The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian

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The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
June 2020
                                         biopharmadealmakers.nature.com — Nurturing biopharma partnerships

The cell & gene therapy
market matures

Wave of collaborations
accelerate vaccine
development

Dealmaking in 2020
faces new challenges

Originally published as an advertising feature in the June 2020 editions of
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
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The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
June 2020
                                                   FEATURE
                                              B3 Next-generation therapeutics sustain momentum
                                                   The next-generation therapeutics space has continued to progress on several
                                                   fronts in the past 12 months, but this could be set to change as the industry copes
                                                   with the COVID-19 crisis.

                                                   PROFILES
                                              B6   Elicio Therapeutics                        B14 Novadip Biosciences
Cover image Gene therapy conceptual
illustration; a double stranded DNA
                                              B8   NovaGo Therapeutics                        B15 Aruvant Sciences
(deoxyribonucleic acid) molecule coming       B9   Biovian                                    B16 Antapodia
out of a viral capsid. Science Photo
Library / Alamy Stock Photo.                 B10   Cellatoz Therapeutics                          Nanotherapeutics
BioPharma Dealmakers is a quarterly          B11   inRegen                                    B17 MiCAN Technologies
publication that facilitates partnering by
profiling the activities of organizations    B12   Synplogen
in the biopharma field, including biotech
companies, global biopharma companies
and academic institutions.
Profiles of organizations are aligned with         FEATURE
relevant editorial features that cover
different therapeutic and technological
themes in each issue.                        B18 Partnering for a pandemic
Note Companies that appear in this                 History has shown that collaborative efforts can have a crucial role in combating
issue have paid for their advertisement            viral outbreaks such as the current coronavirus pandemic.
features and have final approval of
their content. If you would like to appear
in the next BioPharma Dealmakers                   PROFILES
please contact Claire Thompson:
c.thompson@nature.com                        B20 GSK Vaccines                                 B23 TAXIS Pharmaceuticals
                                             B21 Amicoat                                      B24 Atriva Therapeutics
Dealmakers team
Editor Raveena Bhambra                       B22 Sanofi Pasteur
Editorial Assistant Georgia Francis
Profile Writers Emma Dorey,
Suzanne Elvidge, Dan Jones, Jackie Kelly,
Mary Lee Mackichan, Gaspar Taroncher-
Oldenburg, Nick Taylor
                                                   FEATURE
Feature Writers Raveena Bhambra,
Paul Verdin                                  B25 Dealmaking in 2020: navigating a new landscape
Production Simon Fenwick,
Richard Thomas                                     After a slow start to the year, dealmaking for the rest of 2020 is likely to be
Head of Business Development                       profoundly affected by the COVID-19 pandemic.
Claire Thompson
Business Development Manager
Verónica Zacatenco                                 PROFILES
Account Executives Rebecca Djaic,
Carmen Ramirez                               B27 D&D PharmaTech                               B31 Panorama Medicine
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                                             B28 nference                                     B32 Henlius Biotech
                                             B30 Noveome Biotherapeutics
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
Human iPSC derived glutamatergic
neurons for research and HTS
When cells need precision and consistency

                                  www.bit.bio | info@bit.bio
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
FEATURE

                                                                                                                                                                                               Credit: Vitalii Gulenok / Alamy Stock Vector
  Next-generation therapeutics
  sustain momentum
  The next-generation therapeutics space has continued to progress on several fronts in the past
  12 months, but this could be set to change as the industry copes with the COVID-19 crisis.

  Paul Verdin

  In April 2019, the combined 2024 sales forecast for the cell,                     that affect cell therapies in general. It is also too soon to assess the
  gene and nucleic acid therapy market was $41 billion, accord‑                     impact of the COVID‑19 pandemic, which could dramatically
  ing to EvaluatePharma sell‑side consensus forecasts (Biopharma                    affect future forecasts.
  Dealmakers B15–17, June 2019). One year on, we analysed the
  area again, and here we highlight the latest trends in market fore‑               Key approvals
  casts, approvals, development pipeline focus, leading companies                   The past 12 months have kept up the recent approval momentum
  and dealmaking for next‑generation therapeutics.                                  in the field. Among the new products with the greatest expecta‑
                                                                                    tions is AveXis/Novartis’s Zolgensma (onasemnogene abeparv‑
  Fluctuating forecasts                                                             ovec), which became the first US Food and Drug Administration
  Although clinical progress has boosted the number of next‑                        (FDA)‑approved gene therapy for spinal muscular atrophy (SMA)
  generation therapeutic products on the market since 2019, our                     in May 2019. This approval also set up an interesting dynamic
  analysis of the same landscape puts the overall forecast value in                 within the next‑generation therapeutics space, with Zolgensma
  2024 at $38 billion—a 7% contraction of commercial expecta‑                       launching into a market already occupied by Biogen’s Spinraza
  tions (Fig. 1).                                                                   (nusinersen, an antisense oligonucleotide). Both therapies target
    Forecasts fluctuate of course, and volatility in forecast com‑                  the underlying cause of SMA, but Zolgensma is theoretically a
  mercial performance is to be expected in such a pioneering area.                  ‘one‑and‑done’ treatment, while Spinraza requires repeated
  Looking beyond the headline value, however, reveals that forecasts                administration. Zolgensma has checked Spinraza’s growth and
  for DNA and RNA therapeutics (such as antisense oligonucle‑                       is forecast to be the leader in an increasingly crowded SMA market
  otides) and gene therapy have remained relatively stable—cell                     by 2024, with sales of $2.04 billion compared with $1.57 billion
  therapy is where the largest declines are apparent, as forecasts                  for Spinraza.
  have eroded by almost $3 billion (or approximately 20%) since                       Vyondys 53 (golodirsen), the second of Sarepta Therapeutics’
  this time last year (Fig. 2). It is too soon to say whether this is the           growing portfolio of exon‑skipping antisense oligonucleotides
  beginning of a cooling‑off of commercial expectations for some                    for Duchenne muscular dystrophy (DMD), was approved by
  cell therapy approaches. However, perhaps it could reflect grow‑                  the FDA in December 2019. And in Europe, there was a first
  ing recognition of the strong competition in some areas such as                   approval for bluebird bio, with a European Medicines Agency
  blood cancers, as well as the access and affordability challenges                 (EMA) nod for Zynteglo (autologous CD34+ cells encoding the

                             40,000                                                                            18,000
                                                                                                                        2024 (April 2020)
                             35,000    Genome editing                                                          17,000
                                       Gene therapy                                                                     2024 (April 2019)
Sales forecast ($ million)

                                                                                  Sales forecast ($ million)

                             30,000    DNA and RNA therapeutics                                                16,000
                                       Gene-modified cell therapy
                             25,000    Cell therapy                                                            15,000

                             20,000                                                                            14,000

                             15,000                                                                            13,000

                             10,000                                                                            12,000

                              5,000                                                                            11,000

                                 0                                                                             10,000
                                      2020       2021       2022    2023   2024                                         Gene therapy        Cell therapy   DNA and RNA
                                                                                                                                                            therapeutics
  Fig. 1 | Sales growth forecasts of cell, gene and nucleic acid                    Fig. 2 | Changes in sales growth forecast trends of cell, gene
  therapy products from 2020 to 2024. Source: EvaluatePharma,                       and nucleic acid therapy products in 2024.
  April 2020.                                                                       Source: EvaluatePharma, April 2020.

