YouSaid · the spoken record

Vasant Narasimhan

lines on the record: 79
first: 2019-01-14
most recent: 2019-01-14
sittings or episodes: 1
sources: podcast

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“Probably, I would guess, hypertension cardiovascular disease, but I've not looked carefully. But it's worth reflecting on how hard it is to do what we do. And when we find, I tell our people, you have to think every medicine we find is a miracle that fits in the palm of your hand. We've unlocked, in a sense, a billion years of evolution of the eukaryotic cell in human biology. And somehow we found something that was able to move the needle in this incredibly complex system. I think that's easy to forget when we just kind of overly simplify what we do.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Is probably 40 trillion cells that are working together. It's amazing anything even works. It's amazing. We understand a fraction of the proteins, what they do, 1200 druggable proteins, and there's only a fraction of those that we can actually drug. We don't know what most of RNA does, non-coding RNA. We don't know most of what the genomes even talking about. And if you look at it since the creation of the FDA, there's only been about 1,500 new molecular entities ever found. And most of those are actually overlapping in similar therapeutic areas. So, actually, if you were to count for, I haven't done the analysis, but if you count for double counts, my guess is it's in the hundreds of medicines that we've actually found. And by the way, what's a production?”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I'd say focus a lot on how you lead people. I think there's so much of a focus on technical expertise and thinking that that's going to get you there. It matters, of course. Competence matters tremendously. But what really makes the difference is how you lead people, how you lead yourself. And I think investing more in that would pay off a lot. I think the other thing I'd say is don't underestimate the importance of getting multidisciplinary exposure. I mean, I think most people get worried when they have to make those jumps. I've had a career at Novartis where I've worked in commercial areas and marketing areas, so most of my time in R&D, worked across four different areas of the business. And so with that diversity of experiences, it enables you, I think, to take the right decisions. There was one other point I just wanted to raise. I think what's often lost some people, because you mentioned the miracles, right? Yeah. And how incredible it is that we find any human medicine at all. Because if you think about it, every human being.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“On now, you're in the world of the ambiguous, the uncertain, and then things hit you from completely from the blind side, and then you got to keep moving ahead.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I'm just amazed by how vast our company is. I mean, you know, I think even though I've been at the company since 2005 now actually overseeing a company that's 120,000 people and 150 countries and you go anywhere, we are just a vast, vast company. So that's one thing that's really, I think, surprised me just to have to now, when you think about making a transformation happen and you try to make that happen in such a large enterprise, that certainly really, I mean, that really hits you. I think the other thing about this job is crisis management, which you're just not exposed to. I mean, this job is a lot about managing crises. And that's been a big learning curve for me because in the world of R&D, we had clinical trials the last two or three years. I mean, everything's sort of predictable. We sort of, we sort of know what the decisions we need to make. A lot of documentation that you can lean.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I find it fascinating because it alludes to the concepts around skin in the game because you want people to have skin in the game, but at the same time, they need to have just enough out that they can see things a little clearly where you're not only attacking their sacred cows.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. I mean, it is a balancing act between the different forces. I find a lot of it comes down to just encouraging people just to have open, frank debate and be comfortable with task conflict without personal conflict. That's what I keep telling our teams. We have to be incredibly curious about one another, what one another thinks. I think that's just all about trying to get the best ideas. And we're just trying to debate. But it's never personal. And it's never, because I think when, particularly in the world of science, it often becomes personal, right? It becomes this is about me and my science versus you not believing in my science as opposed to saying we need to just find a great medicine or we need to just solve this problem. That's a journey I think we're taking the organization on. But I think that's going to be what's really critical is having that radical transparency in the open debate”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“And you got to figure out where you are in that. And I think that is one of the most difficult things that I would imagine that an innovative company at the scale at which Novartis operates has to always find that balance between.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I mean, we have financial measures, so we look at return on capital employed, NPV, NPV peak sales. So all the traditional financial measures, we look at really the scientific innovativeness for lack of a better word. Is this really something that's changing the game from a scientific standpoint? That's a little bit more of a subjective measure, but we try to ask teams, you know, is this really moving the needle from a standard of care science? And we actually score that based on six different parameters. Are you allowed to share that parameters? I don't know them off the top of my head, but we really try to score the score the medicines to say, is this really transformative? So you have a financial score, you have a transfer, transformational score. And then another kind of subjective element is, does this strategically fit? So is it in one of our core therapeutic areas? So if somebody comes with a great breakthrough, which happens not quite often in an area that we're not in, that's”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Thousand RD people and spend $9 billion plus a year in RD. So if you're a small entrepreneur who wants to start working with us, it's easy to get lost in the fray. We're trying to work on that. I think most of the companies in our industry try to have external offices that try to engage. I mean, we have external scholars program where we really try to enable scientists to use our facilities, interact with our scientists. So we're trying to experiment, but I can't say that we've completely figured that out on the biomedical side. I'm much more optimistic on the data and digital science side, mostly because we just brought people in from that world and they just think differently.