# Episode 180 - April 17, 2026

An episode of [Biotech Hangout](https://invisiblenetwork.ai/podcast/1568911820), 17 Apr 2026, 54 min.

Audio: https://anchor.fm/s/55bdff38/podcast/play/118633970/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-3-17%2F422307108-44100-2-dcc981db1b965.m4a

On today’s episode, Chris Garabedian, Paul Matteis, Tess Cameron, and special guest Adam Feuerstein kick off with a discussion of the public markets, highlighting the XBI’s post‑pandemic highs, Kailera’s IPO pricing and more than $625 million raised, the opening of the IPO window with multiple filings, and increasing generalist interest in the biotech sector. The group also discusses Obsidian Therapeutics going public following a reverse merger with Galera, alongside a $350 million PIPE. The conversation shifts to the rise of clinical trial prediction markets and the growing role of AI tools in the life sciences industry. Next, the co‑hosts highlight another acquisition by Lilly, with their $300 million purchase of Crossbridge Bio. In Regulatory news, the group overview the FDA approval of Travere Therapeutics’ kidney disease drug for FSGS and the broader implications for the renal space. On the data front, the group mentions Allogene’s CAR‑T data and the mixed stock reaction, along with Revolution Medicines’ positive Phase 3 data in pancreatic cancer. Spyre’s positive Phase 2 data in ulcerative colitis is also covered. The episode concludes with a discussion on how clinical data continues to drive market dynamics. *This episode aired on April 17, 2026.

## Transcript

[0:00] You're listening to Biotech Hangout, a live and unedited
[0:02] weekly discussion of all the latest news in our industry with
[0:05] a group of biotech leaders and experts.
[0:08] I'm Chris Garabedian and my Co host today are Paul Mateus, Tess
[0:12] Cameron and special guest Adam Forstein.
[0:14] For more information about our hosts and guest speakers or to
[0:17] listen to the most recent episode, please go to
[0:19] biotechhangout.com. So we started talking about
[0:23] this, but that we're going to start with the the market update
[0:26] and the public markets looking pretty good right now.
[0:30] Now the XBI is that, you know, post pandemic highs, you know,
[0:35] if there's only a like a two week period in early 2021 where
[0:38] there were higher levels of the XBI.
[0:41] So that's good news. And then the IPO window has
[0:45] seemingly started to open up. We saw additional S1 filings
[0:50] this past week specifically. Actually our own Daphne Zohar's
[0:54] seaport filed an S1 EMAB, John Morganori's involved in that
[1:00] also filed. This followed Avalon's S filing
[1:02] last week. And then you know the the big
[1:06] news that today Calera priced their IPO and raised more than
[1:10] 625 million. That's without the shoe that
[1:14] could put them over 700 million at a $2 billion valuation.
[1:18] We were just speculating if trading has started and if it
[1:21] trades up. This is this is a big one.
[1:25] But Tess, you want to comment on kind of the public markets
[1:27] currently and how they're looking?
[1:30] Look, I think the public markets are looking really strong.
[1:33] We haven't seen the XBI at these levels for, you know, for many,
[1:39] many years. Part of that just to, you know,
[1:42] get into a bit of a technical discussion for the minute.
[1:45] You know, part of that is, you know, a function of just XBI
[1:49] construction. And the fact that, you know,
[1:51] going back to the last time we were at these highs, which was,
[1:55] you know, around 2021, the XBI was constructed quite
[1:59] differently. It was, you know, more of an
[2:01] equal weight index across a very broad range of stocks.
[2:06] The XBI, you know, methodology shifted and is now you know
[2:11] more, you know it's not quite market weighted, but you know,
[2:15] weighted a bit more in favor of larger liquid companies.
[2:19] And we've seen some, you know, very favorable M&A of those
[2:23] companies over the past couple of months.
[2:25] And you know, that's really pushed the XBI up high.
[2:29] I thought it was, I thought it was interesting that the, you
[2:32] know, we saw, we saw so much, you know, instability in the
[2:36] XBI, you know, during the first kind of closure of the Strait of
[2:40] Hormuz. And now everyone's just kind of
[2:43] shrugging their shoulders. And, you know, we see stocks go
[2:46] up, you know, we see stocks go up the next day.
[2:49] So I think that the, you know, acquisitions and just
[2:52] performance of a lot of the, you know, biotech companies has, you
[2:57] know, really, you know, really reflected there.
[3:02] Yeah. Paul, how do you see the XBI as
[3:04] a as a true indicator and any comments on on that and just the
[3:07] public markets? I mean, I think Tessa's point is
[3:10] a really good one that it's hard to like compare across our
[3:13] little mini eras of biotech. But I mean, I feel like the, the
[3:16] sentiment right now checks like a lot of the boxes that both
[3:20] specialists and even generalists are, are looking for, right.
[3:23] I mean, I think we're seeing people get rewarded on clinical
[3:26] data. Companies with good clinical
[3:28] data, to say the least, have been able to, to raise, you
[3:31] know, a lot of money on the back of that and even have a number
[3:34] of these stocks trade well, you know, not to be the sell side
[3:38] cliche to bring up M&A, but hey, there's been a bunch of M&A and
[3:41] really different types of M&A, right, Like, you know, the kind
[3:44] of higher science early stage asset deal like a Centessa or
[3:47] the more valuey deals like Amicus and, and a palace and
[3:51] Soleno. And so I mean, I, I find in my
[3:54] conversations like people are super engaged on on stories that
[3:57] have a clinical catalyst and feel comfortable, you know,
[3:59] taking on that clinical risk. And then on the generalist side,
[4:03] you know, it doesn't feel like there's generalists buying, you
[4:06] know, high risk biotech stocks, But you know, I do talk to
[4:08] generalists who are looking for alternatives to kind of their
[4:12] tech investments. And you know, for some of the
[4:14] bigger companies that are more growthy, like I still think
[4:17] there is a a good amount of interest and, you know, maybe to
[4:19] kind of finish it off, right? I mean, we'll see how long this
[4:22] lasts. But you know, the impact of drug
[4:24] pricing under this administration has been pretty
[4:26] benign too. And we've seen a lot of drugs,
[4:28] you know, price above expectations.
[4:30] And so, you know, there's always like risk that one or two of
[4:33] these things can flip. And obviously the FDA
[4:35] unpredictability has been like a whole other story.
[4:37] But like in general, like I think this is a really, really
[4:40] healthy environment for biotech investing.
[4:42] I got a question maybe maybe Paul or or for Tess, but you
[4:45] know, just, you know, talking about that whole, you know, we
[4:47] always have this sort of generalist versus specialist
[4:49] debate in biotech and obviously the specialist funds are doing
[4:53] really well right now. And if particularly with MNA,
[4:56] they're able to reinvest those proceeds back into, into the
[5:00] into the market. Does it really, you think I
[5:03] wonder like are we seeing, you know, Paul, you mentioned, are
[5:05] we seeing an uptick in interest in general as investing
[5:08] investors in the sector or maybe it doesn't really matter right
[5:12] now? Maybe it doesn't really matter
[5:14] because I still think Adam, it's like concentrated and look like
[5:17] my coverage isn't perfect for it.