                                                                                                                                                  biopharmadealmakers.nature.com | June 2020 | B3
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
FEATURE

 Duchenne muscular dystrophy

       Spinal muscular atrophy

      Non-Hodgkin lymphoma

                   Amyloidosis

             Multiple myeloma

                 Hemophilia A

       Acute myeloid leukemia

                    Melanoma

             Sickle cell disease

                  Hemophilia B

            Huntington disease

                   Thalassemia

           Chronic heart failure

Limb-girdle muscular dystrophy

                Hyperlipidemia

                      Porphyria

             Parkinson disease

         Epidermolysis bullosa
                                                                                                                        2024 (April 2020)
  Urinary calculi/kidney stones                                                                                         2024 (April 2019)
  Amyotrophic lateral sclerosis

                                   0     500         1,000       1,500     2,000      2,500      3,000      3,500      4,000      4,500
                                                                           Sales forecast ($ million)

Fig. 3 | Top 20 indications in the field of cell, gene and nucleic acid therapies, based on 2024 sales forecasts. Source: EvaluatePharma,
April 2020.

βA‑T87Q‑globin gene) for patients with β‑thalassemia, as well as           marketed (Zolgensma and Spinraza), and >99% of the 2024 forecast
an EMA approval for Akcea/Ionis’s Waylivra (volanesorsen), an              of $3.6 billion is contributed by these marketed products.
antisense oligonucleotide therapy for familial chylomicronemia               The risk inherent in these forecasts is therefore very different,
syndrome.                                                                  even without factoring in uncertainty around commercial per‑
  The scale and diversity of progress being made in the next‑              formance once on the market. Across the top 20 indications by
generation therapeutics space is a testament to the industry’s             2024 sales, only 6 are currently validated to the extent of regula‑
ability and effort in developing novel science into commercial             tory approval and so clearly the space will continue to be highly
products. Across the industry, EvaluatePharma lists >5,300 active          dynamic.
R&D programs in cell and nucleic acid medicine, an increase of
6% on the same analysis 12 months ago. Just over 2,000 of these            Companies taking the lead
next‑generation therapeutic programs are in clinical development           This dynamism is also reflected in the company rankings (Fig. 4).
(an increase of 8% over 12 months), with more than 200 programs            This time last year Sarepta led the pack in terms of 2024 forecast
in phase 3 trials or at the regulatory filing stage.                       sales, and few major biopharma players featured in the top 20
                                                                           by forecast revenues. Again, only 5 of the top 20 companies are
Leading indications                                                        large biopharma: Novartis, Bristol‑Myers Squibb (following the
Current clinical development pipelines in the field have a large           acquisition of Celgene), Biogen, Gilead and Roche. In this year’s
focus on oncology, with 16 of the top 20 indications in cancer. The        analysis, however, Novartis leapfrogs Sarepta—albeit margin‑
most studied non‑oncology indications are rare ophthalmology               ally—to become the top‑ranked company in the field, with sales
conditions, Parkinson disease, osteoarthritis and peripheral vas‑          forecasts of $4.25 billion versus Sarepta’s $4.14 billion in 2024.
cular disease (Fig. 3). In preclinical research, the trend is different:     Indeed, something of a niche is opening up in an otherwise
13 of the top 20 most studied indications are outside oncology.            highly fragmented landscape, with Novartis and Sarepta cementing
  Looking at where the value is anticipated to rise, at least in the
near term, the picture is similar to 12 months ago. The top ranked
indications by 2024 sales are those for which next‑generation                Methodology box
therapeutics are more clinically and commercially mature, with               This analysis used data extracted from EvaluatePharma (data
DMD, SMA and non‑Hodgkin lymphoma topping the rankings.                      extracted in April 2020). Company and total product sales
  Interestingly, 2024 forecasts for DMD are based on substantial             forecasts are Evaluate Consensus Forecasts, and represent an
sales growth from pipeline products: of the 10 next‑generation               unweighted average of up to six forecasts from equity analyst
                                                                             research. Sales by indication are adapted from total product
therapeutics contributing to the 2024 sales forecast of $4.4 bil‑
                                                                             sales using a proprietary methodology. Historical sales, R&D
lion only two are currently marketed—Sarepta’s Vyondys 53 and                pipelines and product classifications are based on company-
Exondys 51 (eteplirsen)—and 80% of this forecast figure is tied              disclosed information. All analysis, modelling, mapping and
to R&D‑stage programs. For SMA, the picture is the opposite:                 aggregation of data uses proprietary Evaluate methodologies.
two of the three products contributing to 2024 sales are already

B4 | June 2020 | biopharmadealmakers.nature.com
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
FEATURE

                             4,500

                                                                                                                                                                                                                           2024 (April 2020)
                             4,000
                                                                                                                                                                                                                           2024 (April 2019)

                             3,500

                             3,000
Sales forecast ($ million)

                             2,500

                             2,000

                             1,500

                             1,000

                              500

                                0
                                                                                  *                                                                         l         st
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                                         pta          Ph         ol                    Gi                           eB         ce         inP                    ard        Ph                S PR         Ph                 tG          olus
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       Fig. 4 | Top 20 companies in the field of cell, gene and nucleic acid therapies, based on 2024 sales forecasts.
       *Celgene forecasts in Apr 2019. Source: EvaluatePharma, April 2020.

       their leading positions and each expected to generate sales approxi‑                                                 ophthalmic disorders), and a February 2020 worldwide devel‑
       mately double those of the next highest selling company in 2024                                                      opment and commercialization licensing deal with Sangamo
       (Alnylam, in third place with $2.2 billion sales in 2024).                                                           Therapeutics for gene regulation therapies in Alzheimer disease,
         The Novartis portfolio delivering these sales is highly diversi‑                                                   Parkinson disease and other neurological disorders (including
       fied, and includes the gene therapy Zolgensma for SMA (sales over                                                    $350 million upfront). In December 2019, Roche bought in to
       $2 billion in 2024), the chimeric antigen receptor (CAR)‑T cell                                                      Sarepta’s SRP‑9001 through licensing of ex‑US rights in a deal
       therapy Kymriah (tisagenlecleucel) for blood cancers (sales over                                                     worth $750 million upfront and potentially up to $2.85 billion.
       $1 billion in 2024) and the filed lipid‑lowering RNAi candidate
       inclisiran (sales over $1 billion in 2024), which was obtained                                                       Outlook
       through acquisition of The Medicines Company in November                                                             On the face of it, progress in the next‑generation therapeutics
       2019. For Sarepta, the near‑term focus is on DMD, with far and                                                       space continued unabated in the past 12 months—pipelines
       away the biggest catalyst to 2024 being the micro‑dystrophin                                                         progressed, more innovative new products were approved by
       gene therapy SRP‑9001. Despite only being in phase 2 develop‑                                                        the regulators, deals were done and sales forecasts anticipating
       ment, SRP‑9001 is forecast to be the biggest‑selling product in                                                      rapid growth in the space largely held up, barring some declines
       the cell and gene therapy space in 2024, with sales of more than                                                     in cell therapy.
       $2.5 billion.                                                                                                          But it should be noted this activity predates the COVID‑19
         The remainder of the top 20 company ranking is comprised of                                                        pandemic that has swept across the world. It seems unavoidable
       numerous smaller and focused players, with several of their peers                                                    that the industry will feel a negative impact from this unparal‑
       serving as take‑out targets for major biopharma in the recent                                                        leled crisis; for example, in delays to clinical trial progress and
       past—for example, AveXis, Spark and The Medicines Company.                                                           potential delays in regulatory approval for new products—and
                                                                                                                            next‑generation therapeutics will not be immune to this.
       Dealmaking trends                                                                                                      It is less clear how industry and societal thinking may evolve
       Major pharmaceutical companies have predominantly entered the                                                        based on the impact of the pandemic; for example, in terms of
       space through acquisition. Novartis has been particularly active in                                                  allocation of R&D and healthcare spending, and prioritization of
       building its leading position through acquisition—its $8.7 billion                                                   research into infectious diseases over rare genetic and oncology
       purchase of AveXis in 2018 was followed up in November 2019                                                          settings. According to EvaluatePharma data,
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
A DV E RT I S E M E N T F E AT U R E

