Gene therapy
Can this change the
course of todays diseases?
Biotechnology & Drugs, Sector: Healthcare, NASD: TGEN
Targeted Genetics Corp.
1100 Olive Way, Suite 100, Seattle, WA 98101, Phone No. 206-623-7612
Ms. H. Steward Parker, President/CEO
Interview
conducted by: Walter
Banks, Co-Publisher
CEOCFOinterviews.com,
December 2000
President &
CEOs introduction and history:
I have been a member of the
biotechnology community for many years now. I
was the first employee of another biotech company, Immunex Corp., which is now a leading
biopharmaceutical company. I worked at that company for ten years, which allowed me to
manage various functions of the company as we grew and take on a lot of different
responsibilities. I focused most of my career there on corporate development, business
planning, and strategic planning. Most of
early stage biotech development involves turning chaos into order, which is how I like to
talk about it. So, building companies in the
biotechnology field is really what Ive been able to do. We spun Targeted Genetics out of Immunex in 1992. Since then we have grown from a core group of
about four people to a company of about 150 employees now.
Ceocfointerviews:
Can you please explain Targeted in terms that the average investor would understand?
Ms. Parker: There has been a lot
of press on the race to define the human genome, and a lot of publicity about the role
that genes play as the basic instruction codes for your body. The public is developing a greater appreciation
for how genes control so many different functions in the body, everything from how you
look to how you behave, and to how your body functions in terms of physical activity and
health. What Targeted Genetics is trying to
do is take advantage of that genetic information and harness its power to create
therapeutics either for genetic diseases -diseases where you have a defective or missing
gene and therefore the body is unable to perform a necessary function- or for diseases
that are acquired, such as cancer or infectious diseases.
You can actually harness the power of genes to treat both classes of
disease. Our focus at Targeted Genetics is
not on discovering new genes, which is an area in which there are a number of established
players. Rather, we work on making improved delivery systems for getting genes into cells. With gene therapy we can actually introduce new
genes into cells and the cells now read new genetic information as if it were their
original information. Then they can read the
new instruction code and produce the new proteins, the ones that werent being
produced before, which then result in a therapeutic effect.
So what we work on are gene delivery systems that get that new genetic
information into cells. We have a number of
different delivery systems in our technology portfolio, and that allows us to introduce
genes into a number of different types of target cells.
Because each cell in your body is different and has differing
characteristics, youre going to need a different type of vehicle to treat different
types of diseases. So, in a broad sense, we
are working on new therapies for acquired and inherited diseases and in the process, are
capitalizing on genomics information to create new therapeutic product opportunities.
Ceocfointerviews:
Which would you like to focus on, your systems or your products?
Ms. Parker: We need
the systems to make the products. What were really all about is making therapeutic
products. We want to be able to treat
diseases that people cant treat right now. We
have two products currently in clinical trials. One
is a treatment for cystic fibrosis, or CF, which is one of the most common gene
deficiencies and affects about 60,000 patients worldwide.
Its a defect in cells within the lung and this defect ultimately leads
to lung failure. The average age of mortality
is about 31, so its a very serious disease. What
were doing in our CF program is introducing a normal copy of the gene that is
defective, and were using a delivery system that can be administered via inhalation
as an aerosol formulation. Once the inhalation process takes place, the gene is taken up
into the target cells and expressed. Were
just beginning Phase II clinical trials in that area and thats going to be very
exciting for us over the next year.
Ceocfointerviews:
Does that drug have a name?
Ms Parker: It is
called tgAAV-CF.
Ceocfointerviews:
How did the clinical trials go?
Ms. Parker: The
trials are ongoing, but so far we have treated over 70 patients and weve seen
absolutely no side effects related to the drug. Weve
had evidence of very good gene transfer, so we know that the genes are getting into the
right types of cells. We are just now
beginning to look at the classic efficacy measurements that you want to look at: how
efficiently the lungs are functioning, reduction in the need for antibiotics, reduction in
infections, things like that. Weve
found some evidence that shows that we are getting some functional correction at a
molecular level, but thats not classical efficacy measurements at this point.
Its a hint that something good is happening but we are just beginning to measure the
classic efficacy endpoints.
Ceocfointerviews:
Are we talking about a cure or an improvement of living?