[5:18] Like I don't cover like Lily and Nobo, but you know, in my world
[5:21] where I cover, you know, Adam, I cover some stuff that's super
[5:24] early in high science and then other stuff like Al Milam and
[5:26] vertex. It's really like concentrated
[5:28] around the AL Milam vertexes maybe in Ionis, right?
[5:33] But you know, it's not I, you know, I remember much earlier in
[5:37] my career like talking to generals who owned like Bluebird
[5:41] Adam when they had like 10 patients of data and were like a
[5:44] huge market cap, right? Like, I don't think we're back
[5:46] in that world and it's probably like a good thing we're on in
[5:49] that world. Yeah, I'll, I'll just add I.
[5:52] I agree with that. I think it's kind of your
[5:54] companies, your companies that are like, you know, kind of
[5:58] close enough to market and understandable enough that are
[6:02] getting that, you know getting that kind of generalist
[6:05] attention, right. Like I just point to, you know,
[6:09] Rev Med right as a company that is, you know, in that in that
[6:13] phase now of big enough liquid enough, you know, gettable
[6:17] enough that generalist investors can can get involved.
[6:20] But yes, unlikely to be unlikely to be your equivalent of
[6:25] temptations. Yeah.
[6:28] And it seems like the market right now, I mean the sector, I
[6:31] mean look, we've all the sector has grown up.
[6:33] It's become, you know, the companies are generally sort of
[6:36] later stage, you know, we're not like pie in the sky type stuff.
[6:40] And we've a lot of companies have shown that they can
[6:43] commercialize drugs successfully.
[6:45] So all of that points to you know and be and do it
[6:48] profitably, right. So it's, it's a, it's a market
[6:51] that may be more attractive to general investors, even even if
[6:54] they may be only just dipping their toe into it, but it's
[6:57] certainly a totally different like more attractive market
[7:01] overall than it was, you know, like we said back 5-6 or eight
[7:05] years ago, whatever. Yeah, my, my reception is a
[7:11] little bit spotty. Can you guys tell?
[7:12] Me. OK, we got you.
[7:13] OK, Yeah, Now I was just going to add, you know, I also look at
[7:16] the the, the broader public investors, not necessarily the
[7:20] specialty crossovers, but we are seeing activity from, you know,
[7:23] the, the Genesis and the, you know, and the Wellingtons and
[7:27] the, you know, Cormorants and the Red Miles.
[7:29] And so I, I think that that is sometimes a precursor to the
[7:32] generalists coming in when you have to put more money to work
[7:35] and you have higher valuation public companies to support.
[7:38] So I think all of that is good. The I'll just add also, you
[7:41] know, pipes and reverse mergers have been performing pretty well
[7:44] over the last couple years. And we saw another one this past
[7:47] week, Obsidian, which did you know several $100 million in a
[7:52] pipe and a reverse merger with Galera.
[7:55] And again, you know, reverse mergers, you know, used to be a
[7:57] little bit of a dirty word. I think we're seeing quality
[8:00] reverse mergers and you know, high quality investors in the
[8:03] pipes to again, another kind of anchor of a good healthy public
[8:08] market. Let's move to private and I'll
[8:12] just speak a little bit on the VC market.
[8:14] So HSBC, John Norris just gave an update on their first first
[8:18] quarter and his conclusion was that it was a lower, it was the
[8:22] lowest first quarter since 2023. He thought it was a downtick.
[8:27] I, I do think that that's largely a reflection of VCs
[8:30] getting more discerning, concentrating their bets,
[8:34] feeling like, you know, they, they want to be more intentional
[8:38] and purposeful in the new investments that they make as
[8:41] opposed to just tending to their existing portfolio.
[8:44] Stat news, Allison de Angelis did a great report a couple
[8:48] weeks ago. Endpoints did a report on just
[8:49] talking to a bunch of VCs which are kind of reinforcing this
[8:52] idea of going to more de risked opportunities, more clinical
[8:56] stage and then some roll ups. But in the 1st part of second
[9:00] quarter, we've seen activity and one big one was Bain did a deal
[9:06] where they took five assets from BMS, their pipeline a lead
[9:11] program in lupus and they let an investment of $300 million
[9:17] pulled the former CEO of Spring Works, Saqib Islam to lead this
[9:22] company. And Springs Works was exited at
[9:25] 3.4 billion and acquisition by Merck and you know, Bain was
[9:29] doing this with the Spring works and then Ceraval both led to,
[9:33] you know, multi billion dollar exits.
[9:35] So it looks like they're at it again with a pipeline.
[9:39] Interestingly, John Morris said, oh, I and I looked like it was
[9:42] ticking down. Well, this was an I and I
[9:44] portfolio play. So if we added in Baines $300
[9:48] million and you know, this I and I, it might have changed the
[9:52] conclusion of of Q1. But anyway, I think that's all a
[9:55] good sign. And then, Adam, I wanted to
[9:58] touch on you. You tweeted about this clinical
[10:01] trial prediction market. And I'll just add, we're seeing
[10:05] a lot of AI chatter. ChatGPT Open AI just came out
[10:11] with a life science tool. Claude announced their life
[10:13] science tool, Anthropic, brought in Novartis CEO Vos to their
[10:17] board and acquired coefficient. So there's a lot of activity in
[10:21] AI, but this is a different angle on using AI to predict
[10:24] clinical trials. Any what are your thoughts on
[10:27] this? And again, always like your
[10:28] curmudgeon. I'm going to say, Chris, are you
[10:30] calling on me to because I'm the grumpy old man?
[10:33] Is that what you're doing? Well, I didn't call you old, but
[10:36] grumpy baby. I mean, I guess I just.
[10:41] And yeah, again, look, I am, I am not the best person to talk
[10:46] to about AII admit that, right? I am old school.
[10:49] But at the same time, I just do wonder, I guess my, you know,
[10:53] sort of my knee jerk reaction to these prediction markets, these
[10:57] sort of clinical trial prediction markets, whether they
[11:00] they're AI based or whatever. It's just like kind of is what's
[11:04] the what's the value? Like what's the point beyond
[11:07] these just being another betting platform?
[11:10] Like this is like a DraftKings for clinical trials.
[11:16] And I know that, you know, and I I didn't really mean to get into
[11:20] an argument with this guy on Twitter this week who's who is
[11:24] apparently starting up some kind of AI generated prediction
[11:29] market for clinical trials. And maybe I came across just too
[11:33] grumpy, but I just don't, I don't see the value in having a
[11:39] bunch of computers competing against each other to see who
[11:43] can best predict the outcome of a clinical trial.
[11:46] You know, because he has all these sort of science based
[11:49] rationales and how this was going to advance science or help
[11:52] patients. And I, I don't, I don't quite
[11:55] understand that. Yeah, well, look, I I'll just
[12:00] speak for one as the contrary. And we we appreciate those who
[12:03] are willing to speak up. I would say in general, those
[12:07] who bet against these early kind of flashpoints usually are
[12:11] right, Right. We saw this a little bit with
[12:13] aging companies, right? Some of these things take a long
[12:15] time. It's not to say they'll never
[12:19] stuff is moving so fast. It's hard to see how it doesn't
[12:22] get commoditized and how, you know, these AI, you know, first
[12:27] movers are going to win the day. Again, I think if you look at
[12:31] open AI, you look at, you know, you look at these hefty players,
[12:35] you can imagine that they're going to try to get the market
[12:38] share of some of the tools right.
