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      Science, ethics and communication remain essential for the success of cell-based therapies

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          Abstract

          Cell-based therapeutics, such as marrow or peripheral blood stem cell transplantation, are a standard of care for certain malignancies. More recently, a wider variety of cell-based therapeutics including the use of mesenchymal stromal/stem cells, T-cells, and others show great promise in a wider range of diseases. With increased efforts to expand cell-based treatments to several clinical settings, many institutions around the world have developed programs to explore cellular therapy's potential for safe and effective applications. In legitimate investigations, usually conducted through academic centers or biotechnology industry-sponsored efforts, these studies are regulated and peer-reviewed to ensure safety and clear determination of potential efficacy. However, in some cases, the use of cell-based approaches is conducted with insufficient preclinical data, scientific rationale, and/or study plan for the diseases claimed to be treated, with patients being charged for these services without clear evidence of clinical benefit. In this context, patients may not be properly informed regarding the exact treatment they are receiving within a consenting process that may not be completely valid or ethical. Here, the authors emphasize the importance of distinguishing “proven cell-based therapies” from “unproven” and unauthorized cell-based therapies. This publication also addresses the necessity for improved communication between the different stakeholders in the field, patient associations, and advocacy groups in particular, to favor medical innovation and provide legitimate benefits to patients. Considering the progressive growth of cell-based treatments, their increasing therapeutic value and the expectation that society has about these therapies, it is critically important to protect patients and ensure that the risk/benefit ratio is favorable. This paper is a review article. Literature referred to in this paper has been listed in the references section. The datasets supporting the conclusions of this article are available online by searching PubMed. Some original points in this article come from the laboratory practice in our research centers and the authors’ experiences.

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          Most cited references33

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          Selling Stem Cells in the USA: Assessing the Direct-to-Consumer Industry.

          Direct-to-consumer marketing of unapproved stem cell interventions is a well-known phenomenon in countries with lax medical regulations. However, an examination of Internet-based marketing claims revealed widespread promotion of such interventions by businesses based in the United States. Such commercial activity suggests that regulatory agencies must better oversee this marketplace.
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            Glioproliferative Lesion of the Spinal Cord as a Complication of "Stem-Cell Tourism".

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              Global Distribution of Businesses Marketing Stem Cell-Based Interventions

              A structured search reveals that online marketing of stem-cell-based interventions is skewed toward developed economies including the United States, Ireland, Australia, and Germany. Websites made broad, imprecise therapeutic claims and frequently failed to detail procedures. Widespread marketing poses challenges to regulators, bioethicists, and those seeking realistic hope from therapies.
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                Author and article information

                Journal
                Brain Circ
                Brain Circ
                BC
                Brain Circulation
                Medknow Publications & Media Pvt Ltd (India )
                2394-8108
                2455-4626
                Jul-Sep 2016
                18 October 2016
                : 2
                : 3
                : 146-151
                Affiliations
                [1] Laboratory of Cellular Therapy, University of Modena and Reggio Emilia, Modena, Italy
                [1 ] NantKwest, Inc., Woburn, MA, USA
                [2 ] School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA
                [3 ] Gene and Stem Cell Therapy Program, Centenary Institute, University of Sydney, Australia
                [4 ] Sydney Medical School, University of Sydney, NSW 2006, Australia
                [5 ] Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital, Camperdown 2050, Australia
                [6 ] TxCell, Valbonne, France
                [7 ] Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USA
                [8 ] Department of Haematology, St. George's Hospital, London, UK
                [9 ] Cell Therapy Program, Health Sciences Authority, Singapore
                [10 ] Center for Cancer and Immunology Research, Sheikh Zayed Institute, Children's National Health System, Washington, DC, USA
                [11 ] Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA
                Author notes
                Address for correspondence: Dr. Massimo Dominici, Laboratory of Cellular Therapy, University of Modena and Reggio Emilia, Via Del Pozzo, 71, Modena, Italy. E-mail: massimo.dominici@ 123456unimore.it
                Article
                BC-2-146
                10.4103/2394-8108.192525
                6126268
                e7a689ce-79a0-443e-aff1-193fb6116c82
                Copyright: © 2016 Brain Circulation

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 16 September 2016
                : 28 September 2016
                : 28 September 2016
                Categories
                Review Article

                communication,informed consent,medical tourism,mesenchymal stem/stromal cells,regulations,stem cells,unproven cell therapies

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