The Bio Report

Alzheimer’s disease drug development has long focused on slowing memory loss, but for many families, the tipping point that makes home care impossible is not cognition—it is psychosis. Hallucinations and delusions in Alzheimer’s are a distinct, prevalent, and under-recognized target for therapy. We spoke to Elizabeth Thompson, executive vice president and head of R&D at Acadia Pharmaceuticals, about the biology behind psychosis in dementia, the company’s experimental therapy to treat the condition in people with Alzheimer’s disease, and the forces reshaping the drug development landscape to enable the development of such treatments.

RICO, the Racketeer Influenced and Corrupt Organizations Act, was originally designed to prosecute organized crime. Today, it sits at the center of a landmark class action against two of the world’s largest pharmaceutical companies over the diabetes drug Actos. Attorney Harrison James of Wisner Baum discusses Painters and Allied Trades District Council 82 Health Care Fund v. Takeda, a national civil RICO case alleging that Takeda and Eli Lilly carried out a coordinated, years-long scheme to downplay known bladder cancer risks. The complaint asserts that regulators, physicians, and third-party payers were misled, leading to billions of dollars in reimbursements for the drug. James discusses how RICO’s legal framework applies in the pharmaceutical context, what it took to secure class certification where similar efforts have failed, and the broader implications this case may hold for the industry.

Pancreatic cancer remains one of oncology’s deadliest diagnoses, with standard treatments often offering only transient tumor shrinkage at the cost of grueling side effects and rapid resistance. Immuneering is using transcriptomic and informatics tools to design a MEK inhibitor dosed in intense daily pulses rather than continuously. This approach aims to restore a more normal signaling rhythm in healthy cells while repeatedly ambushing tumors. Ben Zeskind, CEO of Immuneering, discusses how the company is using its informatics-driven dosing regimen to re-engineer targeted cancer therapy so it extends survival, delays resistance, and is better tolerated.

Human leukocyte antigen, or HLA, genes, help the immune system tell the difference between the body’s own tissues and outside threats. In some people, certain versions of HLA genes mistakenly flag normal proteins as dangerous, which can push immune cells to attack joints, nerves, the gut, or other organs. Many autoimmune diseases are driven by changes in HLA genes. RheumaGen is developing a new kind of gene-editing treatment that aims to cure autoimmune diseases by going after one of their root genetic triggers. Instead of broadly weakening the immune system, the company’s goal is to switch off a single “bad” version of an immune gene while leaving the rest of the body’s defenses intact. We spoke to Richard Freed, CEO of RheumaGen, about the role of HLA genes in autoimmune diseases, how the company’s gene-editing therapies work, and its lead program in rheumatoid arthritis.

Asia is quickly becoming a powerhouse for biopharma innovation, changing ideas about where breakthrough science and fast, cost-efficient drug development happen. A new McKinsey & Company report shows how countries like China, Japan, and India are each building their own strengths across the drug development continuum. We spoke to Fangning Zhang, a partner in McKinsey’s Shanghai office, about what’s driving this shift, how it could make innovation more affordable, and why treating Asia as optional may mean missing the next wave of global R&D.

Leukemia once threatened Aaron Viny’s life, but now it defines his mission. Diagnosed with acute lymphoblastic leukemia as a college student, he survived chemotherapy, central nervous system relapse, and an allogeneic stem cell transplant from his younger brother—an experience that made him aware of both the power and toxicity of conventional cancer care. Today, as a hematologist-oncologist and laboratory researcher at Columbia University, Viny is helping reimagine how we treat blood cancers by shifting from blunt, cell-killing approaches to precision strategies that rewire malignant cells and their ecosystems. We spoke to Viny, assistant professor of medicine at Columbia University Vagelos College of Physician and Surgeons, about the case for thinking of hematological cancers as regulatory problem rather than focusing on genetic mutations, the potential for looking at epigenetic activators and deactivators of genes to treat them, and how he is harnessing new technology to look at cell-surface proteins to distinguish regenerating marrow from refractory leukemia.

When Amy Burroughs stepped in as CEO of Terns Pharmaceuticals, she not only had to fill a void created by the death of her predecessor, but also lead a strategic shift from an increasingly crowded area of metabolic disease to focus on its experimental therapy for chronic myeloid leukemia. The company’s allosteric BCR-ABL inhibitor binds to a different site on the fusion protein than most first- and second-generation tyrosine kinase inhibitors. The data have the company and its investors believing the drug can reset the bar for both efficacy and tolerability in a multibillion-dollar market. We spoke with Burroughs about reinventing the company, the decision to seek partners for non-core assets, and how she is charting a clear path toward a broader oncology future.

A One‑Two Gene Therapy Punch to Non-Muscle Invasive Bladder Cancer Non–muscle invasive bladder cancer is a common, slow-progressing form of bladder cancer that makes up a majority of the roughly half a million new cases diagnosed each year. For decades, doctors have relied on a weakened bacterium called BCG, an intravesical immunotherapy, as a standard treatment for early-stage disease, but it fails in about 30 to 40 percent of patients. EnGene is taking a different approach with detalimogene, an experimental, non-viral gene therapy designed to trigger a powerful but localized immune response right where the cancer lives in the bladder. We spoke with Ron Cooper, CEO of EnGene, about this therapy for non–muscle invasive bladder cancer, how its dual payload is meant to activate both an innate and adaptive immune response in the bladder, and the company’s $130 million financing at the end of 2025.

One of the challenges of treating brain tumors is delivering potent biologic therapies across the blood-brain barrier. Adaptin Bio has developed platform technology that harnesses a patient’s own T cells to transport bispecific therapeutic payloads across the blood-brain barrier and into other targeted tissue with an initial focus on treating glioblastoma. We spoke to Michael Roberts, co-founder and CEO of Adaptin Bio, about the unmet need in glioblastoma, the limitations of current blood-brain barrier–crossing strategies, and how the company’s platform seeks to change the treatment paradigm by using patient-derived T cells as delivery vehicles for targeted biologics.

Despite the emergence of new modalities and drug development technologies, the cost and time to produce new therapies has changed little, and failure rates remain high. Xaira aims to change that with a systematic, AI‑driven approach that tackles three pervasive bottlenecks—choosing the right targets, designing the right molecules, and matching the right patients—by running as much work as possible in silico and using high‑dimensional causal datasets to train “virtual cell” foundation models. The company is initially focusing on high‑value, historically undruggable targets and ultimately on building a pipeline of differentiated biologics. We spoke with Marc Tessier‑Lavigne, co‑founder and CEO of Xaira, about applying end‑to‑end AI across target discovery, molecular design, and patient stratification; the company’s more than $1 billion in funding, and how it seeks to enable a new generation of scientists fluent in both AI and biology.