Elicio Therapeutics Inc.
www.elicio.com

Orchestrating the immune system
for precision immunity
Elicio’s lymph node-targeting Amphiphile technology delivers potent T cell
activation and boosts the effects of engineered cell therapies.

Immune cells are naturally gifted in recognizing
                                                            1 Albumin binder                         2 Linker                                3 Therapeutic payload options
antigens and fighting off infection and disease. But,
                                                              ✓ Lymph node targeting                   ✓ Improves solubility
just like talented people, they need nurturing and                                                                                                                      Small
                                                              ✓ APC presentation                                                             a
the right training to fulfil their true potential. For                                                                                                                  molecules
immune cells this means a spell in lymph nodes—                                            O
the training camps of the immune system—where                                                                                                b                          Peptides
                                                                                               O
they receive specialized instruction in the art of                                         O
                                                                                                                                             c                          Nucleic acids
immune surveillance and attack.                                                                O
  Today’s immunotherapies do not make use of
this powerful immunological form of education.                                                                                               d                          Proteins
The promise and effectiveness of immunotherapies
are widely recognized: chimeric antigen receptor T        Fig. 1 | A modular conjugation approach for delivery of immune therapeutics to the lymph node. The
(CAR-T) cell therapies directed against the CD19          technology enables a lipophilic tail to bind to a linker domain, which is then able to attach to various types of
tumor antigen have been particularly effective            immunomodulatory payload molecules.
against hematological malignancies, and check-
point inhibitors (CPIs) have emerged as a major           at the Massachusetts Institute of Technology. Irvine           then interact with effector immune cells as part of
focus for treating solid tumors.                          brought together materials scientists, immunolo-               their training to become potent antigen-targeting
  Yet the full potential of these therapeutic             gists and oncologists to work at the interface of              cells (Fig. 2).
approaches has not yet been unleashed. CAR-T              materials science and immunology in an effort to
cell therapies can struggle to achieve clinically ben-    solve the problem of how to target payloads to the             Portfolio of candidates
eficial T cell expansion and persistence, often lack      lymph nodes.                                                   Elicio has a range of candidates based on AMP
the ability to effectively infiltrate the tumor micro-      Lymph nodes are one of the key secondary lym-                technology in its proprietary pipeline: cancer vac-
environment and over time lose their tumor-killing        phoid tissues where immune cells congregate and                cines that combine antigenic peptides and adjuvant
functions. At the same time, CPI therapies have           where adaptive immune responses are initiated. It is           with an AMP molecule; AMP-linked activators of
demonstrated the ability of the immune response           here that the complex cellular interactions required           CAR-T cells for hematological and solid tumors;
to kill solid tumors, but their efficacy has been lim-    for an effective immune response are finely orches-            AMP cytokines; and AMP adjuvants.
ited because in these therapies few spontaneously         trated, and is why the lymphatic system is said to               Elicio’s most advanced cancer vaccine program
arising T cells infiltrate tumors that have a low rate    be the brain or command centre of the immune                   is focused on patients with tumors carrying muta-
of neoantigen mutation. The key to overcoming             system. The learning environment of the lymph                  tions in KRAS, which make up roughly 25% of all
these limitations, Elicio Therapeutics believes, is to    node endows immune cells with skills that are                  human solid tumors and are even more prevalent
make use of the specialized immunological training        harder to learn elsewhere, such as how to achieve              in specific cancers—up to 90% of pancreatic can-
environment of the lymph nodes, to prime T cells          T cell expansion and persistence; how to effectively           cers, 50% of colorectal cancers and 30% of non-
to become more effective at their job.                    hone in on and penetrate solid tumors; and how to              small-cell lung cancers. KRAS is widely recognized
                                                          promote immune memory and antigen spreading.                   as promising in immunotherapy, and has been
Transporting immunomodulatory                               Getting molecules of interest into lymph nodes,              singled out by the National Cancer Institute as
payloads                                                  and making sure they stay there long enough                    one of the only true public neoantigens, meaning
Elicio is tackling this challenge with next-gener-        to do useful work, faces some key hurdles. One                 that it is not only highly prevalent and clinically
ation immunotherapies based on its proprietary            of the most fundamental is that the smaller the                relevant, but also a target that the immune system
Amphiphile (AMP) technology, which can effec-             molecule, the less likely it is to accumulate in the           is especially well suited to recognizing as a tumor-
tively ferry immunomodulatory payloads—from               lymph nodes—an issue that affects small mol-                   differentiating marker. And the biology of KRAS
small molecules and peptides to DNA and pro-              ecules, peptides, proteins and other biopolymers.              is compelling as mutations in this gene need to
teins—to the lymph nodes, where immune cells              The AMP strategy is to piggyback on a very large               be maintained in all the tumor cells in most of
learn how to recognize these immunomodulators             molecule, one that naturally accumulates in lymph              the tumor types in which it is implicated. So if
and react appropriately to them. Elicio is applying       nodes: albumin.                                                all tumor cells carrying KRAS mutations can be
the AMP platform to developing new cancer vac-              The core of the AMP technology is a lipophilic tail          eradicated in a tumor, there is potential for a long,
cines, creating more potent responses from CAR-T          that mimics fatty acids that albumin naturally binds           durable response.
cells and delivering cytokines, immunomodulators          to, connected to a linker domain to which various                Elicio’s ELI-002 comprises AMPs carrying com-
and adjuvants to lymph nodes. The unique, broadly         types of immunomodulatory payload molecules                    mon KRAS-mutated peptides, along with a powerful
applicable lymph node-targeting AMP technology            can be attached (Fig. 1). When injected into tissue,           immune-activating adjuvant, to elicit an immune
has the potential to address many unmet medical           cargo-loaded AMPs bind to locally present albumin,             response that engages both innate immunity
needs and bring enormous benefits to patients.            are transported through the lymphatic vessels and              (dendritic cells) and adaptive immunity (T cells)
  The AMP technology grew out of the multi-disci-         finally accumulate in lymph nodes. Here, the immu-             to increase tumor targeting. ELI-002 targets the
plinary lab of Darrell Irvine, a biological engineer at   nomodulatory payload ferried to the lymph nodes is             seven position 12 and 13 KRAS mutations that are
the Koch Institute for Integrative Cancer Research        taken up by antigen-presenting cells (APCs), which             seen in more than 99% of KRAS-driven cancers,

