Flagship Pioneering has unveiled its latest biotech startup, Etiome, with $50 million in initial funding to develop therapeutics targeting disease-specific biomarkers before symptoms manifest. The Cambridge, Massachusetts-based company aims to identify and drug targets that are specific to different states of disease progression, initially focusing on metabolic, neurodegenerative, and inflammatory conditions.
The funding is expected to provide Etiome with approximately 18 months of operational runway, during which the 20-person team plans to identify targets across all three disease areas and begin developing therapeutic candidates both internally and through pharmaceutical partnerships.
Pioneering "Silent Stage" Disease Detection
Etiome's approach centers on what the company calls "Temporal Biodynamics," an AI-powered platform that creates a comprehensive, time-based view of disease progression. The technology analyzes clinical data from electronic health records alongside cellular and molecular information to identify what Etiome terms "BioStage Markers" – biomarkers specific to particular stages of disease progression.
"The diseases we want to work on are progressive diseases, where we have a long window of the disease and also where we have complex, evolving biology," explained Scott Lipnick, Etiome's co-founder and president, who also serves as an origination partner in Flagship's Preemptive Health and Medicine Initiative.
Lipnick emphasized the importance of identifying disease biology before major symptomatic transitions occur: "There's biology that happens before those major transitions into symptoms. That's 'the silent stage.' We need something more than just 'healthy' or 'has Alzheimer's.' Can we predict who's going to get sick sooner? We are moving to a continuous representation of biology."
Initial Disease Focus Areas
Etiome has prioritized two initial research areas: liver diseases and neurodegeneration.
In the metabolic disease space, the company is targeting metabolic dysfunction-associated steatohepatitis (MASH), a progressive liver condition characterized by excess fat cells causing inflammation and eventual liver damage. Etiome aims to identify distinct targets across MASH's progression stages – from initial inflammation to fibrotic scarring and ultimately cirrhosis.
"As the disease progresses, we have a very different profile of targets," Lipnick noted.
For neurodegenerative conditions, Etiome is focusing on Alzheimer's disease, with particular attention to tau proteins – a departure from the amyloid-β approach that dominates current Alzheimer's medications. The company believes targeting tau could promote neuronal resilience.
This tau-focused strategy may also offer regulatory advantages. The FDA has already approved tau-based diagnostics and recently fast-tracked a tau-targeting drug candidate from Johnson & Johnson.
"Because we're kind of bullish on the idea of tau being a relevant readout that is related to neuronal health, we think that we can use an existing marker to actually get an FDA approval," Lipnick explained. "Then our biomarkers can be used more for signs of efficacy, potential patient subtyping, but we don't need to go through the whole process of getting FDA approval."
An inflammatory disease pipeline is also in early development.
AI-Powered Discovery Platform
Etiome's platform leverages artificial intelligence models trained on datasets from contracted clinical trials and resources like the UK Biobank. The technology identifies shifts in gene expression and protein abundance, biological characteristics that can be plotted along a timeline marking different disease stages.
For Alzheimer's, this might include measurements like percentage of amyloid-beta or tau burden in patients – continuous labels that can be tracked over time before symptoms emerge.
While AI is central to Etiome's approach, Lipnick emphasized that technology is not the end goal: "AI is the tool that is giving us the belief that we can do this, but it is not the protagonist. Our focus is: how do people actually benefit from drugs we develop? And if we can figure that out, how can we stop diseases before they become irreversible?"
Company Background and Future Plans
Founded in 2021, Etiome is led by Lipnick as president and Avak Kahvejian, general partner at Flagship Pioneering, as CEO. The company has remained in stealth mode until now, with Lipnick noting, "If we didn't have anything to take action on, we wouldn't be coming out of stealth."
While Etiome's liver disease pipeline is currently in preclinical stages and Alzheimer's work remains in vitro, the company is already in discussions with several large biopharmaceutical companies regarding potential development partnerships for therapeutic candidates that emerge from its platform.
The company is based in Cambridge, Massachusetts, where it's leasing space from another Flagship-backed company.