[12:40] But I don't know, it's moving so fast.
[12:42] It's hard to predict who would win on this.
[12:44] So I I think that the old guard, as we call it, I think are
[12:48] saying, you know, this seems too good.
[12:50] To I want to hear, I want to hear what Tess has to say about
[12:52] this, because I always feel like.
[12:53] Paul in this on on. Yeah, test what's, what's the,
[12:57] what's the RA, what's the RA angle?
[13:00] Thoughts on on AI prediction markets?
[13:05] Great question. We were actually having a
[13:07] fantastic discussion with our compliance team about this,
[13:10] specifically the markets that you can bet on, you know, with
[13:14] with, with, with money like the. You know, right?
[13:16] Yeah. You know, the the Poly markets
[13:18] of the world. I mean, we love having other
[13:20] sources of information that are like, hey, let's like, you know,
[13:24] we like talking with, you know, smart people in the industry.
[13:28] We like talking with other investors, like, you know,
[13:30] whenever we're not invested in the company and we see, you
[13:34] know, people who we know who are like we want to hear the thesis,
[13:37] we want to get their views. So I think in general, like,
[13:40] fine to have more sources of information, right?
[13:42] And, you know, including, you know, including betting markets,
[13:49] you know, but you know, how much you kind of place on that is
[13:53] really going to come down to like your own judgment.
[13:56] So it can't, you know, things that are a black box and just
[13:59] kind of spit out a probability are going to be a lot less
[14:02] helpful than when you can actually dig into the rationale
[14:05] and, you know, ultimately see if you agree or disagree.
[14:08] But more information, more sources is always better and
[14:12] more helpful ultimately. Like it's hard for me to think
[14:16] that like AI in predicting clinical trials is like really
[14:19] going to be much better than like our collective like brains,
[14:24] which are often reflected in stock prices, right?
[14:27] Like that is kind of like what the market shows now is like a
[14:31] lot of people thinking about the same thing and coming to
[14:34] different conclusions. And that gets reflected like in
[14:37] a price. Is AI necessarily going to be,
[14:41] you know, a lot like a whole lot better than that?
[14:45] Well, like we'll see, like, you know, would love for that AI to
[14:50] start picking stocks and we'll see how it performs.
[14:52] The, you know, the compliance side is just interesting, right
[14:55] test because I know, you know, just from a, you know, if you go
[14:58] sort of down like the Poly market or the Cal she type of
[15:00] prediction market, I mean, I mean just like internally, like
[15:03] that's stat, you know, like we're not allowed, you know,
[15:05] we're not allowed to invest, right, You know, in, in
[15:08] individual stocks, right, just for obvious reasons, for
[15:10] financial conflict of interest reasons.
[15:12] And but in our our edits policy late last year, you know, we
[15:15] added that, you know, we added a policy that, you know, we're not
[15:18] allowed to participate in prediction markets either
[15:21] because it's, you know, the same kind of the same thing.
[15:23] If you have access to inside information.
[15:25] And I'm assuming that, you know, from an investor side that's
[15:28] also a concern and certainly a concern for, you know, anyone
[15:31] working inside of a drug company or a biotech company, right,
[15:34] that has that kind of information.
[15:36] Absolutely no, it totally is. And I'll just share like 2
[15:39] anecdotes on that. You know, one that was, that was
[15:42] really funny. We have a great compliance team
[15:44] and they were, you know, they were chatting through and kind
[15:46] of doing our, our, you know, our regular training sessions.
[15:49] And, you know, someone brought up these, these like polymarket
[15:52] and they were talking about the polymarket and just reiterating
[15:55] our policy of like not participating in those.
[15:57] And, and it was great because one of the compliance guys is
[15:59] like, you know, and like, would you really want to just like bet
[16:02] on these outcomes with like your personal money anyways?
[16:04] And it's like, no, we just like do that professional.
[16:06] I was like, that was that was great.
[16:13] Like, you know, don't. Want to don't want to mix those
[16:15] too much. And you know, but the other one
[16:18] that I thought was actually like really, really interesting is
[16:21] like the economist had this whole thing about these
[16:24] prediction markets and actually talking about these prediction
[16:26] markets as like, you know, like maybe having like inside
[16:30] information in these prediction markets is kind of like what you
[16:32] want, right? Like, you know, with commodity
[16:35] markets, for example, like that, that's really what they were
[16:37] referencing. It's like with commodity
[16:38] markets, like, yes, you're making these bets on, you know,
[16:41] commodity pricing and you kind of have an idea of like what
[16:45] might happen when you're doing that, right?
[16:47] And you're you're doing that for like a risk management
[16:49] standpoint as like an insider, right?
[16:52] So like, is that OK that you're kind of including that like
[16:56] inside information and it's like, OK, maybe that works for
[16:59] commodity markets, you know, wars, like hopefully not, you
[17:03] know, drug trials, like hopefully not.
[17:06] So that that is, you know, that is, that is very much, you know,
[17:11] our our stance on it as a as a fund, but it's, you know, it's,
[17:14] it's really interesting to have another, you know, to have
[17:17] another source of information. I want to see, I want to see the
[17:20] like Twitter AI algorithm on biotech stocks actually.
[17:25] And we can kind of run that against the Poly market 1 and
[17:28] the, you know, open AI, you know, you know, stock stock
[17:33] indices. I think that's what that's what
[17:34] we'll need to see if any of these are worth anything.
[17:38] Well, we'll text you. You mentioned it's hard to beat
[17:40] a collective experience and firms, but that's also with AI
[17:46] tools, right? So I would bet on that
[17:48] collective, right, experience and brain power with AI tools to
[17:52] beat AI alone. And that is kind of what this
[17:54] feels like is that AI is trying to do all of it.
[17:57] But all right, let's move on. There was one deal I wanted to
[18:00] highlight that I thought was very impressive.
[18:04] Michael Torres was CEO of a company called Cross Bridge Bio
[18:08] and he's, he's put out there on, on Twitter and communicated the
[18:14] specifics around this deal for the company for up to $300
[18:19] million. Now a lot of people look at that
[18:22] with derision that how much was upfront.
[18:25] I'm hearing that a sizable amount of it was upfront,
[18:29] although that was not disclosed. But what he communicated was
[18:32] that they raised $10 million only through safe notes and a
[18:37] seed round. The exit happened within 1.5
[18:41] years of the seed round to the exit.
[18:45] He mentioned that the safe investors got a 17X return.
[18:50] It's return tweet that there was a founder friendly firm that
[18:55] passed on Cross Bridge a couple times.
[18:57] You know, I have a venture studio that we think is founder
[19:00] friendly. We also passed, I don't think he
[19:01] was referring to us, but we passed on the Series A.
[19:04] It's been very hard to get preclinical cancer programs
[19:08] approved. This is a program that doesn't
[19:09] even have an open Ind is not in the clinic yet, but but close to
[19:12] it. And so the idea that they were
[19:15] able to bootstrap this without a Series A on $10 million of
[19:19] investment capital to get up to a 300 and, you know, kudos.