B6 | June 2020 | biopharmadealmakers.nature.com                                                    A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T
The cell & gene therapy market matures Wave of collaborations accelerate vaccine development Dealmaking in 2020 faces new challenges - Biovian
A DV E RT I S E M E N T F E AT U R E

           Subcutaneous
                                                                                                                                     Elicio is using its AMP technology platform to
           injection site                                                   AMP            AMP compounds bearing
                                                                            compound                                               bring out the best in CAR-T cell therapies. The
                                                                                           (a) peptide antigens
                                                                                           or (b) CAR ligands are                  approach is to attach CAR-T activators to AMPs,
                                                                                           injected into recipients                which, once carried to lymph nodes by albumin,
     1 Binding to                                                                                                                  insert themselves into the surface of APCs through
                                                                                           and upon binding to
       albumin at
                                                                                           albumin, are transported                their fatty acid tails. These APCs then present the
       injection site
                                                                                           into the lymph nodes                    activator molecules to CAR-T cells in the lymph
                                                                 Albumin
                                                                                                                                   nodes, priming them to mount a potent response
                                                                                                                                   to tumor cells carrying the antigen they have been
                                                                                                                                   engineered to recognize (Fig. 2).
 2 Lymph node                                             3 Migration of                                                             Elicio’s proof-of-concept studies have shown how
   trafficking                                              T cells to tumor                                                       effective AMP CAR-T activators are. In a standard
   on albumin                                                                                                                      CAR-T cell approach, at best 20% of a patient’s
                                                                                                                                   T cells are converted to recognize the tumor anti-
                                                                                                                                   gen that the CAR-T cells have been engineered to
              MHC        a                                                                                                         detect. When combined with AMP CAR-T activa-
                              b        In the lymph node, APCs take                                                                tors, however, this jumps to as much as 70% or
                                                                                            Tumor cell
  TCR                                  up or surface-present AMP                                                                   more in animal models. In addition, a number of
                                       compounds to stimulate                                                                      current CAR-T therapies that have shown potent
                                       (a) TCR-T or (b) CAR-T cells                                                                anticancer activity have been hampered in practice
                                       to induce T cell activation,
                                       proliferation, and                                                                          by toxicity caused by the high doses required for
                                       tumor-homing                                                   Enhanced trafficking         systemic delivery. The AMP technology can rescue
                    CAR                                                                                                            these CAR-T therapies by targeting lower doses to
                                                                                                      of T cells into solid
                                                                                                      tumors results in            the lymph nodes so they become highly effective
                                                                                                      antitumor activity           tumor-destroying cells, while limiting exposure to
       TCR-T cell             Active CAR-T cell               Inactive CAR-T cell
                                                                                                                                   other sites in the body.
Fig. 2 | Targeting the lymph nodes with Elicio’s amphiphile technology. Loaded with its immunomodulatory                             Compared with CAR-T cell therapy alone, Elicio’s
payload, the amphiphiles (AMPs) are injected into tissue where they bind to locally present albumin. From                          AMP–CAR-T combination leads to a tenfold
there they travel through the lymphatic vessels to gather in the lymph nodes. Antigen-presenting cells                             increase in the infiltration of solid tumors, a ten-
(APCs) in the lymph nodes then internalize or surface-present the AMP payloads to enable potent                                    fold greater cytokine response, enhanced cytolytic
activating interactions with TCR-T or CAR-T cells, which empower them to seek out and destroy tumor                                function and the induction of ‘antigen spreading’,
cells. CAR, chimeric antigen receptor; TCR, T cell receptor; MHC, major histocompatibility complex.                                in which the native immune response is triggered
                                                                                                                                   to recognize tumor-specific antigens other than
and contains seven AMP peptides containing these                       control arm to ELI-002 at the time of relapse,              the one targeted by the CAR-T cell. In models in
mutations plus an AMP carrying a CpG Toll-like                         so that RECIST radiographic data on metastatic              which CAR-T cell therapy by itself provides no
receptor 9 agonist.                                                    disease can be assessed. The trial is planned to            detectable therapeutic effect, the AMP–CAR-T
  Preclinical in vivo models have demonstrated                         begin in 2020.                                              combination leads to durable cure in a large pro-
that ELI-002 is precisely targeted to lymph nodes,                       Elicio has recently begun a collaboration with James      portion of animals.
where it creates a powerful T cell response that is                    Yang’s laboratory at the National Cancer Institute,           Beyond developing AMP cancer vaccines and
more than 100 times greater than that achieved                         which has pioneered T cell therapies for solid tumors,      CAR-T cell activator, Elicio is developing ELI-004,
with conventional therapies. These lymph node-                         to characterize T cell responses to ELI-002 in mice         an AMP-adjuvant with applications in a variety of
primed T cells, which become prolific producers                        genetically engineered to carry human leukocyte             indications and therapies, including as the adju-
of cytokines that are important for an effective                       antigen (HLA) genes important for the immune                vant component of ELI-002. Finally, Elicio has
antitumor response, are highly effective killers of                    response. This study will not only inform how patient       earlier-stage programs using AMP technology to
KRAS-specific targets, and are able to specifically                    responses are monitored in the clinical study of ELI-       deliver cytokines, immunomodulators and other
recognize all seven mutational variants of KRAS.                       002, but will also help use trial data to identify novel    adjuvants to the lymph nodes for stimulating a
Similar AMP vaccine approaches developed by                            T cell receptors for future T cell therapies.               potent immune response.
Elicio and tested in other models have produced                          Elicio’s other major application of AMPs is to              Immunotherapies have proved their worth, but
complete cures and resistance to otherwise lethal                      unleash the full potential of CAR-T cell therapies.         for many specific therapies their full effectiveness
doses of tumor re-challenge.                                           CAR-T cell therapies have demonstrated remark-              has remained untapped, or they have been beset
  In colorectal cancer care, patients with KRAS                        able therapeutic results and have been shown to             by problems linked to toxicity. AMP technology
mutations are excluded from treatment with mono-                       completely eliminate tumors in some forms of                addresses both issues. Elicio’s strategy is to con-
clonal antibodies against epidermal growth factor                      cancer, especially hematological malignancies, in           tinue developing AMP applications to expand the
receptor, so that a therapeutic candidate for this                     some patients. Yet they have failed to show similar         range of diseases to which it can be applied, and to
subgroup holds potential to address a large group                      benefits in most other cancer settings, with solid          focus on building a proprietary pipeline around this
currently in need of an effective therapy.                             tumors posing a particular challenge—largely due            core platform. At the same time, Elicio is keen to
  Elicio is poised to begin a prospective, multi-                      to the fact that current CAR-T cells lack the ability       partner with companies developing complementary
center phase 1/2 clinical trial of ELI-002 in patients                 to properly expand their numbers, to efficiently            technology, specifically in the cell therapy space, to
with locally advanced pancreatic ductal adenocar-                      infiltrate solid tumors and to effectively kill cancer      usher in a new era of immunotherapies.
cinoma, colorectal cancer and other tumors after                       cells. A major reason for these limitations is that
standard therapy. In the clinical trial of ELI-002,                    CAR-T cells, as currently used, do not engage the
patients will be screened to identify those with                       lymph nodes at all. As a result, they are not acti-                     Robert Connelly, CEO
                                                                                                                                     CONTACT

tumors containing KRAS mutation and with mini-                         vated at these key immune-orchestrating sites, and                      Elicio Therapeutics Inc.
mal residual disease assessed by the presence of                       miss out on the education and training that lymph                       Cambridge, MA, USA
circulating tumor DNA—a group of patients that                         nodes provide to ensure that T cells become the                         Tel: +1-339-206-0793
almost universally relapse. The trial is designed                      best cancer-destroying cells they can be and remain                     Email: robert.connelly@elicio.com
to allow crossover of patients assigned to the                         functional and expanded over time.

