The Pakistan Genome Resource (PGR), one of the largest genomic studies ever conducted in South Asia, has revealed novel insights into gene function, disease susceptibility, and the translatability of preclinical findings to humans.Published in a Nature article, a collaboration between Novartis, Columbia University Irving Medical Center, and the Center for Non-Communicable Diseases, Karachi, Pakistan, examined 173,303 PGR participants, constituting 0.07% of the population of Pakistan, the fifth most populous country in the world.
The numbers alone are impressive, as the scientists identified more than 6.6 million coding genetic variants, with nearly half of them absent from existing global databases. But the PGR is particularly powerful not just because of its size but also because of the unique genetic structure of the population being studied with high levels of familial relatedness.
The study identified naturally occurring homozygous loss-of-function (LoF) variants in 6,476 genes, about one-third of all human protein-coding genes. The researchers confirmed several well-known genetic associations. For example, individuals carrying LoF variants in the APOC3 gene had significantly lower triglyceride levels, while variants in PCSK9 were linked to lower LDL cholesterol. While both genes are already important targets in cardiovascular medicine, the findings shore up the dataset’s credibility.
New links between genes and biological traits provide clues about conditions ranging from obesity and diabetes to liver disease and neurodegeneration. In one striking example, individuals lacking a functional version of the gene CIDEB, which has become a major target in metabolic research because rare mutations that inactivate the gene provide significant protection against liver diseases, appeared to have a lower risk of liver disease, strengthening the case for therapies that target this pathway.
Some findings provided new context to genes already being widely studied, such as LRRK2—a gene currently targeted by experimental Parkinson’s disease treatments. LoF mutations in LRRK2 showed signs of kidney dysfunction. It’s an observation that raises important safety questions and highlights why human genetic studies matter so much. Sometimes biology sends a warning before a drug reaches the market.
The research also challenged assumptions based on animal studies. A gene called PRDM9 is considered essential for fertility in mice. Yet several people in the PGR with completely inactive copies of the gene had healthy children.
Ultimately, the Pakistan Genome Resource is much more than a national database. It’s a reminder that human genetic diversity remains vastly underexplored. By studying populations that have historically been overlooked, researchers are uncovering entirely new biology that could lead to better treatments, safer drugs, and a more profound understanding of what makes us human.
We are still talking about big pharma deals and biotech fundraising in this episode. The big news this week was Parabilis Medicines’s history-making IPO. We dive into the drug developer’s plans for the eye-popping $770.5 million that it raised. Next, we discuss the details of a collaboration between Merck and Protillion Biosciences to use artificial intelligence to discover multiple therapeutic candidates. Turning to some newly published research, we discuss the early results of a first-in-human clinical trial that is testing a dual vaccine against Lassa fever and rabies, a CRISPR system engineered to selectively trigger cancer cell death by chromatin shredding, and a novel mRNA delivery platform for delivering gene therapies starting with Duchenne muscular dystrophy.
Listed below are links to the GEN stories referenced in this episode of Touching Base:
F2G and Shionogi have reported positive Phase III results for the antifungal drug olorofim in patients with invasive aspergillosis who are not eligible for standard azole therapy. If approved based on this data, olorofim would become the first antifungal agent with a novel mechanism of action for invasive aspergillosis in over two decades.
“Invasive fungal infections remain difficult to treat and can be life-threatening especially in immunocompromised patients,” said Johan Maertens, MD, PhD, professor of hematology at University Hospitals Leuven in Belgium and principal investigator of the study. “The OASIS topline results add to the growing body of evidence supporting olorofim’s therapeutic potential in a hard-to-treat population with limited antifungal options. We’re hopeful this could offer a meaningful alternative for clinicians to treat challenging infections caused by Aspergillus.”
Invasive aspergillosis is a fungal infection with high mortality rates that mainly affects immunocompromised patients. Due to rising drug resistance and toxicity profiles of currently available therapies, a growing number of patients cannot be treated with azole antifungals, leaving them with limited options.
Olorofim belongs to a new class of antifungal agents called orotomides that was discovered by F2G. These drugs can selectively target an enzyme essential for the synthesis of pyrimidine that is shared across mold fungi including Aspergillus, making olorofim effective against a broad range of species including rare and drug-resistant strains.
