What to Watch — Life Sciences 2022
What surprises might this year hold?
While I am no professional prognosticator, I did have the good fortune of personally interacting with hundreds of life sciences companies last year. In fact, Prime Movers Lab saw more than 3000 opportunities last year, which is a mind-boggling number of deals. While it sounds intense (it is!), it has afforded me a bit of perspective on the overall life sciences landscape. This deal flow has also given me hope, big optimistic hope, as I see the amazing progress that is happening in biotechnology. It is so inspiring to interact with these founders every day and engage with them as we seek to impact billions of lives together. As others have declared, we truly are in the golden age of biotech and I am deeply grateful for the teams working on these hard problems to make all of our lives better. While certainly not an exhaustive list — here are ten things to watch for in 2022.
Cancer is on the run
Cancer should definitely be scared — after 4 decades(!) since the “war on cancer” was declared in 1971, it finally feels like science is gaining the upper hand on this scourge. Most of us are familiar with the emergence of immuno-oncology — harnessing the body’s own immune system to attack cancer tumors — with amazing results. But now there are emerging techniques to turn “cold” tumors — ones that can’t normally be reached by the immune system — to “hot” so they can. This opens up a whole new line of attack on some of the most aggressive cancers. And if that doesn’t work — like for those nasty glioblastomas — we can send tiny nanorobots to swim to the site in the brain and deliver chemo drugs directly to the tumor or its remnants. Take that! And one more bit of good news, because this topic can use all it can get, in 2022, we should see more widespread use of GRAIL’s Galleri test, which was rolled out in 2021. Through a single blood draw, it can detect more than 50 different types of cancer — and even predict the site. Imagine the lives that will be saved. Cancer, your days are numbered.
A breakout year for psychedelic medicine
I’ve written enthusiastically about psychedelic medicine over the last year, so you won’t be surprised to see this in my list. Check out my thought paper on the topic if you haven’t seen it yet. This year, I’m excited for a different reason. If you’ve been checking your calendars, many of the nascent “next wave” psychedelic medicine startups creating new molecules got their start between 2018–2020. That means those programs, if they’ve passed their IND enabling pharmacology and toxicology, will be starting to enter the clinic. I expect that 2022 will usher in a flurry of announcements about Phase 1 and 2 readouts that will further energize this inspiring work. This will be a massive shift from many pre-clinical companies to stand-out clinical-stage companies and will be reflected in both program advancement and valuations. It will be worth keeping tabs on what’s a hit and what’s a miss.
Bioelectronic medicine will give drugs a run for their money
I’ve always loved the phrase “run for the money” as I grew up in a family that loved horse racing. And let me tell you, bioelectronic medicine is going to be one to bet on in 2022. The Feinstein Institute defines it as “us(ing) device technology to read and modulate the electrical activity within the body’s nervous system.” This modulation can be delivered through electricity, magnetic pulses, and ultrasound to both the central (brain) and peripheral nervous system. Most, if not almost all of these devices are completely non-invasive and sit outside of the body. I am seeing devices in neuromodulation — for sleep, migraines, pain, even depression. In 2021, a landmark study showed that transcranial magnetic stimulation could be used to successfully treat intractable depression. Similarly — stimulation is being directed at the rest of the body including the spleen, peripheral nerves, and cranial nerves, targeting rheumatoid arthritis, neuropathic pain, sleep apnea, tinnitus, and opioid use disorder. I’m definitely curious which horse will win this race!
A booming year for mushrooms, not just the magic ones
If you have not yet seen Fantastic Fungi — you must watch it. Seriously. Stop reading now and go watch it! The magnificence of mycelium is continuously revealing itself. While the “magic” mushrooms got a lot of the press last year, clever companies were turning mushrooms into gorgeous high-end leather products that could make the traditional leather business obsolete. And on the edible front, several startups were focused on the fungi based proteins — mycoproteins — which turn out to be both exciting and delicious. They can be used as ingredients — adding heft to other plant based proteins or grown as “cuts” with a more substantial meat feel. Mushrooms functional side was also coming into its own — with reishi, turkey tail, chaga, lions mane and others being used as both food products (tacos!) and nutritional supplements. There is some very compelling research on their use in strengthening human immune systems and improving cognition. I will admit to loving my mushroom coffee in the morning! And touching the climate front — it turns out that mycelium communicate with one another underground and support healthy forest growth and connections between trees. What else will we learn from our eukaryotic brethren this year?
The world within us (and on us)
You can’t scan the headlines these days without hearing about your microbiome. These are the trillions of microbes in us and on us that help make us who we are. They are found inside of us, in our digestive system, and outside of us on our skin. As a present to myself for the new year (yep, just that geeky), I had my gut microbiome sequenced by one of the commercially available companies. I’ve got at least 407 strains of fellow travelers in me (as detectable by RNA sequencing) and really we’re just starting to get to know each other. I did this both out of scientific curiosity and in the context of the growing emphasis on the role of our gut in overall health — not just digestive health. First, there is mounting evidence of the gut microbiota’s role in inflammation. Not just in the digestive tract — but overall inflammation in the body which scientists are now targeting for its potential role in auto-immune disorders and even neurodegenerative diseases. Then there’s the gut-brain axis — “the two-way biochemical signaling that takes place between the gastrointestinal tract (GI tract) and the central nervous system (CNS).” The gut actually produces a host of compounds that are neuroactive and this system may play a role in moderating stress and depression. Might 2022 be the year you get to know your internal microbe-team?
