Curative Therapeutics
Creating ventures to cure diseases, using emerging combinatorial techniques.
There are only a small number of diseases in which intervention at a single point, common across all patients, can sufficiently and persistently alter the system towards a healthy state. Most diseases consist of a complex set of dynamic failures from genetics and epigenetics to neural activity: these differ across patients, within patients and over time. Trials often fail because the models used to demonstrate effectiveness in preclinical studies don’t accurately reflect the underlying causes, which can vary substantially across diseases and patients, and endpoints in trials often measure symptoms.
Our approach to creating curative therapeutic companies focuses on four themes: effectively leveraging computational approaches to address complexity; developing therapeutics that can compute in-vivo and respond dynamically to the changing internal environment; creating better systems, models and analytics to support therapeutic discovery and development; and a focus on the root cause, including fixing and buffering molecular level damage, fixing broken or unhelpful messaging and signalling pathways, correcting errors at every level of gene expression and modifying the state of cells to drive regeneration.
AREAS OF VENTURE CREATION:
Curative approaches in Neurofibromatosis
Neurofibromatosis (type 1 & 2) and Schwannomatosis are a group of devastating genetic diseases which lead to the formation of nerve sheath tumours, alongside a constellation of debilitating symptoms including chronic pain, vision and hearing loss, musculoskeletal disfigurement, cognitive defects, and increased risk of various cancers. Despite being more prevalent than cystic fibrosis, NF has been historically neglected. It currently attracts just one FDA-approved therapy (the MEK inhibitor, selumetinib, for NF1 tumours), which slows or modestly reverses tumour growth, but carries significant side effects, and as many as 30% of patients do not respond. As of yet, there are no cures for NF.
The burden of NF is large and multi-dimensional, greatly impacting the quality and duration of patients' lives, while incurring disproportionately high costs to healthcare systems due to the frequent need for complex, life-long, multi-specialist care. Despite being monogenic, these diseases display extensive clinical and biological complexity, making them difficult to treat and cure. How can we exploit the recent emergence of new tools, modalities and datasets to overcome these challenges and develop curative therapies for NF patients?
Curative Approaches in Cystic Fibrosis
Cystic Fibrosis (CF) is one of the most common genetic diseases. In patients with CF, alterations in the gene encoding CFTR, a chloride channel, cause the body to produce a thick and sticky mucus that can clog the lungs and obstruct the pancreas. CF can be life-threatening, and people with the condition tend to have a shorter-than-normal life span. For a curative genetic therapy for CF, delivery is key. Although the most life-threatening symptoms of CF occur in the lung, CF is a systemic disease. To tackle the disease in all affected tissues, we will need to deliver a therapy to multiple tissues whilst ensuring the therapeutic agent reaches the lung in sufficient concentrations.
The mutational profile across CF patients is complex and while life-extending therapies exist for the most common mutations, large patient populations don’t benefit from these therapies, and disease-modifying therapies are lacking.
Tackling immune suppressed solid tumours
Immunotherapies, especially checkpoint inhibitors and CAR-T cells, have revolutionised cancer treatment with incredible results in a subset of solid tumours and blood-based cancers, respectively. Despite this widely recognised success and paradigm shift in oncology, these therapies still only increase patient survival by limited degrees, often only 10-20% versus chemotherapies, or work in selected patient subsets. Importantly, resistance to these therapies is already developing due to selective pressure on the cancer to evade this method of immune detection, leading to resistance initially and, later, recurrence. We are still very far from immunotherapeutics that work across all cancers, or in all patients.
We need entirely new strategies for combating solid tumours that consider the whole system from the outset: both tumour and microenvironment. We need to shift the focus away from blocking singular immune-regulatory targets systemically, towards creating therapeutics that learn and adapt with their environment – addressing the malignant tumour cells and adverse microenvironment, while sparing ‘healthy’ inflammation. Some advances among 4th gen CAR-T cells are a step in this direction, but how could this thinking be extended to other immune players – enhancing beneficial components while inhibiting problematic ones, through leveraging the broader synbio and sysbio toolkits?
Moving cell therapies into the mainstream
With recent advances in cell and gene therapies it feels like cures to some of mankind’s most devastating diseases are within reach. CAR-T therapies can now cure some leukaemias and the first approved gene therapies are reversing some of the effects of rare diseases. This promise of a potential cure, combined with technological advances, has stimulated a lot of investment in the advanced therapies space. However, major hurdles still need to be overcome for cell and gene therapies to deliver on that promise and become mainstays of medicine in multiple therapeutic areas.
