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class="col-md-12 section1"><div class="ContentItemHtml"><div class="HtmlContent"><p> <script src="https://static.elfsight.com/platform/platform.js" data-use-service-core="" defer="defer"></script> </p> <div class="elfsight-app-f18c03fe-0a98-4a95-afd6-1502f94997f8" data-elfsight-app-lazy=""></div> <script src="https://static.elfsight.com/platform/platform.js" data-use-service-core="" defer="defer"></script> <div class="elfsight-app-75cda39b-4f16-4db7-aaf3-c9b243ad2f00" data-elfsight-app-lazy=""></div></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml"><div class="HtmlContent"><div class="row" style="background-color: #002a54; padding-top: 3em; padding-bottom: 3em;"> <div class="column50left" style="padding-left: 4em;"><a href="https://www.isctglobal.org/about/isct-committees/ecgt" target="_blank" rel="noopener"><img src="https://higherlogicdownload.s3.amazonaws.com/ISCT/15175d29-b676-4bb3-8e1a-f7de41062a62/UploadedImages/ECGT/ISCT_2022-CEGTLogo_FINAL_2_inversed_1.png" width="50%"></a> <h2 style="font-size: 300%; color: #ffffff; line-height: 1.25em;">Unproven Cell & Gene Therapies: Guidelines and Resources for Healthcare Providers</h2> <p style="color: #ffffff; line-height: 1.5em;">The <a href="https://www.isctglobal.org/about/about-us" style="color: #ffffff;" target="_blank" rel="noopener">International Society for Cell & Gene Therapy (ISCT)</a> brings together experts from around the globe who are committed to developing new innovative treatments that can have a positive and significant impact on many people’s lives. We are working towards improving both life expectancy and the quality of life of people living with some of the most challenging medical conditions in any society.</p> <h3 style="color: #ffffff;"><strong>TABLE OF CONTENTS</strong></h3> <ul style="color: #ffffff;"> <li style="font-size: 12pt;"><a href="#about" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">What This Guide Is About</span></a></li> <li style="font-size: 12pt;"><a href="#approved-proven-unapproved-unproven" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Approved and Proven vs. Unapproved and Unproven CGT Products</span></a></li> <li style="font-size: 12pt;"><a href="#unproven-therapies" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Characteristics of Unproven Therapies</span></a></li> <li style="font-size: 12pt;"><a href="#marketing" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Marketing of Unapproved and Unproven CGT Products</span></a></li> <li style="font-size: 12pt;"><a href="#further-actions" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">What Further Actions Can Healthcare Providers Take?</span></a></li> <li style="font-size: 12pt;"><a href="#reporting-mechanisms" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Reporting Mechanisms</span></a></li> <li style="font-size: 12pt;"><a href="#summary" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Summary</span></a></li> <li style="font-size: 12pt;"><a href="#appendix" style="text-decoration: none; color: #96c4d9;"><span style="font-size: 12pt;">Appendix</span></a></li> </ul> </div> <div class="column50right"><img src="https://higherlogicdownload.s3.amazonaws.com/ISCT/15175d29-b676-4bb3-8e1a-f7de41062a62/UploadedImages/ECGT/9650622_7774_resized.png" width="100%"></div> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section2"><div class="ContentItemHtml"><div class="HtmlContent"><div class="row"> <div class="column75"> <h2 style="margin-left: -0.25em; margin-top: 2em;"><strong><span style="color: rgb(0, 42, 84);">Cell and Gene Therapies (CGTs) is a rapidly growing field of medicine.</span></strong></h2> <div class="row"> <div class="column50left"> <p><span style="font-size: 11pt;">Some cell and gene-based products are now available as part of routine clinical practice in some, but not all countries, with more products in development. </span><br><br><span style="font-size: 11pt;"><a href="https://www.isctglobal.org/publications/regulatory-quality-initiatives/regulatory-report" target="_blank" rel="noopener">Read More →</a></span></p> </div> <div class="column50right"> <p><span style="font-size: 11pt;">Where proven and approved by regulators who independently assess their safety and effectiveness, these advances should be embraced and supported. In this context, well-studied and approved products can positively impact the lives of people living with certain conditions along with their wider family and support networks.</span></p> </div> </div> </div> <div class="column25"> <div id="about"></div> <p style="text-align: right;"><img src="https://higherlogicdownload.s3.amazonaws.com/ISCT/15175d29-b676-4bb3-8e1a-f7de41062a62/UploadedImages/ECGT/23503347_dna_2_white_500x992.png" width="60%"></p> </div> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-4 section3"></div><div class="col-md-4 section4"></div><div class="col-md-4 section5"></div></div><div class="row row-full "><div class="col-md-12 section6"><div class="ContentItemHtml"><div class="HtmlContent"><div style="background-color: #002a54; padding: 3em; margin-top: -1em;"><center> <p style="padding-bottom: 2em;"><a href="https://www.isctglobal.org/about/about-us" target="_blank" rel="noopener"><img src="https://higherlogicdownload.s3.amazonaws.com/ISCT/15175d29-b676-4bb3-8e1a-f7de41062a62/UploadedImages/Dev_Files/isct-nav-logo.png" width="30%"></a></p> </center> <div class="row"> <div class="column50left" style="color: #ffffff; padding-right: 2em;"><span style="font-size: 11pt;">ISCT wholeheartedly supports the ethical development of cell- and gene-based products with patient safety and benefit in mind and further wants to drive forward improvements in practice.