French can­cer-fo­cused mi­cro­bio­me play­er is flush with €18M Se­ries B in­jec­tion

Last year, the death of an im­muno-com­pro­mised el­der­ly pa­tient in a fe­cal mi­cro­bio­ta trans­plan­ta­tion tri­al — due to a do­na­tion that con­tained a rare type of E. coli bac­te­ria — sent shiv­ers across the field. The in­ci­dent marred an oth­er­wise ex­plod­ing field of drug de­vel­op­ment that backed re­plen­ish­ing the gut with good bac­te­ria as a safe and ef­fec­tive means to for­ti­fy the im­mune sys­tem to fight dis­ease.

Hervé Affa­gard

For France’s MaaT Phar­ma, an on­col­o­gy-fo­cused mi­cro­bio­me com­pa­ny, the set­back was al­most re­as­sur­ing.

“Bot­tom line is if they would have used our prod­uct, this pa­tient would not have died,” chief Hervé Affa­gard said in an in­ter­view with End­points News, sug­gest­ing that MaaT’s rig­or­ous test­ing stan­dards in­clude the screen­ing of drug-re­sis­tant bac­te­ria that would have pre­clud­ed the use of the rogue do­na­tion.

On Wednes­day the com­pa­ny — whose lead ex­per­i­men­tal prod­uct is an en­e­ma for­mu­la­tion de­signed to help pa­tients with acute graft-ver­sus-host dis­ease that have un­der­gone stem cell trans­plan­ta­tion — scored €18 mil­lion in Se­ries B fi­nanc­ing as it works on prov­ing its met­tle in a field crowd­ed with com­peti­tors fo­cused on a raft of dis­eases.

Mi­cro­bio­me-based ther­a­peu­tics to­day is a fe­cund field for drug de­vel­op­ers — big and small — cap­i­tal­iz­ing on sci­ence that sug­gests flush­ing ‘good’ gut bac­te­ria in­to the sys­tem can treat a pletho­ra of con­di­tions — from C. diff in­fec­tions to obe­si­ty — us­ing dif­fer­ent ther­a­peu­tic modal­i­ties, some of which are de­signed to side­step the “ick” fac­tor as­so­ci­at­ed with tra­di­tion­al stool trans­fer or fe­cal mi­cro­bio­ta trans­plan­ta­tion (FMT).

The con­cept of FMT was orig­i­nal­ly doc­u­ment­ed in Chi­na and has been used in the Unit­ed States since the 1950s with lit­tle reg­u­la­to­ry scruti­ny. In the last decade, the FDA sanc­tioned the use of FMT as a last re­sort mea­sure for re­cur­rent C. diff, but the agency con­tin­ues to con­sid­er it an in­ves­ti­ga­tion­al treat­ment. Glob­al­ly, hun­dreds of tri­als are now un­der­way test­ing the po­ten­tial of FMT for pa­tients suf­fer­ing from var­i­ous ill­ness­es, from autism to can­cer.

A few years ago, the spec­tac­u­lar fail­ure of Seres Ther­a­peu­tics’ sem­i­nal ef­fort in­to de­vel­op­ing a “crap­sule” — donor-de­rived processed fe­cal ma­te­r­i­al en­cap­su­lat­ed in a pill — de­railed an emerg­ing field work­ing to har­ness the in­sights gained from gut mi­cro­bio­ta to de­vel­op drugs. How­ev­er, the suc­cess of fe­cal trans­plant ther­a­pies to treat stub­born­ly re­cur­rent C. diff in­fec­tions has gained trac­tion, at­tract­ing a buck­et of biobucks and even in­spir­ing the takeover of a key play­er, Re­bi­otix.

MaaT Phar­ma prides it­self on its metic­u­lous process of donor screen­ing, qual­i­ty con­trol and di­ver­si­ty of bac­te­ria in its prod­uct — which like many oth­ers is for­mu­lat­ed us­ing fe­ces from healthy donors.

The Ly­on-based com­pa­ny’s lead for­mu­la­tion — MaaT013 — is cur­rent­ly in a mid-stage study in GvHD pa­tients. Da­ta from this tri­al are ex­pect­ed by the end of the year.

“It’s a kind of an im­muno-restora­tion, in­stead of im­muno­sup­pres­sion,” Affa­gard said of MaaT013, not­ing that all the drugs that have been de­vel­oped so far for GvHD pa­tients are im­muno­sup­pres­sive.

Late last year, MaaT re­port­ed en­cour­ag­ing MaaT013 da­ta from 8 pa­tients whose GvHD per­sist­ed de­spite up to five pre­vi­ous sys­temic treat­ments as part of a com­pas­sion­ate use pro­gram in hos­pi­tals. Each pa­tient ex­pe­ri­enced at least a par­tial re­sponse af­ter re­ceiv­ing MaaT013, while 3 out of 8 pa­tients at­tained a com­plete re­sponse, the com­pa­ny said.

“So we know our project is work­ing,” Affa­gard said. “Those pa­tients they’re re­ceiv­ing chemother­a­py, stem cell trans­plan­ta­tion…their mi­cro­bio­me was de­stroyed many times dur­ing their jour­ney.”

Next-gen­er­a­tion se­quenc­ing plat­forms and ad­vanced bioin­for­mat­ics ap­proach­es have stim­u­lat­ed re­search eval­u­at­ing the role of the gut mi­cro­bio­me in can­cer. In 2019, a con­sor­tium of ex­perts con­vened to dis­cuss the ev­i­dence un­der­ly­ing the as­so­ci­a­tion and found that while there are plau­si­ble mech­a­nisms and sup­port­ive ev­i­dence from in vit­ro, murine and cross-sec­tion­al hu­man stud­ies —di­rect ev­i­dence from large lon­gi­tu­di­nal co­hort stud­ies is lack­ing. In ef­fect, the role of the hu­man mi­cro­bio­me in the cause and sub­se­quent de­vel­op­ment of can­cer re­mains un­proven, the pan­el con­clud­ed, al­though a ma­jor­i­ty of pan­elists nev­er­the­less agreed with the hy­poth­e­sis.

MaaT is go­ing to use the fresh in­jec­tion of funds to prove its bet on the as­so­ci­a­tion. The mon­ey will be used for the on­go­ing Phase II en­e­ma study, as well as a cap­sule for­mu­la­tion that is set to be test­ed in a tri­al this year. The com­pa­ny is al­so ex­plor­ing the po­ten­tial of “restor­ing a bal­anced mi­cro­bio­me” to im­prove the clin­i­cal out­comes of check­point in­hibitors, with plans for a com­bi­na­tion tri­al in sol­id tu­mors.

The Se­ries B round in­clud­ed the par­tic­i­pa­tion of US in­vestor Sym­Bio­sis as well as sup­port from MaaT’s ex­ist­ing in­vestors Sev­en­ture Part­ners, Crédit Mutuel In­no­va­tion and Biocodex.

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