Fireside Chat, Interview, Podcast
a16z Podcast | Connecting Hearts, Bodies, and Networks to Cure Cancer
- Current Regulatory Appointment: Amy Abernethy has been selected as the new Principal Deputy Commissioner of the U.S. FDA, pending ethics clearance, following her tenure as Chief Medical and Scientific Officer at Flatiron Health and advisory role with One Health.
- One Health Mission: Cristina Lopez, CEO and co-founder of One Health, is building a platform to provide dogs with access to advanced cancer treatments while aggregating data to accelerate human therapeutic development.
- Epidemiological Scope: There are an estimated 6 million dog cancer cases diagnosed annually in the United States, creating a high-volume, real-world evidence (RWE) dataset comparable to human oncology.
- Genetic and Environmental Parallels: Dogs and humans share similar cancer drivers due to co-evolution, shared environmental exposures (e.g., secondhand smoke, lawn chemicals near golf courses), and genetic factors from selective breeding.
- Limitations of Animal Models: Mouse models are often engineered to induce cancer with limited immune system function, whereas dogs develop spontaneous, naturally occurring cancers with fully functional immune systems, making dogs a superior model for immuno-oncology.
- Conserved Biology: Biological pathways involved in cell division and tumor growth are more conserved between dogs and humans than between mice and humans, offering a more accurate predictive model for drug response and toxicity.
- Diagnostic Bottleneck: Current veterinary diagnosis often halts at histopathology due to a lack of resources and funding, unlike human oncology where genomic and immunologic profiling is becoming standard.
- Data Accessibility Advantage: Unlike human healthcare constrained by HIPAA privacy regulations, pet owner data is more readily shared and less protected by privacy laws, facilitating easier aggregation and real-time disease tracking.
- Clinical Trial Synergy: Data from One Health is structured to function as a "virtual clinical trial" network, allowing for the pressure-testing of combination therapies and dosing strategies before human trials.
- Precision Medicine Tool: One Health has launched the first next-generation sequencing panel for dogs, enabling the identification of actionable mutations (e.g., the V600E BRAF mutation in 85% of canine bladder cancer cases) to tailor treatments.
- Access Disparity: There are only 300–400 veterinary oncologists in the U.S. for 23,000 general veterinarians and 6 million dog cancer cases, creating a significant access gap that One Health aims to democratize through technology.
- Startup Product Strategy: Founders must prioritize delivering immediate value to the end-user (pet parent) and veterinarians in Version 1.0 before scaling data infrastructure, avoiding the pitfall of over-engineering premature to secure data for future R&D.
- Team Dynamics: Building a biotech startup requires multi-disciplinary teams to develop shared languages between technical, veterinary, and medical experts to prevent communication silos and ensure effective cross-functional collaboration.
- Long-term vs. Short-term Vision: Leaders must balance a 3–6 month product roadmap driven by immediate market feedback with an 8–10 year scientific vision, ensuring short-term wins do not compromise long-term data integrity.
- Real-World Evidence Application: The One Health network aims to generate RWE that can accelerate "go/no-go" decisions in human drug development, potentially saving tens of millions of dollars per drug candidate.
- Future FDA Priorities: Upon joining the FDA, Amy Abernethy plans to focus on accelerating evidence generation, advancing personalized medicine, and implementing patient-informed drug design.
- Industry Validation: The concept of using veterinary data to save human drugs is validated by the history ofibrutinib, a lymphoma drug whose efficacy was confirmed through parallel dog and human studies.
- Data Network Effects: The platform is designed to create a reinforcing cycle where treating more dogs with combination therapies generates data that improves treatment recommendations for subsequent patients, both within the veterinary and human sectors.