The Phase III OASIS study recruited 225 adults with invasive aspergillosis who either had a refractory infection or were unsuitable for azole therapy. Participants received either oral olorofim or amphotericin B—an antifungal used to treat serious infections known for causing kidney toxicity.
After 42 days, the mortality rate among patients who took olorofim was 23.8%, compared to 24.3% for the control group. The rate of adverse events caused by the treatment was 35.8% for olorofim versus 63.9% for amphotericin B, with the difference being mostly driven by a higher rate of kidney toxicity in the control group.
“This is a promising new development in antifungal medicine—an area where patients have been underserved for more than 20 years,” said John Keller, PhD, director of the board and senior vice president of R&D at Shionogi. “In current clinical practice, safety and tolerability considerations, particularly effects on renal function, can pose significant challenges for treatment selection and continuation. Against this background, the results of the OASIS study suggest that olorofim has the potential to offer a new treatment option for patients with invasive aspergillosis.”
Based on these results, Shionogi and F2G plan to submit approval applications with regulatory authorities across the world. Under their commercial agreement, Shionogi will be responsible for commercialization in Europe and Asia, while F2G will oversee North America and other remaining territories.
Over the past 20 years, most newly approved antifungal drugs have belonged to existing drug classes, limiting progress against the growing threat of antimicrobial resistance. During that period, only a single antifungal with a novel mechanism of action reached the market: ibrexafungerp, which is approved for the treatment of vulvovaginal candidiasis infections. If approved, olorofim would offer a much-needed option in an indication where both existing treatment choices and therapeutic innovation have historically remained limited.
DAKAR, Senegal — The Ebola outbreak in Congo and Uganda has claimed more than 200 lives in its first month and is the worst known outbreak at this stage, with up to 35,000 suspected potential contacts, Africa’s Centres for Disease Control and Prevention said on Thursday.
With 894 confirmed cases so far, the current outbreak is three times worse than a previous outbreak in Uganda in 2000, which had 281 cases at the same point, said Dr. Wessam Mankoula, a medical epidemiologist at Africa CDC.
IDBS, which provides cloud software for biopharma, and Alchemi, an applied AI company, partnered to connect AI agents to data captured and contextualized in the IDBS Polar platform across the drug development lifecycle. By capturing such data at the point of creation within a single governed backbone, Polar delivers the data foundation that makes agentic AI viable in regulated environments, explains IDBS in a statement.
Preparing regulatory filings remains one of biopharma’s most persistent bottlenecks. CMC teams spend months assembling data, drafting reports, and reconstructing process histories, while current AI tools often break the compliance chain by pulling data out of validated systems, according to an IDBS spokesperson, adding that connecting Alchemi’s purpose-built agents to Polar’s AI-ready data foundation keeps validated data traceable and auditable.
CMC technical reports, clinical study reports, and submission dossiers can be drafted faster and routed through human-in-the-loop workflows for review and sign-off, maintaining compliance, points out the IDBS official. According to Alchemi, in customer deployments across biopharma, teams have produced documents of this type up to 70% faster using Alchemi’s agents.
“A regulatory filing that takes a team weeks, our agents draft in minutes, at submission-ready quality, with the compliance trail intact, because they work straight from governed data in Polar,” reports Anuj Chadha, co-founder, Alchemi.
“Our mission is to accelerate life-changing therapies to patients, and as part of Danaher, that means turning ideas into impact with speed and certainty,” says Pietro Forgione, general manager, IDBS. “[Our company] delivers a governed data backbone that makes AI-ready data available across the biopharma lifecycle. By partnering with Alchemi, we can accelerate critical regulatory milestones using high-quality, compliant AI agents,” said Pietro Forgione, general manager, IDBS.
We childproof almost everything. Plug sockets. Medicines. Cleaning products. Toys. Before these products reach children, we expect them to be safe by design. If a toy left one in three […]
Order 818 allows therapeutics whose mechanisms of action are at the cellular or molecular level to be clinically translated at 3A hospitals (tertiary care hospitals, of which there are approximately 1,700) without requiring National Medical Products Administration (NMPA) drug registration. Once translational approval is granted, hospitals may begin charging patients for these treatments.