Ms. Parker:
Currently theres no treatment that addresses the underlying disease and available
therapies only treat the symptoms. What we can envision is a therapy where a patient could
go to a cystic fibrosis treatment center, have the inhalation therapy, go his or her way
for a month or, potentially, several months without actually having any problems with the
disease. This would occur because the lungs
would have taken up the gene, and the gene would be functioning in a normal way in the
cells as long as those cells are alive. When
the cells die off we lose the gene function, so well have to reintroduce the therapy
periodically, but it shouldnt be that often and it may result in a situation where
the patient is, in effect, cured over a long period of time.
Ceocfointerviews: Is
this for use regardless of the age of the patient or is it for a certain age group?
Ms. Parker: We
intend to target younger and younger patients for several reasons, but this doesnt
mean that older patients would not benefit from it. CF
is a progressive disease. Individuals with CF
have normal lungs when they are born, but over time the lungs become scarred and damaged. tgAAV-CF may help to prevent this damage from
occurring by providing the normal function of the CFTR gene, but it cant reverse the
damage that has already been done in the cystic fibrosis setting. As patients get older, there is an increase in
lung damage and we cant reverse that. So
we believe that our best approach may be to treat patients before they develop lung
damage, in which case we may be able to keep their lungs fresh and healthy. We also may be able to prevent any more damage
from occurring in patients who already have demonstrated signs of disease.
We also have a cancer
product that is in clinical trials. We are in
Phase I studies for the treatment of Ovarian Cancer and shortly will be starting a Phase
II study in head and neck cancer. This
product uses a completely different gene and a completely different delivery system from
our cystic fibrosis product. This opportunity
is one that we are also very excited about. So
far, weve been able to see some partial responses and one complete response in the
head and neck clinical trials that weve conducted.
Weve also seen some promising results in ovarian cancer, and we
currently have a Phase I study ongoing that combines our cancer product, called tgDCC-E1A,
with chemotherapy.
Ceocfointerviews:
Are there any risks at all to the patient in gene therapy?
I mean because there is a difference in taking a naturally produced medicine
as opposed to chemotherapy, whats the difference or risk factor to a cancer patient
who is taking something or looking for some-
thing that isnt going to throw their whole system out of
whack?
Ms. Parker: I would
answer that by saying that with every therapy that mankind develops to treat disease,
there is a cost benefit profile. Look at the
chemotherapeutic agents and the serious side effects that occur from chemotherapy but
theyre worth the costs in terms of side effects because they can, in some cases,
cure cancer. In gene therapy the genes are
naturally occurring so we dont expect that there will be these sorts of issues. However, the challenge comes with selecting the
right gene and then using the right delivery system for the right target cell. Just to illustrate that, there have been cases of
side effects with one particular gene delivery system, one that Targeted Genetics does not
use to a significant degree, that is based on the adenovirus. This is a naturally occurring virus and it
delivers genetic information into cells very efficiently. So this system, known as an
adenoviral vector, would seem to have a lot of potential as a gene delivery system. But
your body is designed to recognize this virus as a pathogen, so when you use an adenoviral
vector as a gene delivery system it often causes an immune response to the delivery system
and that, in turn, can cause some fairly significant side effects. So you have to be very
careful about which delivery system you are using for a specific disease and try to match
the properties of the vector with the therapeutic requirements for treating that disease. In the case of these adenoviral vectors,
theyre probably very useful for a disease such as cancer, in which case stimulating
an immune response to cells that have been infected with the virus might help speed the
process by which cancer cells are destroyed.
Ceocfointerviews: Is
this the drug that youre working with?
Ms. Parker: Well, we
do have a program involving adenoviral vectors and it is focused on cancer and is part of
our collaboration with Biogen. We have a
number of gene delivery systems that we can use, and that is one of our most significant
strategic differences from our competitors. With access to multiple delivery systems, we
can pick the right system for the right disease, which should enable us to develop
effective therapies and maximize our market opportunities.
Ceocfointerviews:
Before we leave these two products, is there any competition in this area of technology,
to put it into play before someone else does? What
is the competitive nature of this and how do you feel that your company is ahead of the
competition in delivering and developing this?