A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T                                          biopharmadealmakers.nature.com | June 2020 | B7
A DV E RT I S E M E N T F E AT U R E

NovaGo Therapeutics AG
www.novagotherapeutics.com

Novel regenerative treatments for
CNS disorders and cerebral stroke
Biotech start-up company NovaGo is developing human antibodies that stimulate nerve repair and
regeneration following a stroke. The company’s lead candidate anti-Nogo-A antibody (NG004)
is ready for phase 1 trials, and it is looking for partners to develop it through the clinic.

Stroke is the leading cause of adult disability in                       Stroke
the developed world, affecting approximately                             lesion
33 million patients worldwide and costing more than
€40 billion per year in direct and indirect costs in the
EU alone. Following a stroke, rapid re-establishment
of blood flow can reduce tissue and neuron injury,
                                                                                       Oligodendrocyte                      Nogo-A                                            Sprouting
but there is no pharmacotherapy available that can
                                                                                                                                                                              of nerve
regenerate damaged regions of the brain; the main-                                                                                                                            fibers
stay of stroke treatment is rehabilitation therapy,                                                   NG004                Nogo66
                                                                                           Δ20
which typically results in only modest improvements                                                                      LINGO1, NgR1
or recovery of function, leaving more than half of                                                                       and p75
stroke patients severely and permanently disabled.
As the global incidence of stroke is increasing at the                                   S1PR2            Nerve fiber growth
same time as death from stroke is declining, stroke                                                 Actin destabilization and
is now a disease of chronically disabled survivors,                                    Neuron       growth cone collapse
many of whom lose their independence and are
forced to live in nursing homes.                           Fig. 1 | NovaGo’s anti-Nogo-A therapy for stroke. The recombinant human monoclonal antibody NG004
  NovaGo Therapeutics, a biotech start-up                  induces neurite outgrowth by blocking the binding of Nogo-A to the Nogo-A receptor complex, preventing
company that develops human antibodies that                its activation (centre box). This allows neurons to make new connections, thereby promoting the
stimulate nerve repair and regeneration, is set to         neurological regenerative healing process, which in turn leads to a higher degree of functional recovery
address this large unmet medical need. The com-            (right). Regeneration is observed near the injured site and in contralateral areas of the brain. This illustration
pany’s co-founder and president, Martin E. Schwab,         is a prediction of how NG004 could work in humans based on data obtained from current animal models.
previously discovered that neurite growth inhibi-
tors prevent repair and regeneration in the central        After a cerebral stroke, animals given the antibody            Clinical studies partners
nervous system (CNS). Although needed for proper           for 2 weeks followed by 4 weeks of rehabilitation              NovaGo’s founding and management team has a
CNS development and maintenance, they obstruct             exercises recover 70–85% of function compared                  proven track record in research and drug devel-
the regenerative process following stroke or injury,       with only 40% for control animals receiving rehab              opment, and maintains international networks
limiting recovery of function. Schwab identified           alone. “Our anti-Nogo-A therapy boosts the sprout-             across academia and industry, including close col-
Nogo-A as a key inhibitor of axonal growth. Since          ing of new nerve fibers, and the newly formed                  laborations with the University of Zurich and the
then he has founded NovaGo Therapeutics to pur-            circuits are stabilized by intensive training,” said           University Hospital in Zurich, Switzerland, where
sue the development of regenerative therapies for          Vianna. “Our results have overthrown the dogma                 the company has its headquarters. NovaGo has
CNS disorders. A strategic partnership with bio-           in medicine that injuries of the brain and spinal cord         started a series B investment round and is look-
pharmaceutical company Neurimmune enabled the              will not heal and cannot be repaired.”                         ing for suitable investors willing to participate as
discovery of specifically targeted human-derived             Furthermore, the time window for administering               partners to support clinical studies of anti-Nogo-
antibodies that block Nogo-A.                              the anti-Nogo-A therapy extends from days to weeks             A through proof of concept to phase 2. “We are
  By inhibiting Nogo-A, NovaGo’s lead anti-Nogo-A          or even months after a stroke, enabling treatment              looking for investors who have an understanding
antibody (NG004) induces neurite outgrowth—not             of chronic strokes, months after the acute infarct.            of stroke and are willing to partner with us on this
only near the injured site but also in contralateral         Phase 1 trials are scheduled to start by the middle          journey,” said Vianna. “Our first-in-class regenera-
or other areas of the brain. The neuronal sprout-          of 2021. A trial in patients with spinal cord injury is        tive therapy for stroke has a unique mechanism
ing, together with rehabilitation exercise, enables        already ongoing and has shown that anti-Nogo-A                 of action that leads to a large degree of functional
significantly more recovery of function than rehab         therapies are safe and tolerable. However, high                recovery that could be life changing for sufferers of
alone (Fig. 1). “Unlike a neuroprotectant, our recom-      patient heterogeneity in stroke research presents              this debilitating and disabling condition.”
binant human monoclonal antibody allows neurons            a challenge, as recovery for each patient will depend
to make new connections,” explained Eduardo                on the type, size and location of the resulting lesion,
Vianna, CEO. “This promotes the central nervous            their age, concurrent disorders and so on. Therefore,
system’s regenerative healing process and neuro-           end points will include recovery of motor functions
logical recovery and should allow stroke patients          and quality of life assessment using stroke-specific                       Eduardo Vianna
                                                                                                                            CONTACT

to recover much more function.”                            scales. “Clinically, any improvement in nerve fiber                        NovaGo Therapeutics AG
  Preclinical studies in rodent and non-human              regeneration and neural circuit repair is expected                         Schlieren, Switzerland
primate models demonstrate that anti-Nogo-A                to have a strong impact on patients’ outcomes and                          Tel: +41 43 300 52 63
therapy is highly effective in enhancing nerve fiber       could dramatically enhance their quality of life,”                         Email: info@novagotherapeutics.com
repair and the formation of new fiber connections.         said Vianna.

B8 | June 2020 | biopharmadealmakers.nature.com                                                     A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T
A DV E RT I S E M E N T F E AT U R E

Biovian
www.biovian.com

Biovian: a true one-stop-shop CDMO with
gene therapy capacity and a Nordic ethos
Covering the whole production chain from the supply end to the value end, Nordic Biovian delivers a
comprehensive and reliable manufacturing service, enabling the development of medical therapies.