A good move
While the move appears to be viewed positively by the biopharma industry, some details are still being ironed out. For example, boundary delineation guidelines still need to be issued to specify which technologies fall under Order 818 and which remain under the NMPA’s purview. Interpretations of the order generally suggest that therapies intended for mass manufacturing and wide distribution will be governed by the NMPA, while personalized therapeutics may use the Order 818 pathway.
“We definitely see this as a positive signal,” Boyang Wang, founder of Singapore-based global longevity fund Immortal Dragons, tells GEN. Because advanced therapeutics are intricate and often personalized, it’s quite difficult for them to use the standard NMPA pathway. Before Order 818 was enacted on May 1, “biomedical companies in China would initiate investigator-initiated trials and partner with any training medical institution of their choice.”
Order 818 provides a standardized structure that ensures only hospitals capable of advanced therapy development are involved. It also provides a one-to-five-year risk observation window before the technology can shift from the tech track to a drug track, Wang says. That effectively provides a level of Chinese exclusivity before the therapeutic developer can file for approval with regulators outside China.
Ramifications
For international firms partnering with Chinese companies to develop advanced therapeutics, the new regulatory pathway mainly triggers a review of existing contracts and milestone clauses.
The greatest disruption may be for Chinese companies that are in the midst of investigator-initiated trials for advanced therapies at smaller institutions. This affects contract research and manufacturing organizations, too, who are producing materials, such as stem cells, for investigator-initiated trials.
Boundary guidelines are pending, but Order 818 is expected to cover personalized therapies, while mass-market products remain under NMPA oversight. [STAP/Getty Images]
Speaking to GEN, Todd Liao, partner at Morgan Lewis & Bockius’s Singapore office, emphasizes the need for foreign companies invested in China to review their contracts.
“Legacy agreements were written for a single-pathway world that no longer fully describes the Chinese landscape. If milestones are defined solely by NMPA events, a licensee commercializing [a therapeutic] through hospitals may never trigger them.” The solution, he says, “is to redefine milestones around clinical and commercial outcomes [such as] ‘first fee-paying patient’ rather than ‘first NMPA-approved commercial sale.’”
Liao says he expects “a wave of proactive contract amendments. It becomes contentious only if ignored.” Any disputes, he adds, will most likely be tried internationally rather than in Chinese courts.
To succeed under this dual-pathway system, Liao advises multinational corporations to define success by what happens in the clinic and the market, not the regulatory pathway. Therefore, he says:
Use pathway-agnostic milestone language
Require the Chinese partner to notify you before selecting the translation pathway so you can assess the global intellectual property (IP) and data implications
Address human genetic resources’ joint IP requirements upfront to maintain global commercial control
“The overall regulatory direction is actually loosening, not tightening,” Liao says, citing new, “centralized oversight for clinical research and clinical transformation applications of biomedical new technologies.”
As he elaborates, “Notably, on May 8, 2026, the National Health Commission released a consultation draft that proposes to exclude pure clinical data, imaging data, and protein data from human genetic resources restrictions entirely, limiting the scope to nucleic acid sequence data only. It also introduces same-day filing confirmations for international clinical trials.”
Unless and until that proposal is enacted, export controls for Chinese human genetic resources remain strict, which may affect data-sharing arrangements for non-Chinese companies seeking to license or acquire Chinese cell and gene therapies. Basically, under current laws, Wang says, human genetic resource data “can never leave Chinese soil.” Analyses based on that data may be less restricted, and the differences can be subtle. Understandably, the close collaborations with 3A hospitals required under Order 181 could complicate data export decisions.
Advanced therapies such as CAR T, cell therapy, and gene therapy require highly coordinated systems—regulatory clarity, manufacturing standards, hospital infrastructure, quality oversight, and predictable development pathways. [Zorazhuang/Getty Images]
Additionally, the applicability of Order 818 to free trade zones has not yet been specified. Currently, the 2024 Foreign Investment Negative List prohibits multinational companies from investing in China’s cell and gene therapy development at a national level. Such investment is allowed, however, within the free trade zones of Beijing, Shanghai, Guangdong, and Hainan, but only under the NMPA product registration pathway. The so-called Negative List has not yet been updated to reflect the Order 818 pathway.