Ms. Parker: In the
product areas we always have competition and youre probably not doing anything
interesting if you dont have competition. That said, in the case of cystic fibrosis
I think we definitely have a lead in terms of the competitive position. Other companies in the gene therapy field have
attempted to work in the cystic fibrosis field but theyve used the wrong delivery
systems. Theyve either used these
adenoviral vectors which, as I mentioned, can cause an undesirable immune response, or
theyve used systems that are non-viral based but result in a very short period in
which the protein is functioning. So with the
non-viral system you have to dose fairly often and thats not going to be very cost
effective or patient friendly. So we have a
system, called adeno-associated viral vectors or AAV, and it has two
characteristics that are very important: It expresses genes for long periods of time so
you may be able to dose patients once every few months, and it also is very safe. AAV is a
naturally occurring virus but it is not known to cause any disease in humans. We dont really now why it exists other
than to be used for a gene delivery system. So
its very safe and, as Ive said, weve never seen any side effects, while
at the same time these vectors express genetic information for a long period of time. So with that combination we believe it is the
right vector for cystic fibrosis and for other chronic diseases which are going to require
treatment over long periods of time.
Ceocfointerviews: In
cystic fibrosis, does this gene therapy have a major affect on the chronic inflammation
that occurs?
Ms. Parker:
Weve been able to show that we can reduce the production of a hormone that causes
the inflammatory response. This is a protein
called IL-8 and weve been able to show that we can reduce the presence of IL-8 when
the drug is used. We think this
decrease in IL-8 means that we may be able to reduce the inflammatory response, which in
turn may reduce or prevent lung damage. Thats something about which we are very
excited.
Ceocfointerviews:
These are your two products that we spoke about, the one for the cystic fibrosis and the
one for the cancer are they the closest to market?
Ms. Parker: They are
indeed.
Ceocfointerviews:
Can you give a time period of when you think they might be going to market?
Ms. Parker: It will
really be a function of how well the next trials go.
I think well have a much better sense of that in 2001. Were in Phase II clinical trials in both
areas and if the data from these studies look good then we may be able to move things
along very quickly.
Ceocfointerviews:
Than you might enter Phase III in 2001?
Ms. Parker:
Its possible that we may enter pivotal studies in late 2001 or the first part of
2002.
Ceocfointerviews:
What is your plan for commercialization?
Ms. Parker: Our
early products are products that will be partnered and we will not market these products
ourselves. It is part of our strategy for the
long term to take products through to product registration and approval and marketing, but
I think that is something that biotech companies have to be very careful about. The tremendous resources that are required to do
that and the tremendous distraction that comes with building the sales and marketing force
should not be taken lightly. Our strategy is
to build a solid product base, initially with products that are partnered. We have a
number of partnerships now.
Ceocfointerviews: Ok
before you get into that I just want to ask you something...do you have any alliances or
partners that you have spoke with on the two products that we have spoken about
previously?
Ms. Parker: The
cystic fibrosis product is partnered with Celltech Group plc, which is a pharmaceutical
company based in the UK. The cancer product
is not partnered, and weve decided to take that further in development to acquire
some additional clinical data, which should help raise the value of that product before we
partner it.
Ceocfointerviews:
Lets talk about the newer product that you mentioned to me earlier.
Ms. Parker: The new
partnership for one of our new programs, again using the AAV delivery system, is with the
Genetics Institute, which is a subsidiary of American Home Products Corporation. Were really excited about it because,
although we have competition in the hemophilia field in gene therapy, American Home
Products, selected Targeted Genetics as its partner of choice in this area. Genetics Institute was the first to develop
recombinant protein replacement therapies for hemophilia, so this is a market with which
they are intimately familiar and in which they already have proven themselves to be
innovators. We view their selection of
Targeted Genetics as their partner for expanding their franchise in hemophilia therapies
as an important validation of our underlying gene delivery technologies and our expertise
in product development and manufacturing.
Ceocfointerviews:
Why do you feel they picked you?