<br><br>However, some individuals and companies are providing <span style="color: rgb(255, 91, 89);"><strong>unproven and unapproved products</strong></span> directly to the public, many of whom are in vulnerable situations as they search for a cure or answers in response to receiving a devastating diagnosis. </span> <h2 style="color: #ffffff;">ISCT has major concerns about these unethical practices and seeks to ensure that the public is protected.</h2> </div> <div class="column50right" style="background-color: #fafafa; border-radius: 2em; padding: 2em;"> <h3><strong>WHAT THIS GUIDE IS ABOUT</strong></h3> <p><span style="font-size: 11pt;">This guide provides information for healthcare practitioners on <span style="color: rgb(41, 171, 135);"><strong>how to identify and distinguish safe and approved CGT products from those products that do not have a proven record</strong></span> of safety and efficacy, nor have received approval from appropriate regulatory organizations. </span><span style="font-size: 11pt;">This guide also provides information on how to report concerns, or actual harm that has resulted from the use of unproven products. </span></p> <p><span style="font-size: 11pt;"><em><a href="#appendix">Appendix 1</a></em> provides a list of resources on CGTs and how to determine which are proven and which are not.</span></p> <div id="approved-proven-unapproved-unproven"></div> </div> </div> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-full blue-bg "><div class="col-md-6 section7"></div><div class="col-md-6 section8"></div></div><div class="row row-full "><div class="col-md-12 section9"><div class="ContentItemHtml"><div class="HtmlContent"><div class="row"> <div class="column50left" style="background-color: #29ab87; height: 512px;"><center> <h2 style="font-size: 300%; color: #ffffff; line-height: 1.25em;"><i class="fa-solid fa-circle-check"></i> Approved & Proven<br>CGT Products</h2> </center> <p style="color: #ffffff; line-height: 1.5em; padding-left: 3em; padding-right: 3em; padding-bottom: 2em;"><span style="font-size: 11pt;">CGT products must undergo a rigorous process of quality, safety, and efficacy demonstration under the oversight of appropriate regulatory agencies worldwide. </span><br><br><span style="font-size: 11pt;">Approved and proven CGT products are provided to the public only after their quality, safety, and effectiveness have been demonstrated through carefully conducted and monitored clinical testing and reported in reputable peer-reviewed scientific journals. <br><br>Listings of approved products can be obtained from the websites of appropriate regulatory agencies (<span style="color: rgb(255, 255, 255);"><a href="#appendix" style="color: rgb(255, 255, 255);"><em>Appendix 2</em></a></span>) and the <span style="color: rgb(255, 255, 255);"><a href="https://www.isct-unprovencellulartherapies.org/patient-resources/" target="_blank" style="color: rgb(255, 255, 255);" rel="noopener">Informational Resources webpage</a></span> of the ISCT Committee on the Ethics of Cell and Gene Therapy (ECGT).</span></p> </div> <div class="column50right" style="background-color: #ff5b59; height: 512px;"><center> <h2 style="font-size: 300%; color: #ffffff; line-height: 1.25em;"><i class="fa-solid fa-circle-xmark"></i> Unapproved & Unproven <br>CGT Products</h2> </center> <div id="unproven-therapies"> <p style="color: #ffffff; line-height: 1.5em; padding-left: 3em; padding-right: 3em; padding-bottom: 2em;"><span style="font-size: 11pt;">A growing number of businesses have been providing <span style="color: rgb(255, 255, 255);"><a href="https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(21)00420-3" style="color: rgb(255, 255, 255);" target="_blank" rel="noopener">unproven CGTs</a></span> directly to the public.<br><br>These products are presented as safe and effective for a wide range of clinical conditions, but there is often little scientific evidence to support these claims. Further, false or misleading information is utilized to make these products appear scientific and evidence based.