In a groundbreaking advancement for personalized medicine, Aldevron and Integrated DNA Technologies (IDT) have successfully manufactured the world's first personalized CRISPR gene editing drug product to treat an infant suffering from a life-threatening urea cycle disorder (UCD). The therapy was developed and delivered in just six months—three times faster than the standard timeline for gene editing drug products.
The Children's Hospital of Philadelphia (CHOP) and the University of Pennsylvania (Penn) engaged Aldevron and IDT, both subsidiaries of Danaher Corporation, to create this novel mRNA-based personalized therapy for an infant who was unable to remove ammonia from the body due to neonatal-onset CPS1 deficiency, a form of UCD that currently has no cure.
Unprecedented Speed and Complexity in Development
The technically complex N of 1 therapy required the development of a new guide RNA (gRNA) sequence, a new mRNA-encoded base editor, custom off-target safety services, and a clinically validated lipid nanoparticle (LNP) formulation. This achievement marks a significant milestone in the field of gene editing and demonstrates the United States' leadership in mRNA gene editing therapies.
"We are unique in our ability to deliver this innovative treatment in such a short timeline," said Mark Wetzel, VP/GM mRNA CDMO Services at Aldevron. "This CRISPR therapy was made under exceptional circumstances—not something our industry is built to do consistently—given the steadfast focus and dedication of the Aldevron and IDT teams to leverage years of expertise and strong partnerships to do what was needed to improve this patient's outcome."
The results of this groundbreaking treatment have been published in The New England Journal of Medicine and were showcased at the American Society of Gene & Cell Therapy Annual Meeting, providing proof of concept for the potential of safe and effective personalized CRISPR therapy.
Collaborative Effort Yields Transformative Results
The development of this therapy involved a collaborative effort between multiple organizations. Aldevron provided the mRNA and worked with Acuitas Therapeutics, a private biotechnology company specializing in the development of LNP delivery systems for nucleic acid therapeutics. IDT contributed the gRNA and safety services. Together, these companies delivered a customized in vivo base-editing therapy in a significantly compressed timeline.
Sandy Ottensmann, VP/GM of Gene Writing & Editing at IDT, emphasized the significance of this achievement: "What we've accomplished together sets a new gold standard for operationalizing the future of medicine. The implications of this work are profound and illuminate how collaborations between academic medicine and industry can enable major science wins."
Implications for Future Treatments
Dr. Kiran Musunuru, corresponding author of the NEJM study and the Barry J. Gertz Professor for Translational Research and Director of the Genetic and Epigenetic Origins of Disease Program in the Perelman School of Medicine at the University of Pennsylvania, highlighted the broader implications of this work.
"This study is an important milestone," said Dr. Musunuru. "The impact of this work extends beyond this particular patient and category of clinical indications—it suggests a potential roadmap for transforming CRISPR therapies for other inborn errors of metabolism and life-threatening genetic diseases. It's an exciting future for personalized medicine."
The patient was treated at CHOP by co-corresponding author and physician-scientist, Dr. Rebecca C. Ahrens-Nicklas. The infant had been diagnosed with UCD and suffered from neonatal-onset CPS1 deficiency, which prevented the proper removal of ammonia from the body—a condition that can lead to severe neurological damage and death if left untreated.
Alignment with Broader CRISPR Initiatives
This accomplishment aligns with the goals of the Danaher-IGI Beacon for CRISPR Cures, which was launched in January 2024. The Beacon aims to develop platform approaches that can be easily modified to create gene-editing medicines for hundreds of devastating diseases by uniting scientific expertise in gene editing with R&D and manufacturing capabilities.
The successful development and implementation of this personalized therapy represents a significant step forward in the treatment of rare genetic disorders. By demonstrating that highly customized CRISPR therapies can be developed and delivered in a compressed timeframe, this achievement opens the door to new possibilities for patients suffering from a wide range of genetic conditions that have previously been considered untreatable.
Regulatory Success and Future Directions
The collaboration between all partners' quality and regulatory teams also led to successful Emergency Investigational New Drug (EIND) approvals, highlighting the importance of coordinated efforts in bringing novel therapies to patients quickly and safely.
As personalized medicine continues to evolve, this case serves as a powerful example of how targeted genetic interventions can address the specific needs of individual patients. The ability to rapidly develop and deploy such therapies could fundamentally change the landscape of treatment options for patients with rare genetic disorders, offering hope where previously there was little.
The success of this therapy not only represents a significant advancement in the treatment of UCDs but also establishes a potential template for addressing other genetic disorders through personalized CRISPR-based approaches, potentially transforming the field of genetic medicine in the years to come.
