“With government and industry working hand in hand, we can develop and stockpile monoclonal antibody therapeutics in anticipation of variants to come. We need to be thinking several moves ahead to keep ahead of variants so that stockpiles of therapies do not become obsolete as they have now. Our government needs to ensure the proper funding to support the development and manufacturing of such therapies, and we need to begin demanding they do so.

These are highly complex and time and resource-intensive endeavors. However, the technology exists today through modern antibody platforms to address these needs, and countless lives can be saved with such an approach. The more action we take now, the more we can be ready for future variants from threatening our nation’s health.”

Ian Chan is a health care executive.

He shares his story and discusses his KevinMD article, “To treat future COVID variants, we need more than vaccines.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Ian Chan. He is a health care executive, and he wrote the KevinMD article “To treat future COVID variants, we need more than vaccines.” Ian, welcome to the show.

Ian Chan: Thank you very much, Kevin. Great to be here.

Kevin Pho: We’ll get into the article a little bit, but first off, can you share your story and journey to where you are today?

Ian Chan: Yeah. So I’m founder and CEO of a company called Abpro. We focus on next-generation antibody therapies. We started the company a little over 10 years ago now in the Boston area to develop next-generation antibody therapies against targets that have traditionally been difficult to go after.

Kevin Pho: So tell me some of the challenges that you face.

Ian Chan: Yeah, I think there are certainly a lot of challenges. So for anyone who likes a challenge, I would say this is a great space to be in. It’s also one of the most exciting spaces as well. You have to really juggle many different things at the same time. Certainly, it starts with having great science and being able to pursue difficult needs with novel approaches, with technology, so those are really generally quite difficult. You have to prove your platform works, you have to get validation for it, and then you have to scale it up, all the while in a very dynamic environment.

Scientifically, there can obviously be challenges, certainly getting all the experiments to go properly. Sometimes they don’t go properly, right? So you have to be able to pivot quickly, managing a dynamic team and then growing it. And then on the business side, you’re juggling all the aspects that go with it as well.

Kevin Pho: So on this podcast and on my blog, we have an audience of practicing clinicians, and some of them are interested in stepping outside the clinical space and moving into, say, the field of biotechnology. Tell me about that intersection between physicians and biotechnology companies. Can you comment about how easy it is for physicians to transition, and what’s the role of physicians in biotechnology companies today?

Ian Chan: I think there’s a huge role, obviously, for MDs in this space. Ultimately, all biotech companies are trying to treat patients in the end, and that’s the perspective that doctors have and are trained on in multiple different areas. Certainly, there are a lot of MDs in the space, but making the transition, I would say, is relatively straightforward. There are many areas and avenues into the industry, certainly on the clinical side, whether it’s helping design clinical trials, whether it’s medical affairs, so on and so forth, or even earlier stage. I know a lot of MDs have PhDs as well, and there’s always a big need for that.

Kevin Pho: Is there any specific training physicians need? Do they have to be physician-scientists, MD-PhDs, coming up? Do you have a lot of physicians who transition straight from clinical medicine into the biotechnology space?

Ian Chan: Yeah, so I think there are entryways into biotech. Certainly, getting trained on how drug development works would be in a corporate setting, so there are multiple opportunities for doctors to really go in that way, and then learn how it’s all done, and then grow from there.

Kevin Pho: Great. And if they’re interested in moving into the biotechnology space, what kind of advice do you have for these physicians?

Ian Chan: I would say pick areas that you’re really passionate about scientifically, and go from there. So whatever your background may be, and whatever your specialty may be, there’s certainly a whole host of opportunities to help work on really developing novel therapies that can treat patients across the board.

Kevin Pho: All right, so let’s transition into the KevinMD article that you wrote. It’s titled “To treat future COVID variants, we need more than vaccines.” Now, for those of you who get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Ian Chan: Yeah. So obviously COVID’s been here now for a while. We’re going on year three, and one of the reasons is because we’re getting waves and waves of variants. So we’ve seen more boosters being rolled out. There’s a call for a fourth booster shot now. We’ve seen multiple therapies come and go. All this is a result of the fact that there are waves of different variants, and some of them are quite different.

So we wrote this article just because we believe there’s a best way to move forward on this, especially on the therapeutic and pre-exposure prophylaxis approach through monoclonals. And that way is to design antibody therapies and treatments that are as future-resistant as possible. That way we’re not chasing variants all the time. So I think we wanted to really point out that aspect of it, and how important that will be, so that we’re ahead of the game as opposed to chasing variants.

Kevin Pho: So tell us the current state of monoclonal antibodies as it relates to COVID.

Ian Chan: Yeah, it’s been really interesting. In two years, we’ve seen multiple therapies get launched and then multiple therapies become ineffective. So I think that highlights the need for future-resistant antibody treatments. A lot of those first-generation therapies, even though they were very effective against those variants at the time, quickly lost efficacy because of the lack of future-proofness. And now, as we see even more variants come, it should highlight the need to be able to go after COVID treatments with this approach.

Kevin Pho: So tell me, how do we future-proof monoclonal antibodies so that they will be effective against any variant that may come along our way?