“Advanced therapies such as CAR T, cell therapy, and gene therapy require highly coordinated systems—regulatory clarity, manufacturing standards, hospital infrastructure, quality oversight, and predictable development pathways,” Jeremy Levin, PhD, chairman of Ovid Therapeutics and Opthera, chairman Emeritus of BIO, and author of the recently released Biotech in the Balance: Saving a Strategic Industry in an Age of Distrust, points out. “China is clearly trying to standardize and industrialize that environment.”
“If implemented consistently, that could make China a more attractive environment for advanced therapeutics development, and potentially accelerate local innovation, manufacturing, and partnerships,” Levin says. “China intends to compete at the highest levels of biotechnology over the long term.”
While some of the points of Order 818 are being refined in terms of their interrelationships with other trade regulations, “the clear signal is that biotech, healthcare, and biomedical technologies are at the top of senior government officials’ priority list,” Wang says. “They want to develop this sector. They want investment, and they want to leverage international capital and expertise. If any of the terms of this [order] will stifle innovation development, they will likely make modifications.”
NEW YORK CITY — Patients, colleagues and peers gathered in midtown Manhattan last week to celebrate Carl June, MD, and Michel Sadelain, MD, PhD, who shared the 13th annual Ross Prize in Molecular Medicine.
The prize, which is made possible by the generosity of Feinstein Institutes board vice chairman Jack Ross and his wife, Robin, assistant vice president of principal gifts at the Northwell Foundation, recognizes biomedical scientists whose discoveries have transformed how medicine is practiced. Established in 2013, it is awarded annually through the Feinstein Institutes’ peer-reviewed, open-access journal Molecular Medicine.
June and Sadelain are both well-known in immunotherapy circles but could not disguise their delight at being recognized for their pioneering work in developing CAR T-cell therapy for cancer treatment.
June is an immunologist and cancer researcher at the University of Pennsylvania’s Perelman School of Medicine. He serves as the director of both the Center for Cellular Immunotherapies and the Parker Institute for Cancer Immunotherapy at Penn. Sadelain, who holds dual French and Canadian citizenship, is a professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons, where he directs the Columbia Initiative in Cell Engineering and Therapy.
With so many people wanting a chance to congratulate and interact with June and Sadelain—some even requesting autographs—it was hard to get more than a few minutes of their time to chat. June told me the award was a “huge honor” personally as well as a great way to recognize the efforts of those who have worked with him over the past three decades. “It’s a great way for the public to learn more about the value of what was initially basic research and how it can actually affect lives,” June said.
Sadelain expressed similar sentiments. ”I’m so fortunate that somebody looked at our work and thought that it warranted such recognition,” he told me. Additionally, the presence of both patients and students “who are curious and have a sense that there is something that that would like to get involved with” at the award ceremony reinforced both the human impact and educational value of his work.
That kind of curiosity coupled with persistence certainly served Sadelain and June well in their careers. An important theme that both honorees acknowledged is that scientific breakthroughs often require decades of dedicated work despite repeated setbacks.
As June noted, prior to 2011, when the first checkpoint inhibitor therapy was approved, and then in 2017, when the first CAR T-cell therapy was approved “there were many decades when cancer immunotherapy was tried and failed.” Multiple disappointing results can make science review boards nervous and cause federal funding sources to dry up. For the CAR T field, things changed once regulators and scientists realized that immunotherapies could work but “that initial paradigm shift” was needed for acceptance, June said.
Sadelain concurred. Scientists entering the field today are far less likely to face the same challenges that he and June and their teams had to contend with. “When we opened the first clinical trials, we couldn’t find patients,” he told me. “Today, there are waiting lists.”
A brief history of CAR T
The first CAR T trial was not in cancer but in HIV. In the 1990s, June’s lab explored the possibility of using T cells to treat the disease which at the time lacked treatments. “My first clinical protocol began when I was in the Navy in Bethesda and it was called RV 100,” he said in his award lecture. The work was done as part of a joint navy/army effort and marked “the first time we gave T cells to patients.”
