Speaker 1: A black van with tinted windows is parked in front
Speaker 1: of an Art nouveau building not far from Munich's English garden.
Speaker 1: It's September. The COVID nineteen vaccine drive is in full swing,
Speaker 1: with countries around the world debating just who should get
Speaker 1: booster shots. Inside the Munich villa's heavy door is a
Speaker 1: narrow entry foyer that leads up a wooden staircase. There's
Speaker 1: a cluster of people coming down. It's Germany's star scientists
Speaker 1: erz Lam, Too, Duchy and war Shachen. There the husband
Speaker 1: and wife duo behind BioNTech, Weiser's partner for the COVID vaccine,
Speaker 1: and they're on their way out of a meeting with
Speaker 1: the company's chairman, Helmett yuggla ertz Lam and Uer say
Speaker 1: hello politely and then head out the door. Helmett is
Speaker 1: waiting upstairs to talk to me about BioNTech and it's
Speaker 1: race to develop a messenger RNA vaccine. Helmett laughs when
Speaker 1: I asked what they talked about that day. Next generation
Speaker 1: m R and A treatments are in everyone's mind. Next
Speaker 1: generation now next generation No, of course, we have to
Speaker 1: think about how we developed the company because of the
Speaker 1: situation now. Helmont has known the BioNTech founders since two
Speaker 1: thousand seven. He was working then for the strong One Brothers,
Speaker 1: the German billionaires who helped fund the company. He's been
Speaker 1: involved with Biontic since the beginning and chairman of the
Speaker 1: board since two thousand eight. When we talked, it had
Speaker 1: been almost a year since Helmot, Uger, and utz Lum
Speaker 1: found out that the bet on BioNTech and a messenger
Speaker 1: RNA technology had paid off in the biggest possible way.
Speaker 1: Helmote compares it to a moon landing. You plan and
Speaker 1: you work and you prepare, and it's all THEO nicole
Speaker 1: until you step out the door of your spacecraft and
Speaker 1: suddenly you're there. It's almost hard to believe that you've
Speaker 1: actually made it. He tells me that after he heard
Speaker 1: the news from Ugre about how well the vaccine worked
Speaker 1: in a patient trial, he left his phone at home
Speaker 1: and went out for a walk. He lives out in
Speaker 1: the country, and it was a peaceful night. He says.
Speaker 1: He figured it would be his last quiet night for
Speaker 1: a while. That's exactly why I want to enjoy this
Speaker 1: moment quietly myself. Helmont turned out to be right. The
Speaker 1: vaccine isn't just one of human kind's best weapons so
Speaker 1: far against the COVID pandemic. It's also the vindication for
Speaker 1: an entirely new field of medicine. Suddenly, messenger RNA vaccines
Speaker 1: are the world's best selling drugs, and suddenly the young
Speaker 1: biotechs that developed them, Germany's BioNTech and modern of from
Speaker 1: the US, are among the world's most closely scrutinized drug makers.
Speaker 1: Everybody wants to know what their next step will be.
Speaker 1: Welcome to the eighth episode of our series. This time
Speaker 1: we're looking at what's next for the biggest scientific breakthrough
Speaker 1: to emerge out of the COVID pandemic, Messenger RNA vaccines.
Speaker 1: Up until last year, it wasn't even clear that they'd
Speaker 1: work at all. Now everyone from hospitals and drug makers
Speaker 1: to Wall Street are waiting to see where else they
Speaker 1: can be used and what the payoff could be for
Speaker 1: patients and for the company's The technology could help engineer
Speaker 1: a better flu shop, for example, but its potential goes
Speaker 1: far beyond zapping viruses. Messenger RNA is being tested in
Speaker 1: cancer medicines and in heart disease. Some researchers are also
Speaker 1: studying whether it could be useful against autoimmune diseases like
Speaker 1: multiple sclerosis, or even treat genetic illnesses like sickle cell anemia. UH.
Speaker 1: Some argue that we can't even imagine how widely this
Speaker 1: technology will eventually be used, and then eventually there won't
Speaker 1: even be such a thing as an m R and
Speaker 1: a vaccine company. That the technology will become so widespread
Speaker 1: that it's just another piece of the puzzle for drugmakers
Speaker 1: working in all sorts of fields. My name is Naomi
Speaker 1: Kraski and I'm a health reporter for Blue Broke News
Speaker 1: from the Prognosis podcast. This is Breakthrough. That's the sound
Speaker 1: of equipment at BioNTech's headquarters in Minz, Germany. It's about
Speaker 1: a half hour drive west of the Frankfurt airport. Okay,
Speaker 1: what do you see here? Inside? The lab and infrastructure
Speaker 1: director frescois Perrino is showing me around. I've been at
Speaker 1: BioNTech offices before, in late and I'm struck by what
Speaker 1: has changed and what has stayed the same. Now they
Speaker 1: have a fence and a security officer who takes his
Speaker 1: time letting me in, but the building itself doesn't look
Speaker 1: any fancier than it did before. Most farmer headquarters that
Speaker 1: I've visited have a certain class. Eveneer there tends to
Speaker 1: be a lot of modern art soaring atriums and high
Speaker 1: tech elevators. Not by on Tech. We mostly take the stairs,
Speaker 1: which is okay because the building is only a couple
Speaker 1: of stories tall. The labs are on the same floor
Speaker 1: as the CEO's office. They've been adding research space and
Speaker 1: equipment though, so this is a kind of workbench where
Speaker 1: all the stereo processes are performed, kind of The whole
Speaker 1: facility is called cell Culture facility, and within this facility
Speaker 1: we do all our experiments with south sets from human
Speaker 1: For example, when for us while joined by on Tech,
Speaker 1: in about five fifty people worked at the Mind's headquarters.
