Statistical analysis plan considerations for autologous cell and cell-based gene therapy clinical trials

By early 2023, there were over 100 gene, cell and RNA products approved globally (Chancellor et al. 2023). The way in which autologous cell and cell-based gene therapy products are administered can include multiple treatment stages, at times including leukapheresis, optional bridging therapy during manufacturing, conditioning regimen, and one or more doses of product. This brings important considerations in the development of the statistical analysis plan for clinical trials of autologous cell and cell-based gene therapies, including application of the estimand framework for key facets. In this article, we review all of the FDA currently approved autologous cell and cell-based gene therapy products as examples as they apply to general considerations for the statistical analysis plan as well as more in-depth discussion of treatment exposure, safety and efficacy analyses, and other aspects.