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.

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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.

The NIH's cancellation of mRNA research is a profound strategic error. The technology's key advantage is speed, which is critical not only for future pandemics but also for personalized cancer treatments. These therapies must be developed for individual patients quickly, making mRNA the most promising platform.

An ideologically driven and inconsistent FDA is eroding investor confidence, turning the U.S. into a difficult environment for investment in complex biologics like gene therapies and vaccines, potentially pushing innovation to other countries.

CRISPR reframes its commercial strategy away from traditional drug launches. By viewing gene editing as a 'molecular surgery,' the company adopts a go-to-market approach similar to medical devices, focusing on paradigm shifts in hospital procedures and physician training.

After several tau-targeting antibodies failed, including J&J's pazdenimab, confidence in blocking extracellular tau is waning. The field's new hope is Biogen’s Biv80, an antisense drug that prevents tau protein production at the mRNA level, a mechanism that has shown potential to reverse pathology in early data.

A massive disconnect exists where scientific breakthroughs are accelerating, yet the biotech market is in a downturn, with many companies trading below cash. This paradox highlights structural and economic failures within the industry, rather than a lack of scientific progress. The core question is why the business is collapsing while the technology is exploding.

The success of Praxis's small molecule for a genetic epilepsy presents a strategic alternative to cell and gene therapies. In an era where complex modalities face funding, safety, and commercial hurdles, advanced small molecules offer a viable and potentially more practical path for treating genetic disorders.

Venture capital for US seed and Series A cell and gene therapy companies has collapsed from a historical high of 17-21% of deals to only 7% this year. The sharp decline is driven by a confluence of factors including patient deaths, persistent manufacturing challenges, and growing regulatory uncertainty.

The past few years in biotech mirrored the tech dot-com bust, driven by fading post-COVID exuberance, interest rate hikes, and slower-than-hoped commercialization of new modalities like gene editing. This was caused by a confluence of factors, creating a tough environment for companies that raised capital during the peak.

"China Speed," once synonymous with rapid antibody development, now extends to RNA silencing technologies. A surge in homegrown RNAi companies and programs, with dozens unpartnered, indicates China's biotech ecosystem is rapidly diversifying into new, complex therapeutic modalities beyond its established strengths.

Advanced RNA Therapies Are Eroding the Commercial Viability of First-Generation CRISPR Treatments | RiffOn