Biovian is clearing bottlenecks in gene therapy pro-
duction with its complete one-stop-shop service.
Guided by its Nordic ethos, the contract develop-
ment and manufacturing organization (CDMO)
has built a reputation for delivering high-quality
work on time and on budget to a global client base.
Having done so, Biovian is continuing to expand its
operation, adding scale and capabilities to support
the development of breakthrough therapies.
  ‘One-stop shop’ is a term frequently used in the
CDMO space, yet it is often poorly defined. Biovian
views the concept along two axes, the supply chain
and the value chain. To be a true one-stop shop, a
CDMO needs to offer the full breadth of services
along both the supply chain and the value chain.
  Biovian meets that definition (Fig. 1). On the
supply chain, Biovian’s services span from master
cell banking to qualified person release of the final
labelled drug product.
  Similarly, on the value chain Biovian’s services run                 Fig. 1 | Biovian offers clients a true one-stop-shop good manufacturing practice (GMP) contract
from preclinical supply up to commercial supply or                     development and manufacturing organization (CDMO) service, with modularity available from gene
manufacturing, enabling it to continue supporting                      to finished vial.
clients as they take molecules through development
and onto the market. At each stage, Biovian adheres                    education system, Biovian’s staff share its focus on       Specifically, Biovian moved into the production
to good manufacturing practice (GMP) and works                         quality, honesty and reliability, values that are rein-    of the plasmids that form the building blocks of
out of fully inspected, fully certified facilities.                    forced through the nature of interactions between          viral vectors, making it a true one-stop shop for
  The breadth of Biovian’s offering along both the                     the company and its employees.                             gene therapies.
supply and value chains differentiates it from some                      By taking a straightforward, human-centric                 Biovian is continuing to add to its capabilities.
other CDMOs, which present themselves as one-                          approach to internal and external relationships,           In 2021, the CDMO will open an aseptic filling
stop shops but have gaps in their offerings that force                 Biovian has built a culture that prioritizes customer      line for recombinant proteins and plasmid DNA,
clients to enlist other service providers for some                     satisfaction and employee fulfillment equally. The         adding to its existing biosafety level 1 and 2 viral
work. Biovian is a true one-stop-shop CDMO.                            result is a CDMO that is institutionally driven to         vector fill-and-finish capabilities. The new fully
                                                                       deliver on its promises.                                   automated filling line, which supports batches of
How Nordic values guide Biovian                                                                                                   up to 10,000 vials, features a restricted-access
The clear definition of one-stop shop is in keeping                    Investing to serve changing client needs                   barrier system to ensure aseptic quality without
with Biovian’s straightforward, transparent approach                   Biovian’s strong relationships with employees and          sacrificing process flexibility.
to all communications and interactions with clients.                   clients alike help it stay abreast of changes in the         The investments in viral vectors and fill-and-
As a Finnish CDMO, Biovian’s approach is informed                      type of services biopharma companies need. Such            finish capacity are in line with the approach that
by the culture and world-leading education system                      insights helped Biovian to foresee the ongoing surge       has established Biovian as a premium CDMO. In
of the Nordic region. Words such as quality, hon-                      in demand for gene therapy manufacturing services          a competitive market, Biovian has differentiated
esty and reliability that are inextricably linked to the               and invest accordingly. Having done so, Biovian            itself by pairing leading-edge production capabili-
Nordic region are embedded deep in Biovian’s ethos.                    is easing two critical bottlenecks in gene therapy         ties with its Nordic ethos, enabling it to deliver the
  That ethos can be boiled down to a simple state-                     production today: viral vectors and plasmids.              materials clients need, when they need them, at
ment: “We do what we say we will do.” Those eight                        In 2020, Biovian opened an expanded GMP viral            the agreed quality.
words capture the essence of Biovian’s approach                        vector manufacturing plant, more than doubling
to clients, an approach that has enabled it to build                   its capacity to make adeno-associated viruses,
a global customer base since it began operating in                     adenoviruses and other viral vectors vital to the
2003. If Biovian says it will provide a deliverable by                 delivery of gene therapies. Through the expansion,                     Antti Nieminen, Director,
                                                                                                                                    CONTACT

a particular date for a particular price, clients can be               Biovian added a 200 l bioreactor, equipping it to                      Business Development and Projects
confident it will do everything in its power to do so.                 continue to serve clients as they take gene therapies                  Biovian
  Biovian’s ability to live up to those expectations                   into late-phase clinical trials and onto the market.                   Turku, Finland
rests on its employees, who have the expertise and                       Reflecting Biovian’s definition of one-stop shop,                    Tel: +358 40 502 13 32
scientific skills needed for challenging projects.                     that expansion along the supply chain was accom-                       Email: antti.nieminen@biovian.com
As importantly, having come through the Finnish                        panied by an expansion along the value chain.

A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T                                         biopharmadealmakers.nature.com | June 2020 | B9
A DV E RT I S E M E N T F E AT U R E

Cellatoz Therapeutics, Inc.
cellatozrx.com/en

A new era of cell therapies for intractable diseases
Biotech company Cellatoz Therapeutics is developing innovative cell therapies by applying its proprietary cells, known
as A-to-Z cells to multiple therapeutic areas. The company is now looking for partners to develop the therapies further.