We need to find more efficient ways to generate cellular therapies. Many existing cell therapies use autologous sources (and therefore can’t be scaled up), and those that use allogeneic sources tend to require expensive reagents and lengthy protocols to differentiate cells, but still end up with a sub-optimal product. If we could develop analytical systems to evaluate pluripotent and multipotent cells, and then use that information to optimise differentiation methods, including through leveraging the array of synbio technologies now at our disposal, we could generate numerous therapeutic products at scale. This would revolutionise our ability to develop cell therapies across a variety of diseases with high unmet need.
Curative approaches for inflammatory disease
Immune-mediated inflammatory diseases (IMIDs) encompass a range of chronic and debilitating disorders that together affect 3-7% of the global population. We still don’t understand exactly what causes most IMIDs, but know that it usually involves a complex interplay between genetic susceptibility and environmental triggers. While the treatment landscape for IMIDs has been transformed over the past two decades, therapeutic responses are still often incomplete, occur in only a subset of patients, lead to drug resistance, or incur significant side effects. There are still no cures, and long-term drug-free remission is rare.
The clinical and economic impact of IMIDs is tremendous and steadily increasing globally. The market for anti-inflammatory drugs alone is expected to reach $165 billion annually by 2030, underscoring the great need for novel approaches with transformative efficacy. To achieve this, we must find ways to durably restore immune homeostasis – turning off the causal upstream sources of inflammation rather than simply mopping up downstream inflammatory signals. How can we leverage recent advances in single-cell-, systems- and synthetic-biology to dissect the complexity of IMIDs, and develop curative therapies that address root causes, tailored to the needs of individual patients?
Curative Approaches using Immune Strategies in Paediatric Oncology
Childhood cancers are rare and heterogenous; however, their collective impact is significant, whereby they remain a top cause of death. In addition to the rapid progression of their primary tumours and frequent metastases, many proceed to develop secondary cancers. Moreover, high doses of chemotherapy and radiation can result in neurocognitive, developmental, and fertility defects later in life.
Historically, children have been treated using the same modalities as for adults. However, their genetic and immunological makeup differs greatly and there is a significant need for more tailored therapeutics. Can we exploit some of these unique characteristics and commonalities to devise a curative solution across multiple paediatric indications?
Our Advisors
Keith Thompson
74% of cancer patients experience cumulative adverse events with combination therapies. 80% of solid tumour patients are unresponsive to a monotherapy approach due to multiple resistance mechanisms.
OligoTune’s Technology is an siRNA conjugate platform designed for optimal pharmacodynamics, long lasting effects and immune activation. The platform will allow enhanced stability, improved potency and specificity and reduced immunogenicity.
Gene therapies currently in development focus on local lung delivery. For example, Cystic Fibrosis is caused by mutations in a single gene (CFTR), which results in thick sticky mucus that blocks the lung, the pancreas, the GI tract and other organs. Current treatments only allow local, temporary delivery, leaving diseases like CF untreated in the test of the body.
Panthura is developing a gene therapy for systemic cDNA delivery to target multiple organs, starting with Cystic Fibrosis.
Cell therapies offer huge promise in an array of diseases. However, there are three major challenges to bring pluripotent stem cells to market: tumorigenicity, immunogenicity, and heterogeneity.
Plurify is a disruptive platform to generate pure PSC-derived use of molecular logic to eliminate unwanted cells and a data-driven approach to understand culture composition and impurities, allowing oh purification and amplification in a single protocol within 3 months and ultimately an all-in-one solution to go directly from stem cells to pure cell products.
The bio-economy holds enormous potential: everything from fuel to therapeutics and food can be produced in modified bacteria, algae and yeast. The existing challenge is the unscalable, energy-intensive separation process, with high up-front capital costs of centrifuges and operational expense of liquid particle separation (often more than a third of total cost of production).
uFraction8 provides massively scalable bioprocessing without pre-concentration steps, filters, membranes or flocculants. It does not clog, does not have a theoretical size limit and significantly reduces energy costs, which currently represent the highest proportion of costs for producers.
