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A general strategy

The AFM’s policy for the development of therapies is centred around three axes. The first is  fundamental research and its development – to help the progress of muscle knowledge, transfer or gene repair techniques as well as the use of differentiated cells or stems for therapeutic ends. The other two axes are: the application of techniques gained from knowledge about and diagnosis of genetic diseases and research applied in therapies (vectorology, cell therapy, development of animal models, and tools for evaluation and clinical trials in humans). Since 1989 the AFM has been engaged in using genes to attain its aim – cure. Ten years later, in 1998, it launched the “Great Attempt,” an ambitious five-year scientific programme aimed at demonstrating the feasibility of gene therapies. This challenge proved to be a success beyong all expectations, with the first victories in the form of therapies. In 2002 the AFM launched a new (five-year) challenge – “The New Frontier,” its aim being to increase the number of therapeutic trials in humans.
In 2007, the AFM supported nearly 400 projects coming from 4 calls for tender following the expert opinion by the Scientific Council’s committee of experts.
In 2006 the AFM carried out an in-depth reorganisation of its Scientific Council in order to reinforce its orientation towards clinical development.
With the investment of 845 million euros for its Cure mission since the first Téléthon (1988) to the end of 2007, the AFM has become an indispensable actor in the field of research.

Treatments – the great turning point

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After publishing the human genome maps, AFM and Genethon decided to take up a new challenge: use genes to cure. Ever since 1989, the Association had been laying the groundwork by financing the first studies on gene therapy. Ten years later in 1998, it launched the Great Attempt (''La Grande Tentative ''), an ambitious five-year scientific program whose aim was to demonstrate the feasibility of gene-based therapies (a combination of therapeutic pathways arising from an understanding of the genes: gene therapy, cell therapy, stem cells, etc.). From 1998 to 2002, AFM invested 132 million euros in the Great Attempt.

In this context, Généthon changed its activities by turning to the development of gene therapy techniques. The Association had come to the conclusion that there were no suitable tools to implement the therapeutic strategies based on an understanding of the genes. These strategies are theoretically applicable in a large number of medical disciplines: genetic diseases, but also cancers, cardiovascular diseases, neurodegenerative diseases, auto-immune diseases, infectious diseases or even trauma cases.
For that reason, Généthon developed an original strategy combining basic research and pre-industrial development, with the design, development and production of vectors that could transport the gene-drug to the nucleus of cells.The Généthon III project was born. Généthon IV is the first laboratory in France authorised to produce AAV clinical vectors, and Généthon V is becoming a biotherapy company for rare genetic diseases.

The Great Attempt led to the development of tools, networks and research centres for gene-based therapies. The first successes in gene therapy confirmed that we made the right choices. Since further steps need to be taken towards a cure, AFM takes up a new challenge in 2002 : another five-year project called the '' New Frontier ''("la Nouvelle Frontière"), with an aim to increase the number of clinical trials in humans and implement gene-based therapies.

At the time when innovative therapies are first being tried out in humans, the AFM must face up to a new challenge – effectiveness. Effectiveness in the choice of programmes financed as well as in the therapeutic result for the patients included in the programmes. To attain this objective, during 2007 the AFM considerably increased its motor role in the initiation and support of clinical trial projects, while all the time ensuring a balance with fundamental research, necessary to the understanding of the mechanisms linked to neuromuscular diseases and to the development of therapeutic leads. This has been carried out in the context of international collaboration, essential in the field of rare diseases.

Methods of funding the scientific projects

The 400 projects supported by the AFM each year are submitted to an a priori expert opinion in order to  judge their quality and relevance in the curing of neuromuscular diseases.
The funding decision is down to the Administrative Council (AC) or the Bureau of the AC (BAC) which, on the basis of expert opinion, verifies the balance between the project, the strategy of the AFM and the funds available.
The most important projects are also evaluated a posteriori in order to judge their quality and the results obtained.

The AFM has identified five types of research project :

* Projects presented within the framework of a call for tender
Expert opinion : required at least from one outside expert and a member-reporter of the Scientific Council (SC)
Decision : Bureau of the AC
Evaluation : general analysis by the Scientific board.

* Strategic projects (strong impact on AFM research policy and financial engagement > 500 000 euros/year over more than 2 years (eg Transgène, Upenn, Trophos, Nématode etc)
Expert opinion : required from two outside experts and a member-reporter of the SC with presentation by the project leader to the permanent committee of the SC.
Decision : AC
Evaluation : carried out on the basis of regular updates by an evaluation committee composed of members proposed by the President of the SC, the AFM Scientific Board and validated by the BCA.

* Occasional projects (colloaboration already validated, urgent project, congress organisation etc)
Expert opinion: required from at least one outside expert or a member-reporter of the SC.
Decision : BCA

* Association partnerships (AC decides to establish a systematic partnership with an association)
Expert opinion : by outside experts and the SC of the partner association. Presentation of the projects by the partner association of the AFM and selection (by the scientific directors) of the projects that best reflect the strategy of the Association.
Decision : BCA for the funding of the projects of the year or via the partner association.


Update 2008/07/10
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