Decision support tools for next-generation vaccines and advanced therapy medicinal products: present and future

Resilience in the Vaccine Supply Chain: Learning from the COVID-19 Pandemic

Background: The COVID-19 pandemic revealed vaccine supply chain (VSC) weaknesses and enabled post-pandemic analysis highlighting the growing importance of supply chain resilience. This study analyzes weaknesses and potentials for VSC resilience from an industry perspective. Insights from this study are aimed at supporting helping managers and policy-makers build a more resilient vaccine supply. Methods: A qualitative semi-structured interview study was conducted with 12 industry experts along the VSC. The interviews were assessed concerning the learnings from the pandemic in a two-step content analysis. Codes were assigned to key VSC concepts and variables and then linked to political, economic, social, technological, legal, and environmental (PESTLE) dimensions. The complex multi-stakeholder supply chain was visualized in a system overview, highlighting main actors, roles, constraints, and resilience. Results: The analysis resulted in 60 codes, categorized into the six PESTLE dimensions and three additional (sub)groups (mRNA, Supply chain resilience, and Solutions). The largest dimension was Economic, with 39 codes, including the Supply chain resilience subgroup. Twelve stakeholder groups were identified, with purchasers, manufacturers, suppliers, developers, and regulatory agencies being the most significant in emergency vaccine manufacturing situations. Conclusions: The system overview demonstrated the VSC as a complex network of actors with unaligned goals rather than a linear supply chain. This study shows that the VSC is characterized by uncertainty due to external factors, like the unpredictability of new emergencies, and internal factors like vaccine demand. The lack of transparency between industry stakeholders exacerbates VSC disruption. We conclude that infrastructures and management practices that enable increased transparency and collaboration between stakeholders hold the greatest potential for strengthening the VSC's resilience to future pandemics.

Advances in ex vivo expansion of hematopoietic stem and progenitor cells for clinical applications

As caretakers of the hematopoietic system, hematopoietic stem cells assure a lifelong supply of differentiated populations that are responsible for critical bodily functions, including oxygen transport, immunological protection and coagulation. Due to the far-reaching influence of the hematopoietic system, hematological disorders typically have a significant impact on the lives of individuals, even becoming fatal. Hematopoietic cell transplantation was the first effective therapeutic avenue to treat such hematological diseases. Since then, key use and manipulation of hematopoietic stem cells for treatments has been aspired to fully take advantage of such an important cell population. Limited knowledge on hematopoietic stem cell behavior has motivated in-depth research into their biology. Efforts were able to uncover their native environment and characteristics during development and adult stages. Several signaling pathways at a cellular level have been mapped, providing insight into their machinery. Important dynamics of hematopoietic stem cell maintenance were begun to be understood with improved comprehension of their metabolism and progressive aging. These advances have provided a solid platform for the development of innovative strategies for the manipulation of hematopoietic stem cells. Specifically, expansion of the hematopoietic stem cell pool has triggered immense interest, gaining momentum. A wide range of approaches have sprouted, leading to a variety of expansion systems, from simpler small molecule-based strategies to complex biomimetic scaffolds. The recent approval of Omisirge, the first expanded hematopoietic stem and progenitor cell product, whose expansion platform is one of the earliest, is predictive of further successes that might arise soon. In order to guarantee the quality of these ex vivo manipulated cells, robust assays that measure cell function or potency need to be developed. Whether targeting hematopoietic engraftment, immunological differentiation potential or malignancy clearance, hematopoietic stem cells and their derivatives need efficient scaling of their therapeutic potency. In this review, we comprehensively view hematopoietic stem cells as therapeutic assets, going from fundamental to translational.

Leveraging rAAV bioprocess understanding and next generation bioanalytics development

Recombinant adeno-associated (rAAV) vector-based gene therapy has been the focus of intense research driven by the safety profile and several recent clinical breakthroughs. As of April 2021, there are two rAAV-based gene therapies approved and more than two-hundred active clinical trials (approximately thirty in Phase III). However, the expected increase in demand for rAAV vectors still poses several challenges. Discussed herein are key aspects related to R&D needs and Chemistry, Manufacturing and Control (CMC) efforts required to attend this growing demand. Authors provide their perspective on strategic topics for rAAV-based therapies success: scalability and productivity; improved safety; increased process understanding combined with development of orthogonal bioanalytics that are able to identify, monitor and control Critical Quality Attributes (CQAs) during bioprocessing.

Resilience and efficiency for the nanotechnology supply chains underpinning COVID-19 vaccine development

Nanotechnology facilitated the development and scalable commercialization of many SARS-CoV-2 vaccines. However, the supply chains underpinning vaccine manufacturing have demonstrated brittleness at various stages of development and distribution. Whereas such brittleness leaves the broader pharmacological supply chain vulnerable to significant and unacceptable disruption, strategies for supply chain resilience are being considered across government, academia, and industry. How such resilience is understood and parameterized, however, is contentious. Our review of the nanotechnology supply chain resilience literature, synthesized with the larger supply chain resilience literature, analyzes current trends in implementing and modeling resilience and recommendations for bridging the gap in the lack of quantitative models, consistent definitions, and trade-off analyses for nano supply chains.