Epoch 16: Engineering Your Body's Own Defense: How Cell Therapy Fights Autoimmunity

Future Treatment Algorithms, CAR-T, T Cell Engagers

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Hello Avatar! Welcome back for another week of biotech analysis. Today is Sunday, which means this is our Building Biotech newsletter that is focused on discussing biopharma strategy topics. Today we are going to provide an overview of the exciting area of using cell therapy (mainly CAR-T) to treat auto-immune disease. People are excited because we have potentially unlocked curative therapy for a significant patient population.  You will hear first hand today from the man who started this revolution Georg Schett with experts from a recent interview he participated in.  We will aso touch on therapeutic approaches beyond cell therapy as well as provide a glimpse of the future at what treatment algorithms could evolve to for patients.

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Enough shilling for the day, lots to cover this week, let's get started!

CAR-T FOR AUTO-IMMUNE DISEASE

We are all well aware that with professor George Schett’s work with CD19 CAR-T in autoimmune patients the concept of B Cell depletion and immune reset has quickly become one of the hottest topics in biopharma.  

Below is a slightly dated map from William Blair of the competitive space which seems to be growing by the day. (Please drop updates in the comments if you note something missing or inaccurate)

To the untrained eye this looks like a ridiculous misallocation of capital.  Scientifically under the hood each of these approaches is differentiated, and at this point is too early to tell which will be the best approach.   William Blaire goes on to narrow this down by scientific approach as shown below.  Again, this is a bit dated as new players enter the space by the day.

AUTOLOGOUS

• $CABA: CABA-201 data  lupus & myositis in 1H24

• $NVM: fast CMC

• $AUTL: compelling data obe-cel (CD19 fast off-rate) 

ALLOGENEIC

• $ALLO CD19/CD70 CAR-T B+T cell targeting

• $ACET Gamma-delta CAR-T (natural tropism)

• $BMY:  MS CAR-T

• $SANA: lenti CD19

IN-VIVO

• Capstan: mRNA/tLNP

• Umoja: Lenti

• Interius: Lenti

Back in February Canaccord hosted a call with Dr. Georg Schett to discuss his views on autoimmune disease with a focus on CD19 CAR-T vs mAb based approaches.   Given the spotlight on his work we thought our readers would be interested to hear the highlights of the discussion.