This post first appeared as an issue of the a16z Bio Newsletter. Subscribe to stay on top of the latest trends in bio and healthcare.
The Moderna and Pfizer/BioNTech COVID vaccines mark a major milestone – not just for this pandemic, but for their entire therapeutic class: RNA-based drugs. While companies like Alnylam, Sarepta, and IONIS have received FDA approval for a handful of RNA therapeutics, the design of new RNA drugs has been slower than promised due to some technical and practical challenges, so the excitement for this class has waned over the last two decades. The COVID mRNA vaccines have now re-ignited interest in a huge way – and perhaps most importantly – demonstrated that many of the challenges that plagued these early companies can be resolved. In this blog post, bio deal team partner Judy Savitskaya lays out how the COVID vaccine operation will help validate and accelerate development in key areas of RNA-based drug design, as well as the open problems for the field. And this episode of the Bio Eats World podcast with host Hanne Winarsky, a16z general partner Jorge Conde, and MIT Professor Rick Young, dives into the world of “junk” DNA – which, spoiler alert, turns out to be fueling an RNA revolution.
Real-time data collection about the spread and impact of COVID infection has been a central challenge throughout the global pandemic. This data is critical not just for public health measures like contact tracing, but also for understanding the impact of new medicines. The UK’s RECOVERY trial set the bar for the world on how to conduct randomized, controlled clinical trials for anti-COVID drugs. And now, Israel is setting another, with the creative deal forged with vaccine manufacturers: “Vaccines For Data” (you can actually read a redacted version of the agreement from the Israel Ministry of Health here!). They locked in a supply of the Pfizer/BioNTech vaccine by promising not only a swift vaccine rollout, but also a continuous stream of data from their centralized medical record system to study the real-world efficacy of the vaccines (which, by the way, is looking incredible). It’s hard to even imagine such datasets in the fragmented US healthcare system right now (compare this to our cutting-edge system of hand-annotated, paper CDC vaccine cards)… but these examples from the UK and Israel paint a vision of a future tech-enabled clinical research ecosystem.
We’ve been jamming on Clubhouse. In our “It’s Time to Heal” room (every Monday at 5pm PT), a16z cofounder Marc Andreessen and general partners Julie Yoo, Vijay Pande, Jorge Conde, and Vineeta Agarwala chat with special guests about the future of bio and healthcare in a live, interactive discussion. We’ve covered a lot of ground:
The origin story of Silicon Valley has become the stuff of legend. The origin story of biotech, on the other hand, is a much less familiar tale. The closest thing we have to a Hewlett-Packard “two-guys-in-a-garage” story in biotech is Robert Swanson and Herb Boyer teaming up to form Genentech. For a crash course in the industry’s history, here’s Jorge Conde’s list of key books on the origins of biotech, with some additional suggestions from our network:
The application of genomics and genetic testing in healthcare has evolved from a novelty to an incredibly useful tool for certain specific and rare conditions. But genomics is growing up: as we discuss on two episodes of the Bio Eats World podcast, genomics is finally primed to be part of the care journey of every patient. First, on “The Genetics of Risk,” host Lauren Richardson speaks with Peter Donnelly, Oxford Professor and CEO of Genomics PLC, and Vineeta Agarwala about the new era of genetic testing and its potential to reorient our entire healthcare system via genomic prevention. And on Journal Club: Why Do Only Some People Get Severe COVID?, Helen Su, Chief of the Human Immunological Diseases Section at the NIAID, and Lauren discusses the massive international effort to uncover genetic risk factors for severe COVID. DNA might not be entirely deterministic, but it will increasingly determine our healthcare journey.
Biology doesn’t exist in a vacuum. As Nobel Laureate Frank Wilczek tells Bio Eats World co-hosts Lauren Richardson and Hanne Winarsky, “Physicists tell us what’s conceivable, chemists tell us what’s possible, and biologists tell us what actually happened.” In this wide-ranging and philosophical conversation, Wilczek talks all about the essential principles of modern physics that have built our understanding of reality and the universe around us; the idea of “radical conservatism” and how it pushes every theory to its limit; how biological complexity arises from the elegant simplicity of physics; and much more. And on Journal Club: A Safer Psychedelic, Lauren and UC Davis Assistant Professor David Olson dive into psychedelic medicine – and whether hallucinations are essential for therapeutic benefit.