</span></p> <p style="color: #002a54; line-height: 1.5em; padding-left: 3em; padding-right: 3em; padding-bottom: 0.25em; font-size: 10pt;" id="Examples-of-Unproven-Therapies"><a href="#" style="color: #002a54; text-decoration: none;"> <span style="background-color: #ffffff; padding: 0.75em; color: #ff5b59; border-radius: 2em; text-transform: uppercase;">Examples of Unproven Therapies <i class="fa-solid fa-up-right-and-down-left-from-center"></i></span></a></p> <br><br><br></div> </div> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section10"><div class="ContentItemHtml"><div class="HtmlContent"><div style="padding: 1em;"></div> <h3><strong>CHARACTERISTICS OF UNPROVEN THERAPIES</strong></h3> <p><span style="font-size: 11pt; color: rgb(0, 0, 0);">Unproven therapies typically meet some or all of the following criteria:</span></p> <div style="padding: 1em;"></div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-3 section11"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-clipboard-question"></i></p> <p style="font-size: 10pt;">Unclear scientific rationale to suggest potential efficacy<br><br><br><br><br><span style="color: rgb(0, 0, 0);"></span></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section12"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-person-circle-question"></i></p> <p style="font-size: 10pt;">Lack of understanding on the mechanism of action and/or the biological function to support clinical use<br><br><br></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section13"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-calendar-xmark"></i></p> <p style="font-size: 10pt;">Insufficient data from in vitro assays, animal models, and/or clinical studies regarding the safety profile to support the use in patients<br><br></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section14"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-list"></i></p> <p style="font-size: 10pt;">Lack of a standardized approach to confirm product quality and ensure consistency in manufacturing based on adherence to mandatory guidelines</p></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section15"><div class="ContentItemHtml"><div class="HtmlContent"><div style="padding: 1em;"></div> <div id="marketing"></div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-3 section16"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-chalkboard-user"></i></p> <p style="font-size: 10pt;">Inadequate information disclosed to patients to enable proper informed consent<br><br><br></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section17"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-chart-column"></i></p> <p style="font-size: 10pt;">Administered utilizing non-standardized or non-validated methods<br><br><br></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section18"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-users-viewfinder"></i></p> <p style="font-size: 10pt;">Supervision, review, and approval by appropriate national regulatory agencies is lacking<br><br></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section19"><div class="ContentItemHtml red-panel-border"><div class="HtmlContent"><p style="font-size: 200%;"><i class="fa-solid fa-comments-dollar"></i></p> <p style="font-size: 10pt;">Payment, often of high fees, for the treatment(s) or for participation in clinical studies (“pay-to-participate”)<br><br></p></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section20"><div class="ContentItemHtml"><div class="HtmlContent"><h3 style="padding-top: 1em; padding-bottom: 1em;"><strong>MARKETING OF UNPROVEN AND UNAUTHORIZED CGT PRODUCTS</strong></h3></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12" ><div class="row row-wide clearfix "><div class="col-md-12 section21"><div class="ContentItemHtml"><div class="HtmlContent"><p style="text-align: center;"><span style="font-size: 11pt;">Unproven CGT products are often marketed in ways that seem to be supported by more robust scientific evidence than actually exists. </span></p> <p style="text-align: center;"><span style="font-size: 11pt;">These marketing strategies are collectively known as:</span></p> <h1 style="color: rgb(150, 196, 217); text-align: center;"><strong>“tokens of scientific legitimacy”</strong></h1> <p style="text-align: center;"><strong> </strong></p></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-6 section22"><div class="ContentItemHtml"><div class="HtmlContent"><p><span style="font-size: 11pt;">These <a href="https://www.science.org/doi/10.1126/scitranslmed.aag0426" target="_blank" rel="noopener">tokens of scientific legitimacy</a> are often included in direct-to-consumer advertising through social media, and can even mislead clinicians and other healthcare providers into choosing unproven interventions without fully considering the lack of appropriate scientific evidence. These persuasive tactics go beyond patient testimonials and celebrity endorsements. </span></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-6 section23"><div class="ContentItemHtml"><div class="HtmlContent"><p><span style="font-size: 11pt;">While these "tokens of scientific legitimacy" might be characteristics of legitimate clinical research, none alone provides sufficient evidence to establish a novel therapy as safe and effective. Healthcare providers therefore have a significant role in preventing unproven CGTs, as they are a reference group from which the lay public usually seeks advice.