CRISPR 2.0 and the Future of Gene Therapies | Summary and Q&A

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October 5, 2019
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a16z
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CRISPR 2.0 and the Future of Gene Therapies

TL;DR

Gene therapy is revolutionizing medicine by using technologies to rewrite our genetic code, but there are significant challenges that need to be overcome to make these therapies accessible to more patients.

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Key Insights

  • 💅 Gene therapy is a powerful therapeutic modality that has the potential to cure diseases by addressing the root cause of genetic mutations.
  • 🥺 Recent breakthroughs in gene therapy have led to FDA-approved cures, and the number of gene therapies in clinical trials is expected to increase significantly.
  • 🚚 Delivery of gene therapies to targeted cells and ensuring precision genome editing are major challenges to overcome.
  • 🔨 Computational tools and synthetic biology innovations are driving advancements in gene editing technologies.
  • 🚚 Manufacturing and scaling up production of gene therapies are critical for delivering these treatments to patients.
  • 👶 There are opportunities for startups to develop better delivery systems, engineer the gene editing machinery, explore new modalities, and apply AI and automation to manufacturing.
  • 🪡 Successful gene therapy companies need to carefully consider indication selection, execution of a strategic pipeline portfolio, and partnerships to propel their platform technologies.

Transcript

hello everyone my name is Andy Tran and I'm a partner on the a6 in Z bio investing team what I want to spend time to talk about is one of the most important shifts impacting medicine today specifically on how technologies used to rewrite our genetic code is becoming one of the most powerful therapeutic Arsenal's of all time with massive new progres... Read More

Questions & Answers

Q: What is gene therapy and how does it work?

Gene therapy involves using technologies to modify our genetic code in order to treat and cure diseases. This can be done by introducing healthy copies of genes into cells to compensate for mutated genes.

Q: What are the key challenges in gene therapy?

One major challenge is delivering the therapeutic molecules to the targeted cells in a precise and efficient manner, while minimizing immune responses. Additionally, ensuring the precision of genomic targeting and optimizing the potency of the therapy are crucial. Finally, scaling up production to meet the demand for these complex treatments is a significant challenge.

Q: What are the potential solutions for improved delivery systems in gene therapy?

Researchers are exploring viral vectors, such as adeno-associated viruses (AAVs), as well as non-viral delivery systems like lipid nanoparticles and exosomes. Other innovative approaches include membrane disruption technologies and microinjection devices.

Q: How can gene editing techniques be improved for higher efficiency and precision?

Protein engineering and synthetic biology tools can be used to optimize gene editing nucleases, such as CRISPR-Cas9. New tools, like CRISPR 2.0, expand the genome engineering toolbox and allow for more precise editing at the base-pair level. Computational approaches, such as machine learning, can also aid in designing better guide RNA sequences.

Summary

In this video, Andy Tran discusses the advancements in gene therapy and the challenges and opportunities it presents. He explains how the use of technology to rewrite our genetic code is becoming a powerful therapeutic tool. Tran highlights the recent breakthroughs in gene therapies, including the approval of several drugs that can combat genetic mutations directly inside the body. He discusses the potential for more gene therapy approvals in the future and the opportunities it creates for startups in the biotech industry. Tran also delves into the history of gene therapy, from early rudimentary approaches to the development of more precise and efficient tools like CRISPR. He emphasizes the importance of addressing challenges in delivery, genomic targeting, potency, and manufacturing to make gene therapy accessible to more patients. Tran explores potential solutions in each of these areas, including novel delivery systems, protein engineering, computational analysis, and automation in manufacturing. He concludes by noting the need for companies to have a clear indication selection, an effective pipeline strategy, appropriate partnerships, and an engineering approach to navigate the complexities of the gene therapy landscape.

Questions & Answers

Q: What is the main shift impacting medicine today?

The main shift is the use of technology to rewrite our genetic code, which has become a powerful therapeutic tool known as gene therapy. This shift allows us to precisely target and eliminate the origin of diseases and provides the potential for curative treatments with just a single dose of a drug.

Q: What are some recent breakthroughs in gene therapy?

In the past two years, there have been significant breakthroughs in gene therapy, with the approval of four FDA-approved cures for patients. Two of the most recent approvals include a gene therapy for a form of congenital blindness and a gene therapy for spinal muscular atrophy. These breakthroughs mark important milestones in the history of medicine.

Q: How many gene therapy approvals are expected in the near future?

