Breaking Down Silos: Metrodora Xcelerate 2023

Today, we’re spending more money than ever on basic scientific research, but it’s not resulting in proportional improvements in health outcomes. In fact, only about 14% of original research actually ends up having an impact on clinical practice at all — and it can take an average of 17 years for that to happen.?

This problem is particularly evident for people living with complex, chronic conditions that impact multiple body systems.?

Over the last decade, novel approaches to precision medicine, the rapid adoption of AI, and immunotherapies have led to incredible advances for diseases we more clearly understand – like cancer. Unfortunately, progress for complex chronic diseases is decades behind, in part because our medical system has been built around medical specialties focused on one organ instead of the interactions between different body systems.?

As a result, hundreds of millions of people are living with debilitating diseases that we don’t know much about. Today, complex, chronic disease accounts for more than 80% of U.S. healthcare costs.?

Metrodora Institute was built to solve this problem. At Metrodora, world-class clinicians, scientists, and technologists work together under one roof to break down barriers across different medical specialties and between clinical medicine and scientific research. Our goal is to maximize the impact of scientific discovery, and rapidly translate research into better outcomes for patients living with complex chronic diseases. The Metrodora Foundation exists to catalyze essential scientific research that will lead to breakthrough therapeutics and cures for these devastating diseases.?

But we know we can’t do it alone. Finding solutions to these diseases requires true collaboration.?

That’s why we recently hosted the first-ever Metrodora Xcelerate. The three-day event brought scientists, physicians, and leaders across biotech, healthcare, and technology together with patient advocates and philanthropists. The goal was simple: collaborate to find better ways of advancing scientific research that will improve the lives of millions of people.?

Several important themes came out of the discussions we had — themes that will serve as a roadmap for the changes we all need to make to accelerate progress toward better therapeutics, and ultimately, cures for complex chronic conditions.?

Accelerating the path to scientific discovery starts with building the right data infrastructure for chronic disease research. Critically, this data must be deep and biologically diverse. And it should be seen as a vital for-profit business asset that can serve as the foundation of an entire industry.?

• “We have to move away from this idea that biobanks are just big freezer farms. We're collecting these samples for a reason and we have an ethical purpose to fulfill to the patient – which is that we are going to take their samples and analyze them, and we’re going to use them [for research]. Samples put in a freezer and banked away for decades is not a way to do justice to that. That’s what it really comes back to - every sample has a story to tell. Every sample needs to be analyzed. – Rohit Gupta , Chief Medical Officer and Chair of the Scientific Advisory Board, Spectrum Solutions
• “We have to change the dichotomy around biobanking being part of academic or nonprofit institutions, solely sustainable by grants. We need to start thinking about them as for-profit products… assets for companies. It’s really creating that complete ecosystem, by creating it as a product rather than a “nice to have” tool that may or may not be used in an academic or nonprofit setting.” – Rohit Gupta , Chief Medical Officer and Chair of the Scientific Advisory Board, Spectrum Solutions
• “A lot of research dollars and innovation have been so focused on studying the male immune response and then assuming that we can just extrapolate to women and children. That’s not true. We have very different physiology and we really have to dedicate resources to studying and understanding the female response, and how it’s different. The big missing data set is the safety of drugs that were approved before ever being tested in females, and are now available over the counter. People assume they’re safe for them, but they don’t realize these drugs were never tested in women, and never post-market reviewed.” – Michal (Mikki) Tal , Principal Scientist, Department of Biological Engineering at MIT and the Associate Scientific Director of the Center for Gynepathology Research at MIT

By leveraging machine learning and artificial intelligence, we can use these improved data sets to advance how we stratify clinical trial cohorts, diagnose patients — and eventually develop better drugs to treat them.?

• “If you look at how AI was applied to drug discovery in the past, it was really through classification. You would look at a million member small molecule library, and then you'd use AI to say ‘which of these candidates should I take forward?’ Now, we're into this new area of generative AI where we're actually able to create something from scratch that didn't exist in your training site. And in our case, what we're doing is designing antibodies that haven't existed in nature before.” – Sean McClain , Founder & CEO of Absci?

Ultimately, this will lead to a rise in precision medicine for chronic conditions driven by a deeper understanding of the diseases themselves – just like we’ve seen with cancer. Instead of classifying diseases based on symptoms, we will classify diseases based on root causes.?

• “If you are talking about precision medicine, you have to be talking about - ‘what are the drivers of disease biology for particular patient subgroups?’ You have to be able to stratify patients not necessarily by symptomatology, but by the causes, or the drivers of their disease at a molecular level. And then you also have to be able to look at the pathophysiology of those processes that are going on inside disease.” – Steve Gardner , CEO of PrecisionLife

More biotech companies are realizing the massive opportunity in addressing complex chronic conditions, leading to a rise in new therapeutics hitting the market.

• “Some of the greatest innovation in immunology has actually happened with FDA-approved products in the last 10 years of their life cycle rather than early-stage drugs being tested in mice or in their first indication... [Biotech] is in a position to expand clinical development well beyond just one disease or two diseases. For example, argenx talks about being in 15 diseases in the next five years. Over 10 years, could they be in 20 or 30 diseases? It seems possible to me… Once we have one success like this, it creates a platform to build more and more success. The next decade or two will be defined by the autoantibody.” – Sam Huang , Managing Partner, Checkpoint Capital?

The hospitals and medical centers that exist today were built for acute care. Treating and curing chronic conditions will require an entirely new, collaborative approach to healthcare.?

• “Hospitals and the NIH really emerged and were adapted to the immediate and most obvious acute problems that we as a society first faced. But, we've now mostly won against those challenges and now the kind of organizational models, funding models, scientific approaches, and so forth for the challenges that we now face at the frontier - like chronic diseases - might look very different from the prior status quo.” – Patrick Collison , Co-Founder of Arc Institute
• “If you're at research institutes of universities, most of the time, it's really basic science-driven, and you're reaching out to the clinicians to try and pull them in to test the research hypothesis. [Metrodora] is one of the unique places that I've seen where it's been clinician-driven, where it's a physician recognizing that in order to accelerate and advance in these complicated diseases, we need to work with the basic science piece of that. My view is if those two groups can come together and start providing those linkages, it will help accelerate these things into the clinic.” – Michael Boyne , VP of Product Development and Analytics, COUR Pharmaceuticals
• “One of the things I ask myself is how do we all collaborate more across companies because everyone's creating this critical data in silos. I think one thing we did much better in tech is when Google created those maps then lots of other people could use those maps to build things on top of them. Whereas, all of us are building these data sets in separate [biotech] companies. And, I do challenge ourselves to say, if our collective goal is to get these therapeutics faster to people, how do we think out of the box about how we collaborate all across this chain? Whether it's with people on the clinical side, people who've been building all these data sets because none of us, given the cost of advancing therapies, can advance as many therapies [without partnerships].” – Margo Georgiadis , Co-Founder and CEO of Montai Health

I was inspired and energized to meet so many experts who care deeply about revolutionizing healthcare and improving lives. Because understanding the biological drivers of disease really can change everything.?

Today, 90% of clinical trials fail. But?clinical trials that include biomarkers and well-stratified patient cohorts — two of the things we’re working on at Metrodora — have a 90% success rate. This is obviously an extreme simplification of one part of the process, but it’s an example of the difference we can make.?

Together, we have a chance to accelerate desperately needed research and come up with the first cures for many complex, chronic conditions. After Metrodora Xcelerate, I’m more confident than ever that we’ll get there.

If you’re interested in learning more or getting involved, please visit us or donate at metrodora.org.