Ms. Parker: I think
because of our expertise in this AAV arena. We
have significant intellectual property and capabilities for making large amounts of
products in a very cost-effective way. Weve
really tried to approach the manufacturing and scale up of these delivery systems like a
classic pharmaceutical company would. So what
were doing in this area is trying to make sure that people in the pharmaceutical
industry can see what were doing, understand it and appreciate it. Weve use proprietary manufacturing
techniques and we have a well-developed infrastructure in place in this area. This is
important because in the area of AAV development no one else can do what we can do. Weve gotten a lot more attention from
pharmaceutical companies who are looking for people who can make cost-effective products
and thats something at which we excel. This
is a 3-year research partnership that is structured to create new products for the
treatment of factor VIII deficiency, which causes hemophilia A, a blood clotting disorder. We may collaborate in the area of factor IX
deficiency as well. Factor IX deficiency
causes another blood clotting disorder known as hemophilia B.
Ceocfointerviews:
What is it that American Homes Products does in this agreement?
Ms. Parker: They
will fund the research at Targeted Genetics Corporation.
We received $5 million dollars up front and well receive up to $15
million dollars over three years in research funding.
Then Genetics Institute and AHP are responsible for managing the clinical
trials and the regulatory interactions with the FDA related to the clinical development of
the product. Ultimately they will be responsible for marketing and selling the product. Well be responsible for manufacturing it,
which is important, because it provides a mechanism by which we can derive long-term
revenue from the collaboration.
Ceocfointerviews: In
manufacturing it, would you have to set up a different plant for that?
Ms. Parker: We are
now expanding out our existing manufacturing capabilities at our facility in Seattle and
we will be breaking ground in 2001 for a much larger manufacturing facility which will
allow us to manufacture product at the 2000 liter scale.
Our ability to scale-up manufacturing in a cost-effective manner should
enable us to meet demand for products.
Ceocfointerviews: When this product finally reaches the market, you
will receive revenues from obviously the manufacturing, am I correct?
Ms. Parker:
Thats right, what we have built in is a supply agreement which gives us a very nice
double digit fixed percentage of sales as a payment for manufacturing and inherently built
in royalties.
Ceocfointerviews:
How many products do you have in the pipeline, currently?
Ms. Parker: Probably
5 additional preclinical products. One is another cancer therapy, which is being developed
for the treatment of metastatic disease, the types of cancer that are spread throughout
the body. We have a delivery system that
localizes to tumor cells when it is delivered intravenously. This is something that has not been achieved with
any other delivery system, as far as we know, so were very excited about it. We have
another product for the treatment of rheumatoid arthritis, which also is in preclinical
studies. Weve been able to show that we
can really have an impact in animal studies on the swelling of the joints that occurs from
rheumatoid arthritis.
Ceocfointerviews:
What is the name of this product?
Ms. Parker:
Its called tgAAV-TNFR:Fc.
Ceocfointerviews: And the cancer products name?
Ms. Parker: Well, the cancer product that I just mentioned is
called tgLPD-E1A. That is the metastatic
cancer disease product. The rheumatoid
arthritis product is called tgAAV-TNFR:Fc. Then
we have the Factor VIII product, which, as I mentioned, is the subject of our
collaboration with American Home Products, and that also, is in preclinical studies. We have another product for the treatment of
hyperlipidemia. Its actually in the
earlier stages of research and development, so Im not going to say much about it at
this time. Weve got a lot on our plate right now for a company our size.
Ceocfointerviews: What about the partnership with Elan
Ms. Parker: Thats a research partnership, one that we
are really excited about, and its a joint venture called Emerald Gene
Systems. The focus of the collaboration
is on marrying our gene delivery technology with Elans drug delivery technology and
coming up with different ways to deliver genes in an enhanced fashion. The types of systems we are looking at, for
example, are ones that might be useful for oral gene delivery or more targeted delivery to
specific cell types. Were in the second year of a three-year research partnership
and we are mixing and matching various components of each companys technologies. Were now getting some systems that are
looking very exciting, and I think well have more to say about that in the next
year.
Ceocfointerviews: What about T cell expansion technology?
Ms. Parker: The T-cell expansion technology is the subject of
a news announcement that we made recently. We
announced that we are forming a subsidiary of Targeted Genetics, called CellExSys, and
were planning to spin out the T-cell expansion technology into the new company and
have that company focus on ex vivo cell therapy
for the treatment of infectious diseases and cancers.
Having put together the subsidiary, our plan is to do some additional preclinical
work in various areas, with the goal of doing a private financing for CellExSys in 2001.
Ceocfointerviews: Whats the goal of T-cell expansion
technology, can you tell us just a little bit about it?