<br><br></span></p></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section24"><div class="ContentItemHtml"><div class="HtmlContent"><div style="padding: 1em;"></div> <center> <p style="color: #002a54; line-height: 1.5em; font-size: 10pt;" id="Examples-of-Tactics-to-Be-Aware-Of"><a href="#" style="color: #002a54; text-decoration: none;"> <span style="background-color: #002a54; padding: 0.75em; color: #ffffff; border-radius: 2em; text-transform: uppercase;">Examples of Tactics to Be Aware Of <i class="fa-solid fa-up-right-and-down-left-from-center"></i></span></a></p> </center> <div style="padding: 0.5em;"></div></div><div class="HtmlFooter"></div></div></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-6 section25"></div><div class="col-md-6 section26"></div></div><div class="row row-full "><div class="col-md-12 section27"><div class="ContentItemHtml blue-bg"><div class="HtmlContent"><div style="padding: 0.5em; margin-top: 2em; text-align: center;"></div> <h2 style="text-align: center;"><span style="color: rgb(255, 255, 255);"><strong><span style="color: rgb(150, 196, 217);"> What Further Actions can Healthcare Providers Take </span><br><span style="color: rgb(255, 255, 255);">to Help the Public Evaluate CGTs? </span></strong></span></h2> <div style="padding: 0.5em; text-align: center;"></div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-full blue-bg "><div class="col-md-3 section28"><div class="ContentItemHtml grey-tile"><div class="HtmlContent"><div style="height: 466px;"> <p style="padding-top: 2em;"><span style="color: rgb(0, 42, 84);"><strong><span style="font-size: 48pt;">01</span></strong></span></p> <p><span style="font-size: 11pt; color: rgb(0, 42, 84);"><strong>Help potential recipients review the scientific data</strong> to determine if the product has had appropriate pre-clinical and clinical studies conducted. Websites that facilitate such discussion are included in <a href="#appendix" style="color: rgb(0, 42, 84);"><em>Appendix 1</em></a>.</span></p> </div></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section29"><div class="ContentItemHtml grey-tile"><div class="HtmlContent"><div style="height: 466px;"> <p style="padding-top: 2em;"><span style="color: rgb(0, 42, 84);"><strong><span style="font-size: 48pt;">02</span></strong></span></p> <p><span style="font-size: 11pt; color: rgb(0, 42, 84);">In the absence of approved and proven cell therapies for a particular condition, <strong>help potential recipients identify appropriate clinical trials</strong> being conducted in a scientific manner and with proper regulatory oversight.</span></p> </div></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section30"><div class="ContentItemHtml grey-tile"><div class="HtmlContent"><div style="height: 466px;"> <p style="padding-top: 2em;"><span style="color: rgb(0, 42, 84);"><strong><span style="font-size: 48pt;">03</span></strong></span></p> <p><span style="font-size: 11pt; color: rgb(0, 42, 84);"><strong>Report clinics or companies making therapeutic claims that cannot be scientifically substantiated</strong> to the relevant regulatory body, to patient advocacy groups and to scientific organizations/societies such as <a href="https://www.isctglobal.org/home" style="color: rgb(0, 42, 84);">ISCT</a> and its ECGT committee. Patient advocacy groups and scientific organizations/societies can distribute information that steers individuals toward legitimate providers and away from unethical ones.</span></p> </div></div><div class="HtmlFooter"></div></div></div><div class="col-md-3 section31"><div class="ContentItemHtml grey-tile"><div class="HtmlContent"><div style="height: 466px;"> <p style="padding-top: 2em;"><span style="color: rgb(0, 42, 84);"><strong><span style="font-size: 48pt;">04</span></strong></span></p> <p><span style="font-size: 11pt; color: rgb(0, 42, 84);"><strong>Help individuals who are harmed through unproven cell therapies</strong> to report the event to regulatory agencies, patient advocacy groups, ISCT and its ECGT committee, and/or relevant scientific societies. The more individuals involved in distributing information, the more likely it is that the information will get to people who need it.</span></p> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-full blue-bg "><div class="col-md-12 section32"><div class="ContentItemHtml"><div class="HtmlContent"><div id="reporting-mechanisms"> <div id="summary"> <p style="margin-top: -1em; padding: 2em; text-align: center;"><span style="font-size: 11pt; color: rgb(255, 255, 255);"><em>Further details on reporting are provided below (<a href="#appendix" style="color: rgb(255, 255, 255);">Appendix 3</a>).</em></span></p> </div> </div></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix grey-tile "><div class="col-md-6 section33"><div class="ContentItemHtml"><div class="HtmlContent"><h3 style="padding-top: 1em; padding-bottom: 1em;"><strong><span style="color: rgb(0, 42, 84);">REPORTING MECHANISMS</span></strong></h3> <p><span style="font-size: 11pt; color: rgb(0, 0, 0);">In the unfortunate situation that an individual has been harmed through receiving an unproven CGT product it is important that such harm be reported to their physicians and caregivers and also to the proper regulatory agencies (<a href="#appendix"><em>Appendix 3</em></a>). </span></p> <p><span style="font-size: 11pt; color: rgb(0, 0, 0);">These agencies can not only track such events, but they can also track and prosecute unscrupulous providers and practitioners. </span><strong><span style="color: rgb(0, 42, 84);"></span></strong></p></div><div class="HtmlFooter"></div></div></div><div class="col-md-6 section34"><div class="ContentItemHtml"><div class="HtmlContent"><h3 style="padding-top: 1em; padding-bottom: 1em;" id="summary"><strong><span