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of the work was fast exceeding the center’s ability to tap grants from the National Institutes of Health, and it needed an industry partner. The Hutchinson Center never seriously considered a Big Pharma partner, partly because it wanted to continue to work with academic collaborators and maintain a higher degree of control over the strategic direction of the work. Corey didn’t want to see a classically underfunded biotech startup bite off more than it could chew. He talked with Nelsen, an experienced startup venture investor and member of the Hutchinson Center board of trustees, about possibilities. Nelsen ended up running with the idea of a big financial commitment in collaboration with the big money guys from the $48 billion Alaska Permanent Fund, a state-owned corporation funded mostly by oil revenue.
“We were getting grants, but only for 5 or 10 patients at a time, and the studies didn’t have the kind of rigor and numbers required to take this from a boutique therapy into something bigger,” Corey said. “Our goal is to make immunotherapy into front-line therapy for cancer. To do that, we needed a clinical trial program, and the kind of infrastructure that companies use to get FDA licensure. There was the moment to do that, and to recognize that what we needed was an investor committed to cell therapy, committed to a novel form of therapy, a novel distribution system, the personification of personalized care. It was not in the sweet spot of the pharma industry.”
The Hutch is known around the world as the place that pioneered bone-marrow transplantation for certain forms of blood cancer, which is essentially an early form of cell therapy that often results in cures. Although bone-marrow transplants have their issues—with side effects like infections and graft-versus-host disease—they have saved many thousands of lives over the years. That’s the same kind of impact Juno aspires to have, as a pioneer in immunotherapy, Corey said.
To that end, both the Hutchinson Center and Memorial Sloan-Kettering have retained two seats each on Juno’s board of directors. The board isn’t fully put together yet, but currently includes Corey, Bishop, Klausner, and Nelsen.
The Alaska Permanent Fund was set up in the 1970s to manage the state’s vast oil wealth. It isn’t a typical investor in biotech startups like Juno. The fund got involved after Corey says he serendipitously bumped into David Fallace, a senior portfolio manager for the fund, on an Alaska Airlines nonstop flight from Boston to Seattle. Corey remembers they met at Gate A18 at Logan International Airport.
“He was a nice guy. We talked about children, and life, and where you’re from,” Corey said. “He said he was interested in cancer and cancer therapy.” That was enough to get Corey going. About 3.5 hours into the cross-country flight, he had filled Fallace in about the exciting opportunities in cancer immunotherapy. The two agreed to follow up later.
Corey then brought in Klausner for an independent review of the scientific assets in April. Klausner, who was well aware of competing work in June’s lab at Penn, wasn’t sure what to expect. He was a bit skeptical at first, he says, just because institution heads like Corey sometimes have an inflated opinion of the work that goes on under their own organization’s roof.
“I was skeptical I’d see something that would make me say to them ‘This looks so good you ought to jump into this highly competitive space, because you have some real potential,” Klausner said.
The risks, of course, with any new biotech venture are longer than any one news article can contain. Manufacturing scale up, cost, and distribution logistics are obvious challenges the new company will have to address. Getting the right people is always tough, but Nelsen said he’s excited to have “the most qualified person on the planet” to build a cancer cell therapy business in Bishop—who oversaw manufacturing at Dendreon. Nelsen said he’s confident that Bishop will create a focused culture at Juno that’s not about hype, and Bishop said in my interviews with him this fall that he didn’t want to create false hope.
Scientifically, there are some notable effects to watch for. As with any therapy that fiddles with the immune system, researchers have to make sure they don’t go too far and flip a switch into overdrive and cause autoimmunity like rheumatoid arthritis. Church, the cancer consultant, notes there’s a risk in manufacturing mix-ups of cells that could end up giving patients someone else’s cells—a real problem. There’s also data to suggest that CART therapy is so powerful that it may essentially kill tumors so fast that the body has a hard time excreting the waste through the kidneys, which could end up putting patients on kidney dialysis in a worst-case scenario, Church said. That effect, which June’s group has noticed, is called “tumor lysis syndrome.”
Those kinds of questions will all have to be asked and answered at future scientific meetings, and in the scientific literature. Bishop said he isn’t ready yet to talk about when Juno will provide more of the kind of clarity about Juno’s technology, and its body of medical evidence, that people in science and industry obviously want to see.
One final aspect that’s unusual here is the relationship between the Hutch and Memorial Sloan-Kettering. These institutions normally view each other as competitors more than collaborators. The initial force behind Juno came from the Seattle group, but the scientists there felt there was an even bigger opportunity by joining forces and bundling their respective technologies with respected peers at Memorial Sloan-Kettering, Corey said.
All of the key players at Juno interviewed for this story—Corey, Klausner, Nelsen, and Bishop—said they think highly of the competing work in June’s group at Penn, as did independent expert Sally Church. The Juno team, however, said it believes its diverse group of technologies will give it the variety it needs to tailor treatment to certain kinds of malignancies.
Given the amount of excitement in the field, common sense would say the Novartis/Penn and Juno/Fred Hutchinson/Sloan-Kettering efforts—if successful—will naturally invite even more aggressively financed competitors. Some preliminary results from CART therapy are expected to be on display, generating buzz, this weekend at the American Society of Hematology meeting in New Orleans.
“I don’t want to create false hope,” Bishop said. “But what’s most exciting, undoubtedly, is that we have a technology here with the potential, the potential, to provide curative therapy. We have the potential to do that in a way that may ultimately avoid all the lifelong toxicities that can be associated with chemo or radiation. There’s a lot still to be learned. I don’t want anybody to say we’re overreaching even a tiny bit, but it’s the potential of that that makes the company so extraordinary.”
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