Ms. Parker: Our proprietary technology in this area is a
technology for growing large numbers of antigen specific T cells. These are the T cells that occur in your body
naturally and that are your bodys major weapon for fighting off infectious diseases
and cancers. The problem is that in some
diseases there just arent enough of them in the body and your body is overwhelmed,
with infectious agents for example, and the T cells just cant respond in a
reasonable amount of time to prevent the spread of the infection. What weve been able to do is develop
technology to isolate these T cells and then grow them very rapidly into large numbers of
cells, even millions and billions of cells and then reinfuse them into the body. When these cells are reinfused, every single one
of them will go seek out the infected cell or cancer cell and destroy it. Its a very specific interaction and we have
seen very few side effects. The proprietary process also allows us to grow these cells in
a very cost-effective manner, which is what will enable this technology to be the basis of
commercial products. Some of the other
approaches being evaluated by others in this area seem to work well at the laboratory
scale but are unwieldy and expensive to scale up.
Ceocfointerviews: Is that gene therapy
Ms. Parker: No its cell therapy
Ceocfointerviews:
What made you decide to spin it off and what are going to be the benefits of it long term
Ms. Parker: Well as Targeted Genetics has evolved weve
been moving more and more into in vivo gene delivery, which is delivering genes to
cells inside the body rather than manipulating cells outside the body and then
reimplanting them. At the time when Targeted Genetics was first spun out from Immunex,
most gene delivery technologies required taking cells out of the body, genetically
modifying them and then re-infusing them. As the Company has grown and the technology has
evolved we have moved more toward trying to develop our products in a manner that will
allow them to be manufactured, marketed and sold just like classic pharmaceutical
products. As a consequence of that evolution,
the cell therapy area has been of lesser focus at Targeted Genetics for the last four or
five years. However, the cell therapy
technology in our portfolio has enormous potential and we want to try to leverage what
weve already done in that area. We
believe that bringing in some additional outside funding while still maintaining a
significant equity ownership in CellExSys is the best way to realize value for our
shareholders and move this very powerful technology closer to commercialization. This
structure should enable the cell therapy team to get their legs under them and generate
more data to show that this technology is capable of being an important approach to new
therapies and has utility in other drug development initiatives. So its just a great opportunity for us to
try to maximize the value of the investment weve made in this technology. Potentially, this technology could yield a number
of novel therapies for infectious diseases and cancer.
Ceocfointerviews: Which do you see or think that might be the best
revenue producer for the future out of all of these that weve talked about
Ms. Parker: Thats a hard question to answer because all
of these products are very interesting. For example, in cystic fibrosis the average
treatment cost per patient now is about $65,000 a year.
Even if we could capture a part of that as an annual therapy, we could
save the health care system significant amount money and yet we could still have a major
market opportunity. Analysts estimate it at
between half a billion to a billion dollars, so thats a nice opportunity for
Targeted Genetics and one that may also help to improve quality of life for the patients. Our rheumatoid arthritis product is still in
preclinical development, but we think that it might be given once every three months
instead of twice a week. So that is another opportunity that we believe may be a great
money maker for Targeted Genetics and that also may save the health care system a lot of
money. Moreover, it may provide more
patient-friendly treatment regimens. Its somewhat hard for me to say which product
has the most potential but I think the ones that currently are in clinical trials have the
most near-term potential.
Ceocfointerviews: Now you have a lot of things in the works and your
pipelines quite full of different drugs that you are working on. Do you have any strategy for external growth, such
as acquisitions?
Ms. Parker: Well, yes actually weve just completed an
acquisition of another gene therapy company called Genovo.
This was an opportunity for us to amalgamate technology that was very
complementary to ours, bring in some new product opportunities and two new partnerships. We really want to be a consolidator in the field,
not a consolidatee if you will, and so were often looking for new
opportunities to bring in some new products or products that are in later stages of
development or new technologies that might complement what we have. This is certainly a key area for growth in the
company, in addition to doing partnerships, which allow us to fund greater amounts of
research and growth.
Ceocfointerviews: With that in mind and the fact that you still have
a way to go with some of these products in terms of taking them through clinical trials
and expanding your manufacturing facilities. Do
you have the cash or credit to carry out all of these plans?
