Immortality as an investment asset

Race for survival

Anton Gopka, Founder of Atem Capital, Forbes, 26.08.2016

Investments in the fight against aging were formerly the lot of major philanthropists and committed transhumanists. In recent years, new classes of investment assets have been formed that can provide both high returns and radical life extension.

Over the last century, the average life expectancy of a person has doubled: previously, the life span fluctuated in the range of 25-40 years, and since the beginning of the XX century it has been actively growing and already exceeds 70 years. In many ways, this is the triumph of the last century in the fight against infectious diseases and infant mortality. Due to the redistribution of the main causes of death from parasitic diseases to non-communicable and chronic diseases, the next major breakthrough in prolonging life is expected to be progress in the treatment of diseases of old age, in rejuvenation and prevention of aging of the body.

Recently, Raymond Kurzweil, the famous American inventor, futurist and technical director of Google, said: "Within 10-15 years, we will get rid of physical failures and aging of our body and will approach the milestone when the annual increase in life expectancy will exceed a year – thus, by 2029 we will be able to prolong life without restrictions."

Kurzweil is famous for his detailed and fairly accurate technological forecasts, which he has been publishing for more than 30 years. Regardless of your confidence in his relatively shocking long-term forecasts, today you can consider investing in a number of breakthrough medical developments that can lead to an extension of life expectancy by 10-15 years in the coming years and, if successful, provide exceptionally high returns.

The obvious first line of "investments in spite of all deaths" are investments in companies that develop drugs to combat the main causes of mortality: diseases of the cardiovascular system, cancer and Alzheimer's disease. According to a recent study by Silicon Valley Bank, from the investor's point of view, oncology undoubtedly remains the leading therapeutic area – 36% of the total investment volume of US venture funds for 2015 and the 1st half of 2016.

Changes in this trend are not expected in the next few years due to a number of reasons. According to the American Cancer Society, every second man and every third woman will develop one or another tumor disease during their lifetime. Every second woman over the age of 30 may be diagnosed with one or another type of breast cancer. Oncological diseases occupy a leading place among the causes of mortality and lead to enormous social and economic losses. As a result, oncological drugs form the largest (more than $100 billion in 2015, according to IMS Health) and the fastest growing segment of the market. In addition, in the next few years, it is expected to create a regime of maximum preferences on the part of states.

So, in his last annual address to Congress in early 2016, Barack Obama announced the launch of a new Cancer Moonshot 2020 program with a total funding of $1 billion during 2016-2017 and the goal of finally defeating cancer by 2020.

In recent months, several well-known entrepreneurs who have made their fortunes in the IT field have begun to actively invest in research in the field of oncology.

In April 2016, Sean Parker, co-founder of Napster and founding president of Facebook, donated $250 million to establish the Parker Institute for Cancer Immunotherapy and fund the work of more than 300 scientists. In May 2016, Larry Ellison, co–founder of Oracle, allocated $200 million to create an oncological research center - the Lawrence Ellison Institute for Transformational Medicine at the University of Southern California.

Russian investors have also begun to actively consider biotechnology as a priority industry for investment. In May 2016, a new division of the Mikhail Fridman Foundation L1 Health was created, which plans to invest up to $3 billion in biotech projects in the United States, including on the recommendations of Franz Hammer, former chairman of the board of Directors of Roche Holding AG, who joined the advisory board of the fund.

ATEM Capital also invests in oncology companies together with a number of large public Chinese pharmaceutical companies with investments of up to $500 million. For the purposes of investing in oncology, ATEM Capital has attracted Joseph Camardo, Senior Vice president - Global Medical director of Celgene, a leader in oncology, as well as Bruce Burlington, an acting member of the board of directors of AstraZeneca, who previously led a number of areas at the FDA, and Ed Godber, a former senior vice president of GlaxoSmithKleine, to the advisory board of the fund.

Anton Abugov, former First Vice President of AFK Sistema, is working on a strategy to create an oncology fund in cooperation with Mayo Clinic, a leading cancer center in the United States. The advisory board of the foundation includes Daniel Von Hoff, one of the most famous oncologists in the world, who was responsible for conducting more than 200 clinical research programs of oncological drugs and is the chief research scientist at US Oncology, the largest association of practicing oncologists in the United States.

Andrey Fomenko, the founder of the Senator development group of companies, as well as the IVAO investment company, whose mission is to increase life expectancy, invests in technologies aimed at treating cancer and other diseases associated with aging.

The main strategic advantage of investing in oncology is the technological breakthrough that has occurred in this area over the past few years, when there were signs of high efficiency of fundamentally new therapeutic modalities: immunotherapy, genetic engineering and cellular technologies.

Jonathan Norris, managing director of Silicon Valley Bank, who runs a healthcare practice, notes: "In oncology, unlike other therapeutic areas, we observe acquisitions and IPOs at very early stages – already at the preclinical or at the first phase of clinical trials. This leads to accelerated exits and increases the internal rate of return (IRR) of investments."

One of the most famous opinion leaders in the field of oncology is James Watson, a Nobel laureate and one of the discoverers of the structure of the DNA molecule. Three years ago, we met with him in New York and discussed the most promising areas of research on the treatment of cancer. Watson then told me that if he had previously doubted the prospects of immunotherapy, now he is sure that "immunotherapy methods and therapeutic vaccines are the most likely means of solving the cancer problem." In the next three years, developments in the field of immuno-oncology really radically transformed the market for investments in biotechnology.