[19:26] You know, a lot of times we hear founders who talk about their
[19:29] interests that they've been, you know, getting meetings with
[19:32] pharma and there's real interest.
[19:34] And honestly, you know, easily 9 out of 10 times that is a
[19:38] nothing burger and there's really nothing there.
[19:40] This is the case where we heard that and it was true.
[19:43] And Lily seemed to be interested in this program.
[19:45] So again, those economics, you know, hard to deny that this was
[19:49] a big success for, you know, kind of a founding team.
[19:52] Also, Michael Torres mentioned that the two scientific add some
[19:57] of the amount of equity that he had sounds like everybody who
[20:01] was involved in the in the founding did well.
[20:03] So again, as a venture investor, we like to see these stories.
[20:07] We think it encourages a lot of entrepreneurs to kind of, you
[20:11] know, bootstrap and find a way to invest in their programs and
[20:15] advance it, even if the the top tier, you know, VCs or seed
[20:19] investors are are passing. So again, Congrats to the Cross
[20:22] Bridge bio team for executing that.
[20:24] And for Lily, I mean, look, they generated 12 billion in EBITDA.
[20:31] And the number of deals that they could do like this early
[20:33] on, just 1/4 of cash flow is pretty overwhelming.
[20:38] It's a very small fraction of their market value.
[20:41] So again, Lily can kind of change the game as it relates to
[20:45] early stage, right, biotech, you know, land grabs, if you will,
[20:50] you know, and still still look good in the end.
[20:52] So that that was an interesting deal.
[20:55] So let's move to kind of regulatory and policy positions.
[20:59] Paul, let's go to you first and I think Adam may have some
[21:01] comments on Previer. Yeah.
[21:04] I'm so it. Surprised a lot of people, but
[21:08] go ahead, Paul. Yeah, no thanks, Chris.
[21:10] Sorry to interrupt. Yeah, no thanks.
[21:12] I'm I'm like going to tee it up and then I want to hear Adam's
[21:14] perspective because Adam, I read your Curmudgeony article on it
[21:18] and I really enjoyed it. But Trevier secured approval
[21:21] first Sparsentan in FSGS. FSGS is a super hot space for
[21:27] for drug development. I mean, just renal in general, I
[21:30] think has seen kind of a renaissance over the past couple
[21:33] years. And there's a number of
[21:34] different, different treatments. You know, this is a drug that
[21:37] has been around for a while, right?
[21:39] And, and some of the data that led to approval is a couple
[21:41] years old. You know, one of the issues with
[21:44] this drug was that it did show a benefit on proteinuria, but not
[21:48] on EGFR. And I think there are some kind
[21:50] of broader implications for some other kidney programs that I'd
[21:53] love to sort of touch upon. But you know, I mean, I think
[21:56] some of the questions that investors are kind of asking and
[21:59] grappling with, this is 1. You know, I mean, FSDS is a big
[22:02] unmet need. But you know, what do these data
[22:04] mean for the commercial prospects of sparse and TAN?
[22:07] And then two, you know, sort of what does this mean for the FDA
[22:09] and kidney, but also like more broadly, right?
[22:12] Like are we seeing a shift back towards flexibility with Vinay
[22:15] Prasad being out? This was a cedar product, but
[22:18] there's been a lot of good reporting from STAT and others
[22:20] about Doctor Prasad kind of overreaching his siever role
[22:24] into some sort of cedar reviews. And so Trevier stock was up a
[22:27] lot. And I think again, like we'll
[22:29] have to see kind of what this on how this unfolds and what it
[22:32] means for the space. But Adam, let's hear your
[22:35] perspective and then I, I want to round it out with some other
[22:38] drugs that I think this has some implications.
[22:40] I guess I'm just playing to type today with the commercially
[22:43] thing. No, it's awesome dude.
[22:44] You did a great article on that. No, I think, you know, I, I did,
[22:49] like you said, Paul, I did write a column about it and, and it
[22:53] wasn't, you know, obviously it was after the fact and I, and I
[22:56] certainly don't, I think that, you know, the drug will probably
[22:58] sell well and, and, and this is the first and only approved
[23:02] medicine in FSGS. So you know all that.
[23:06] But I, I did find that the sort of the story behind the approval
[23:10] and how it, you know, how it got there to be interesting.
[23:14] And for those who, you know, aren't familiar or who didn't
[23:17] read my story, you know, just the fact, like, as you
[23:19] mentioned, Paul, that this was a, a company that did, they ran
[23:22] a phase three study, you know, kind of your traditional kidney
[23:25] disease study, right, where, you know, yes, you have protein,
[23:28] urea. It's kind of like the, you know,
[23:29] the intermediate endpoint, but you know, ultimately what you
[23:32] want to see is an improvement in kidney function, you know,
[23:36] measured by EGFR, which is the traditional sort of full
[23:39] approval endpoint. And you know, that's where they
[23:42] missed in an active control arm study in which the, the Trevir
[23:48] drug, you know, actually underperformed the active
[23:50] control across the entire 2 year time point of the study.
[23:54] You know, but then obviously there was this sort of, you
[23:57] know, kind of this effort, scientific effort among a bunch
[24:00] of different groups under this kind of something called the
[24:03] parasol project in which they did some analysis and you know,
[24:08] and basically came to the conclusion that reductions in
[24:12] protein urea, you know, was should be an approvable
[24:17] endpoint. It should be the new regulatory
[24:19] standard, right in that. And that was accepted.
[24:21] Obviously the FDA agrees with that.
[24:24] You know, I did point out that, you know, Trevir is a is a big
[24:27] funder of these groups that that came up with this new endpoint,
[24:32] which, you know, again, I mean, that's not necessarily a
[24:34] surprise to any of us, but you know, that's just the way the
[24:37] game works. So, you know, I and I think just
[24:40] the label, like, you know, Paul, you probably looked at the label
[24:42] and the label is interesting, right, Because the label sort of
[24:45] points out that the face you study didn't work.
[24:48] Yeah. Right.
[24:49] You know, they, there's a big, there's a big graph, there's a
[24:51] big chart in the, in the label that shows EGFR missing.
[24:56] And then, you know, you go down to the next paragraph and it
[24:58] says, Oh yeah, you know, they hit on protein area.
[25:01] Now, you know, we all know that doctors probably don't read
[25:04] labels, you know, so none of this probably matters at all.
[25:08] But I I just found it interesting enough to write
[25:11] about. Yeah, No, I thought it was a
[25:13] great, it was a great article. I think extrapolating the
[25:16] implications to sort of a broader FDA flexibility
[25:19] conversation, it's I think it's really hard to do from just this
[25:22] one event. I do think that the interesting
[25:25] other space we've been looking at in kidney is this April 1
[25:28] space. This is a scenario of the Vertex
[25:31] and Maze and some other earlier stage programs where essentially
[25:35] it applies to FSGS but also a number of different types of
[25:37] kidney disease where patients, they essentially have these
[25:41] April 1 mutations that are significant risk factors for
[25:46] kidney disease. There's this kind of
[25:47] pathological description of how they create pores in the kidney
[25:50] and are pathological. And Vertex has gone into Phase 3
[25:53] here with their drug Anaxa plan based on some early FSGS data.
