Gates Foundation makes unusual investment in experimental cancer trial

The Bill & Melinda Gates Foundation is making an unusual investment in a biotech start-up’s experimental cancer trial, hoping that its novel technology will one day allow HIV patients to rebuild their immune systems.

Smart Immune, a French cell therapy company led by three female co-founders, has developed technology to coax stem cells, which have the ability to develop into many different cell types, into becoming immature “progenitor” T-cells in a lab. These are then injected into the body, where they mature into a crucial part of the immune system and learn to differentiate between normal cells and threats.

These new T-cells mature in less than 100 days, against the 18 months it takes for an immune compromised patient receiving a bone-marrow transplant to rebuild their immune system. They also live for up to a decade in the body, as opposed to the current survival time for injected T-cells of two to six weeks.

The Gates Foundation, which usually focuses on tackling infectious diseases in developing countries, is investing $5mn in Smart Immune to fund an early-stage trial of the technology in leukaemia patients, which aims to rebuild their immune systems after chemotherapy.

Smart Immune also recently received a €17.5mn grant and equity investment from the European Innovation Council.

Chief executive Karine Rossignol said the company was now hoping to raise a series A fund of €50mn to develop its research further.

“Our work in rearming patients’ immune systems is particularly exciting for global health since this concept has application beyond oncology and into infectious diseases such as HIV,” she said.

Marina Cavazzana, Smart Immune’s co-founder, originally developed the technology to help treat “bubble babies”, who are born without an immune system. She said it was a “very, very huge breakthrough”, with an “immense” number of applications.

It could also be used to improve the innovative cancer treatment known as CAR-T, which relies on removing mature T-cells from an individual patient and editing them to attack cancer, by creating an off-the-shelf product that could be used in any patient.

The Gates Foundation is hoping that the technology will eventually allow patients with HIV, which affects 38mn people worldwide, to completely rebuild their immune systems.

A few patients with HIV who have received bone marrow stem cell transplants from HIV resistant donors have gone into remission. Smart Immune’s therapy offers hope that the same effect could be achieved on a large scale, by modifying the cells to be resistant to HIV.

But the therapy would need to be far cheaper and easier to make, particularly if it were to be distributed in developing countries, where the vast majority of HIV patients live. Cavazzana said the company was working to create a small bedside machine that could make it easier to produce the progenitor T-cells without a lab.

“We would like to make this technology affordable and sustainable for all patients that need it. But first of all comes the proof of concept in clinical trials that our claim is correct,” she said.