Carl June, MD, director of the Center for Cellular Immunotherapies and the Parker Institute for Cancer Immunotherapy at University of Pennsylvania, giving his lecture at the 13th annual Ross Prize Awards [Uduak Thomas]
For that first protocol, June’s team took patients with late-stage AIDS and expanded their T cells in the lab, without making any genetic modifications. They then infused those cells back into the patients to determine whether they could restore their immune systems.
“We thought it would be pouring fuel on fire” in the sense that “adding T cells back to the patients would cause more HIV replication.” But that did not happen because the scientists expanded the cells in a way that made them resist reinfection by downregulating the HIV co-receptor. The first clinical trial, published in 2002, showed a dose-dependent increase in T-cell counts following the infusions without a corresponding increase in viral load. June and his colleagues conducted three additional trials, which showed that the infused cells survived on average more than 10 years in patients.
Following those trials, June and his team engineered T cells with a receptor composed of the CD4 molecule fused to the CD3 zeta signaling chain of the T-cell receptor. Over the next five years, June’s group ran trials using these first-generation CAR T cells, demonstrating that they were safe and persisted in the body. Those findings provided important safety data as CAR T technology began moving towards oncology applications.
There were of course disappointments along the way. Several studies using the first-generation CARs did not demonstrate clinical benefit in cancer patients (in contrast to HIV patients). Enthusiasm for the technology waned and skepticism about its potential grew. Still June and his collaborators persisted. The second-generation CAR design incorporated a co-stimulatory domain rather than relying solely on CD3 zeta signaling. Specifically, they used 4-1BB in combination with CD3 zeta to target CD19-positive leukemia cells.
And that’s when the tide turned. The first patient treated with this new generation of cells, a 67-year-old man with end-stage leukemia, achieved a complete response. In total, three of the first patients that were treated responded. “We didn’t know if we were really lucky at that time or not, but it was a striking result,” June said.
Today, there are seven FDA-approved CAR T-cell therapies, and more than 60,000 patients have been treated. Several additional products are in development with many different designs being tested in thousands of labs. June closed by presenting some new, unpublished studies including a program in glioblastoma. It’s clear that June’s work is far from done.
Sadelain’s milestones
Sadelain said there were four major milestones that marked efforts to bring CAR T cells to the clinic. First was the development of methods for introducing genes into primary T cells. Before these techniques were available, scientists largely studied genes in leukemia cell lines as a surrogate for normal T cells. As such, critical aspects of T-cell biology remained poorly understood, including how they respond to antigen, when they proliferate, and when they undergo cell death.
Michel Sadelain, MD, PhD. professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons and director of the Columbia Initiative in Cell Engineering and Therapy, giving his lecture at the 13th Ross Prize Awards [Uduak Thomas].
Sadelain’s second milestone was the identification of the gene encoding the CD3 zeta chain, which sparked efforts to engineer fusion receptors that enabled T cells to recognize and kill target cells in a sustained way. Third was identifying a target that could be studied in the lab. Sadelain’s lab settled on CD19, which was known to be expressed in lymphomas and leukemias.
The fourth milestone was less a scientific discovery and more of a realization. If scientists wanted to bring T cells into clinical use, “you had to do it yourself,” Sadelain said. “There was no industry interested in developing or manufacturing cells as medicines.”
While CAR T-cell therapies today are spreading beyond cancer to other disease areas, there are still challenges to solve in oncology. CAR T cells do not yet work well in solid tumors, Sadelain said. Despite some promising clinical results, “it’s clear that what had been designed for these blood cancers cannot be applied exactly as is to solid tumors,” Sadelain said. “They can be applied exactly as is to autoimmunity perhaps but not solid tumors.”
Sadelain said the first challenge is the T cell itself. Once the engineered cells are released into the patient’s bloodstream, they have to reach the tumor and penetrate its defenses, which is not easy. Even if they are able to penetrate the tumor, they may not work because tumors have evolved mechanisms to shut off the immune response in order to survive. “The good news is that many of these mechanisms are understood today,” so the next step is to figure out how to engineer T cells that can overcome these mechanisms.
Other challenges include identifying suitable targets and developing ways to support the CAR T cells to ensure they persist. Lastly, scientists need a way to manufacture these cells at sufficient scale to make treatments more affordable and accessible. It may be possible to lower the cost to patients through better reimbursement or policy changes “but some of that can be improved through biology.”
