Edelman argues gene editing is still slightly overhyped if its sole purpose is to replace an injectable drug, as safer alternatives may exist. He sees underhyped gene therapy, previously sidelined by safety concerns, as poised for a comeback due to its enormous power and potential for major breakthroughs.
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Despite experts advising he would "waste his money," Immortal Dragons' founder received a controversial gene therapy in Honduras. He viewed it not as a cure, but as a low-risk chance to experience the process firsthand and support the "first wave" of companies attempting mass-market gene therapies.
Ophthalmology has become a "safe haven" for gene therapy because it mitigates the field's two main challenges: safety and manufacturing. Localized delivery to the immune-privileged eye improves the safety profile, while the thousand-fold lower required doses simplify manufacturing and dramatically improve the cost of goods.
The focus in advanced therapies has shifted dramatically. While earlier years were about proving clinical and technological efficacy, the current risk-averse funding climate has forced the sector to prioritize commercial viability, scalability, and the industrialization of manufacturing processes to ensure long-term sustainability.
To normalize the ethically fraught practice of embryo gene editing, startups like Preventive are shifting the narrative from just curing disease to radical cost reduction. They claim editing embryos could cost $5,000, a fraction of the $2 million price tag for current adult gene therapies.
In stark contrast to the US, Chinese investors are accelerating funding for early-stage cell and gene therapies, which now account for 29% of seed/Series A rounds. These firms are specifically backing technologies like NK cell therapies, which have fallen out of favor in the West, creating a divergent global innovation strategy.
The commercial advantage of one-time CRISPR/Cas9 therapies is shrinking. Advancements in RNA modalities like siRNA now offer durable, long-lasting effects with a potentially safer profile. This creates a challenging risk-reward calculation for permanent gene edits in diseases where both technologies are applicable, especially as investor sentiment sours on CRISPR's long-term safety.
The gene therapy field is maturing beyond its initial boom-and-bust cycle. After facing the reality that it isn't a cure-all, the industry is finding stable ground. The future lies not in broad promises but in a focused approach on therapeutic areas where the modality offers a clear, undeniable advantage.
CEO Lance Baldo suggests that gene therapy in the eye is uniquely positioned for success. As an encapsulated organ with "immune privilege," the eye reduces risks like hepatotoxicity seen in systemic therapies. This creates a safer environment to generate learnings that can then be applied to advance gene therapies for other organs.
Gene therapy companies, which are inherently technology-heavy, risk becoming too focused on their platform. The ultimate stakeholder is the patient, who is indifferent to whether a cure comes from gene editing, a small molecule, or an antibody. The key is solving the disease, not forcing a specific technological solution onto every problem.
Beam's platform strategy extends beyond diseases with one common mutation. They believe that as regulators accept the base editing platform's consistency, they can efficiently create customized therapies for diseases with numerous rare mutations. This shifts the model from one drug for many patients to a platform that rapidly generates many unique drugs.
