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ease chest pain (angina) or the long-term use of beta blockers, calcium channel blockers, or metabolic modulators that reduce the heart’s demand for oxygen. In cases where this approach, known as “medical therapy,” is no longer appropriate, the next step would be to consider an interventional procedure intended to increase the supply of oxygen-rich blood to the heart by inserting a coronary stent or by coronary bypass surgery.
Angionetics aims to establish its gene therapy as an option for patients who no longer respond to drugs and who are not good candidates for bypass surgery or stents, Reinhard said. He estimates that as many as 1 million Americans might fit this description. “Our view is that inside this population, there is room for another alternative, and that is what we call ‘medical revascularization,’” he says.
One of the biggest questions that has dogged Ad5FGF-4 development in recent years is why, in previous studies, some patients have responded to the treatment and others haven’t.
“What we learned was that cell transfection [i.e. getting new genes into heart cells], appears to be enhanced by patients with higher levels of ischemia” Reinhard said. The company believes that means people with a higher degree of ischemia would tend to have a better response to Ad5FGF-4. So Angionetics intends to be highly selective about the patients to be enrolled in its upcoming “Affirm” trial, which is set to take place at dozens of medical centers around the country, Reinhard said.
With the company on the cusp of its pivotal moment of truth, Reinhard also reflected on the twists and turns that Angionetics has taken since 1995 to get to this point.
For Reinhard, the saga began in 1996 when he joined the San Diego startup Collateral Therapeutics to advance research findings from UC San Diego on coronary heart disease. After forming a strategic partnership with Schering AG, Collateral went public in 1999, and advanced its technology to mid-stage trials. In 2002, Schering acquired Collateral Therapeutics for $160 million. A few years later, Schering ended its cardiovascular R&D activities, throwing the Collateral team into limbo.
“Schering ran into trouble, and got acquired by Bayer,” Reinhard recalled. Around 2005, “Bayer made a strategic decision to abandon gene therapy.”
San Diego’s Cardium Therapeutics acquired Collateral’s technology, and continued work on various aspects of the technology. In 2014, under a deal with China’s Shanxi Taxus Pharmaceuticals , Cardium became Taxus Cardium Pharmaceuticals.
A year later, Angionetics was established as a subsidiary of Taxus Cardium to advance work on Ad5FGF-4, and sold a 15 percent stake to China’s Huapont Life Sciences for $3 million. Eventually, Taxus Cardium plans to fully spin out Angionetics.
Reinhard told me he’s now approaching the culmination of what has been a two-decade odyssey.