style="color: rgb(0, 42, 84);">SUMMARY</span></strong></h3> <p><strong><span style="font-size: 11pt;">The use of unproven CGT-based treatments can be a risk not only to the individuals who receive the product, but also may have broader impact on families and caregivers. </span></strong></p> <p><span style="font-size: 11pt;">The unproven treatments can adversely affect legitimate studies attempting to develop safe and proven effective new therapies. ISCT urges healthcare providers to review all available information carefully and be alert to common features of unproven interventions to make the best-informed recommendations concerning CGTs and ultimately protect their patients. </span></p> <p id="appendix"><span style="font-size: 11pt;">A list of organizations that can provide further information is provided below.</span></p></div><div class="HtmlFooter"></div></div></div></div><div class="row row-wide clearfix "><div class="col-md-12 section35"><div class="ContentItemHtml"><div class="HtmlContent"><h2 style="padding-top: 1em; padding-bottom: 1em;"><strong><span style="color: rgb(0, 42, 84);">APPENDIX</span></strong></h2></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-heading"><div class="HtmlContent"><p><button type="button"><strong>APPENDIX 1:</strong> Resources Related to Proven and Unproven CGTs</button></p></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-text container make-buttons grey-tile"><div class="HtmlContent"><ul> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="http://www.isct-unprovencellulartherapies.org/patient-resources/" target="_blank" rel="noopener">International Society for Cell & Gene Therapy</a> (ISCT)</span></strong><br><span style="font-size: 11pt;">Includes the ISCT Reference Guide on Unproven Cell-Based Interventions, the ISCT Guide of Cell/Gene Products with Marketing Authorization and a COVID-19 Research Spotlight</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://www.aboutstemcells.org/" target="_blank" rel="noopener">International Society for Stem Cell Research</a> (ISSCR)</span></strong><br><span style="font-size: 11pt;">Includes the “The ISSCR Guide to Stem Cell Treatments” and disease-specific Fact Sheets</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="http://www.stemcellsaustralia.edu.au/" target="_blank" rel="noopener">Stem Cells Australia</a></span></strong><br><span style="font-size: 11pt;">Includes Q&A on stem cell treatments and information on the status of cell-based treatments for a wide variety of diseases/conditions</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://www.eurogct.org/" target="_blank" rel="noopener">EuroGCT</a></span></strong><br><span style="font-size: 11pt;">Includes information on various stem cell types, diseases/conditions, and educational videos</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;">German Stem Cell Network:</span></strong><span style="font-size: 11pt;"> <a href="https://de.gscn.org/Portals/0/Dokumente/AnnualReport/Einzelartikel2017/GSCN-Report_2017-18_EN_unproven.pdf?ver=2019-01-09-143904-573" target="_blank" rel="noopener">Unproven Stem Cell Therapies</a></span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://www.cirm.ca.gov/patients" target="_blank" rel="noopener">California Stem Cell Agency</a> (CIRM)</span></strong><br><span style="font-size: 11pt;">Includes information on CIRM-funded clinical trials, disease research programs, and patient stories</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://stemcellnetwork.ca/stem-cells/" target="_blank" rel="noopener">Stem Cell Network</a> - Canada</span></strong><br><span style="font-size: 11pt;">Includes educational videos and profiles of stem cell researchers</span><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://patienteducation.asgct.org/" target="_blank" rel="noopener">American Society of Gene+Cell Therapy</a> (ASGCT)</span></strong><br> <ul> <li style="font-size: 11pt;"><a href="https://asgct.org/publications/landscape-report" target="_blank" rel="noopener"><span style="font-size: 11pt;">Quarterly Report of Gene, Cell & RNA Landscape</span></a><br><strong><span style="font-size: 11pt;"><br></span></strong></li> </ul> </li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://www.esgct.eu/gct-101" target="_blank" rel="noopener">European Society of Gene & Cell Therapy</a></span></strong><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;"><a href="https://www.cmrijeansforgenes.org.au/research/research-explained/what-is-gene-therapy" target="_blank" rel="noopener">Children’s Medical Research Institute</a> - Australia</span></strong><br><br></li> <li style="font-size: 11pt;"><strong><span style="font-size: 11pt;">US FDA</span></strong><br> <ul> <li style="font-size: 11pt;"><a href="https://www.fda.gov/vaccines-blood-biologics/enforcement-actions-cber/bimoteam-biologicsinternet-surveillanceother" target="_blank" rel="noopener"><span style="font-size: 11pt;">CBER Untitled Letters</span></a></li> <li style="font-size: 11pt;"><a href="https://www.fda.gov/consumers/consumer-updates/what-gene-therapy-how-does-it-work" target="_blank" rel="noopener"><span style="font-size: 11pt;">What Is Gene Therapy?