I've spent 2022 helping set up a system for rapidly making personalized, safe phages for patients. Here's what I've learned about team science, scaling in bio, & balancing overwhelm with progress.
I'm delighted to discover your move to Australia is paying dividends. Clearly you have come a long way since we talked a couple of years ago.
We are already seeing some of our investments in non toxic infection control coming to profitable fruition.
Phage technology is high on our list of potential investments. However I'm still puzzling over the shape of commercial opportunities in phage technology. Any thoughts on that?
Thank you so much for the opportunity to get a closer look into the phage.kitchen, Jessica. Good move to go to Australia! We are short of phage labs in Germany and Europe, our regulatory body imposed full genome sequencing under GMP standards, which stopped all activities immediately for being much too costly and time consuming. At least for compassionate cases, I therefore liked your statement on being less perfect in favour of rescuing people.
I got one question, still: How (and where) would you draw the line between regular treatment and (early enough) compassionate treatment eventually?
Thanks for advising. Have a nice Christmas leave! Warm regards - Barbara (Bonn/D)
Thanks so much Barbara! I love the phrase 'phage kitchen', haha -- perfect! Sorry to hear about the challenges you're facing with phage making in Germany -- if sequencing is a main bottleneck we may be able to find you some collaborators (maybe worth posting on the Phage Directory community board: https://phage.directory/msg). But I understand it's usually much more than just having the sequence.
As for drawing the line between regular treatment and compassionate treatment, for us we're in a unique spot in Australia because we were able to get a clinical trial approved (https://bmjopen.bmj.com/content/12/12/e065401) that allows multiple compassionate treatments to be done (the trial tests the process, not the product; the phages administered are all given through compassionate use - Special Access Category A, as they call it here). I know it's been hard in other countries to convince the regulator that repeated compassionate cases like this is acceptable. But moving beyond this into 'regular' treatment will require phages to be examined through controlled trials as drugs (or maybe through new as-yet-created phage-specific pathways, similar to how fecal transplants are starting to work - we are working on helping craft the rules here in Australia in parallel). But for now we're sticking to repeated compassionate treatments as step one, and with the data generated, we'll aim to launch controlled trials with specific phages/indications.
Yes! It will be excellent to pair antibiotic lvls with phage. We can talk soon when you are available to as I m cognizant that it is holiday season for many
I love this! We are starting phage therapy in Singapore. I have thought about this before and I have no answers to them. We have braced ourselves to take the bull by its horns when it comes charging….And this journal is totally useful now to know what to expect ( before the bulls come charging!). My team and myself will love to visit Jessica’s lab next year if we can!
Hi Andrea! Thanks so much for your note, and so glad it was helpful - that is so exciting that you're setting this up in Singapore! Yay!
I think I saw you share that article about the new antibiotic dosing test that had been developed in Singapore (https://www.straitstimes.com/singapore/health/sgh-develops-test-for-doctors-to-monitor-antibiotic-levels-in-critically-ill-patients) -- are you working on that too? I was thinking it would be amazing to pair that with phage therapy! Would love to chat sometime about that / curious if you've thought about how the two might feed into each other. Anyway, you are welcome to come and visit our lab if you're ever in Sydney!!
Thanks for reading, David, so nice to see you here - it’s been a while! (Time really has flown - feels like the other day). That’s awesome about the infection control companies -- really good to hear.
I agree that phage is tricky to commercialize. We are feeling out the idea of phage therapy as a clinical/diagnostics service / possibly even an insurance product for hospitals / health payers (ie. they pay for access for their patients to have phage sourcing, matching, production done, and administer their phages through compassionate use channels for patients in need - a growing number), rather than trying to develop the phages themselves as a collection of biologic drugs. Besides that, my colleague Ruby Lin has been writing about her thoughts on a bunch of different phage therapy commercialization opportunities at https://phageaustralia.org/blog, if you want to have a look. Would love to hear your take!