Immunotherapy, unlike chemotherapy, which tries to destroy cancer cells, primarily affects the human immune system and directs the body's own defense mechanisms to cure. The advantage of immunotherapy technologies is prolonged exposure, a significant reduction in side effects and an estimated reduction in the risk of cancer metastasis – the actual cause of death in 90% of cases of cancer.

Watson is constantly raising funds to find new solutions to cure cancer. Three years ago, his elevator pitch sounded in his typical style: "I have only five years left, so I will do everything to achieve results on this horizon." Last year, the indefatigable Watson organized fundraising for his project in the form of an unprecedented auction for the sale of his Nobel medal. Alisher Usmanov nobly bought the medal for $4.1 million and returned it to the discoverer of the DNA structure – also, by the way, a kind of investment in immortality.

Now James Watson is 88 years old, but he does not stop in his fight against cancer: "I give myself five years to see how 80% of oncological diseases will become curable." The scientist plans to take a direct part in this. In a recent interview, he shared his own anti-cancer complex: aspirin, metformin, sugar withdrawal and regular exercise. He is actively engaged in tennis and still performs serves under 160 km/h. In his opinion, such a regime reduces the risk of cancer by 50%.

The previous skepticism and failures regarding immunotherapy are quite understandable. For decades, scientists have not been able to achieve any noticeable clinical results. The low effectiveness of immunotherapy methods based on attempts to activate the patient's own immune response (peptide, dendritic, gene vaccines) was due to the mechanism of evasion of the immune response, which is perfectly "mastered" by cancer cells.

Long–term comprehensive scientific research in the field of immunology and immunotherapy of malignant diseases ended with a resounding success - in 2013, in the final issue of the journal Science, achievements in the field of tumor immunotherapy were named the breakthrough of the year.

In several clinical studies of immunotherapy using autologous T cells with a chimeric receptor (CAR-T) in extremely complex cases of blood cancer, remission occurred in 100% of patients, and up to three-quarters of patients remained in remission without signs of cancer a year after the procedure.

These successes marked the beginning of a new era in antitumor therapy, when the effective use of high-tech immunotherapy methods gave hope that tumor diseases can be defeated using CAR-T technology.

CAR-T is both cell therapy, genetic engineering and immunotherapy. The CAR-T procedure can be described quite simply: immune T cells are taken from the patient's blood, they are trained to attack cancer by reprogramming for the synthesis of the chimeric antigen receptor CAR, which recognizes cancer cells, and CAR-modified T cells are introduced back into the patient's body. Specially prepared and "armed" T-cells destroy cancer cells, as well as reactivate other elements of the immune system that have been suppressed by cancer.

Over the past three years, a number of biotech companies have entered the stock exchange, which have begun active development of CAR-T, and Big Pharma companies have concluded major partnership agreements. Within the next 12-18 months, the leading CAR-T projects – Juno Therapeutics and Kite Pharma – can apply for technology approval in the USA. Among the investors of Juno Therapeutics is billionaire Jeff Bezos, founder and CEO Amazon.com , and a specialized Life Sciences fund with the participation of JSC Rusnano.

Meanwhile, CAR-T technology has its own high risks. CAR-T treatment is accompanied by fever, an intense inflammatory reaction – a "cytokine storm" that can last from several days to weeks. At this time, patients are on the verge of life and death under the constant supervision of doctors in the hospital. If doctors fail to regain control of the patient's condition, this reaction can lead to death. For example, at the end of July this year, the FDA suspended clinical trials of Juno Therapeutics in connection with the death of two patients. On this day, Juno shares fell by 30%, and capitalization decreased by $ 1 billion. However, in an unexpectedly short three–day period, clinical trials were again authorized by the FDA, as Juno is investigating the effectiveness of its developments in terminal patients - if treatment was suspended, many of them would have died within a few weeks.

At the moment, many Juno competitors are beginning to look for and implement technologies that will control or prevent the development of a "cytokine storm" associated with CAR-T.

Another significant disadvantage of most of the current CAR-T developments is the complex production, limited scaling and the high estimated cost of a course of treatment – $ 500,000 per patient.

To solve these problems, the American company Formula Pharmaceuticals (a private company) and the French company Cellectis do not use the cells of the patients themselves (autologous), but create a universal bank of human cells (allogeneic) with preset parameters, which will significantly reduce the production time and reduce its cost.

Unfortunately, even the reduced cost of a CAR-T course of treatment for the US market will probably not be available for practice in Russia. I recently discovered that there are organizations in Russia that understand the importance of CAR-T transfer to Russia and have all the necessary infrastructure and knowledge of this technology. It all started with a charity evening by Chulpan Khamatova and violinist Dmitry Berlinsky in New York, where poems by Tsvetaeva and Pasternak were played to the music of Shostakovich, and the organizers of the evening - the Gift of Life Foundation — raised funds for technology transfer to Russia for the treatment of sick children.

Upon arrival in Moscow, I met with Mikhail Maschan, Chairman of the Board of the Foundation and Head of the Department of Bone Marrow Transplantation of the FNCC DGOI. Dmitry Rogachev, who shared his opinion about the prospects of CAR-T in Russia. In his opinion, CAR-T can give hope to previously incurable children in Russia in the coming years on the basis of a laboratory within the framework of the FNCC. The Gift of Life Foundation is currently looking for the necessary support for the implementation of CAR-T in Russia. Simultaneously with CAR-T, the next generation of breakthrough technologies is approaching clinical research and the healthcare market.

Portal "Eternal youth" http://vechnayamolodost.ru  30.08.2016