[25:58] Maze had some data recently from their program and FSGS and a
[26:01] couple other subtypes. You know, my perception from
[26:04] covering Vertex in this program is that it is like a pretty high
[26:07] risk phase three program in the sense that they only did their
[26:10] phase 1B and April 1 FSGS, but their their phase three study is
[26:13] in a broader population of April 1 quote and quote apathies.
[26:17] But I think there's a debate on whether or not this mechanism is
[26:19] going to work actually more broadly.
[26:21] And then second, back to the regulatory side, you know,
[26:24] Vertex has coronary data. We haven't seen EGFR data yet.
[26:28] I think it's been Gray around this program, exactly what the
[26:30] FDA wants to see in EGFR. Vertex has talked about, you
[26:33] know, something related to an analysis at the slope of
[26:35] decline. But like at least from my seat,
[26:37] like it's been a little bit Gray of like, do they need a clear P
[26:40] value? What effect size is significant?
[26:42] And so to the extent that this is sort of extrapolatable, it
[26:45] does seem to lower the bar broadly in the space.
[27:01] I think Chris, are you there? I think Chris moved on, might
[27:06] have had to dial back in. Reception but.
[27:11] We hear you again. We hear you again.
[27:12] OK. All right, good.
[27:14] All right. So do we want to move to data,
[27:18] Adam Allogene had B cell lymphoma data.
[27:21] Everybody's been waiting for some good Allogene, a CAR T
[27:24] data, but just what's your take on the Allogene data and their
[27:28] stock reaction? Yeah, we should probably
[27:30] separate those two things out, Chris, the the data and the
[27:33] stock reaction because they went in different directions.
[27:37] You know, the data, I thought, I thought the data would look
[27:39] really good, you know? Yeah, this was, you know, they
[27:42] had, they were, this is a, you know, this was basically a very
[27:45] preliminary look. It's you know, kind of a
[27:47] futility analysis based on MRD negativity and they wanted to
[27:51] show that they could like, you know, this is in that frontline
[27:54] consolidation setting. They wanted to show that
[27:56] patients who were MRD positive, you know, with a complete
[27:59] remission coming, you know, coming after our chop, but who
[28:04] but who were MRD positive that could then be converted or
[28:07] cleared to MRD negativity with the use of this this allogeneic
[28:12] car T called Sema cell and they did that.
[28:15] They did that, you know, again, very small numbers of patients,
[28:17] right, 12 in each arm between the seamless cell arm and the
[28:22] observation arm. So, you know, it's encouraging
[28:26] for the rest of this study, which ultimately will be looking
[28:30] to show that they can show an improvement on inventory
[28:33] survival. I mean, I think the company did
[28:35] a pretty good job of like kind of explaining what they wanted
[28:38] to do and then executing and delivering data that certainly
[28:42] looked as good or better than what they had expected.
[28:46] And there's a lot more to, there's a lot more work to do
[28:48] here. The stock reaction was, you
[28:51] know, really kind of was, was very mixed, right?
[28:53] I mean, the, it initially went up on the data.
[28:56] It went, it went that and then it fell.
[28:59] They did an offering. I think they raised about
[29:01] $175,000,000. They priced it at $2.00 a share,
[29:06] which was actually lower than the stock price was before the
[29:10] data came out. I don't maybe someone else on
[29:14] this call could explain to me how how that works.
[29:20] It doesn't seem like they executed the financing very
[29:23] well. I did talk, I did ask around
[29:25] about it. I think you know, you in terms
[29:28] of like the reaction to this from kind of the buy side.
[29:30] I, I heard a mix of things. I heard, you know, that some
[29:34] folks who are just like not interested in cell therapy
[29:37] generally, you know, and that's, and that's probably a theme that
[29:41] a lot of funds are just like this is not an area they want to
[29:44] invest in. You know, there are some
[29:46] concerns about just the timelines here and whether
[29:48] allergy can meet enrollment timelines.
[29:51] And, you know, the fact that, you know, really this is kind
[29:53] of, you know, the company Co is kind of dormant after this,
[29:56] right? I mean, they're, they're,
[29:58] they're, they continue to roll the study.
[30:00] There's going to be an interim analysis in the middle of 2027.
[30:04] So there's, you know, there's that typical sort of Dead Space
[30:07] where, you know, maybe people get out of it.
[30:10] But yeah, you know, I mean, like I said, I did good data and the
[30:14] stock just, you know, went in the other direction.
[30:21] Yeah, I mean, look, allergies had a long road.
[30:23] I remember when they were one of the hype.
[30:29] We lost you, Chris. We we lost Chris, but I'll
[30:34] sorry, tasks go ahead. Oh, no, I think I was just, I, I
[30:37] think I was just going to say that.
[30:38] I think Chris was about to say he remembers when they were one
[30:41] of the high flying, high profile, you know?
[30:44] Companies. They were.
[30:45] Certainly were, yeah. No, totally.
[30:48] And like to your point, Adam, I mean, cell therapy now is like
[30:52] it's just like a non starter for for a lot of people and it's not
[30:55] just an oncology, right. I mean, I there was AI won't say
[30:58] the company, but I met a really cool private rare disease
[31:01] company that was doing cell therapy.
[31:02] That was a really, really different sort of thesis.
[31:05] And just the fact that it was cell therapy in the first one
[31:09] liner on it, I think took like a lot of people to even get over
[31:11] just to take a meeting with them.
[31:13] So I mean. I think, I think from a, from a
[31:15] scientific or medical standpoint, I think one of the
[31:17] interesting lingering questions that's not answered yet is, you
[31:20] know, is whether you know, this is again, this is sort of this
[31:23] consolidation, their frontline consolidation treatment, you
[31:29] know, which is kind of slots, if you think about it, it's slots
[31:31] between like first and second line treatment of for BC, for
[31:34] BC, for B cell lymphoma. And so I think there are a lot
[31:38] of people who wonder whether, you know, treating somebody with
[31:41] an autologous with, I'm sorry, with an allogene, a CAR T in
[31:44] that setting is really going to be any different than if you
[31:48] treat patients in the second line with an autologist.
[31:51] Like, you know, whether, let's say with the yes, Carta or with
[31:54] a Briansi, right, like is our patients, are you are you going
[31:57] to see any difference in survival or any difference in
[32:00] event free survival? And and I you know, that's still
[32:03] a question that's up in the air. Now.
[32:04] There are certainly some sort of logistical and safety reasons
[32:09] why you would want to use an Aloe car T in that setting.
[32:14] From a safety standpoint, it's maybe a little bit cleaner.
[32:16] You don't have the CRS, the icons.
[32:18] You can potentially treat patients in an outpatient way
[32:23] versus having them be hospitalized.
[32:25] So, but that all remains to be seen.
[32:30] Yeah, yeah, I I think, I think another, you know, kind of point
[32:34] here that's, you know, an an important one is, is in the
[32:38] space. Look at the the cell therapies
[32:41] of being, you know, show absolutely phenomenal efficacy.
[32:44] But you know, it's still being, you know, pretty tough to get
[32:47] into the community setting, right.
[32:50] And you know, I think it's and that's kind of caps.