</span></a></li> <li style="font-size: 11pt;"><a href="https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/approved-cellular-and-gene-therapy-products" target="_blank" rel="noopener">Approved Cellular and Gene Therapy Products</a></li> <li style="font-size: 11pt;"><a href="https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/resources-related-regenerative-medicine-therapies" target="_blank" rel="noopener">Resources Related to Regenerative Medicine Therapies</a><br><br></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Consumer Reports:</strong> <a href="https://www.consumerreports.org/medical-treatments-procedures/trouble-with-stem-cell-therapy/" target="_blank" rel="noopener">The Problem with Stem Cell Therapy</a></span><br><br></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>ProPublica:</strong> <a href="https://www.propublica.org/article/amniotic-stem-cell-treatment-transplant-therapy" target="_blank" rel="noopener">The Birth-Tissue Profiteers</a></span><br><br></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Paul Knoepfler’s Lab:</strong> <a href="https://ipscell.com/scope-global-stem-cell-outreach-program-for-education/" target="_blank" rel="noopener">Stem Cell Outreach Program for Education</a><br><br></span><span style="font-size: 11pt;"></span></li> <li style="font-size: 11pt; font-weight: bold;"><a href="https://alliancerm.org/available-products" target="_blank" rel="noopener"><strong><span style="font-size: 11pt;">Alliance of Regenerative Medicine (ARM)</span></strong></a></li> </ul></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-heading"><div class="HtmlContent"><p><button type="button"><strong>APPENDIX 2:</strong> Regulatory Agencies Worldwide</button></p></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-text container grey-tile"><div class="HtmlContent"><p><em><span style="font-size: 11pt;">Disclaimer: This is not an exhaustive list. If you would like ISCT to consider including additional regulatory agencies, please <a href="mailto:isct@isctglobal.org">contact us here</a>.<br><br></span></em></p> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><b>Argentina: </b><a href="https://www.argentina.gob.ar/anmat/anmat-en" target="_blank" rel="noopener">Administración Nacional de Medicamentos, Alimentos y Tecnología Médica</a> (ANMAT)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Australia:</strong> <a href="https://www.tga.gov.au/" target="_blank" rel="noopener">Therapeutic Goods Administration</a> (TGA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Austria:</strong> <a href="https://www.ages.at/en/" target="_blank" rel="noopener">Austrian Medicines and Medical Devices Agency</a> (AGES MEA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Belgium:</strong> <a href="https://www.famhp.be/en" target="_blank" rel="noopener">Federal Agency for Medicines and Health Products</a> (FAMHP)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Brazil:</strong> <a href="https://www.gov.br/anvisa/pt-br/english" target="_blank" rel="noopener">Agência Nacional de Vigilância Sanitária</a> (ANVISA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Canada:</strong> <a href="https://www.canada.ca/en/health-canada.html" target="_blank" rel="noopener">Health Canada</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>China:</strong> <a href="http://english.nmpa.gov.cn/" target="_blank" rel="noopener">National Medical Products Administration</a> (NMPA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>EU:</strong> <a href="https://www.ema.europa.eu/en" target="_blank" rel="noopener">European Medicines Agency</a> (EMA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>France:</strong> <a href="https://ansm.sante.fr/" target="_blank" rel="noopener">Agence nationale de sécurité du médicament et des produits de santé</a> (ANSM)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Hong Kong:</strong> <a href="https://www.dh.gov.hk/english/index.html" target="_blank" rel="noopener">Department of Health, Hong Kong</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>India:</strong> <a href="https://cdsco.gov.in/opencms/opencms/en/Home/" target="_blank" rel="noopener">Central Drugs Standard Control Organisation</a> (CDSCO)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Iran:</strong> <a href="https://www.fda.gov.ir/en" target="_blank" rel="noopener">Iran Food & Drug Administration</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Israel:</strong> <a href="https://www.gov.il/en/departments/ministry_of_health/govil-landing-page" target="_blank" rel="noopener">Ministry of Health, Israel</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Japan:</strong> <a href="https://www.pmda.go.jp/english/" target="_blank" rel="noopener">Pharmaceuticals and Medical Devices Agency</a> (PMDA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>New Zealand:</strong> <a href="https://www.medsafe.govt.nz/" target="_blank" rel="noopener">Medicines and Medical Devices Safety Authority</a> (MEDSAFE)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>South Korea:</strong> <a href="https://www.mfds.go.kr/eng/index.do" target="_blank" rel="noopener">Ministry of Food and Drug Safety</a> (MFDS)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>United Kingdom:</strong> <a href="https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency" target="_blank" rel="noopener">Medicines