Hi Jessica
Fascinating article.
I'm delighted to discover your move to Australia is paying dividends. Clearly you have come a long way since we talked a couple of years ago.
We are already seeing some of our investments in non toxic infection control coming to profitable fruition.
Phage technology is high on our list of potential investments. However I'm still puzzling over the shape of commercial opportunities in phage technology. Any thoughts on that?
Best wishes
David
Davidwilliamport@gmail.com
Thank you so much for the opportunity to get a closer look into the phage.kitchen, Jessica. Good move to go to Australia! We are short of phage labs in Germany and Europe, our regulatory body imposed full genome sequencing under GMP standards, which stopped all activities immediately for being much too costly and time consuming. At least for compassionate cases, I therefore liked your statement on being less perfect in favour of rescuing people.
I got one question, still: How (and where) would you draw the line between regular treatment and (early enough) compassionate treatment eventually?
Thanks for advising. Have a nice Christmas leave! Warm regards - Barbara (Bonn/D)
Thanks so much Barbara! I love the phrase 'phage kitchen', haha -- perfect! Sorry to hear about the challenges you're facing with phage making in Germany -- if sequencing is a main bottleneck we may be able to find you some collaborators (maybe worth posting on the Phage Directory community board: https://phage.directory/msg). But I understand it's usually much more than just having the sequence.
As for drawing the line between regular treatment and compassionate treatment, for us we're in a unique spot in Australia because we were able to get a clinical trial approved (https://bmjopen.bmj.com/content/12/12/e065401) that allows multiple compassionate treatments to be done (the trial tests the process, not the product; the phages administered are all given through compassionate use - Special Access Category A, as they call it here). I know it's been hard in other countries to convince the regulator that repeated compassionate cases like this is acceptable. But moving beyond this into 'regular' treatment will require phages to be examined through controlled trials as drugs (or maybe through new as-yet-created phage-specific pathways, similar to how fecal transplants are starting to work - we are working on helping craft the rules here in Australia in parallel). But for now we're sticking to repeated compassionate treatments as step one, and with the data generated, we'll aim to launch controlled trials with specific phages/indications.
Yes! It will be excellent to pair antibiotic lvls with phage. We can talk soon when you are available to as I m cognizant that it is holiday season for many
I love this! We are starting phage therapy in Singapore. I have thought about this before and I have no answers to them. We have braced ourselves to take the bull by its horns when it comes charging….And this journal is totally useful now to know what to expect ( before the bulls come charging!). My team and myself will love to visit Jessica’s lab next year if we can!
Andrea Kwa
Hi Andrea! Thanks so much for your note, and so glad it was helpful - that is so exciting that you're setting this up in Singapore! Yay!
I think I saw you share that article about the new antibiotic dosing test that had been developed in Singapore (https://www.straitstimes.com/singapore/health/sgh-develops-test-for-doctors-to-monitor-antibiotic-levels-in-critically-ill-patients) -- are you working on that too? I was thinking it would be amazing to pair that with phage therapy! Would love to chat sometime about that / curious if you've thought about how the two might feed into each other. Anyway, you are welcome to come and visit our lab if you're ever in Sydney!!
Thanks for reading, David, so nice to see you here - it’s been a while! (Time really has flown - feels like the other day). That’s awesome about the infection control companies -- really good to hear.
I agree that phage is tricky to commercialize. We are feeling out the idea of phage therapy as a clinical/diagnostics service / possibly even an insurance product for hospitals / health payers (ie. they pay for access for their patients to have phage sourcing, matching, production done, and administer their phages through compassionate use channels for patients in need - a growing number), rather than trying to develop the phages themselves as a collection of biologic drugs. Besides that, my colleague Ruby Lin has been writing about her thoughts on a bunch of different phage therapy commercialization opportunities at https://phageaustralia.org/blog, if you want to have a look. Would love to hear your take!