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Endpoints 11 winner Mirador Therapeutics: Applying precision medicine to immune disease

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  • CEO Mark McKenna
  • Total raised $400 million
  • Headquarters San Diego, CA

2024 is on track to be a record-breaking year for venture capital funding of immunology-focused biotech startups. And Mirador Therapeutics is the biggest of them all.

The California biotech launched with more than $400 million in March, just nine months after CEO and co-founder Mark McKenna sold his previous company, Prometheus Biosciences, to Merck for $10.8 billion.

Prometheus developed an experimental drug for inflammatory bowel disease and a companion diagnostic to identify patients with a particular kind of inflammation who would be most likely to benefit from the treatment’s novel mechanism. That biomarker approach, increasingly the norm for cancer, was at the time practically unheard of for an immune disease.

Mirador is an unabashed sequel, bringing much of the Prometheus executive team back, and running the same precision medicine playbook for immunology but with bigger and broader ambitions.

“At Prometheus, the value of the company was largely driven by one asset,” McKenna told Endpoints News. “Five years from now, I think this is going to look a lot more like a Regeneron.”

His vision is as big as the specifics are light. But the company already has 60 employees and counting, and in March, McKenna set an ambitious goal of starting clinical trials of multiple drugs in 2025. He declined to provide an update on the status of those programs but said “we’re not constrained by cash.”

Mirador’s medical chief Allison Luo said the startup is focusing on gastrointestinal diseases, fibrotic lung diseases and skin diseases — all with large numbers of patients who don’t get better with existing drugs. She pointed to psoriasis as a condition that Mirador wouldn’t work on, because several blockbuster medicines made by other companies have made a huge dent in the condition in recent years. “That’s what we’re aiming for,” she said.

To get there, McKenna said the startup has four main strategies: a focus on novel targets; finding the right drug for the right patient; combining different mechanisms to improve efficacy and minimize side effects; and testing drug modalities beyond the standard monoclonal antibodies that dominate immunology.

None of these ideas are particularly groundbreaking on their own, but most are just beginning to trickle into immunology. In cancer, drugs are increasingly developed to target tumors driven by particular genetic mutations, regardless of where in the body they arise. “I&I is not quite there yet, but it’s really the same idea,” CSO Olivier Laurent said.

Although most immune conditions can’t be linked to a single genetic cause, Laurent believes the field is headed toward a time where a person’s genetic background could suggest that a disease is driven by a specific set of overactive cytokines, the inflammatory proteins that most immune drugs target. “And that will really define the drugs you take, as much as what the disease is,” he said.

Immunology drugs are often approved for many conditions because the same cytokines and immune cells can manifest different diseases depending on where in the body they arise. But when there are multiple drugs targeting multiple immune proteins for a single disease, figuring out which one will help a patient is guesswork.

“If you find your way to precision with an interesting drug in one disease, there will almost certainly be some other indications where that precision will take you,” chief strategy officer William Sandborn said. “Our platform allows us to chase a precision pipeline-in-the-product.”

And that concept gets to the core of the company. Mirador is founded on the increasingly common viewpoint that drug programs built on genetic associations have a higher probability of success. The startup is centered around a database dubbed Mirador360 that could soon hold “molecular profiles” of two million people. And AI will play a role in helping make sense of it all.

“And it’s going to allow us to do drug development in a way that even big pharma can’t,” McKenna said.

Key backers: ARCH Venture Partners, OrbiMed, Fairmount, Fidelity Management & Research Company, Point72, Farallon Capital Management, Boxer Capital, TCGX, Invus, Logos Capital, Moore Strategic Ventures, Blue Owl Healthcare Opportunities, Sanofi Ventures, Woodline Partners LP, Venrock Healthcare Capital Partners, RTW Investments, Alexandria Venture Investments

Find the full list of 2024 Endpoints 11 winners here.


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