Ms. Parker: Right now, according to our current operating
plan, we have cash that gets us through mid 2003. The
corporate partnerships that we have done to date have a total potential value of over $275
million dollars, so I think were pretty well poised to move our programs forward. Now this doesnt mean that if the market
brightens up and we have some interest from the investment community that we would not
take advantage of that and go to the market, but we have no need currently to raise
additional funds. We could make considerable
progress in our clinical trials without raising additional cash
Ceocfointerviews: What does your current burn rate look like
Ms. Parker: At the
moment it is in a state of flux because of the acquisition and the new deal we just
established with American Home Products. Its been running at about a million and a
half a month and it will likely go up next year as a result of our increased clinical
trial activities.
Ceocfointerviews: Where do you envision your company three years
from now
Ms. Parker: Well I would hope that by three years from now we
would be close if not at the point where we would have a product on the market. I just see enormous promise for gene therapy in
general as we and others move products through the clinical trial process. I believe that were going to be a large
player in the biopharmaceutical arena.
Ceocfointerviews: Do
you foresee any need in the near term for management
restructuring, or are you set with your team
Ms. Parker: We have a great team for what we need to do right
now. I think that in the case of biotech
its always good to be mean and lean on the business side, if you will, until you are
a very stable company. We want to focus our
resources on the research and development effort and not so much on the administrative
effort. That means that often the senior management gets a little bit stretched so we
might consider at some point looking at opportunities for bringing in additional
management expertise.
Ceocfointerviews: What is the key thought that you convey to your
staff?
Ms. Parker: Its too bad you are not in our facility,
because when we walk in the door every day we see written on the wall our vision
statement, which says We discover, develop and deliver molecular medicines to cure
disease. Gene therapy development has been a tough row to hoe, but weve always
taken the view that its a marathon not a sprint.
What we are doing takes a lot of focus and determination but were also
doing something that is very gratifying because we really believe we can make a difference
in peoples lives. We have to be able to maintain a sense of focus on making that
vision a reality, but we also make sure to
have some fun in the process. This is a tough
job and a tough business and it can be risky and its very much of a roller coaster,
so if we arent having fun then its going to be hard. We try to balance all that and it seems to work
out very well
Ceocfointerviews: In closing, youve got a bunch of investors
that will be looking at your story in our publication and obviously you probably have your
own shareholders that will be seeing this story, what is the thought that you would like
to leave in their minds? Any biotech investor
has to look at the long term, so what kind of thought would you like to leave with them
Ms. Parker: I think
that this is a great time to be looking at Targeted Genetics and I would use an analogy,
comparing the technology sector that we are in to that of a sector called monoclonal
antibodies. I think this analogy shows that,
as new technologies develop, there are ups and downs along the road. If you look at
monoclonals, way back in the 80s they were thought to be the magic bullet, the
answer to cancer, and that was really promising more than the technology
available at that time could deliver. The
technology got over hyped and disappointment resulted when there were technical hurdles
that slowed the process of translating some very seminal scientific discoveries into new
products. So investors ignored
monoclonals and just figured they were bad and would never work and meanwhile the people
in the field were working hard on overcoming those technical hurdles and figuring out how
to build commercial products on this very exciting science.
Then suddenly you have products, such as Genentechs Herceptin and Idec
Pharmaceuticals Rituxan, that show that monoclonal antibodies work well in clinical
settings and also have block-buster potential from a sales and revenue perspective. Some
of the largest companies are developing monoclonals now, and so the investors that caught
the ride at the point when, I like to joke, monoclonals were the dog you like to kick, and
then held on for the ride to the top have made tremendous amounts of money. I really feel
that gene therapy is following a similar trajectory and that it is approaching that stage
where people are less interested in kicking us and more interested in understanding how
gene delivery technologies can be developed and commercialized now that the technological
hurdles are being overcome. We are delivering clinical data and we are beginning to show,
and will continue to show over the next year, that this sector is real and that its
producing a number of products that have real clinical data and commercial potential. So I
see this time as a nice opportunity for people to take a serious look at gene therapy in
general. But within that area we believe that Targeted Genetics expertise in both
viral and non-viral delivery systems, our clinical programs, our product pipeline and the
number and caliber of our corporate partners make us the leader in the field. |