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I think in data and digital, what we've tried to do is make us feel a lot smaller because I think we recognize that we are a huge beast. And so with things like the biome, we work with many other entities to try to say how can we make ourselves feel smaller, work in smaller units. We created our own digital data organization so that entrepreneurs would have an input into Novartis where it's people like them. I mean, the people in that team are all come from the tech sector. They're working in a much smaller agile way. They do sprints and scrums and they work in all the ways that the people are used to working. And so I would say really engaging through someplace in a large company that I think has a natural affiliation for the entrepreneur makes a lot of sense. I think it is harder on the kind of traditional biomedical side, right? I mean, we have, I mean, if you just think of, we have 17.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“So we're in the business of funding early stage companies, supporting entrepreneurs. If I'm an entrepreneur, I obviously see a ton of benefit in partnering with Novartis, access to data that doesn't exist elsewhere. Obviously validation in my approach and my technology, et cetera. But if I'm an entrepreneur, I'm also scared to approach a large company like a Novartis because I'd worry about basically you're an elephant and I'm a mouse. If I want to dance, I have to hope you're a very graceful elephant because otherwise you're going to crush me.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, we have lots of debates. If we were to build a scaled hub in digital and data science health, where would we go? I think one of the challenges in the Bay Area is, again, just the competition for talent is so intense, especially in the tech sector.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“It was really saying, you know, let's go where the talent is as opposed to force everyone to come to us. So we'll see. That's the experiment we're undertaking.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“It's interesting, when you look at research, we have three main hubs or three main hubs are in Cambridge, in Basel, Switzerland, and in Shanghai in China. Those are three main research hubs. In terms of development centers for product development, you would add on to that list Hyderabad, India as kind of the main East Hanover, New Jersey. But when it comes to data science and digital, what we've actually decided to do is take a much more distributed approach. So we're building up these biome centers in San Francisco, in London, other locations in the Middle East, perhaps in China, just trying to say we're not going to constrain ourselves with our current locations. We're going to just try to source talent wherever it is, particularly because talent in these areas doesn't necessarily have to be housed next to the other functions. We're really asking these people to explore our data and find big, big new insights. So that's the approach we're taking right now.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“And there's actually an interesting shift that can happen in academia with my group at Stanford. Many people actually, during their PhD, have gone to work in pharma. And it's hard to, it's impossible to pull the data out of Pharma, but it's actually easier to put the grad student into Pharma. And so the grad student comes with the code, runs internally through the firewall of Pharma. And we see how it does. And then you can still publish papers where maybe you have to obscure what the target is or something like that. But you can at least see how things are going. And there's nothing like sort of trying it in the real world.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“That's right. That's right. And is it really to what your earlier point? I mean, the opportunity is to say, look, come and work with us and we'll let you work with our data and you can learn and we'll learn. And maybe then there's a partnership that's created or maybe you want to come work for us, which would also be great. But that's how we're approaching it.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“And That's right, looking for There's a recent peanut butter cup issue because startups sometimes have some innovation on the data science, but not the data. And so bringing the two together, I think, seems like a very natural combination.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I think one of the things we're working through is how do we get the talent as we really start to organize the data? And we've brought in some great talent to really help us work on data architecture and come up with a whole data landscape for the company. So that we're always now thinking about how do we treat data as an asset. That's one of the things we keep harping on is data as an asset, whatever data we collect from the external world has to be organized in a clear data architecture. But then to take the next step to get the data scientists to really find the insights. We're not the traditional place where data scientists coming out of Stanford is looking for where they want to come to. So we're working through partnerships with universities, potential partnerships with startups.