Cellatoz Therapeutics is leveraging lessons learnt                 Cell types                      Functions                                                            Indications
from the first wave of cell therapies to overcome
barriers to the treatment of intractable diseases.                   16
                                                                       ENK
Equipped with proprietary cells, Cellatoz is ushering
in a new era for cell therapies defined by cell-specific                   CD16                    ADCC and
markers and the regeneration of damaged cells or                                                    immune
                                                                                                   balancing                                                            Lung cancer
tissues. Now, having generated evidence that its
approach has potential, Cellatoz is seeking a partner                     NK cell
and funding to bring its cell therapies to patients.
                                                                     NRPC                                                                                               Prostate cancer
  Early attempts to use stem cells to treat disease
failed to live up to expectations, with the harvesting                                                                                                                  Ovarian cancer
                                                                                                   Peripheral                                                           PNI caused by
and activation of primary cells and mesenchymal                                                      nerve
stem cells (MSCs) yielding therapies with marginal                                                                                                                      CMT disease
                                                                                                  regeneration                                                          and other
efficacy. The setbacks pointed to a new way forward                                                                                                                     diseases
for the field, leading Cellatoz to set out in 2017 to
create reliable, novel, stem cell therapies.                         MSSC                                                                                               Osteoarthritis
  Cellatoz’s approach is based on proprietary cells,                                             Skeletal tissue
known as A-to-Z cells, with applications in multiple                                              regeneration
therapeutic areas. Rather than simply harvesting                                                (bone, cartilage,
                                                                                                  tendon, etc.)
and activating primary cells and MSCs, Cellatoz is
working with different starting materials and dif-
ferentiating them to create therapies capable of           Fig. 1 | Applications of the proprietary A-to-Z cells at Cellatoz. The illustration shows the individual
treating intractable diseases.                             functions of each of the cell types and the diseases that they directly target. 16ENK, CD16-highly expressing
                                                           NK cell; ADCC, antibody-dependent cellular cytotoxicity; CMT, Charcot–Marie–Tooth; MSSC,
How A-to-Z cells treat disease                             musculoskeletal stem cell; NRPC, neuronal regeneration-promoting cell; PNI, peripheral nerve injury.
Cellatoz has discussed three applications of its
A-to-Z cells to date (Fig. 1). In one program, Cellatoz    disease and other health conditions caused by dam-              The progress of the programs has led Cellatoz to
is using pluripotent stem cells to create musculo-         age to the peripheral nervous system. CLZ-2002                seek support for the next steps. With the MSSC
skeletal stem cells (MSSCs) capable of differentiat-       remyelinated sciatic nerves in an animal model                CLZ-1001 targeting osteoarthritis, a major indica-
ing into bone, tendon, muscle and cartilage. As the        of CMT, driving Cellatoz to start testing the cell            tion, Cellatoz is seeking a partner to support clinical
cells themselves, as well as the methodology and           therapy in another animal model1.                             development of that drug candidate.
media used to make them, are proprietary, Cellatoz           Cellatoz is also developing autologous CD16-                  Cellatoz is taking a different approach to CLZ-
is in the process of establishing a thicket of patents.    highly expressing natural killer cells (16ENKs). Using        2002 and CLZ-3001. As CLZ-2002 targets a rare
The protection is more comprehensive than is usual         a proprietary high-yield method, Cellatoz manufac-            disease, CMT, Cellatoz is talking to patient advocacy
as ordinarily companies use non-proprietary cells.         tures homogenized NK cells that express CD16 on               groups and plans to take that cell therapy forward
  There is evidence that Cellatoz’s proprietary            their surface. Cellatoz thinks the presence of CD16           itself using the proceeds of a series B round that it
approach to cell therapy could translate into bet-         will lead to antibody-dependent cellular cytotoxic-           is in the process of raising. Cellatoz also plans to
ter outcomes. Nonclinical studies showed that              ity, suggesting that 16ENKs will work synergistically         test CLZ-3001 in patients in Korea, its home market,
a MSSC therapy, CLZ-1001, proliferates and dif-            with immuno-oncology drugs.                                   and Japan itself before expanding globally.
ferentiates at the injection site to regenerate bone         Work is underway to validate that hypothesis by               Through the clinical trials, Cellatoz stands to
tissue, thereby enabling recovery from severe inju-        testing Cellatoz’s lead 16ENK, CLZ-3001, in ovarian           validate the hypothesis that its A-to-Z cells could
ries. Buoyed by the data, Cellatoz plans to develop        cancer and other tumor types. As an autologous                perform better than the first generation of cell thera-
CLZ-1001 as a treatment for osteoarthritis of the          cell therapy, CLZ-3001 is suitable for repeat dosing,         pies based on primary cells and undifferentiated
knee, either as a new drug or in combination with          enabling Cellatoz the potential to treat cancer by            MSCs. In doing so, Cellatoz will lead to the era of cell
a medical device.                                          rebalancing the immune system, rather than by just            therapy 2.0, unlocking the therapeutic potential of
  Cellatoz is advancing MSSCs in parallel to work on       activating certain cells.                                     human cells to tackle major unmet medical needs.
allogeneic neuronal regeneration-promoting cells                                                                         1. Park, S. et al. Int. J. Mol. Sci. 19, E2393 (2018).
(NRPCs). These Schwann-like cells are differenti-          Taking the pipeline forward
ated from tonsil-derived MSCs. By differentiating          Having raised a $10 million series A financing
the cells, Cellatoz has improved on the efficacy           round in 2019, Cellatoz has advanced its lead pro-                        Jaeseung Lim, Chief Executive Officer
                                                                                                                           CONTACT

of MSCs that are merely harvested and isolated.            grams into nonclinical studies with a view to filing                      & Chief Scientific Officer/Co-founder
NRPCs secrete neurotropic factors to induce axon           investigational new drugs (INDs) in the first half                        Cellatoz Therapeutics, Inc.
sprouting and remyelination of damaged nerves.             of 2021. The work is taking place at a state-of-the-                      Gyeonggi-do, Republic of Korea
  In light of those characteristics, Cellatoz is           art research laboratory and good manufacturing                            Tel: + 82 31 622 4300
applying NRPCs, in the form of CLZ-2002, to the            practice (GMP) production plant that Cellatoz                             Email: jlim@cellatozrx.com
treatment of Charcot–Marie–Tooth (CMT) type 1A             constructed to house its 35-person team.

B10 | June 2020 | biopharmadealmakers.nature.com                                                   A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T
A DV E RT I S E M E N T F E AT U R E

inRegen
www.inregen.com

A personalized approach to halting kidney disease
inRegen’s personalized progenitor cell therapy injects autologous kidney cells (REACT) into patients’ damaged kidneys, where
cells migrate and restore kidney function. The cell-based treatment is showing signs of promise in ongoing phase 2 trials.

inRegen has developed a treatment for chronic                                         INJECTION               MIGRATION
kidney disease (CKD), now in phase 2 trials, that
leverages a patient’s own kidney cells to repair dam-                                                                                     INTEGRATION
age and improve kidney function. The approach is an
auto-transplant of progenitor cells obtained via kid-                                                                       New cells
ney biopsy and then reintroduced back into the kid-                                                                         integrate
ney where they migrate to damaged kidney tissue,                                                                                                                          REPAIR and/or
averting disease progression. According to inRegen                                         Formulation is                                                                REGENERATION
CEO Tim Bertram, “Our personalized, autologous                                             injected in the                                             New
                                                                                                               Live cells
cell therapy doesn’t require immunosuppression, is                                         cortex of the                                               glomeruli
                                                                                                               migrate to
given as a simple injection, yet has unique potential                                      diseased kidney
                                                                                                               injured                                                             Cytokines
to restore renal function lost to progressive CKD,                                                             structures                                                          generate
transforming treatment and outcomes by delaying                                                                                                                                    healthy new
or preventing end-stage kidney disease.”                                  Progenitor cell
                                                                          therapy                                                                                                  structures in
  Kidney disease affects ~850 million people world-                                                                                                                                the nephron
wide. In the USA alone, 37 million people, half of
them diabetic, suffer from CKD and are at risk of                                                                                                                          New
progressing to kidney failure. Arnold Silva, Director                                                                                                                      tubules
of Clinical Research, Boise Kidney and Hypertension
Institute, and an investigator in inRegen’s clinical
trials, notes, “The full impact of CKD has been under-
appreciated, with little in the way of new treatments
in the last two decades. Current therapies typically                   Fig. 1 | Renal progenitor REACT patient-derived cell therapy. Autologous kidney progenitor cells are
address the effects of reduced renal function, such                    injected into the kidney, where they rapidly migrate to diseased areas and integrate into nephronic
as anemia, acid/base imbalance and hypertension,                       structures (glomeruli and tubules), re-establishing kidney repair potential and restoring function.
or underlying systemic disease, like diabetes and
autoimmune disorders. inRegen’s cell-based therapy                     reintroduced into the kidney via injection on an            treatment group. The studies are nearing comple-
treats the kidney itself, and may finally offer a means                outpatient basis, without the need for immuno-              tion, with phase 3 trials slated to begin within the
to stop or even reverse CKD progression.”                              suppression. The infused progenitor cells migrate           year. In addition, a phase 1 trial in adult patients with
                                                                       rapidly to diseased areas, replacing damaged cells in       CKD due to congenital anomalies of the kidney and
Identifying kidney regeneration cells                                  tubules and glomeruli and regenerating new neph-            urinary tract (CAKUT) is currently enrolling in the
Although kidneys are normally capable of recover-                      ron structures (Fig. 1). The cells also localize in the     USA and will be expanding to Mexico, where lack
ing from acute injury, there is no current scientific                  interstitium, reducing fibrosis and inflammation,           of surgical correction of CAKUT in childhood leads
support for the existence of a kidney stem cell.                       while modulating epithelial transdifferentiation.           to a higher incidence of CKD in adulthood.
Undeterred by the decade-old challenge, with                           inRegen scientists hypothesize that kidney pro-               Kidney progenitor cells are highly sensitive to
venture backing, inRegen scientists pursued a                          genitor cells are programmed to heal damage, but            handling and prone to apoptosis. inRegen has
functional approach, systematically testing multiple                   in CKD become trapped by scars and effete from              developed proprietary methods to enable isolation,
kidney cell types in hundreds of combinations                          chronic inflammation, preventing normal function.           growth, formulation, and shipping of its cell-based
to deconvolute the activity in healthy kidneys                         This view is supported by the observation that these        therapy and holds extensive intellectual property
responsible for regeneration in vivo. Their efforts                    progenitor cells produce high levels of anti-inflam-        (200-plus patents and patent applications) for
ultimately succeeded in identifying a combination                      matory cytokines. By isolating and re-infusing these        composition, therapeutic use and methods of
of cells able to form kidney tubules and Bowman’s                      expert repair cells, inRegen’s therapy may replenish        manufacturing. For patients in the on-going clini-
capsule in vitro. The cell mix included kidney pro-                    natural reserves, allowing them to re-establish and         cal trials, GMP manufacturing of autologous cell
genitors with distinct phenotypic markers, including                   maintain a healthy baseline function in the kidney.         treatments is being conducted in partnership with
SIX2, OSR1, PAX2 and RET1. In preclinical studies,                                                                                 Twin City Bio. inRegen plans to scale up clinical and
this combination of cells was able to induce new                       Promising clinical trials                                   commercial efforts to address the global scope of
nephron formation, reduce disease and stabilize or                     A first-in-human study with inRegen’s progenitor            the unmet need in CKD.
improve multiple kidney functions, demonstrating                       cell-based treatment, conducted at the Karolinska           1. Kelley, R. et al. Cell Transplant. 22, 1023–1039 (2013).
long-term improvement in three different rodent                        Institute (Sweden), demonstrated that it was well
models of severe CKD and a 70% nephrectomized                          tolerated. The therapy was granted US Food and
canine model1.                                                         Drug Administration fast-track status, and phase 2                      Tim Bertram, CEO
                                                                                                                                     CONTACT

