Advanced therapy medicinal products: Overview

Advanced therapy medicinal products (ATMPs) are medicines for human use that are based on genes, tissues or cells. They offer groundbreaking new opportunities for the treatment of disease and injury.

ATMPs can be classified into three main types:

  • gene therapy medicines: these contain genes that lead to a therapeutic, prophylactic or diagnostic effect. They work by inserting 'recombinant' genes into the body, usually to treat a variety of diseases, including genetic disorders, cancer or long-term diseases. A recombinant gene is a stretch of DNA that is created in the laboratory, bringing together DNA from different sources;
  • somatic-cell therapy medicines: these contain cells or tissues that have been manipulated to change their biological characteristics or cells or tissues not intended to be used for the same essential functions in the body. They can be used to cure, diagnose or prevent diseases;
  • tissue-engineered medicines: these contain cells or tissues that have been modified so they can be used to repair, regenerate or replace human tissue;

In addition, some ATMPs may contain one or more medical devices as an integral part of the medicine, which are referred to as combined ATMPs. An example of this is cells embedded in a biodegradable matrix or scaffold.

For detailed definitions of the different groups of advanced therapy medicinal products, refer to Regulation (EC) No 1394/2007 and Directive 2001/83/EC.

In April 2020, EMA'sCommittee for Advanced Therapies (CAT) advised patients and the general public to beware of unproven cell-based therapies.

This followed the appearance of advertisements for cell therapies as cures for serious conditions across the European Union in early 2020.

In its statement, the CAT warned against the use of unregulated cell-based therapies, which may be ineffective and increase the risk of serious adverse reactions.

Healthcare providers should explain the benefits and risks of the cell-based therapies that they are providing to patients, as well as confirming that regulatory authorities have approved their use.

Anyone with doubts can contact EMA or their national competent authority.

The CAT’s statement replaces a statement it issued in 2010 following reports of unregulated stem-cell therapies being offered to patients.

Infocard -advice for_patients considering treatments with a cell-based therapy

EMA role

All advanced therapy medicines are authorised centrally via the European Medicines Agency (EMA). They benefit from a single evaluation and authorisation procedure.

As with all medicines, the Agency continues to monitor the safety and efficacy of advanced therapy medicines after they are approved and marketed. The Agency also gives scientific support to developers to help them design pharmacovigilance and risk management systems used to monitor the safety of these medicines.

Action plan on ATMPs

In October 2017, the European Commission and EMA published a joint action plan on ATMPs, which aims to streamline procedures and better address the specific requirements of ATMP developers.

It contains several actions for the European Commission and EMA.

In February 2018, as part of the joint action plan, EMA published

The action plan takes into account the ideas collected at an EMA-hosted multi-stakeholder workshop to explore solutions to challenges in the development of ATMPs.

Committee for Advanced Therapies

The Agency's Committee for Advanced Therapies (CAT) plays a central role in the scientific assessment of advanced therapy medicines. It provides the expertise that is needed to evaluate advanced therapy medicines.

During the assessment procedure, the CAT prepares a draft opinion on the quality, safety and efficacy of the advanced therapy medicine. It sends this to the Committee for Medicinal Products for Human Use (CHMP). Based on the CAT opinion, the CHMP adopts an opinion recommending or not the authorisation of the medicine by the European Commission. The European Commission makes its final decision on the basis of the CHMP opinion.

The CAT also:

Stem cells

Stem cells are naturally occurring cells in the body that have the ability to divide and produce a range of different cell types. Stem cells are important in the growth and development of the body, as well as in repair after injury. 

Stems cells are categorised as ATMPs when these cells undergo substantial manipulation or are used for a different essential function. They can be somatic-cell therapy products or tissue-engineered products, depending on how the medicine works in the body.

EMA follows research into the use of stem cells in medicines very closely and is responsible for assessing marketing authorisation applications for medicines containing stem cells.

The Agency has been advising developers of stem cell-based medicines for a number of years:

In February 2011, the Agency published a PDF icon reflection paper on stem cell-based medicinal products . The paper stressed the fact that developers of stem-cell based medicines need to pay close attention to the way the medicines are manufactured, to ensure that the final medicine is as consistent and reproducible as possible. Pre-clinical and clinical testing also needs to take account of the cells' properties, ensuring that the possible risks of tumour development and rejection by the body are studied adequately and balanced against their benefits for patients.

The reflection paper was adopted by the CAT on 14 January 2011. This followed a public consultation between March and June 2010 and discussion at a public workshop in May 2010 involving 230 participants from academia, industry and regulatory authorities.

For more information, see the PDF icon draft reflection paper and the PDF icon overview of comments received .


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