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I agree with short term. I think longer term, my gut feeling is that this is a solvable problem statistically because there is even issues with clinical trial design that one has to overcome today because randomization isn't just picking people literally randomly necessarily. True.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“The study visits, and so I think that will help a lot, but I still think in the end you're going to need to randomize and blind. I mean, I think if you don't randomize, I think it's really hard to figure out what is going on in a complex system.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Here we need to really be able to replace what are pretty rigorous tests. And we haven't seen that yet. Now we're exploring, I think, use of many different sensors. The real power of it is a continuous variable to actually see how a patient's doing in between.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“When I think about, first of all, I would say just in general, in sensors, there's another place where there's been a lot of hype above expectations. I mean, we've been really trying to explore the use of sensors in clinical trials now, in my own experience at least six years. And it's been tough to get sensors that really meet clinical trial grade outcomes. I mean, to really show that they can be validated versus our current clinical endpoints. Now, as consumer products, fine. I mean, the perfect people can do that. But you're talking medical.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I mean, that's my expectation as well. You'll see it first come out as a phase four, you know, something where you're using real world evidence, which was right now used for reimbursement anyways and so on. But then maybe see how far it can go back. But it's not going to replace it.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Randomized placebo controlled data that really tells us that something has the effect we think it is, then to explore more effects or explore more uses through real world evidence makes a lot of sense. But I don't see this as a panacea that suddenly will make the world much, much easier.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I think we're experimenting with that. I think other companies are as well. The other thing people talk about, but I mean, I'll take a skeptical voice around it, is the ability to use real-world evidence to try to get at these things. But as somebody who's worked in clinical trials for most of their time in the industry, I do believe that the power of randomization, the power of blindedness is what enables us to control for all of the things we don't know about the complexity of human life and human biology and to think that we're going to take that away and then be able to really determine the efficacy of a medicine puts a lot on the statistics that I don't think we have. And so I'm more of a real world evidence. I don't know if it's a skeptic, but realist who sort of says after we have”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“The ideal world, if we could get there, would be we would have integrated health records where we could easily insert the fields that we needed for clinical trials. And then we could use something like a blockchain or some other distributed architecture that enabled patients to consent for us then to access the data and then run the trials through that. And that would eliminate so much of the effort of creating a second database versus the EHR monitoring that database, QAing that database, locking that database. You could get the data on an ongoing basis. I mean, we would radically simplify this. I believe that's a huge, huge opportunity. I think we have a long way to go, as you know, because EHRs are not where they need to be. We're probably not where we need to be to get there. But I see opportunities in baby steps to actually get towards that.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“An area that's desperately in need, I think, of innovation is how we think about clinical trials, recognizing we have to operate within the system that we live in. But if you could design testing safety and efficacy in humans on a blank sheet of paper, what would look different from a clinical trial perspective versus where we are today and the way we do it now?”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Are spending a lot of our energy just trying to get all of our data harmonized so that some algorithm could maybe find anything of use.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“It's a great question. I mean, really, what we focus on is the operational data. So, one level up from the patients is the trial enrolling on time. Are the sites open? All of that, all of those elements. On the operational side, it was really easier to do this than trying to get all the way down to patient level data. The other area, interestingly, in the financial area as well, we find that AI does a great job predicting our free cash flow, predicting a lot of our sales for key products. And it does better than our internal people because it doesn't have the biases. And the data is very clean. And we've got very long-term data. So that's been all positive. But there have been other areas where I think it's just simply not met up. I mean, I think the holy grail of kind of having unstructured machine learning go into big clinical data lakes and then suddenly find new insights. We've not been able to crack mostly because the data to link it up, I mean, we.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“It should be. I mean, it And if you then apply that as well to the vast doors of imaging data we have from our clinical trials, we have 2 million patients in clinical trials, at least in the last 10 years. And we have MRI, CT scans, retinal scans, heart scans, and all of that as well. I think ML.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah. That's been so much of it. And then the other thing is, is there patterns that can be really learned from the day? I mean, do you have a good training data set to actually train the algorithms? So there's a few places, I think we've seen a lot of traction. One, I think the vision or image problem has been very well solved. So right now we're in the process of digitizing all of our pathology images and having AI just be able to scan all of the pathology images at Novartis. And we have millions of, of course, records of biopsies and tissue. And so that's a huge project we have called Path AI to really work on that as a single.