Tele-health and at-home diagnostics
If there is one silver lining from COVID, it is that it finally thrust tele-health into mainstream acceptance. It went from merely a convenience to a critical part of our health care system over the last two years. This opens up a whole new mechanism to deploy healthcare at home and at scale. For tele-health to be transformative, it also needs to integrate with new therapies and services. 2021 may have been the year that the most humans stuck swabs up their noses in all of history. This increase in home testing reflects what I have been seeing in terms of diagnostics and health monitoring opportunities moving from the clinic to the home. I suspect will see a wave of home testing apparatuses hitting the market, including PCR quality results. As part of my nerdy self-exploration for the new year, I’ve also bought a few of the home testing kits for various biomarkers. I haven’t yet worked up the courage to poke my fingers with the sufficient vigor required but I did end up having to hire a phlebotomist to come to my house — which was a lot harder than it should have been. I think we are at the very beginning of what can happen here — and I do think the lab testing companies should be paying attention.
Neuroscience data, AI, and middleware
I’m still futzing with the terms that I want to use here. I’m calling out neuroscience middleware to distinguish it from the hardware focus that neurotechnology has been dominated by over the last decade. I’m over exaggerating, but it’s as if the neuroscience community woke up and realized that the stores of data that we’ve all been sitting on are the real treasure. And that it’s the operations that can be done ON the data and how disparate data sources (behavioral observations, cognitive tests, tissue samples, blood, CSF) can be pulled together that is the “big aha.” We can now use those combined datasets to answer questions that have profound diagnostic and clinical outcomes. I have seen a wave of companies that are working on using neuroscience data for patient stratification in clinical trials to rescue compounds that big pharma has abandoned and to begin a complex but exciting journey towards early diagnosis for several neurodegenerative diseases. I predict that neuroscience measurement hardware (EEGs, MRI, NIRS, etc) will continue to move toward commodification and that the data and AI/ML transformations on those data sets will be the driver of neuroscience value in the coming years.
Biology on the blockchain
Ok, this one caught my eye just at the end of last year. I’ve been used to thinking about blockchain in much different contexts. But, it's not just for cryptocurrency anymore! Blockchain makes so much sense for biology. Sure, sure — medical records might come to mind first — and that will be an important application. But I’m talking about tissues, cord blood, organs, stem cells, embryos, eggs, sperm… biological material on the blockchain. This is one area that is ready for disruption, particularly with the increase in fertility treatments and egg freezing. Did you know that, in part due to the lack of regulation in the fertility market, embryos and reproductive tissues can be misplaced (permanently)? Yikes! This is exactly the type of application that a tamper-resistant ledger system is good for. Would you put a little of yourself on the blockchain?
Vaccines, not just for infectious disease anymore!
There is clearly a dominant silver lining to the COVID pandemic and that is the quality and speed at which the global scientific community was able to produce vaccines against SARS-CoV-2. From traditional vaccine methods to emerging mRNA and peptide vaccines, our toolkit had opened up considerably. That toolkit is now being turned against some other nasty targets that aren’t “traditional” infectious disease pathogens. Vaccines for cancer and vaccines against neurodegenerative diseases, like Alzheimer’s and Parkinson’s disease. For example, now that we know the HPV virus can CAUSE cervical cancer — a vaccine against HPV has been developed. There is also a who’s who list of cancers that are currently being tested as vaccine candidates and I expect this to continue and expand. Although the non-infectious disease applications are newer onto the scene — it’s interesting to think about them through the lens of aging and the relative vigor of the human immune system. The argument is that a healthy young immune system can protect us from these infectious insults — but as we age our immune system loses potency — and that’s why these are typically diseases of aging. As we age, could we be vaccinated against Alzheimer’s disease? It’s worth finding out.
Regenerative medicine
I will admit, I left the topic that I am most excited about for last. Within our human augmentation theme at Prime Movers Lab — we have a specific interest in longevity — which includes regenerative medicine. Regenerative medicine, to me, is one of the next big frontiers in how we think about living with, and improving upon our human biology and its limitations. From tissue regeneration, replacement organs, and using gene therapy to give old tissues new functions — the potential is huge. I have already seen exciting work on wound healing, limb regeneration, and 3D printed scaffolds for tissues that have absolutely blown my mind. Did you ever think about repurposing tissue in your own body, say a lymph node, and turning it into a second liver? Me neither! My time in the Department of Defense sadly coincided with the height of injuries from improvised explosive devices. The work on prosthetics for limb loss was some of the most important work that I think the DoD has done in biology. And yet, it was still just a substitute for what was lost. The vision of our own bodies repairing themselves to complete function through these technologies is my biggest dream and hope for this year.
Prime Movers Lab invests in breakthrough scientific startups founded by Prime Movers, the inventors who transform billions of lives. We invest in companies reinventing energy, transportation, infrastructure, manufacturing, human augmentation, and agriculture.
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