6
May
2020

Extending an Immune Medicine Platform Against the Common Foe

Chad Robins, co-founder and CEO, Adaptive Biotechnologies

Every few days, I walk through our labs to say hello to my colleagues. They are the ones who are literally and figuratively keeping the lights on at Adaptive Biotechnologies.

Rest assured, I’m maintaining physical distance while seeking human connection. With a Telepresence Robot that I can drive with a remote control from my home, I’m able to get real-time updates on the day-to-day work being done, and hear how employees are doing. It’s a high-tech version of “management by walking around.”

As Adaptive’s CEO and co-founder, it is a top priority for me to stay socially connected with all of our employees while we are mostly isolated. Especially our lab and lab support staff. Executives like me have meetings on Zoom with partners, investors, and my executive team. People in the labs are the ones coming into the office every day, taking extra safety precautions.

They are making sure our important work on behalf of our patients continues to move forward.

This has been a hard pill to swallow. I seriously want to be there in person. We’ve been keeping our distance for two months now. But we must continue to protect our essential lab employees by staying home.

We are all in unchartered waters. While COVID-19 may be bad for our physical health, it also has the potential to threaten our mental health and well-being, especially as the pandemic drags on. Like many others in the biotech community, I am grateful to be healthy and productive while so many others have not been as lucky. And like so many around the world who continue to shelter in place, I get what this new normal means. Home schooling my two teenage daughters, virtual birthday celebrations with family, and online all-company meetings – it’s not the same, but it’s amazing what we can continue to do all of this with technology.

At Adaptive, we are fortunate to be able to contribute. Our immune sequencing platform gives us a powerful tool that can be used both for quantitative molecular diagnostics, and, potentially to identify neutralizing antibodies to be made as therapeutics against the SARS-CoV-2 virus.

We are working harder than ever to deliver on this urgent need. We sometimes feel gratitude, but also the stress that comes with a demanding job, homeschooling, isolation and blurry lines between work and personal time. When, exactly, should you take a break? This is new to us all, and we’re all doing the best we can.

Extending the Company

Our story with COVID-19 starts in late February when we saw the early warning signs in other countries but just before the virus brought the U.S. to its knees. Adaptive president Julie Rubinstein came to my brother and co-founder, Harlan, and I with a persuasive proposal: we already had the technology to help advance solutions for this virus. It was time to jump in.

I reached out to our long-time partner Microsoft, and Peter Lee immediately agreed to lock arms on this endeavor. We originally partnered in 2018 to create the TCR-Antigen Map, an approach to map population-wide adaptive immune responses to diseases at scale with a simple blood test.

We’ve been looking at diseases where there’s no single biomarker of inflammation to look for. We can see a broader immune repertoire at work, which is necessary for understanding a more complex and nuanced immune response that you see in many diseases. Since the beginning of our partnership, we have confirmed clinical signals in two diseases, and established our first proof of concept in molecular diagnosis of Lyme disease.

Given the maturing state of our technology, we knew we could potentially help on both the diagnostic and therapeutic front against COVID-19.

Our lead independent board director, Peter Neupert, happens to also be the lead independent director of LabCorp of America – one of the two biggest diagnostic companies in the US. Peter helped make the connection to quickly bring LabCorp into the fold with us. Illumina, the DNA sequencing leader, and Providence St. Joseph, a major healthcare system on the West Coast, then joined forces with us. By Mar. 20, we announced a joint effort to find the relevant immune response signature to the virus to help advance solutions.

We all agreed to do what isn’t normally done in industry — to make the data available to any researcher, public health official or organization around the world via an open data access portal.

Since then, new information about the virus and potential solutions continue to mount with remarkable speed. The first US death was reported on Feb. 29. Now, on May 6, Covid-19 has claimed more than 72,000 lives in the US. We are learning that the virus may be far more widespread than originally thought.

There are many unanswered questions with the current RT-PCR testing paradigm.

  • Can it detect asymptomatic carriers?
  • How about segment patients based on immune response of those who will develop mild symptoms versus those who will require hospitalization?
  • Can it tell us which patients have truly cleared the disease?

We hope to answer one, if not many, of these questions with one test.  

Right now, to contain the spread of COVID-19, the world needs more of the existing tests, and other kinds of tests.

A new virtual clinical study, ImmuneRACE, sponsored by Adaptive and Microsoft, will enroll 1,000 participants around the US. We’re seeking to map and measure the immune response to COVID-19 to inform a cellular immune test to potentially help address current challenges in testing. As part of the study, we will measure the presence of T cells, which identify the disease early and multiply to combat the infection.

In parallel, we expanded our partnership with Amgen to develop potential antibody therapies for COVID-19. Like others, we think that neutralizing antibodies may be effective since this virus seems to mutate more slowly than other RNA viruses and mutated strains are genetically similar – making them likely susceptible to a broadly neutralizing antibody in the months ahead. The promise of an approach using engineered neutralizing antibody therapies is the ability to select and confirm the best antibodies and manufacture them in large quantities. Amgen is a world leader in engineering and manufacturing antibodies. This was a perfect pairing of our immune sequencing platform with the world’s largest biotechnology company.

We have seen some early successes using convalescent plasma therapy to boost the ability of patients with severe cases of COVID-19 to fight off the infection, but this approach is not sustainable in mass quantities. Our goal is to find the strongest antibodies from patients who are actively fighting or have recovered, and manufacture them into a therapeutic that can be used in two ways: for treating patients fighting the disease, and to prevent the disease in those at higher risk, such as healthcare workers. 

We see ourselves as well-positioned to respond. Our technology can read the immune system, which is different from other solutions which focus on the virus itself. That means we can let the immune system tell us which are the strongest antibodies to neutralize the virus without assuming what those antibodies are targeting. We also have the scale and speed to assess a much broader pool of possible antibodies against a wider range of targets. Our platform allows us to look at all the activated antibodies in patients currently fighting the virus. We aren’t limited in our view to just 1-2. We then funnel them down through a series of techniques to find the best antibodies. This may also dictate whether we develop a single antibody therapy or a cocktail of antibodies, and at what point during treatment an antibody therapy would have the greatest impact. It’s like being able to scout every high school basketball player at the same time — Michael Jordan, Scottie Pippen, LeBron James – to assemble a Dream Team of antibodies.

We are all racing to find solutions, and we will need many to address the magnitude of this problem. I’ve been privileged to be one of the voices representing the diagnostics perspective as part of several national working groups. It has been amazing to see such an unprecedented level of collaboration. Normally partnerships with big companies like Microsoft and Amgen, or with academic research centers, would take months to years to materialize. Instead, we moved in days and weeks, acting on “virtual” handshakes. 

We all know there is no time to lose, and you see this reflected across the entire industry.

I wish I had the foresight to know now what lessons I will learn as this plays out. For now, I’ll share two thoughts. The first is sincerity – be sincere. I want my employees to know that I care about them, that I worry about them, that I am thankful to them for showing up every day. That human connection is something that cannot be replaced by technology.

My other advice: we all have a role to play in ending this pandemic, whether it’s working in a lab, serving food, or staying home. People are dying. If you are in a position to help, in whatever way you can, you have an obligation to humankind. Sometimes people find purpose in surprising and remarkably generous ways, like the people who are delivering restaurant meals to testing labs in my hometown of Seattle. That helps both the lab workers, and the restaurants. There are things we can call do.

It is my biggest hope that we – our whole community – can make an impact, together.

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