  In the REACT (Renal Autologus Cell Therapy)                          trials in patients with diabetes with moderate to                       inRegen
clinical trials, patients undergo a kidney biopsy,                     severe CKD were approved. Interim results of the                        Grand Cayman, Cayman Islands
and cells are isolated from the tissue under good                      randomized, controlled phase 2 trial showed earlier                     Tel: +1-336-448-2845/2880
manufacturing practice (GMP) conditions. The                           disease progression to dialysis in the control (stan-                   Email: tim.bertram@inregen.com
selected autologous, healthy progenitor cells are                      dard-of-care) group compared with the REACT

A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T                                         biopharmadealmakers.nature.com | June 2020 | B11
A DV E RT I S E M E N T F E AT U R E

Synplogen Co., Ltd.
www.synplogen.com

Using one-step DNA assembly
to create designer DNA
Japanese company Synplogen uses technology based on over a decade of academic research
to design and manufacture long and complex sequences of synthetic DNA. The company
is also engaged in novel drug discovery and R&D of gene and cell therapies.

As the synthetic biology market continues to grow,                                                                                          47             7               9    37
there is increasing demand for longer length, error-                      26                    35                 24                                                34                            50 DNA fragments

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                                                                                                                                                            1
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free DNA of over 5,000 bp in length, sometimes                      9

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                                                                                                                                                                                                     Plasmid vector

                                                                                                                                                                22
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                                                                                                     12
                                                                                                               15
much longer. These sequences of bespoke DNA                          19
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                                                                                                                                                                          31
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are crucial for unlocking the power of synthetic
biology for use in a wide range of sectors such as                                                                                               One step
medical, industrial biotech, materials engineering,
and the chemical, agricultural and energy sectors.                                         1              5             10             15                  20         25            30         35     40   45   50
However, creating these designer strands accu-
rately, efficiently and cost-effectively can be chal-
lenging. Factors such as the length, complexity or                                                            Plasmid DNA assembled 50 DNA fragments
                                                               B. subtilis                                        with designed orientation and order
repetitiveness of the sequence, or unusually high
concentrations of certain types of nucleotides, often                                                                   Plasmid extraction
make certain desirable DNA sequences difficult
or impossible to synthesize with currently com-
                                                                                                                                 Synthesized long DNA (~100 kb)
mercialized methods. Synplogen’s mission is to
develop and commercialize technologies for the
design and synthesis of these complex and high-                                            By adjusting the size of material DNA fragments strictly,
value stretches of DNA, which are traditionally                                             gene assembly of more than 50 fragments is feasible:
challenging to manufacture.                                • Feasible to construct                            • Very precise DNA                                                • Construction is                • Automation
                                                             ~100 kb DNA with                                   compared with other                                               finished in a single             friendly
The origins of the technology                                designed sequence                                  methods                                                           step
In 2003, Kenji Tsuge and his colleagues at the
Mitsubishi Kagaku Institute of Life Sciences cre-       Fig. 1 | Synplogen’s OGAB technology. Ordered gene assembly in Bacillus subtilis (OGAB) uses B. subtilis to
ated a technology for the one-step assembly of          assemble DNA fragments into a specific orientation and order to create long-chain DNA.
DNA fragments into a strand of DNA with a specific
order and orientation. The proprietary technology,      Creating longer length DNA using OGAB                                                                         exponentially harder to achieve as the length of the
known as ordered gene assembly in Bacillus subtilis     Long chain DNA is constructed in vitro, using strands                                                         linear DNA increases. On the other hand, yeast-
(OGAB), grew out of a project to create hybrid bac-     of genetic material of around 1,000 bp in length.                                                             based technologies can struggle with GC-rich DNA,
terial genomes, as well as novel genomic DNA not        These strands or ‘blocks’ of DNA then have to be                                                              especially at 70% or greater. To overcome these
found in existing organisms (Fig. 1). OGAB became       linked together using cell-based processes. Many                                                              issues, Synplogen chose the well-characterized
the basis for Kobe City-based startup Synplogen,        companies and researchers use Escherichia coli or                                                             organism B. subtilis, known for its industrial use in
founded in February 2017 by Tsuge and Akihiko           budding yeasts for this process, but each of these                                                            the production of natto (fermented soya beans), to
Kondo, now both company directors. In May 2019,         techniques has its own challenges. On one hand,                                                               use as the basis for the OGAB technology.
Synplogen licensed another key companion tech-          in the case of E. coli, as it can only take up circular                                                         Synplogen’s OGAB-based platform can assemble
nology from Kobe University for the combinatorial       DNA, an additional step is required to circularize                                                            linear DNA strands of up to 100 kb with very high
use of the OGAB method (combi-OGAB), which              the genetic material in vitro. However, the effi-                                                             precision. 50 or more DNA fragments, referred
was developed by Tsuge during his time there.           ciency of in vitro circularization is low and becomes                                                         to as OGAB blocks, can be used with a success

B12 | June 2020 | biopharmadealmakers.nature.com                                                                             A D V E R T I S E R R E TA I N S S O L E R E S P O N S I B I L I T Y F O R C O N T E N T
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