# From Bench to Bedside: Ethical and Clinical Best Practices for Genome Editing Applications

## TL;DR

This paper reviews ethical and clinical guidelines for safely applying genome editing in medicine, focusing on patient safety and regulatory compliance.

## Contribution

The paper synthesizes current scientific literature and regulatory guidance to outline best practices for responsible genome editing in clinical settings.

## Key findings

- CRISPR-based systems are the most accessible and popular genome editing technology.
- Regulatory agencies emphasize preclinical testing, patient monitoring, and ethical consent for genome editing therapies.
- Unintended DNA alterations and non-target cell modifications remain major technical challenges in genome editing.

## Abstract

Genome editing (GE) has transformed medicine by allowing precise changes to DNA, offering potential treatments for a range of inherited and acquired disorders. Several technologies support these advances, including zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)-based systems, of which the latter has emerged as the most accessible, versatile, and popular. While GE holds great promise, its clinical use requires careful attention to safety, ethics and regulatory standards. Inadvertent on- and off-target DNA alterations and unintended modification of non-target cells pose major technical challenges, while bioethical considerations and the need for harmonized safety standards create regulatory challenges. The Food and Drug Administration (FDA) and European Medicines Agency (EMA), as regulatory agencies for key advanced therapy markets, provide detailed guidance on these aspects, emphasizing rigorous preclinical testing, patient monitoring, ethical consent, and compliance with legal frameworks. This concise review summarizes what is currently published in the scientific literature and recommended by regulatory agencies, providing an overview of the responsible clinical application of GE, with emphasis on patient safety, adherence to regulatory guidance, and ethical practice.