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, I have to first say, I completely agree about the hype cycle here. I mean, as we've gotten quite scaled and working on digital health and data science, we've learned that there's a lot of talk and very little in terms of actual delivery of impact. But we've learned a lot. I think the first thing we've learned is the importance of having outstanding data to actually base your ML on. And in our own hands, in our own shop, we've been working on a few big, big projects, and we've had to spend most of the time just cleaning the data sets before you can even run the algorithm. That's taken us years just to clean the data sets. And I think people underestimate how little clean data there is out there and how hard it is to clean and link. It was never intended.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“And they want to work in a very different environment than, let's say, an industrial company 20 years ago. And so we call our new culture inspired, curious, and unbossed, and we want our people to feel inspired by the work, really curious about the outside world, and not lived in a bossed company, but really live in an unbossed, much more empowered company. And when we talk about areas like digital and data science, cell and gene therapy, it's so critical because these are so complex areas. You need your people to figure out the answers. And we can't be in a world where everybody's waiting for management to tell everybody what to do because none of us know what to do either. Because these are whole new spaces for us. So that's a big shift. The other element of that journey is to get a lot more comfortable with rapid failure. I mean, we have to be much more rapid cycle. We can't expect that we're going to sort it all out and it's all going to work perfectly because the first thing we've learned already in cell and gene therapy is nothing works the way you expected.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, we're making, trying to make a quantum change, I think, in our culture. I mean, what we have is as context, I believe, we've moved to become truly just a knowledge organization. I mean, so much of the rudimentary tasks have been either automated or sent to third parties. So we have a whole organization of knowledge workers, 50% of them are millennials.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, it's not artisanal anymore, but I think once you can have this ability to shift towards that mindset where you have reproducibility and like almost like a factory-like process. Can be built. Once you can have that shift, as long as everyone is ready to make that shift, then things can really start rolling. But there has to be a major shift. In terms of in America, people really care about the artisanal part as much. And we got factories, and that was a huge part of the early 1800s. And I'm curious, you spoke so much about how no virus is changing. And so presumably there's internal cultural change as well.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Also, I think there's going to presumably have to be a culture that shifts along with this. I read Alan Greenspan's book, A History of Capitalism. And he talked about how actually in Europe, like furniture was bespoke, and you'd make this beautiful chair, and it's this handicraft. And they actually hated the idea of factories Engineering because it takes the art out of it”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“More engineering of medicines up front because we really come from a heritage where everything was just trial and error. We just tried many, many, many molecules until we found one that worked and we just took it forward. How can we become much smarter about that? And so in our research labs, we're spending a lot of time thinking about how do we engineer the medicine up front to do what we want it to do. And that's a whole new world, I think.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I think the easiest place is going to be in continuing to innovate on the processes by which we really manipulate cells and gene and really get to the next wave of manufacturing. Because I would say we're really on the only learning to crawl with respect to most of these technologies and how we produce them. Pretty rudimentary. And so I think there's going to be an engineering problem of how do you handle cells and how do you handle the vectors and make this a much, much more efficient process. And there's a lot of, I think, very smart engineering firms now working on that space. So I think that's one place. An area I'm quite interested in is how we can get much smarter at actually engineering the medicines themselves. I mean, we spend a lot of work investing in AI and 3D visualizations to say in the so-called world of chemical biology, or if you even think about using quantum chemistry to really understand how to define your monoclonal antibody, how can we do a lot?”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“You've just mentioned multiple places where the sort of repeatability and different aspects of engineering have already come in. How is this trend going to continue? Where are there going to be the new places where engineering can play a role?”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Unfortunately, in our industry, it's always that the answer is it depends. I think in the specific example of CAR T, I do think that's what's going to happen because you have such a complex manufacturing that you're going to have the first generation, let's say, of a CD19 card, which is a cart that targets B cell cancers. And you're going to try to then move into a next generation that hopefully has more rapid manufacturing, maybe higher efficacy, and then even more rapid manufacturing. So you're going to get into that iteration. Now, it's not like medical device iteration. I mean, this is still going to take years to do, but you are going to get to that iteration. I think another way, what I see happening, though, with these new technologies is real platforms insofar as once you have the backbone of the production and even the go-to-market model depending, you can put multiple products onto the platform. What we have done at our company is build a global network of manufacturers.