Speaker 1: Now it's about three times as many, and most of
Speaker 1: the development of the car Are Community Vaccine was performed
Speaker 1: inside police facilities over here. The wholesale culture facility is
Speaker 1: approximately about four d square meters and it's just about psyculturing.
Speaker 1: We're there in the late afternoon, so the labs have
Speaker 1: emptied out quite a bit. A few scientists linger taking
Speaker 1: advantage of the quiet to finished projects. Some of the
Speaker 1: people we meet are working on research that's still far
Speaker 1: from being ready to be tested in patients. The mind's
Speaker 1: facility also makes R and A for use in research
Speaker 1: and development. BioNTech is pouring its COVID vaccine profits into
Speaker 1: its pipeline of new experimental medicines. Company scientists are working
Speaker 1: on some infectious disease projects, including vaccines from malaria, HIV,
Speaker 1: and tuberculosis. None of those are far enough along to
Speaker 1: be tested in humans, though the more advanced part of
Speaker 1: the pipeline is almost entirely potential cancer treatments. The companies
Speaker 1: running nineteen patient trials and cancer About half of these
Speaker 1: are m R and A vaccines. In fact, before the
Speaker 1: COVID pandemic, BioNTech was basically a cancer company. As we
Speaker 1: learned in last week's episode. It didn't work on infectious
Speaker 1: disease vaccines until mid when its signed a deal with
Speaker 1: Fisser to develop a flu shot, but it's already treated
Speaker 1: about six hudd patients and cancer trials. Most were small
Speaker 1: studies designed to look at safety. That's how drug development works. First,
Speaker 1: you test a potential medicine and only a few people,
Speaker 1: and if it's shown to be safe, you can move
Speaker 1: on to testing its efficacy in a bigger it. You
Speaker 1: might see some hints of an impact against disease in
Speaker 1: phase one, but that's not really what those trials are
Speaker 1: designed to find out. But thanks to the COVID vaccine cash,
Speaker 1: BioNTech has been able to move quickly on the bigger
Speaker 1: studies it will need to push its cancer programs forward.
Speaker 1: One of those programs is called Ionest. Essentially, it's a
Speaker 1: personalized m R and a cancer vaccine. We're standing in
Speaker 1: front of a washing machine sized piece of equipment in
Speaker 1: one of the labs. It's crucial to the project and
Speaker 1: this machine is uh, yeah, it's very important. It's very
Speaker 1: important for us because this is one of, let's say,
Speaker 1: kind of the heart for our analysis for the Ionest treatment.
Speaker 1: In order to make a personalized cancer vaccine, BioNTech has
Speaker 1: to sequence the genetic code of each patient's tumor. The
Speaker 1: researchers use this machine to do the sequencing. So every
Speaker 1: every the tumor is caused by different mutations inside the genome,
Speaker 1: and we have to have a look at the TOLO
Speaker 1: genome to be sure that we if we find or
Speaker 1: that we that we identify the mutations and that we
Speaker 1: know how to shape the m RNA computer algorithm helps
Speaker 1: them find the special pattern of mutations that's unique to
Speaker 1: the tumor not found elsewhere in the body. Then bion
Speaker 1: text teams can take that pattern and build a template
Speaker 1: for an m r and A treatment. Remember how the
Speaker 1: m r and A vaccine for COVID works. It delivers
Speaker 1: instructions for cells to make the spike protein of the
Speaker 1: stars copy two virus that jolts the immune system into action,
Speaker 1: so if it encounters the real virus, it can act
Speaker 1: quickly to stop it. The m RNA cancer vaccine would
Speaker 1: train the body's immune system too, but to attack a tumor,
Speaker 1: not a virus. It's a treatment, not a preventative measure,
Speaker 1: and the mr and A is, let's say, the needed
Speaker 1: trigger for your immune system. Bion Tech already has some
Speaker 1: promising results with Ainest in a small trial with just
Speaker 1: thirteen patients. It's now testing the technology and bigger studies
Speaker 1: and melanoma and colorectal cancer. Like for the COVID vaccine,
Speaker 1: they're working with an experienced partner. It's one of the
Speaker 1: biggest cancer drugmakers in the world, a Swiss company called
Speaker 1: Roche Holding. You may have heard of Roche's u S
Speaker 1: unit called Genentech. I wanted to get Roche's view on
Speaker 1: m R and A cancer vaccines, so I called Charlie Fuchs,
Speaker 1: who runs their oncology and hematology product development. He's the
Speaker 1: former director of Yale Cancer Center and as an oncologist,
Speaker 1: he helped run huge clinical trials for other successful cancer immunotherapies.
