Driving discovery to clinical success

San Francisco-Drug discovery is a wonderful experience. “When an experience works, it is very exciting,” said Anthony P. Adamis, MD, vice president, global head of ophthalmology, Genentech. In 1994, he was in the forefront of vascular endothelial growth factor research. “We just saw those vessels shut down.”
    
But seeing vessels shut down in an experimental model is just the first step. He eventually left academic discovery for the world of biotechnology to drive research to clinical success to found Eyetech.
    
“The company was successful because of the motivation of the people involved, especially given the natural history of age-related macular degeneration,” said Dr. Adamis during the Glaucoma 360 New Horizons Forum on Friday, as he was interviewed by Emmett Cunningham Jr., MD, PhD, MPH, partner with Clarus Ventures.
    
So why leave biotech for big pharma?
    
“You want to translate your science to patients,” Dr. Adamis explained. “If you do it right, you can have a huge impact on patients.”
    
But success with patients is not a sure thing. Wall Street is pushing pharmaceutical firms to cut research and development (R&D). The reason: R&D has a poor return on capital.
    
Wall Street is partially correct, Dr. Adamis said. Only 8% of molecules that enter clinical trials emerge as approved products.
    
“That 92% failure is one reason drugs are so obscenely expensive,” he said. “Our R&D budget at Genentech is the highest in the world. We are doubling down on R&D.”
    
The goal, promulgated by Roche, is to create a diagnostic for every therapeutic.
    
“We are betting on biology and relying on research,” Dr. Adamis said. “If you have a diagnostic, you are more likely to enroll responders in your trials. We are trying to deliver diagnostics and new drugs for the major causes of blindness.”
    
What is the next step? Add-ons or adjustments to prostaglandin agonists that reduce IOP to less than 18 mm Hg. The latest data suggest that an IOP below 18 mm Hg slows progression.
    
The second area is compliance. Some noncompliance is voluntary, patients that skip doses. And some noncompliance is involuntary, when drops miss the eye.
    
“If we can get compliance close to 100%, we may be able to affect blindness,” Dr. Adamis said.