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“And at least my sense has always been that because it's so bespoke that there are some learnings that are generalizable in any given disease area, but every sort of program is a unique thing. When you start to move to the RNA world, to the cell world, to the gene world, is it going to become much more of a modular world where the first version of a CAR T is going to be by definition less sophisticated than the second version, but the second version will be built off the first. And you go from being in a bespoke world to going much more into sort of an iterative world.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“I love sort of the sweeping history you have here in terms of starting with chemistry and then moving to large molecules and then now moving more into the cell and engineered world. Historically, every single sort of drug program has been a very bespoke thing, a very sort of its own ground war, right? You have your target discovery and then you have your validation and then you have your lead and then you optimize that molecule and then so on and so on.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Inside, outside. So these are new ways of actually delivering medicines or creating medicines in the human body. And now you see early stage companies doing even more radical things, trying to turn red blood cells into therapeutics amongst other things. So it's really an expansion, let's think about if you think about it of the game board of how you can address human diseases.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Really, touching other elements of what happens in a cell. So, one is RNAs, which is really the way DNA gets translated into a protein. It goes through an RNA. So that's one new modality. Another modality, both of them really are about editing DNA in different ways. One is to take the cells out of the body and edit the DNA of the cell or enable the cell to produce something different. The other is to do it inside the body. That's what we call gene therapy. So we make that distinction as cell therapy and gene therapy.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. So when you think about the history of our industry, maybe another way to describe the trend I see that's happening is we used to be about chemicals, the small molecules. So for probably 100 years, I mean, most of the pharmaceutical companies had their basis in the chemicals industry. And so we made these small molecules that happened to have various effects on the body and over 100 years we figured out we could really target what those chemicals do. Around the late 1980s, we realized you could actually make large molecules, large proteins, and make them be therapeutic. So this is antibodies and recombinant proteins. And that led to a whole new renaissance in our industry. And so over the next 20 years and up to today, probably still the largest category, so-called biologic medicines. These are antibodies and proteins. What I see happening now is a shift to a next set of modalities that move beyond small molecules and proteins. And that is now.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“So there's a couple of really nice examples now with RNA interference. One that our company is working on is RNA interference to impact a factor that's really a big part of heart disease. It's called LP little A. LP little A is actually thought to be one of the remaining risk factors for heart disease that have not been addressed. You know cholesterol, everybody's, of course, addressed cholesterol extremely well, triglycerides. LP little A is another factor, but there's no never been a medicine against it. And it turns out it's really hard to drug LP LP little A. And so the only way to really target it turns out to be using RNA-based therapies. These RNA-based therapies are able to block the production of the gene, translation of the gene into the protein, and then actually reduce the LP little A in the blood. And so this is one example of how we're trying to take this into an area where otherwise you wouldn't.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Another big area, hot area, is in the world of RNAs. So these are really ways to deliver, let's call it genetic instructions into specific cells. This has been an area that's been worked on for many years. It's always been difficult. But I think companies are now starting to crack the problem of delivering RNAs into specific cells in a highly effective way.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“We had actually an aging program, a small aging program for some time where we were trying to work on things like Sarcopenia, which is muscle wasting and similar kinds of conditions. It turns out to be very, very difficult because, again, multifactorial and you probably need a medicine with behavior, with diet, with exercise, with all kinds of things to actually help healthy aging happen. But like I said, I mean, we continue to focus on more the pure regenerative parts. I mean, if you think about the whole world of joints and movement has not really been addressed and cracked. And so this is an area where we have exploratory programs to see maybe we could find something. I mean, if you could regenerate cartilage or tendons or enable muscle strength incrementally, you might be able to improve a healthy aging quite a bit.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source
“Regenerative medic I think another area, yes, I think if zero transplantation being one, I think the other is going to be we are going to start to solve problems of regenerating tissue. We already see examples where we, in our own labs, where we can start to crack, how can you regenerate cartilage or how can you regenerate other tissues in the body, which would again seem like science fiction, but I think actually harnessing the pathways to really get regeneration to happen, which would help healthy aging is another thing I think we'll likely come. So there's a lot of, I think, things that are still on the way.”
2019-01-14 · a16z Podcast · a16z Podcast: The Science and Business of Innovative Medicines · IDENTIFIED FROM THE TRANSCRIPT · source