[32:53] I mean, we we obviously see kind of shifting of share, you know,
[32:56] in the US market in that space for like, you know, Briansi I
[33:00] think increasingly recognized just having a safety advantage
[33:02] every day as Carta. So so you know, they're kind of,
[33:05] you know, there's there's certainly share shifts, but
[33:08] there hasn't been like a huge amount of Tam expansion that,
[33:12] you know, I think, you know, maybe maybe as as people were
[33:15] hoping. And you know, that then becomes
[33:17] a more challenging argument around, you know, OK, launching
[33:22] into a market that is more about share games than Tam expansion,
[33:26] you know, is probably, you know, is probably harder, right.
[33:29] So, you know, I think that, I think, I think that maybe, I
[33:32] think that maybe part of it. Yeah, I'll just say, I think
[33:39] it's hard to time these allogeneic investments as is
[33:43] indicated with allergy in stock this week, sauna, I think
[33:46] there's a lot of parallels there, a lot of money that have
[33:49] gone into these before you had really de risking data.
[33:52] So again, it's just a cautionary note of like, you got to time
[33:55] these things the right way even when they end up working at the
[33:59] end of the day. Let's pivot to revolution.
[34:02] That is another big story this week.
[34:05] Test, you want to kick this off? And Adam, I know you wrote or
[34:08] spoke about this as well, but this was a big data set.
[34:11] And this is coming off of a rumored take out of $30 billion.
[34:16] Now they're trading at or above that today.
[34:19] But test you want to kick this one off.
[34:21] Absolutely, yeah. So recall, you know, Revolution
[34:24] medicines, they have, you know, a, a pan Ras and a whole, you
[34:29] know, really a whole portfolio franchise of these, you know,
[34:33] Ras, K Ras inhibitors that are both kind of pan inhibitors as
[34:40] well as, you know, as well as more targeted, you know,
[34:44] inhibitors. And they are aggressively
[34:47] pursuing, you know, combinations in a number of different
[34:51] indications with pancreatic really being the furthest along.
[34:55] And earlier this week they shared data that really looks,
[34:59] you know, best in disease and in second line PDAC and they showed
[35:04] overall survival hazard ratio of .4 in all comers.
[35:09] So that is, you know, extremely impressive, right?
[35:13] They're also looking, you know, they're also studying, you know,
[35:16] small cell lung cancer. They're also looking at
[35:18] colorectal. So number of different
[35:19] indication expansion opportunities.
[35:22] This is a company that is a development stage company that
[35:26] is now valued at $30 billion. So, you know, huge, you know,
[35:32] huge congratulations to the, you know, to the team for executing
[35:35] on that. I think a lot of that comes from
[35:38] just the the uniqueness of the portfolio they have the fact
[35:41] that it's a number of combinations and the fact that
[35:45] they're taking not just a like first generation approach to,
[35:50] you know, here is a drug for PDAC, right?
[35:53] And here's a combination for PDAC, but they have several next
[35:57] Gen. approaches that they're studying in parallel, which
[35:59] really allows you to think about a higher multiple on the company
[36:03] because it's less about just, you know, one particular drugs
[36:06] and you know, how to kind of build a franchise that can, you
[36:12] know, be more than just one drug.
[36:13] It can be a series of, you know, a series of combinations that
[36:16] kind of continues to improve on whatever came before.
[36:19] And there there is a lot of, you know, they showed phenomenal
[36:22] data, but there's, you know, certainly room for, you know,
[36:25] improvement, especially on the tolerability side.
[36:29] Hey test we. Hey test we.
[36:30] Other combinations can help to solve.
[36:32] Please go ahead. No test, I said.
[36:33] We should note that Revolution Medicine now trays is now just a
[36:38] little bit more valuable on a market cap basis than Insmed.
[36:43] Yes, right, yes. So I was also, I was also
[36:47] racking my brain and this is the right group of people to think
[36:50] about this, but I was racking my brain for like other development
[36:54] stage companies, let's like take kind of COVID out of it.
[36:56] But like other development stage companies that have like traded
[36:59] around 30 billion and I was struggling to think of like
[37:03] other, I was struggling. To think of other companies did.
[37:05] Insight insight. Ever get there with Ida back in
[37:08] the day? I can't imagine it got to 30,
[37:11] but I mean, yeah, that's a good one.
[37:12] You know, like. In.
[37:14] The 20s maybe for a little while, Summit was trading pretty
[37:17] high. It wasn't trading this high, but
[37:19] it was trading pretty high. But yeah, I mean, it is, it is
[37:21] right now. It's amazing because like you
[37:23] said, it's technically still a, you know, a development stage
[37:26] company, although obviously this is a drug that's going to be
[37:28] approved relatively quickly. But yeah, it's pretty
[37:32] phenomenal. Just look at this market cap
[37:34] here. Yeah, absolutely.
[37:36] And then they just. And, and I'll just add, we, we,
[37:39] we all know pancreatic cancer has been that elusive data set
[37:43] that many people have gone after some have given up and moved to
[37:46] other, you know, high, severe, you know, stage 4 metastatic
[37:49] relapse refractory. But I think, I mean even Tim
[37:52] Opler said that he thinks this could be $100 billion valued
[37:55] company like a lot of people think this is undervalued.
[37:59] So it is interesting to see how they end up moving this forward.
[38:02] And they're gonna buy Merck, Chris.
[38:04] They're gonna be so big they'll buy Merck.
[38:06] There you go. We might see it.
[38:10] Test. I'm sorry.
[38:11] You're gonna add something here? Oh, yeah, no, I was just gonna
[38:13] add and, you know, then they went out and just raised $2
[38:16] billion, no problem, right? You know, I think they're, you
[38:19] know, probably gonna get, you know, a little bit less than
[38:22] that in terms of the actual net proceeds.
[38:23] But, you know, the company's gonna be in an extremely strong
[38:27] position to, you know, commercialize independently if
[38:30] that's, if that's what they want to do.
[38:32] So and then and then exactly as you say, maybe we have another
[38:36] potential acquirer, you know, in the in the space.
[38:40] So, you know, that's, that's always, that's always exciting.
[38:43] So I think they'll be in a position from a cash standpoint
[38:46] of, you know, having, you know, 3 1/2, you know, 3 to 3 1/2
[38:51] billion or so, which is, you know, a very, very strong
[38:55] position to very strong position to be in.
[39:00] Yeah. Well, it is a little bit of a
[39:01] master class to you know do the head fake of a potential sale
[39:05] and then get the data that looks good and then raise 2 billion,
[39:09] which is less than 10% of their outstanding shares and having
[39:13] the real ability to move it forward and commercialize and
[39:16] become one of the the really true breakout.
[39:19] Yeah. And Chris, you know, we should,
[39:20] I know we, I know we spent a lot of time, you know, talking about
[39:23] stock prices and valuations and stuff like that.
[39:25] But at the same time, I mean, like you mentioned, you know,
[39:27] Panka cancer obviously is just one of the most devastating
[39:29] types of cancer. It's been so difficult to, to,
[39:34] you know, to, to advance therapies there.