Ian Chan: Yeah, so future-proofing will certainly give you increased protection against future variants, as opposed to something that’s not future-proof, where you have a high risk of mutations coming up and knocking the treatment out. So you want to get the future-proofness as high as possible, ideally 100 percent, although that would be extremely difficult to do, but as close to that as possible.

So there are certain ways you can design your antibody therapies to go after portions of COVID which don’t change as much over time. Through analysis, usually done by bioinformatics or other types of techniques, and extensive preclinical testing and analysis, you can find these regions that antibodies can bind to that have less chance to change over time. It’s kind of like having a house. The foundation generally doesn’t change over time. Everything over it can change, like paint colors, furniture, different tenants, so on and so forth. So these regions do exist, and those are generally more future-resistant.

Kevin Pho: So where are we in terms of technology, and in terms of coming up with a viable product right now? Tell me where we are in the timeline.

Ian Chan: Yeah, so we’ve been working on this recently, since COVID broke out. We’ve had a lot of experience with, certainly, neutralizing antibodies against infectious disease. So we have a cocktail that’s moving quickly. We’ll be moving quickly through the clinic, and the goal is to get that available for patients as early as next year. It’s a cocktail of multiple antibodies, including ones that have these conservative features.

Kevin Pho: Now, you mentioned that there may be a prophylactic role when it comes to monoclonal antibody treatment. Can you talk more about that?

Ian Chan: Sure. So that’s a really unique space that monoclonal antibodies can play in. These are really for immunosuppressed patients. These are defined as individuals generally over age 65 who may have certain health conditions that will put them at a high risk for not developing a response against vaccines. They may have other diseases going on, or they’re taking other medications that prevent their immune system from really raising antibodies. So that’s where monoclonals can play a huge role. Antibodies can circulate quite long in patients to provide protection. Antibodies are also very safe, and it’s an area where only monoclonals can really do a good job in that kind of category.

So certainly these patients won’t raise a response against vaccines. Small molecules are generally too toxic. So antibodies can protect these types of individuals, and there are about 25 million such individuals in the U.S. alone.

Kevin Pho: Now, in terms of what you envision in the next year or so, you have these monoclonal antibodies that would be less susceptible to any variants in the vaccines, perhaps for both a prophylactic use as well as for a treatment use. So in an ideal world, assuming all your clinical trials go well, what do you envision happening if everything were to go right?

Ian Chan: If anything went right, we would have the pre-exposure treatment available next year, as well as the therapy. So this would be a cocktail that would work against, and it would be available for patients.

Kevin Pho: We’re talking to Ian Chan. He’s a health care executive. He wrote the KevinMD article “To treat future COVID variants, we need more than vaccines.” Ian, let’s take a step back. How has the pandemic changed your company?

Ian Chan: Yeah, it’s been, I would say, transformative in some ways. Certainly, as a monoclonal antibody company, it’s obviously a very dynamic space. It’s a space where you have to react very quickly. It’s changing by the day. I think it’s really made our whole organization a lot more efficient overall. Everything happens, I would say, almost five times faster than your typical drug development process, but the FDA has certainly helped facilitate a lot of that. But the pace at which you need to move is, I would say, breathtaking. So I think that kind of practice can be applied across the board to other programs as well. We have oncology programs and eye care programs, and it’s just the way you can actually move things much faster.

Kevin Pho: Now, your company specializes in monoclonal antibodies. Can you contrast that with, say, a traditional drug development biotechnology company?

Ian Chan: Yeah. Monoclonals are certainly one of the most proven modalities that have been out there. It’s almost the mainstay as far as the biotech industry goes. It’s also one of the most important molecules. It’s really molecules that your own immune system develops to fight disease. So first, it’s very natural. They’re highly proven. They’ll continue to be around, for sure, since it’s from our natural immune system. There are a lot of targets out there that we don’t know much about that antibodies can be used for. So I would say, for all those reasons, including safety, this is going to be one of the pillars that will certainly continue forward, as opposed to, I would say, newer technologies that are just being tried out and have less of a track record.

Kevin Pho: And in terms of areas, say, outside of COVID, just give us a sense of how this technology is being applied to conditions and diseases outside of COVID.

Ian Chan: Yeah, so with antibodies, we’re applying novel approaches in immuno-oncology, stimulating the immune system with antibodies, for example, bringing T cells directly to the tumor-related targets. So that’s a very key area where there’s great data coming out for antibodies for that approach. And then eye care as well. We found unique combinations of targets that can provide next-generation treatments for wet AMD and DME, using combinations of antibodies.

Kevin Pho: And my final question, what are some of your take-home messages that you want to leave with the KevinMD audience?

Ian Chan: I think there’s a huge role for monoclonals to play continuously in COVID, especially in the immunosuppressed population. These individuals really have very little protection right now. They can take vaccines, but there’s going to be limited protection, because their immune system can’t mount a response. Antibodies are a great solution here. They’re safe, they’re long-acting, and there’s been great data across the board in the clinic to show efficacy. And then also in the treatment space, too, these are very safe and effective molecules, compared to, for example, small molecules, where there could be a lot of drug-drug interactions, or even mutational risk, right? Those are not issues that antibodies have to really contend with.

Kevin Pho: Thank you so much for sharing your time and insight, and thanks again for being on the show.

Ian Chan: Yes, thank you very much, Kevin.