Abstract
Recent decades have seen advancements in the management and treatment of difficult--
to-treat diseases such as cancer. A special class of therapeutics called cell and gene therapy has
been introduced in the past 10 years. Cell and gene therapy products have strengthened the treatment
options for life-threatening diseases with unmet clinical needs and also provided the possibility
of a potential cure for the disease in some of the patients. Cell and gene therapy products are
gaining recognition, and the interest in clinical development of cell and gene therapy products is
increasing. Moreover, as the class of cell and gene therapy products is relatively new, there is a
limited regulatory experience in the development, and the developers of the cell and gene therapy
products can often be puzzled with an array of questions on regulations. The current review intends
to provide a basic understanding of regulatory guidelines from the FDA and EMA that are
applicable to cell and gene therapy products. Essentials such as which office is responsible for the
evaluation of applications, which regulatory class/pathway is appropriate for development, and
what are the quality, nonclinical and clinical studies that are needed to support the application are
discussed in the article. In addition, a summary of regulatory designations and the post-approval
requirements, such as Risk Evaluation and Mitigation Strategies (REMS) and long-term follow-
up, is included in the article. Developers (referred to as ‘sponsors’ in this article) of cell and
gene therapies can use the respective guidance documents and other specific review articles cited
in this review for detailed information on the topics.
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