[39:36] We on our podcast yesterday, we talked to, we had a, we had an
[39:41] oncologist on Paul Oberstein from NYU lingo and he's a
[39:46] pancreatic cancer expert and, you know, just kind of getting
[39:48] his reaction to all this. And, you know, you can, you can
[39:50] imagine how, you know, physicians who treat these
[39:53] patients feel a lot of you probably saw that Ben Sasse
[39:56] interview, the former Senator Ben Sasse interview with the New
[39:59] York Times, you know, who has was diagnosed with advanced
[40:03] metastatic pancreatic cancer. And he, you know, he's also on
[40:07] the drug in a different, in a different study.
[40:10] So, you know, it really it's, it's nice to see these kinds of
[40:13] advances in cancer, you know, this doubling of survival,
[40:17] particularly in, in pancreatic cancer.
[40:20] Yeah, and I like how the Stat Read Out Loud does deep deeper
[40:24] dives on some of these topics. So I encourage the audience to
[40:26] really tune into to Stat Read Out Loud and then it.
[40:30] Was a highlight for one Adam that.
[40:32] Was a very. Non permetrically response like
[40:34] very non permetually. So just for anyone out on this
[40:37] you. Know listening hey, that was see
[40:39] that was yes, you see that was the data point.
[40:42] I, I I can be. I can be positive.
[40:45] See that. Adam, you're not.
[40:46] Adam, you're not a hero for not disparaging innovation.
[40:49] In pancreas. Adam does always surprise us
[40:57] with a different side. I can, I can like things, guys.
[41:00] I can, I can. I'm capable of doing that.
[41:04] We're glad that unambiguously. Positive.
[41:06] Other areas I feel like by. You.
[41:07] I mean, I like all of you. There you go.
[41:15] All right, so another area that has been elusive with good data
[41:19] sets has been the IBD space, ulcerative colitis, Crohn's.
[41:22] But this week's Spire had good data and a positive stock
[41:26] reaction test. You wanna cover this one?
[41:28] Yes, I absolutely will. So Spire announced some open
[41:32] label data from there. You know think of it is like the
[41:36] Spire version of Entyvio, right? It's another A4 beta 7 antibody
[41:42] that they're developing and you know, they have, they have a
[41:46] longer half life, but you know, there's really a, a, a pitch
[41:48] here that is better coverage, better, you know, PK for that
[41:52] target. And you know, the ability to do
[41:55] this, you know, with subcutaneous administration.
[41:58] And you know, what Spire is doing that is really exciting is
[42:02] they're, you know, kind of similar to Rev Med, right?
[42:04] Like think about both Spire and Revolution medicines is like,
[42:08] these are companies that are kind of looking at the disease
[42:10] area that they are involved in and they're trying to like think
[42:13] of solutions, right? It's like, it's not just one
[42:15] drug, it's combinations. It's, how do you, you know, and
[42:21] how do you keep kind of upping the bar on what efficacy and,
[42:25] and safety should look like for an indication?
[42:28] And so Aspire is really approaching that for IBD where
[42:30] they have their A4 beta 7, they have ATL 1A, they have an IL 23.
[42:34] They're looking at combinations for all of these, including, you
[42:37] know, combinations for their A4 beta 7 with TL1A and IL 23.
[42:43] And that is the A4 beta seven that they presented open label
[42:46] data for. And you know what they, what
[42:50] they shared, you know what they shared with the you know what
[42:53] they shared with the open label data is they looked at 12 week
[42:58] induction data and they were looking at this in moderate to
[43:02] severely active ulcerative colitis.
[43:05] And so, you know, what can you do with with open label data?
[43:09] Well, you can compare it to everything else that is out
[43:12] there and you know, look at how it compares and the uncontrolled
[43:18] outcomes, you know, really compared favorably to the
[43:21] historical, the historical benchmark.
[43:23] So I think that's why, that's why the stock was up and why
[43:26] there was a lot of, you know, why there was a lot of
[43:28] excitement about this, especially when you think that,
[43:31] hey, this is something that is just monotherapy, OK.
[43:34] And there's the, there's all these, you know, combinations
[43:38] that are being studied that can presumably that can presumably
[43:41] lift that bar. So, you know, this fire went and
[43:47] raised on the back of this and you know, pretty easily pulled
[43:51] in, you know, over over 400,000,463 million to continue,
[43:59] you know, to continue funding their, their pipeline.
[44:02] Hey, Tess, do you have a view on just like these data and whether
[44:06] or not this proves that their drug is more efficacious than
[44:09] vitalizumab? Like do you think you see as a
[44:11] space where you can, you know, draw that conclusion from open
[44:14] label data or is it too speculative at this?
[44:17] Point speculative to be definitive about it, but looks
[44:20] interesting, looks potentially promising as better, right?
[44:26] So I think it can't be too definitive about open label
[44:31] data. This is an area where placebo
[44:34] rates are really important, but I think it it does kind of
[44:38] support that, you know, it does support that that thesis, right,
[44:43] which which also has, you know, which also has other kind of
[44:46] justification in terms of, you know, looking at the
[44:50] relationship between, you know, looking at the relationship
[44:53] between exposure and and efficacy for, you know, for
[44:56] interview itself. So not, not definitive, but you
[45:02] know, not definitive, but, but likely supportive.
[45:06] I don't know, Paul, if you'd if you'd think about it
[45:07] differently. No, I think that, I mean, I
[45:10] think that makes a lot of sense, right?
[45:11] I mean, it's, you know, it's worth kind of like noting,
[45:14] right, that this is like a Fairmont company and you know,
[45:16] for a number of these, right, there's been like the longer
[45:18] acting better convenience thesis.
[45:20] And then to your point, like the exposure hypothesis, Alex
[45:23] Thompson, who I work with, who's super duper smart covers this
[45:26] company and is, is a total believer in it.
[45:28] And yeah, I mean, the data looks obviously there's been like data
[45:31] sets in UC that haven't been replicated before.
[45:33] But given the underlying validation of the mechanism and
[45:36] the thesis around exposure, it it seems like it's got a really
[45:38] good chance from from my less educated view of like at the
[45:41] very least trending better. Yeah, yeah, yeah.
[45:46] Well, I just want to highlight these three data stories.
[45:48] Allogene Revolution, MSN Inspire kicked off the Monday morning.
[45:53] Adam, you, you tweeted this was probably one of the better
[45:56] Monday morning data releases you seen in a while.
[45:59] Little bit of a trifecta with these three data sets.
[46:02] And, and Paul, I want to come to you also.
[46:04] You believe that you mentioned early at the the front of the
[46:06] hour, the clinical data has really been the story behind
[46:10] kind of driving the markets. And you know, so Adam, I don't
[46:13] know if you want to comment on what you're saying is a trend of
[46:16] a positive data, if you think that's that's real or just
[46:19] happened to be a good week and and Paul, your thoughts around
[46:23] clinical data kind of driving the the dynamics in the
[46:25] marketplace. Go ahead, Paul.
[46:28] Yeah, thanks. I mean, I think it's from my
[46:30] vantage point, like last year felt like it was like the
[46:33] biotech launch year and like a number of the stocks that were
[46:37] on these steep launch curves, right?
[46:39] Like Al Myelom, Insmed, Argenix, Magical, where like I felt like
[46:44] really carrying the group, especially, you know, maybe this
[46:46] time of year ago when, you know, things felt a little bit bleak
[46:50] for the stuff that was higher risk.
