Roche vet Jean-Jacques Ga­raud woos in­ter­na­tion­al be­liev­ers in his French star­tup's take on sep­tic shock

Jean-Jacques Ga­raud

When Jean-Jacques Ga­raud left the top role in re­search and ear­ly de­vel­op­ment at Roche to build and ad­vise ear­ly-stage biotechs in his na­tive Paris, one fledg­ling quick­ly drew close to his heart.

The start­up, In­otrem, was de­vel­op­ing an im­munother­a­py to treat sep­tic shock. Hav­ing trained as a crit­i­cal care physi­cian be­fore mov­ing to Scher­ing-Plough and then No­var­tis, Ga­raud was all too fa­mil­iar with the dearth of treat­ments for sep­sis, which is dead­ly even in de­vel­oped coun­tries, claim­ing more than a quar­ter-mil­lion deaths in the US each year.

To­geth­er with co-founders Sébastien Gi­bot and Marc De­rive (De­rive did his PhD at Gi­bot’s lab and is now In­otrem’s CSO), he swift­ly gath­ered €18 mil­lion from French VCs An­dera Part­ners and Sofinno­va Part­ners, as well as the trans­fer seed fund known as In­serm and Swiss play­er Bio­Med­In­vest. But for the next round of fund­ing, Ga­raud told Phar­ma Board­room ear­li­er this year, he’d be look­ing to bring in in­ter­na­tion­al in­vestors out­side of France and Eu­rope.

Marc De­rive

And bring in in­ter­na­tion­al in­vestors he did. Morn­ing­side Ven­tures, which traces its roots to Hong Kong, is lead­ing In­otrem’s €39 mil­lion Se­ries B. New York-based In­vus al­so joined the syn­di­cate.

“This fi­nanc­ing val­i­dates the po­ten­tial of our tech­nol­o­gy plat­form cen­tered on the TREM-1 path­way and of our lead drug can­di­date for sep­tic shock, nan­gi­botide, which will be en­ter­ing a large Phase IIb clin­i­cal tri­al lat­er this year,” Ga­raud said in a state­ment.

Char­ac­ter­ized by dan­ger­ous­ly low blood pres­sure, sep­tic shock is the most se­vere com­pli­ca­tion of sep­sis, which oc­curs when the body mounts an over­whelm­ing re­sponse to an in­fec­tion, lead­ing to or­gan fail­ures. While an­tibi­otics can help tamp down the in­fec­tion, nei­ther it nor sup­port­ive care ad­dress­es the un­der­ly­ing shock.

In­otrem’s hy­poth­e­sis is that by in­hibit­ing TREM-1 — a re­cep­tor ex­pressed on myeloid cells — its pep­tide drug can mod­u­late the im­mune at­tack with­out com­plete­ly stop­ping the in­flam­ma­to­ry re­sponse from clear­ing harm­ful bac­te­ria.

The field is not packed, but the biotech is not alone ei­ther. Berlin-based Adrenomed is tack­ling a tar­get called adrenomedullin, while Medicxi-backed UK start­up Crit­i­cal Pres­sure reck­ons hit­ting DDAH1 is the way to go.

With the new fund­ing, In­otrem plans to launch a glob­al Phase IIb tri­al to test that the­o­ry, re­cruit­ing 450 pa­tients and test­ing two dos­es of nan­gi­botide against stan­dard of care and place­bo.

Keep­ing his phar­ma con­nec­tions close, Ga­raud has al­so se­cured a part­ner­ship with Roche on a com­pan­ion di­ag­nos­tic tool based con­cen­tra­tion of TREM-1 in pa­tients.

In ad­di­tion to sep­tic shock, In­otrem is al­so de­vel­op­ing its TREM-1 drugs in car­dio­vas­cu­lar dis­eases and chron­ic in­flam­ma­to­ry con­di­tions.

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Vas Narasimhan. Getty Images

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IM­brave150: Roche’s reg­u­la­to­ry crew plans a glob­al roll­out of Tecen­triq com­bo for liv­er can­cer as PhI­II scores a hit

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Given their breakthrough and Big Pharma status as well as the use of two approved drugs, FDA approval may well prove to be something of a formality. And the Chinese have been clear that they want new drugs for liver cancer, where lethal disease rates are particularly high.
Researchers at their big biotech sub, Genentech, say that the combo beat Bayer’s Nexavar on both progression-free survival as well as overall survival — the first advance in this field in more than a decade. We won’t get the breakdown in months of life gained, but it’s a big win for Roche, which has lagged far, far behind Keytruda and Opdivo, the dominant PD-1s that have captured the bulk of the checkpoint market so far.
Researchers recruited hepatocellular carcinoma — the most common form of liver cancer — patients for the IMbrave150 study who weren’t eligible for surgery ahead of any systemic treatment of the disease.
Roche has a fairly low bar to beat, with modest survival benefit for Nexavar, approved for this indication 12 years ago. But they also plan to offer a combo therapy that could have significantly less toxicity, offering patients a much easier treatment regimen.
Cowen’s Steven Scala recently sized up the importance of IMbrave150, noting:

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David Liu, Liu Group

David Liu un­veils newest ad­vance­ment in CRISPR tech: Prime edit­ing

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Bhaskar Chaudhuri. Frazier Healthcare Partners

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