SPOTLIGHT ON BIOCENTURY

What have been the most significant shifts in life science investment trends during the past few years?
The bear market has created a much higher bar for investment, starting with public markets and rippling through to private markets. Public investors want to see clinical proof-of-concept or catalysts in a much shorter time frame than in the years leading up to 2021, meaning a skewing to clinical rather than preclinical companies, and less being splashed on very early-stage discovery technologies. Among private investors, there’s still appetite for early-stage innovation, but the bar is much higher to show rigorous plans that can lead to value creation, meaning programs that will lead to clinical readouts in a believable time frame.

In disease areas, the past few years have seen a shift from heavy investment in oncology towards more in Immunity & Inflammation (I&I), and Neurology. That doesn’t mean oncology is being left behind, only that there are new opportunities in I&I and neurology that are driving revived interest. In both cases, the uptick in investment is driven by a combination of new biology yielding new insights, and investors seeing a path to commercialization. Genetics have been one big driver of the change. Others have been the promise of biomarkers which enable large patient populations to be segmented. In neurodegeneration, the results of the Alzheimer’s drugs – however flawed and however controversial – have demonstrated that cognitive decline can be slowed at least, and a relatively low bar has been set where investors can believe new mechanisms and products can show value-adding improvements. In neuropsychiatry, though omics are yielding some new targets, the use of electrophysiological and image-based metrics are enabling new ways of assessing target engagement that give much more confidence than behavioural animal models. And in I&I, the success of a few standout products have opened up areas such as atopic dermatitis, while in parallel a realization that immune or inflammatory mechanisms underlie many other diseases has meant that identification of new targets and mechanisms can yield therapeutic opportunities that can make a significant difference for patients.

What do you think are the most exciting breakthrough areas, and areas of need, from academia and biotech?
There’s no question that the most exciting breakthrough for patients is the emergence of highly effective obesity drugs. At a societal level these can deliver step changes in human health that could be comparable to the introduction of antibiotics and other major breakthroughs. These drugs of course took decades to go from discovery to market, and much persistence, so the question is whether academia can now deliver on the gaps in these medications — oral availability, muscle preservation, duration of effect without rebound, and we are seeing a lot of investor interest in innovations coming from academia in those areas. There are also major challenges in supply and manufacturing so whether those solutions come from academia remains to be seen.

Academics and biotechs have also delivered a whole new toolbox of modalities in the last decade, dramatically expanding the options for drug developers to find the optimal way to intercept at a target of interest. These fall, broadly, in two categories: modalities that increase the therapeutic index and allow for greater efficacy and/or lower toxicity – such as ADCs, bispecifics, radioligand therapies; and modalities that open up new target space completely, such as RNA-based therapies, gene therapies and other types of nucleic acid therapies. The big challenge, in particular for the latter, is delivery — the dream of being able to deliver the treatment to any cell in any tissue at the right time. It will likely not be a single technology but a suite of options, and academics are driving progress on this front, while biotechs are creating their own options. It’ll take years for this picture to fill out, but both basic and translational science in academia will be clearly a big part of the solution.

There are numerous other areas of both breakthrough and need: progress in Alzheimer’s disease beyond amyloid and tau; how AI will refashion drug discovery and development; how precision medicine can carve up large populations, chronic indications and end up redefining many diseases to categorize them by target or pathway rather than symptomology or organ. The key will be to improve on the efficiency of converting academic discoveries to drug development programs that can sustain investor interest and provide value to patients.

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