-L201, an investigational gene therapy for Leukocyte Adhesion Deficiency-I (LAD-I) (03/09/21)
- Rocket Pharmaceuticals – RP-A501, the company’s investigational adeno-associated virus (AAV)-based gene therapy for the treatment of Danon Disease (02/07/2023)
- Rocket Pharmaceuticals – RP-L301, gene therapy to treat pyruvate kinase deficiency (PKD) (05/23/2023)
- SanBio – SB623 for Chronic motor deficits secondary to TBI (09/20/19)
- Sangamo Therapeutics – SB-525 (giroctocogene fitelparvovec) for Severe Hemophilia A (07/05/19)
- Sangamo Therapeutics – ST-920 ( isaralgagene civaparvovec) for Fabry disease (02/12/24)
- Takeda – Alofisel for the treatment of perianal fistulas (02/10/21)
- Talaris – FCR-001 for Preventing Renal Transplantation Rejection (04/18/19)
- Taysha Gene Therapies – TSHA-102 for the treatment of Rett Syndrome (05/02/24)
- Tessa Therapeutics – CD30-directed autologous CAR-T cell therapy for relapsed or refractory CD30-positive Hodgkin lymphoma (02/27/20)
- TissueTech, Inc. – Cryopreserved human umbilical cord product, TTAX02 (04/16/20)
- TScan Therapeutics – Two T-cell receptor (TCR)-engineered T cell (TCR-T) therapy candidates, TSC-100 and TSC-101, for the treatment of hematologic malignancies (05/29/24)
- uniQure – Investigational Gene Therapy AMT-130 for the treatment of Huntington’s Disease (06/03/24).
- University of California San Francisco (UCSF) – Lentiviral gene therapy for Artemis-SCID (02/14/2022)
- Vericel Corporation – Ixmyelocel-T for Dilated Cardiomyopathy (05/10/17)
- Voyager Therapeutics – VY-AADC for Advanced Parkinson’s disease (06/21/18)
- Wugen – WU-CART-007 for the treatment of relapsed/refractory (R/R) T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) (05/20/2024)
Total RMATs Received and Awarded by FDA
To date, the U.S. FDA has received at least 260 requests for RMAT designations and granted 109.
The table below presents the cumulative number of RMAT requests that the FDA has received by year.
YEAR | # REQUESTS | GRANTED | DENIED | WITHDRAWN |
---|---|---|---|---|
2017 | 31 | 11 | 18 | 2 |
2018 | 47 | 18 | 27 | 2 |
2019 | 37 | 17 | 18 | 2 |
2020 | 34 | 13 | 21 | 0 |
2021 | 24 | 9 | 13 | 2 |
2022 | 30 | 14 | 15 | 1 |
2023 | 35 | 17 | 18 | 0 |
2024 | 41 | 29 | 6 | 1 |
TOTAL | 279 | 128 | 136 | 10 |
*Source: U.S. FDA
What is an RMAT?
RMAT is an acronym that stands for “Regenerative Medicine Advanced Therapy.” The designation was introduced in December 2016 as part of the 21st Century Cures Act.
Sponsors of cell and gene therapies are eligible to obtain an RMAT designation from the U.S. FDA if their product is intended to treat serious or life-threatening diseases and there is preliminary clinical evidence that it can address unmet medical needs. An RMAT submission request must be made in conjunction with an Investigational New Drug application (IND), either concurrently or as an amendment to an existing IND.
Products eligible for an RMAT designation include:
- Cell therapies
- Gene therapies
- Therapeutic tissue engineering products
- Human cell and tissue products
- Combination products using such therapies or products
RMAT Definition
By definition, an RMAT is an award from the U.S. FDA that allows for faster, more streamlined approvals of regenerative medicine products within the United States, such as cell and gene therapies, tissue engineering products, and combination products. RMAT designations make innovative products eligible for quicker development and review of a marketing application.
An RMAT designation is similar to the breakthrough therapy designation that is available to drugs.
Benefits of an RMAT include increased opportunities to meet with FDA officials, as well as early meetings to discuss potential surrogate or intermediate endpoints.
21st Century Cures Act
The 21st Century Cures Act was passed by the 114th U.S. Congress in December 2016. The act authorize $6.3 billion in funding, most of which is allocated for the National Institutes of Health (NIH).
The bill, passed by both houses of Congress and signed into law by President Obama, puts the U.S. on the same playing field as other countries that support accelerated of innovative medicines. Other regions that have accelerated pathways include Japan, South Korea, and the EU. The bill encourages late-stage development in regenerative medicine, recognizing the field’s potential to address severe unmet medical needs.
Congress included several provisions related to cell and gene therapies in the 21st Century Cures Act, the most important of which is the RMAT designation.
RMAT Reviews by The FDA
For more detail, the following is from the U.S. FDA:
As described in Section 3033 of the 21st Century Cures Act, a drug is eligible for regenerative medicine advanced therapy (RMAT) designation if:
- The drug is a regenerative medicine therapy, which is defined as a cell therapy, therapeutic tissue engineering product, human cell and tissue product, or any combination product using such therapies or products, except for those regulated solely under Section 361 of the Public Health Service Act and part 1271 of Title 21, Code of Federal Regulations;
- The drug is intended to treat, modify, reverse, or cure a serious or life-threatening disease or condition; and
- Preliminary clinical evidence indicates that the drug has the potential to address unmet medical needs for such disease or condition.
Another RMAT announced today by MiMedx for AmnioFIx https://finance.yahoo.com/news/amniofix-injectable-granted-regenerative-medicine-174500602.html
Organicell will be filing for RA using their Exosome technology
Cade this is impressive and useful information for the industry and those scientist who want to bring products to market legally.
Thank you.
Don’t know if they have or will, but Biostage fits this perfectly.
Opregen from Lineage Cell Therapies LCTX
https://www.ucsf.edu/news/2022/02/422276/ucsf-gene-therapy-deadly-mutation-fast-tracked-fda-review
Autologous cartilage implantation, CartiLife is also designated as an RMAT on August 2023.