and Healthcare products Regulatory Agency</a> (MHRA)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>USA:</strong> <a href="https://www.fda.gov/" target="_blank" rel="noopener">Food and Drug Administration</a> (FDA)</span></li> </ul></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-heading"><div class="HtmlContent"><p><button type="button"><strong>APPENDIX 3:</strong> Adverse Event Reporting Mechanisms and Databases Worldwide</button></p></div><div class="HtmlFooter"></div></div><div class="ContentItemHtml accordion-text container grey-tile"><div class="HtmlContent"><p><span style="font-size: 11pt;"><em>Disclaimer: This is not an exhaustive list. If you would like ISCT to consider including additional regulatory agencies, please <a href="mailto:isct@isctglobal.org" target="_blank" rel="noopener">contact us here</a>.<br><br></em></span></p> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><b>Argentina: </b><a href="https://www.argentina.gob.ar/anmat/anmat-en" target="_blank" rel="noopener">Administración Nacional de Medicamentos, Alimentos y Tecnología Médica</a> (ANMAT)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.argentina.gob.ar/sites/default/files/farmacovigilancia-ficha-eventos-adversos-pacientes.pdf" target="_blank" rel="noopener">Sistema nacional de farmacovigilancia comunicación de eventos adversos formulario para pacientes</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Australia:</strong> <a href="https://www.tga.gov.au/" target="_blank" rel="noopener">Therapeutic Goods Administration</a> (TGA)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.tga.gov.au/safety-information" target="_blank" rel="noopener">Safety information</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.tga.gov.au/news/news/stem-cell-treatments-and-regulation-quick-guide-consumers" target="_blank" rel="noopener">Stem cell treatments and regulation</a> - a quick guide for consumers</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.tga.gov.au/resources/resource/guidance/complying-advertising-requirements" target="_blank" rel="noopener">Complying with advertising requirements</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.tga.gov.au/advertising-enforcement-and-outcomes" target="_blank" rel="noopener">Advertising enforcement and outcomes</a></span><br><br></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Austria:</strong> <a href="https://www.ages.at/en/" target="_blank" rel="noopener">Austrian Medicines and Medical Devices Agency</a> (AGES MEA)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.basg.gv.at/en/market-surveillance/reporting/tissue-vigilance#c20596" target="_blank" rel="noopener">Tissue vigilance</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://basg.gv.at/en/market-surveillance/official-announcements/blood-tissue" target="_blank" rel="noopener">Blood & tissue</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.basg.gv.at/en/consumers/illegal-market" target="_blank" rel="noopener">Illegal market</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.basg.gv.at/en/market-surveillance/official-announcements/illegal-market" target="_blank" rel="noopener">Illegal market</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Belgium:</strong> <a href="https://www.famhp.be/en" target="_blank" rel="noopener">Federal Agency for Medicines and Health Products</a> (FAMHP)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.famhp.be/en/human_use/health_products/human_body_material/biovigilance" target="_blank" rel="noopener">Biovigilance</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.famhp.be/en/human_use/medicines/medicines/pharmacovigilance/data_collection_evaluation_measures" target="_blank" rel="noopener">Data collection, evaluation and measures</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.famhp.be/en/notification_effets" target="_blank" rel="noopener">Reporting of adverse effects reactions and/ or incidents</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Brazil:</strong> <a href="https://www.gov.br/anvisa/pt-br/english" target="_blank" rel="noopener">Agência Nacional de Vigilância Sanitária</a> (ANVISA)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://primaryreporting.who-umc.org/BR" target="_blank" rel="noopener">Notificação de Eventos Adversos a Medicamentos e Vacinas</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Canada:</strong> <a href="https://www.canada.ca/en/health-canada.html" target="_blank" rel="noopener">Health Canada</a></span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://healthycanadians.gc.ca/apps/radar/MD-IM-0005.08.html" target="_blank" rel="noopener">Health Product Complaint Form</a> (FRM-0317)<br></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.competitionbureau.gc.ca/eic/site/cb-bc.nsf/frm-eng/GH%c3%89T-7TDNA5" target="_blank" rel="noopener">Complaint form</a><br></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-reporting.html" target="_blank" rel="noopener">Report a side effect</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>EU:</strong> <a href="https://www.ema.europa.eu/en" target="_blank" rel="noopener">European Medicines