[46:52] And I just think an interesting observation I had across my
[46:54] coverage is, you know, for the large cap companies that I cover
[46:57] or the more mature midcap companies I cover, you know,
[47:00] investors right now seem to be selectively bullish on the ones
[47:04] that have like a potential golden ticket in the pipeline,
[47:07] right, Almost irrespective of like the base business.
[47:11] Like I look at large cap biotech and feel like, you know, Biogen
[47:15] and Vertex, you know, and this is maybe Biogen before this
[47:18] appellate steel that was controversial.
[47:19] But those were two names that have been, you know, much, much
[47:22] hotter this year, right? Their commercial businesses
[47:24] couldn't be any more different. I mean, one company's growing,
[47:26] one company's declining, but yet they have like the most
[47:31] attractive array or perceived most attractive array of
[47:34] pipeline catalyst. Whereas like the Elm Islands of
[47:36] the world or the inspects of the world have kind of been looped
[47:39] into this whole sort of broader what's next conversation.
[47:42] And then, yeah, we've obviously talked about it before with the
[47:44] the Smids with great data, you know, going back to a month ago
[47:48] when we talked about Xenon and dianthus.
[47:50] And now this week, just, you know, great data sets are
[47:52] getting rewarded and fundraising.
[47:53] But you know, it's almost like we said this before in the past
[47:56] with biotech. We're not at this point, by the
[47:58] way, where I think people are just going, Oh my God, short the
[48:00] launch. But we've made this joke in the
[48:01] past, right, where it's like it's better to be a
[48:04] developmental stage company where people can dream the dream
[48:07] versus the reality of a company that is selling a drug and
[48:10] getting judged on quarters and having people try to model
[48:13] inventory and selling weeks. And again, it's not that
[48:15] extreme. But I do think like this is just
[48:18] like the commercial names are just not doesn't feel like it's
[48:22] really what a lot of investors care about right now.
[48:27] Yep, Yep, Adam, any. Comment No, I think Paul, Paul
[48:31] articulated it really well. Yeah, great, great.
[48:38] Well, I, I just looked at Kyler again.
[48:40] I don't think it's started trading yet, but I think for our
[48:43] audience, it's something to keep an eye on of the health.
[48:45] I mean, some have commented just to come back to Kyler that, you
[48:49] know, have we hit peak obesity? You know, this was AGLP 1 GIP
[48:54] dual mechanism, very pedigree group around this.
[48:57] This was an early Bane investment.
[48:59] Adam couple sits on the board. Ron Renault has been a serial
[49:03] CEO who sold several companies in the past.
[49:07] John Milligan, my former boss at Gilead, who was the former CEO
[49:11] of Gilead is the chair of Cholera, You know, so it'll be
[49:15] interesting to watch this obesity space continues to drive
[49:18] value and a lot of players in the space.
[49:21] So, you know, definitely encourage our audience to to
[49:24] keep an eye on that as a signal of, of again, further strength.
[49:28] Any other comments from from the group on obesity And, you know,
[49:31] are, are we getting too crowded in the space?
[49:33] Are the valuations getting lofty?
[49:36] Any any thoughts on that? I.
[49:43] I think look, is it crowded? Yes.
[49:47] Is there still a lot to improve on?
[49:48] Yes. So, you know, I think I, I think
[49:54] a lot of it will, you know, what kind of play out over the coming
[49:56] years. But we're seeing, you know,
[49:58] we're seeing new mechanisms that can potentially help with, you
[50:02] know, tolerability, maybe fit in, you know, nicely in, in
[50:06] maintenance therapy. I think my big question around,
[50:10] you know, a lot of just how the space will play out is like what
[50:14] are the different, what, what are some of the different
[50:16] settings and also like patient segments that the, that the
[50:20] market will start, you know, that will start kind of sorting
[50:24] itself into. You know, I think that's, I
[50:27] think, you know, the general thinking is still like, Gee,
[50:30] this is a really big market. Maybe there can be, you know, a
[50:33] lot of players, But you know, as we get more and more mechanisms
[50:37] out there it it will really start to be a question of, you
[50:41] know, what is the sequencing? You know, what are the, should
[50:46] you know, elderly people, you know, with obesity and issues
[50:50] with bone density, maybe be taking something different than,
[50:54] you know, young people who are looking for something that's
[50:56] more like maintenance. So I think that's something that
[51:00] has get to play out, but will be, you know will be really
[51:03] important and kind of increasingly necessary as you
[51:06] know companies think about commercializing in a very in a
[51:11] very crowded space. Tess, I, I don't like cover this
[51:14] space that closely, but like obviously just how could you not
[51:18] follow it and read all the articles in the headlines?
[51:20] Like do people care at all with these next Gen. obesity plays
[51:24] that like for the first Gen. assets, it's kind of like, for
[51:27] lack of a better term, a race to the bottom on pricing.
[51:32] You know, it's a good question. I I think it depends on the kind
[51:37] of quantum of benefit, right, and, you know, in the setting
[51:42] and how much of an improvement like over the first Gen.
[51:45] So, yeah, I mean, we'll, we'll see how, we'll have to see how,
[51:49] you know, pricing kind of plays out for some of these, you know,
[51:52] for some of these next Gen. you know, for some of these next
[51:56] Gen. mechanisms. And that'll take a while.
[51:58] But you know, if you think about it, it's like we have a lot of
[52:02] the, you know, first Gen. stuff where, you know, Novo has been
[52:07] like super aggressive on pricing, right.
[52:09] I think they, they know that's what's going to, you know,
[52:12] that's kind of what they need to do to, to maintain, you know, to
[52:15] maintain market share. And but I think I think there is
[52:22] kind of niches, right? And there's there's
[52:24] opportunities in different settings where especially with,
[52:29] you know, better tolerability and, you know, potentially
[52:32] better duration of therapy. That is actually a very
[52:35] different pitch to house plans than a drug that adds cost.
[52:41] And we're certainly there, you know, payers are seeing a
[52:44] benefit for many individuals who are able to like stay on the
[52:48] drug, but you have a lot of people who are just like coming
[52:51] off the therapy, right. And so I think we're solving
[52:54] that issue is still like an extremely important issue, you
[52:58] know, to try and get the best value out of these drugs and
[53:01] society going to be willing to pay more for that hopefully.
[53:04] But you know, what we'll have to see.
[53:06] Depends on, you know, depends on how much competition.
[53:10] What do you think, Paul? No, I think that makes a lot of
[53:13] sense. And like, I guess, I guess the
[53:15] way I sort of see it is like, you know, in a lot of these big
[53:18] markets that are mega crowded but impact tons and tons of
[53:21] people, right? Like we're we're still willing
[53:23] to withstand blockbuster drugs even in the face of generics.
[53:27] I mean, if you look at like almost every CNS or INI market,
[53:31] right? So, and I'm using those just
[53:32] because like they're, you know, not, not that they're not severe
[53:35] diseases, but most are not imminently life threatening,
[53:37] right? So like, I think, I mean, I
[53:39] think that makes a lot of sense. Great.
[53:43] Well, well, this has been a great session.

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