James Peyer on breaking the geroscience dam

Ahead of the fourth annual Longevity Leaders World Congress, Cambrian’s James Peyer talks stepping stones and silver bullets in geroscience research.

Geroscience research is at an inflection point. As the world reflects on the pandemic, a groundswell of investors, regulators and members of the medical community are realising the enormous potential of geroscience research to fundamentally change how we diagnose, target, prevent and treat disease.

Longevity.Technology: Cometh the inflection point, cometh the conference. The Longevity Leaders World Congress kicks off later this month and brings the world’s most prominent regenerative medicine and longevity scientists; as well looking at innovation in regenerative medicine and longevity therapeutics, the conference will overview responsible drug development and how targeting age-related diseases is commercialised.

With giant strides being made in our understanding of aging biology and investor interest in geroscience research continuing to increase, we sat down with James Peyer, the founder and CEO of Cambrian Biopharma, to gain his perspective on both the longevity space and the upcoming conference where Peyer will be moderating a keynote panel featuring Thomas Rando, Georgina Ellison-Hughes and Nir Barzilai and enticingly entitled Regenerative, Rejuvenate or Reprogram?

There is great progress being made in longevity research, but the real trick is applying that research to translational biology and human clinical medicine. There is an understanding of the molecular drivers of the changes that come with age, whether that’s cancer or heart attacks or Alzheimer’s disease, or the more subtle things such as age-related muscle weakness or age-related immune senescence, and this understanding has created a cornucopia of new drugs that target those changes.

Cambrian takes an approach it calls “the stepping stone indication approach”, identifying drugs that target these fundamental changes that happen with age and then seeing on which diseases they have an effect. Rather than playing a guessing game, Cambrian’s approach is iterative: identify drugs that help patients suffering from a disease, do initial FDA trials for safety and efficacy and once successful, use the drug for primary prevention on healthy people, keeping them healthier for longer.

Ahead of the fourth annual Longevity Leaders World Congress, Cambrian's James Peyer talks stepping stones and silver bullets in geroscience research.

Taking it step-by-step in geroscience research

“It’s a two-stage approach,” Peyer explains. “Step one is using the biology of aging to make new drugs in the existing biotech world today, and step two is using that safe and effective drug in a prevention approach – which is the kind of holy grail of geroscience!”

Prevention is both the starting block and the finish line.

“You start with prevention in the context of mouse studies, move into disease, do the initial clinical work and then move back to prevention,” says Peyer. “We’ve seen this work before in drug development. I think the best example is the cholesterol lowering drugs called statins that were tested on the rare disease hypercholesterolemia, showed safety and efficacy  and then went immediately into prevention studies, which is how we have statins today.

“The answer that we came up with was the stepping stone approach – the only way to justify spending the money to do these trials properly was to lower the regulatory risk, make sure you are creating something valuable, and then you can ask ‘Can it slow aging?'”

No silver bullets

Peyer is moderating a keynote panel at Longevity Leaders that asks Regenerative, Rejuvenate or Reprogram? However, the answer to that is far from straightforward.
“It’s going to be fun to talk about that on the panel with with a few different folks who are taking very different approaches to this field,” he enthuses.

There are many different drivers of aging, so there won’t be any silver bullets, according to Peyer. “However, we will probably see some drugs that have pretty strong effects on their own – a drug that has the ability to extend human health span by five or 10 years would be a massive change, but it would still only address one small fraction of all of the things that go wrong with us as we age,” he explains, adding that as this industry matures, there will have to be complementary approaches targeting aging.

“Some will be regenerative, some rejuvenating, but it will need multiple therapies,” Peyer adds.

Breaking the geroscience research dam 

Peyer thinks that actually the first breakthroughs in geroscience are going to be none of those three. “It’ll will be something with less ‘re’,” he explains. “It’s just going to be modifying and tweaking well-understood pathways with with therapies that change some of the fundamental processes that go wrong as you age.”

Research should look to more simple therapeutics that are just directly impacting one of the key drivers of aging, says Peyer as one of these will be the first to break the dam.

“Nothing as radical as a newt being able to rejuvenate its tail, but changing the way that our metabolism works or changing the way that our extracellular matrices signal to the cells around them.”

It will be the lowest hanging fruits that are going to be entering the clinic first and this is where Cambrian’s approach is. “Not that we don’t have some regenerative medicine stuff under the hood – we do,” he teases, “But I think that the first prevention trials are going to be with things that look more like metformin than the Yamanaka factors.”

Different approaches, similar goals

Peyer says he has never been part of an industry where the phrase a rising tide lifts all ships has been more apropos.

“Almost everyone that I know really is rooting for the success of everybody else because it validates the scientific and the investment thesis of other people in the space,” he says.

“Getting more of a chance to talk about strategies for the overall approach to this field, what others are doing, how we’re going to execute the shift from therapeutic to prevention as an industry. And so it’s going to be fun to talk about on the panel with with a few different experts who are taking very different approaches to this field – those are all great conversations to have!”

Peyer confirms that the new Longevity Biotech Association will have have a presence at Longevity Leaders Conference in London, discussing the strategic aims of that group moving forward and he is delighted that it’s an IRL event. “It’s going to be wonderful to be in-person with all of these folks again,” he says “Fostering collaboration within the industry – that’s what I’m most excited about.”

Read the second part of our interview with James Peyer HERE.

The fourth annual Longevity Leaders World Congress takes place 26-27 April in London, UK.

Find out more about the exciting line-up HERE and Longevity.Technology readers can benefit from a 25% discount – simply use the code LT25 when booking.