By the end of the decade, it is expected that there will be 10 to 20 gene therapy approvals per year. This represents an order of magnitude increase in the number of one-and-done cures available annually. The clinical pipeline for gene therapies is expanding, and the excitement and promise of these breakthroughs are creating opportunities for startups in the biotech industry.

Q: What are the challenges in gene therapy delivery?

One of the challenges in gene therapy delivery is getting the complex medicines into the target organ and cell with high precision. Additionally, minimizing immune responses that can neutralize the effect or cause lethal side effects is essential. Current delivery vectors, such as adeno-associated viruses (AAV), have limitations in organ-level precision and immunogenicity. There is a need for novel platforms, materials, and targeting moieties to improve delivery systems.

Q: What are the challenges in genomic targeting in gene therapy?

Genomic targeting in gene therapy involves ensuring the precision of the targeting process to prevent unintended collateral damage to the healthy genome. Off-target effects, low efficiency, and immunogenicity of the current protein-based genome editing nucleases pose challenges. Protein engineering techniques and the development of new chemical or synthetic biology tools are being explored to optimize the genomic targeting process.

Q: How can computational analysis contribute to gene therapy?

Computational analysis can play a crucial role in gene therapy by helping to design better guide RNAs for higher efficiency and precision. Machine learning-driven solutions can improve the design of guide RNAs, making the CRISPR system more adept at engineering difficult-to-edit cell types. Algorithms can predict how CRISPR will interact with the genome, allowing for the engineering of more precise and safer therapies. High-throughput screening and metagenomic analysis can aid in the discovery of new genome editing systems.

Q: What are the challenges in gene therapy manufacturing?

Manufacturing gene therapies at scale poses significant challenges. There is a need for automation, both in hardware and software, to increase speed and efficiency in the production process. Automation can improve the oversight of critical steps, track supply chain logistics, and provide real-time monitoring of cells. Advances in synthetic biology and metabolic engineering can help improve the scalability and yield of producer cell lines. Redesigning and optimizing bioreactor systems also contribute to efficient manufacturing.

Q: What are the key areas to focus on when building a gene therapy company?

When building a gene therapy company, it is important to focus on delivery systems, engineering the gene editing machinery, developing new modalities, utilizing AI innovations, and rejuvenating the manufacturing infrastructure. Creating better delivery systems, optimizing the genomic targeting process, expanding the genome engineering toolbox, leveraging computational analysis, and adopting automation are all crucial for success in the gene therapy industry.

Q: What are the factors to consider when evaluating gene therapy companies?

When evaluating gene therapy companies, it is important to assess the indication selection, pipeline strategy, partnerships, and engineering approach. Companies should identify the specific modality and unmet clinical need they are targeting and strike a balance between low-risk and high-impact programs. Partnerships that showcase unique capabilities of the platform can be beneficial. Additionally, companies should have an engineering mindset throughout the organization and leverage interdisciplinary expertise.

Q: What are the main takeaways from the talk?

The main takeaways are that gene therapy presents enormous opportunities for innovation in the biotech industry. The advancements in technology are transforming the fundamentals of medicine, allowing for precise targeting and potential cures for various diseases. However, there are challenges in delivery, genomic targeting, potency, and manufacturing that need to be addressed. Companies focusing on these challenges can create scalable and valuable solutions. The success of gene therapy requires clear indication selection, effective pipeline strategy, appropriate partnerships, and an engineering approach across the organization.

Takeaways

Gene therapy, powered by technology that can rewrite our genetic code, is opening up new possibilities in medicine. Recent breakthroughs in gene therapy have led to FDA-approved cures, and the clinical pipeline is expanding rapidly. Startups in the biotech industry are well-positioned to capitalize on the opportunities created by these breakthroughs. Challenges in delivery systems, genomic targeting, potency, and manufacturing must be overcome to make gene therapy accessible to more patients. However, there are promising solutions in the form of novel delivery systems, protein engineering, computational analysis, and automation. The evaluation of gene therapy companies should consider indication selection, pipeline strategy, partnerships, and an engineering approach. Embracing the interdisciplinary nature of gene therapy and leveraging expertise across various fields will be critical to success. Ultimately, gene therapy has the potential to transform the treatment of diseases and improve patient outcomes.

Summary & Key Takeaways

  • Gene therapy has the potential to cure diseases by precisely targeting and eliminating the root cause of genetic mutations.

  • Recent breakthroughs in gene therapy have led to FDA-approved cures for patients, with many more therapies expected to enter clinical trials in the near future.

  • Startups working on gene therapies have seen significant opportunities for innovation and have become valuable within the biotech industry.

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