Agency</a> (EMA)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.ema.europa.eu/en/human-regulatory-overview/research-and-development/pharmacovigilance-research-and-development/eudravigilance/access-eudravigilance-data" target="_blank" rel="noopener">Access to EudraVigilance data</a><br></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.adrreports.eu/" target="_blank" rel="noopener">European database of suspected adverse drug reaction reports</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>France:</strong> <a href="https://ansm.sante.fr/" target="_blank" rel="noopener">Agence nationale de sécurité du médicament et des produits de santé</a> (ANSM)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://ansm.sante.fr/documents/reference/declarer-un-effet-indesirable" target="_blank" rel="noopener">Déclarer un effet indésirable</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Hong Kong:</strong> <a href="https://www.dh.gov.hk/english/index.html" target="_blank" rel="noopener">Department of Health, Hong Kong</a></span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.drugoffice.gov.hk/eps/do/en/pharmaceutical_trade/adr_reporting/index.html" target="_blank" rel="noopener">Adverse Drug Reactions</a> (Reporting)<br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>India:</strong> <a href="https://cdsco.gov.in/opencms/opencms/en/Home/" target="_blank" rel="noopener">Central Drugs Standard Control Organisation</a> (CDSCO)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://cdsco.gov.in/opencms/opencms/en/PvPI/" target="_blank" rel="noopener">Pharmacovigilance Programme of India PvPI</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://cdsco.gov.in/opencms/opencms/system/modules/CDSCO.WEB/elements/download_file_division.jsp?num_id=ODQ5MA==" target="_blank" rel="noopener">Suspected Adverse Drug Reaction Reporting Form</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://cdsco.gov.in/opencms/opencms/en/Notifications/Adverse-Drug-Reaction-related-Notifications/" target="_blank" rel="noopener">Adverse Drug Reaction related Notifications</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Israel:</strong> <a href="https://www.gov.il/en/departments/ministry_of_health/govil-landing-page" target="_blank" rel="noopener">Ministry of Health, Israel</a></span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.gov.il/en/service/adverse_effects_reports" target="_blank" rel="noopener">Report adverse effects and problems associated with medications and drugs</a><br></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://sideeffects.health.gov.il/" target="_blank" rel="noopener">Side Effects</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>Japan:</strong> </span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.caa.go.jp/en/law/" target="_blank" rel="noopener">Consumer Affairs Agency: Law</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>New Zealand:</strong> </span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://comcom.govt.nz/make-a-complaint" target="_blank" rel="noopener">Commerce Commission: Make a complaint</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>South Korea: </strong>Korea Institute of Drug Safety & Risk Management (KIDS)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.drugsafe.or.kr/iwt/ds/en/report/WhatIsKAERS.do" target="_blank" rel="noopener">The Korea Adverse Event Reporting System</a> (KAERS)</span><br><br></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>United Kingdom:</strong> <a href="https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency" target="_blank" rel="noopener">Medicines and Healthcare products Regulatory Agency</a> (MHRA)</span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://yellowcard.mhra.gov.uk/sideeffects" target="_blank" rel="noopener">Side effects</a> (adverse drug reactions)</span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://yellowcard.mhra.gov.uk/idaps" target="_blank" rel="noopener">What is being reported</a><br><br></span></li> </ul> </li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><strong>USA:</strong></span> <ul> <li style="font-size: 11pt;"><span style="font-size: 11pt;">Federal Trade Commission: <a href="https://reportfraud.ftc.gov/#/" target="_blank" rel="noopener">Report to help fight fraud!</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;"><a href="https://www.fda.gov/" target="_blank" rel="noopener">Food and Drug Administration</a>: MedWatch: <a href="https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program" target="_blank" rel="noopener">The FDA Safety Information and Adverse Event Reporting Program</a></span></li> <li style="font-size: 11pt;"><span style="font-size: 11pt;">Federation of State Medical Boards (FMSB): <a href="https://www.fsmb.org/contact-a-state-medical-board" target="_blank" rel="noopener">Contact a State Medical Board</a></span></li> </ul> </li> </ul></div><div class="HtmlFooter"></div></div></div></div> <div id="MainCopy_extraPanel"> </div> </div> </div>  </div> </div> <div id="MPOuterFooter" class="row siteFrame"> <div id="FOOTER" class="col-md-12"> <div class="row row-wide clearfix "><div class="col-md-12 section1"></div></div><div class="row row-full bg-footer-top "><div class="col-md-12 section2"><div class="ContentItemHtml footer-home col-md-1"><div 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