Video: Nicole Junkermann in conversation with James Peyer
“Healthspan” might not be a term you’ve heard before, but be prepared to encounter it more and more often in conversations about healthcare. James Peyer, founder and CEO of Cambrian Biopharma, explains why in an in-depth discussion with NJF Capital founder and principal Nicole Junkermann
A long life spent bedbound and sickly is hardly one that most people would consider fulfilling. And yet what’s rarely addressed in conversations around lifespan is the quality of the years we live rather than the quantity we enjoy – and by extension, how young people can pre-empt potential illnesses later in life. If you spend half the years of your life in chronic, debilitating pain, for example, isn’t it worth trying to solve or prevent that pain, rather than extend it?
This is the guiding principle behind much of the groundbreaking work of Cambrian Biopharma, a biotech company in NJF Capital’s portfolio that seeks to improve – rather than necessarily extend – human lifespan. And this week, Cambrian’s founder and CEO James Peyer sat down with NJF Group principal Nicole Junkermann for a conversation that touched on preventative medicine, drug development, intermittent fasting and much more.
“Extending lifespan is not really a good,” James told Nicole. “It’s not a North Star, in and of itself. The goal has to be a high quality of life that lasts as long as possible. If that’s the North Star – which I think is what it is for anyone in healthcare, if you really boil it down – then I think you can do very interesting and positive things.”
Nicole Junkermann in conversation with James Peyer
Lifespan, as James explains, is less important than what the biotech community has taken to calling “healthspan” – the period during which a person enjoys a fulfilling, healthy quality of life. After all, getting older is the number one cause of disease in humans, associated with higher rates of cancer, dementia, cardiovascular disease, arthritis and osteoporosis. So why bother extending the lifespan of humans if we are only going to live for longer, and therefore develop more diseases?
Instead, Cambrian is developing preventative drugs to pre-empt the diseases associated with growing old, by identifying changes at a molecular level that happen in older people’s bodies and then stopping or reversing these processes. These, James explains, are “therapies that have the potential not just to treat a disease, but also to prevent multiple diseases.” In this way, Cambrian’s work upends the traditional process whereby diseases are diagnosed then treated. Rather, the causes of those diseases are diagnosed, and treated before the disease can ever set in.
Having identified 80 different ways to extend healthy lifespan in mice, Cambrian is now busy transposing those into humans. Unusually for the biotech sector, in which companies often focus on solving a single, identified problem, Cambrian has more than a dozen subsidiaries under their aegis, giving them a holistic approach to tackling ageing. The company has 17 drugs in their development pipeline, each of which focuses on at least one of Cambrian’s 13 “mechanistic drivers of ageing” – the aforementioned molecular changes that the company has identified from research as those that trigger diseases. “[We are] asking at the molecular level: what went wrong to cause us to get that disease?” says James. “We’re uncovering new things all the time, every day.”
There is, of course, an obvious difficulty that arises when trying to measure the impact of a drug on a person’s healthspan: the fact that it can take years to tell whether a drug is working or not. To do this, Cambrian has embraced what James calls “a surprisingly well trodden pathway that most of the pharma world has forgotten about”: primary prevention clinical trials. These involve identifying healthy but at-risk people and giving them the drugs to prove that they are eventually less susceptible to disease (statins, which treat cholesterol, and anti-hypertensives were pioneered the same way).
Once again, Cambrian is bucking the usual process of drug testing, in which drugs are trialled on people who already have a disease, rather than those who might eventually get it. And while preventative trials are much more costly and arduous, says James, the risk is ultimately worth it. “Mostly,” he says, “pharma doesn’t like to do this any more, because it’s long, and expensive, and risky. But when the prize at the other end is as big as increasing human healthspan? We can do it.”