Investment in neuroscience is experiencing a resurgence, fueled by recent approvals like Bristol Myers Squibb’s Cobenfy (xanomeline-trospium) for schizophrenia and Sage Therapeutics’ Zurzuave (zuranolone) for post-partum depression, signaling a shift after nearly four decades of dormancy, according to Kabir Nath, CEO of Compass Pathways. However, significant hurdles remain, particularly in Phase III trials, which are costly and complicated by the poor translation of current animal models for CNS disorders. This makes strategic patient selection critical for neuropsychiatry and neurodegenerative disease research.
Challenges in Neuroscience Drug Development
Seth Ettenburg, President and CEO of BlueRock Therapeutics, noted that investment in neuroscience is cyclical, driven by excitement for emerging treatments but hampered by a lack of clear causality and biomarkers, making cures more elusive compared to other fields. Kylie Bromley, Vice President and Managing Director, UK & Ireland, Biogen, highlighted the challenges in launching new treatments for diseases like Alzheimer’s, requiring massive infrastructure. The approval of Leqembi, an amyloid-targeting drug, was cited as a remarkable example of establishing proof of concept in neurodegenerative diseases, though its commercial success has been limited.
The Importance of Biomarkers and Technology
Identifying the right patients is crucial, as only a small subset of diagnosed Alzheimer’s patients (around 2%) are suitable for current treatments, with early-stage patients showing the best response. Improving diagnosis through less intrusive methods, such as blood-based biomarkers, is essential. Bromley emphasized the importance of biomarkers and technology, such as AI-powered diagnostic tools like Novoic, in identifying patients earlier for clinical trials. These advancements could improve diagnostic efficiency and foster a more targeted approach, crucial for treatments with narrow patient applicability.
Psychedelics and Neuropsychiatry
In neuropsychiatry, there is growing interest in the therapeutic potential of psychedelics for conditions like PTSD, depression, and anxiety, despite regulatory hurdles and mixed public perception. Nath emphasized the need for large-scale, robust trials, especially in a field that lacks robust biological markers. The neuropsychiatry field faces persistent challenges due to the lack of biological biomarkers for conditions like depression, relying instead on broad diagnostic labels. Nath cited Alto Neuroscience’s recent setback in a Phase IIb trial as an example of the difficulties in transitioning from Phase II to Phase III clinical trials. However, the potential for functional improvements and quality-of-life gains fuels optimism and investment.
Unmet Needs and Opportunities
With one in nine people having a CNS disorder, there is an unmet need and untapped opportunity. Ettenburg stated that this "opportunity in the space drives investment."