60% of therapeutics are antibody-based. The discovery process is often longer than 18 months and costs hundreds of thousands of pounds, largely based on trial and error: testing of “libraries” of millions of antibodies against the target to see what “binds”, with no guarantee that the library contains the desired antibody.
Using a combination of robotics, state of the art machine learning and cell-free protein synthesis, Antiverse aims to be the first company in the world capable of developing antibody drug candidates in one day for any given antigen.
Patient safety in surgery is a serious global public health concern. Approximately 42.7 million adverse events occur in patients annually, with at least 7 million people a year experiencing disabling surgical complications and each OR delay costing $7000-$8000 per operating room day. There is an urgent need to upgrade current operating theatres.
Scalpel integrates data from healthcare records, AI-based analytics, sensors within the operating room and clinical actions to improve patient safety and operating theatre efficiency.
A significant component of biotech is manual preparation and growth of cells. This is expanding exponentially as therapeutics themselves become cell-based, most notably in cancer treatment. This is not just a significant time sink, it often involves significant waste, scope for human error and limits reproducibility.
Mytos have developed a system to fully automate cell manufacturing. Each machine completes the work of 10 scientists, whilst also reducing wastage and improving consistency.
Treatment resistance is responsible for 90% of cancer related deaths and consumes approximately 30% of the total cancer care spend.
ConcR combines cutting edge machine learning techniques and knowledge of tumour progression. Concr’s software provides drug developers with insights on appropriate in vivo models, patient populations and stratification biomarkers, as well as giving clinicians evidence-based outputs of patient-specific cancer progression, enabling therapy adaptation before treatment resistance arises.
Current microbiome companies view the microbiome as either healthy or diseased but this is not reflective of the fact that microbiome diseases occur gradually over time.
CC Bio are using synthetic biology to sense the presence of harmful bacteria and produce targeted therapeutic products to neutralise them. Their automated discovery platform enables rapid identification and prototyping of similar technologies for multiple other disease indications (<4 weeks), including skin health, gut health and dental health, as well as drug metabolism.
The gut microbiome has been implicated in a number of chronic diseases. Bacterial therapies offer promise to restore the healthy composition of the gut and treat disease, but many of these therapies do not effectively populate the gut. One hypothesis is that this consistent failure is due to native bacteriophage that prey on live bacterial therapeutics introduced to the gut.
Ancilia are developing a new class of engineered bacterial therapies, resistant to pathological phages, that effectively alter the human to treat the growing number of diseases linked to the microbiome.
Immunotherapy offers the potential to eradicate cancer, however today, only around 20% of patients with solid tumours can benefit from these cutting-edge treatments. Multiple factors contribute to this low level of efficacy, but chief among them is the existence of physical matrix barriers around the tumour that lead to the generation of an immune "excluded" microenvironment.
Neobe Therapeutics are harnessing the synthetic biology toolkit to engineer tumour-colonising bacteria that locally disrupt this microenvironment and enable the success of immunotherapies in current non-responders.
CAR-T therapy is a form of cancer treatment. These therapies currently only work well in blood cancers (less than 4% of total cases) and require therapeutic cells to be modified and grown outside the body. This highly complex and expensive process doesn’t work for everyone, results in cells of variable quality, and treatments that costs hundreds of thousands of pounds.
ImmTune Therapies is developing therapies that allow the patient’s body to develop these therapeutic cells themselves; which is considerably cheaper, and produces more effective products.
Therapeutic viruses offer huge potential to treat solid tumours but are typically destroyed rapidly by the patient’s immune system. Being limited to intratumoral injection, researchers have struggled for decades to safely and effectively harness this power, restricting their clinical use.
Stratosvir is developing improved viral immunotherapy, engineered to allow systemic delivery by avoiding immune clearance. This allows their cancer-killing virus to deliver medicinal payloads within the tumour to stimulate and reprogram the immune system to attack and destroy cancer.
Every cancer undergoes an evolutionary process which generates millions of mutationally and biologically diverse cells. As a result, synthetic lethality therapeutics raised against specific driver mutations only work in a limited subset of patients and only work until the cancer evolution strikes again, with drug resistance arising within a few months.
Enedra harnesses the power of Synthetic Lethality and Advanced Computational Systems Biology, to discover the first therapeutics that work against the complexity, biological and mutational heterogeneity of cancer.