Sadelain went on to describe three CAR designs that go beyond the foundation models and could be the treatments of the future. These designs aim to improve on some previous shortcomings, including a longer lifespan and requiring orders of magnitude lower doses than their predecessors. Sadelain closed by noting that it took nearly four decades for the field to get from “the very first ideas to where we are today,” but “it’s not static by any means.”
“These molecules keep getting better and better, and that’s why we are optimistic,” he said. Moving forward, “we need persistence combined with potency. We need greater sensitivity. I think many of these beautiful receptors are on the way to deliver these results.”
From discovery to deployment
Following the awards, I spoke with Kevin Tracey, MD, president and CEO of the Feinstein Institutes. He told me that the Ross Prize celebrates the complete scientific journey from discovery to deployment. “We live in a time where we benefit from all the work that came before us by brilliant people who used science and medicine and technology to eradicate diseases that some people have never even heard of and will never see,” he said. “But somehow, some of that of the importance and the optimism of that gets lost in the modern era we’re living in.”
Established in 2013, Tracey said the Ross Prize is unique because it celebrates that “rare individual who sets out to solve a problem, to cure a disease” and “stays with the entire process from discovery to development to deployment.” Sadelain and June “have lived that for decades,” Tracey said. Tens of thousands of people “are alive because of what these two men did and all of their colleagues.”
But the Ross Prize is also important at a time of rising anti-science sentiments, amplified by some news media and social media platforms. “What we’re losing is the tradition of storytelling and the creation of stories and themes that bind us all together for a common good. Stories have to be told or they are lost,” he said. The Ross Prize is “an opportunity to tell those stories and to celebrate that excellence.”
While the prize has always focused on rewarding excellence in science that forms the basis of new therapies, Tracey told me that over the past five years or so, the focus has expanded from basic research to include research that has made it into clinical use. There are many worthy science prizes that recognize “very elegant science,” Tracey said. But much of the downstream utility of that early science is “maybe decades in the making, and we decided to focus on the small number of times it actually does go the whole way. Those people deserve a prize too!”
Decisions about the awardees each year are made by committee, with representatives from multiple institutions. It has always been a tough decision selecting a few winners from the hundreds of nominations, Tracey acknowledged, “but we always come to a consensus.”
The next transformative therapy
The transformation from risky experimental therapy to standard of care for some cancers demonstrates how scientific consensus can completely reverse. These days, the future is certainly bright for immunotherapies far beyond its original oncology focus.
Both honorees expressed excitement about the possibilities while maintaining an awareness of practical limitations and reiterating the need for continued research. “I think basically all blood cancers will be treated with some kind of cell therapy,” June predicted. “That’s more of an engineering problem now.” Where advances are still needed, he said, is in similar therapies for solid cancers, something that both he and Sadelain are working on with their respective teams.
Asked whether in vivo CAR T-cell therapy could be the next transformative therapy, June said: “It’s very early. Just two months ago, the first in vivo CAR T cells were reported, and they had a mixture of toxicity and efficacy in myeloma, so that’s great.” But “it’s too early now to know how long [they] will last and how safe” they will prove. He also noted the cost savings that in vivo CAR T therapies could offer, not just for cancer. “There are 10 times more people that have autoimmune disease than cancer. If we have a way to make it cheaper and more readily available, that’s what we really need.”
Looking ahead, Sadelain said “there are many new potential directions that are really tantalizing.” There are, of course, many more cancers that need effective treatments, but researchers are starting to look to other areas as well including organ transplantation, neurodegenerative diseases, and infectious diseases.
Among the important questions left to answer is how to produce these cells? “If this starts working for some more common diseases… we’re going to hit a bottleneck,” Sadelain noted. Could allogeneic cells from healthy volunteers be adapted to work for some recipients? Or could we use T-cells made from pluripotent stem cells? “That’s a very interesting direction.” Another “exciting new frontier” is emerging from in vivo studies, although there is still much to learn about their efficacy and toxicity, especially in cases where multiple doses are required.
The Ross Prize committee is already thinking about next year’s honorees. In a few weeks, Tracey said a new batch of emails will be sent to solicit nominations for next year’s awards. The awardees for the 14th Ross Prize will be selected in January 2027.