Presage Biosciences - 2013 Fierce 15

Presage Biosciences
Presage makes cancer drug developers smarter

Based: Seattle
Founded: 2008
CEO: James Towne
Clinical focus: Cancer

The scoop: Dr. James Olson grew tired of not knowing which therapies would work best on his pediatric patients with cancer, and his journey to find the right cocktail of chemotherapies and other drugs against tumors led him to form Presage Biosciences. After four years in operation, Presage has begun to show how its technology offers cancer drug developers the ability to make early decisions about which combinations of compounds to advance in clinical trials. Last year, Takeda subsidiary Millennium teamed up with the startup. Celgene ($CELG) soon followed with a major deal early this year that added more money and resources to the growing Presage operation. Its mission to improve cancer drug development and patient treatment seems well underway.

What makes Presage fierce: Presage has spearheaded work on a key upgrade to the way drug developers judge disease response to cancer therapies in development. With technology from Olson's lab at the Fred Hutchinson Cancer Research Center (a.k.a. "the Hutch"), the startup is working on a platform for gaining early proof of the activity of combos of anticancer drugs in patients' tumors before companies roll out expensive clinical trials. 

Prior to major clinical trials, pharma groups try their best to gauge the activity of anticancer compounds in tumor cells grown in labs and in preclinical trials of mice with cancer. These methods have shown their limitations in a majority of early human studies that fall short after the treatments fail to replicate their promising performances from preclinical tests.

"The fundamental challenge is that making decisions about whether the drug or drug combination is going to work based on something other than a patient's tumor is fundamentally flawed," Presage President Nathan Caffo says. 

Presage is working on a system called CIVO that enables researchers to inject microdoses of up to 10 combinations of anticancer drugs into a patient's tumor, avoiding release of the therapies to other parts of his or her body. After a day or so, the researchers can remove parts of the tumor from the patient and analyze the results. The approach factors in variation of disease drivers in tumors, which can make a tumor respond or resist therapies differently than others.

In March, Celgene and Presage announced an alliance to use the startup's technology to evaluate multiple combinations of treatments on solid tumors. Presage executives say the pact was the richest in the short history of the company, with the Summit, NJ-based biotech powerhouse pumping $13 million into the startup up front, including $8 million in the form of an equity investment and $5 million in research funding. The April 2012 deal with Millennium had also focused on solid tumors.

Celgene has made the largest single investment in Presage. Presage CEO Jim Towne says he decided early on to avoid soliciting venture firms for funding. A former Microsoft executive with plenty of startups under his belt, Towne met with Olson for coffee on a weekly basis before they formed Presage in 2008, and he led efforts to raise capital from angel backers to get the operation off the ground in 2009. With the investment from Celgene, Presage has reeled in nearly $16 million from equity backers.

Towne says he took on the work of raising money for Presage after Olson told him over one of their many coffee meetings that he felt "intellectually bruised" by the VC investors that had rejected plans for the company.

"There is no venture investor in place, so we don't have that usual and often-seen selfishness of the [VC] fund needing liquidity that's going to drive us to liquidity," Towne says. "We will achieve liquidity when we decide it's best for the company and the technology."

In addition to his duties at Presage, Towne also served as an early chief executive for another Olson-founded startup known as Blaze Bioscience. Blaze, now led by former ZymoGenetics exec Heather Franklin, is advancing development of "tumor paint" used to illuminate cancerous tissue in MRI scans prior to surgeries to remove cancer.

Even without VC bucks, Presage has enough money to fund operations for another year and a half, Towne says. The startup plans to land another pharma collaborator to bolster its financial strength and gain more runway to advance the technology.  

The NIH's National Cancer Institute has funded a clinical trial of the startup's CIVO system at the Hutch and the Seattle Cancer Care Alliance. In April, the company launched the study, which aims to study response of lymphoma to chemotherapy in nontherapeutic, microinjected doses in 12 patients.

The trial will build on preclinical use of the CIVO tech, which Caffo says has already helped two undisclosed drug developers decide on which treatments to advance into human studies.

In addition to providing early evidence to support drug-development decisions, Presage provides data quickly relative to prior methods of testing combo treatments in animals. It could take a pharma lab more than a year to find effective combos the old way, but this takes about a month with the CIVO system.

Given the advantages of Presage's tech, the company is considering whether to in-license anticancer compounds to develop internally, Caffo says. This would be a step in a new direction for the company, yet it would provide another way to capitalize on the strength of its core technology.

Investors: Celgene and individual angel investors

For more:
Celgene buys into upstart's new approach to picking cancer combos
Seattle startup attracts early adopters of cancer drug tech

-- Ryan McBride

Presage Biosciences - 2013 Fierce 15

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