Speaker 1: Charlie says the COVID vaccine's success is a good sign
Speaker 1: for the likelihood of m R and A technology working
Speaker 1: for cancer too. Seeing that on a population level and
Speaker 1: seeing the validation in patients that this technology really does
Speaker 1: enable a robust immune responses, I think is an important
Speaker 1: step in believing that we can leverage this technology for cancer. Still,
Speaker 1: just because MR and A vaccines worked against COVID doesn't
Speaker 1: mean they'll stop tumors. You know, Viruses are tiny little
Speaker 1: packages of limited genetic code that can create havoc by
Speaker 1: interfering with functions the normal functions of a human cell,
Speaker 1: or for that matter, creating an immune response. That's harmful,
Speaker 1: but um they're very limited. Cancers are a lot more complex.
Speaker 1: They're a lot better at defending themselves. Cancers are human
Speaker 1: cells that have mutated to leverage the full extent of
Speaker 1: the machinery and genetic code of a complex human cell,
Speaker 1: such that it will um become a lignan spread and
Speaker 1: because it has the availability of the entire human genome
Speaker 1: associated with it, that it can actually come up with
Speaker 1: lots of different mechanisms to overcome response to cancer therapy,
Speaker 1: to sustain itself, to avoid the immune surveillance. This is
Speaker 1: one reason that doctors often combine cancer therapies, and that's
Speaker 1: one reason, unfortunately, the cancer treatments sometimes stop helping after
Speaker 1: a few months or years, and so there's just a
Speaker 1: lot more to deal with when you're developing a cancer
Speaker 1: therapy as opposed to a virus, which is a tiny
Speaker 1: little compartment of very limited genetic code, very limited DNA
Speaker 1: r n A. Charlie tells me he thinks they'll have
Speaker 1: a better sense of how well m r n A
Speaker 1: vaccines can help with cancer treatment within the next two years.
Speaker 1: Thinking about Charlie's words, when I talk with BioNTech chief
Speaker 1: medical officer, it's them too, Rechi a few weeks later.
Speaker 1: She and her husband, Ushahi, and the CEO are also oncologists.
Speaker 1: They treated patients for years before they started BioNTech. We
Speaker 1: spent most of our time at the patient's bedside. That
Speaker 1: was the motivation to provide better medicines for those patients
Speaker 1: whom we had to tell that we had nothing to
Speaker 1: offer him. Some agrees that cancer is a tougher target
Speaker 1: than COVID for the immune system Sara's COVIE two is
Speaker 1: foreign cancer as part of us. So it's not about
Speaker 1: a about preventing, it's about melting away a substantial to
Speaker 1: more burden. So there are already immune suppressive mechanisms where
Speaker 1: cancer has installed, and you have to to fight against
Speaker 1: them and fight against immune tolerance because it's not really
Speaker 1: a foreign protein which you are using as target and
Speaker 1: um so this is a very different, higher challenge. All
Speaker 1: those years working to optimize mRNA technology for cancer vaccines
Speaker 1: helped when it came time to make the COVID chat.
Speaker 1: I think the reason why we have been successful for
Speaker 1: in COVID nineteen is that we have sharpened our weapons
Speaker 1: against cancer with all those um yeah, higher thresholds for
Speaker 1: for success. And once they'd optimized mRNA for cancer, Reson
Speaker 1: tells me, they started realizing there would be potential and
Speaker 1: lots of other diseases too. They want to develop mRNA
Speaker 1: treatments for autoimmune diseases illnesses in which the body attacks itself.
Speaker 1: Multiple sclerosis is one example for a disease like MS
Speaker 1: and mr and A vaccine will work in the opposite
Speaker 1: way how it's used against cancer or covids. Some explains.
Speaker 1: We have shown that while for cancer or infects disease vaccines,
Speaker 1: the mrn A is used to deliver two signals or messages, namely,
Speaker 1: on the one hand, to present the target, for example
Speaker 1: the COVID nineteen spike protein or a tumor integen plus,
Speaker 1: to provide um the message that the immune system needs
Speaker 1: to attack, in particular that the c D eight killer
Speaker 1: T cells need to be directed against this the target.
Speaker 1: For autoimmune diseases, m RNA vaccine would still wave a
Speaker 1: flag for the immune system to recognize something, but the
Speaker 1: second message we deliver is that the immune system, once
Speaker 1: it cease this target, needs to calm down and needs
Speaker 1: to accept this target and not a tack, so it's
Speaker 1: telling the body to stop turning against itself. BioNTech has
Speaker 1: had a successful experiment in this area with mice, but
Speaker 1: there's still quite a ways a way from having an
Speaker 1: mr ANDA vaccine to test in people with autoimmune diseases. Moderna,
Speaker 1: the other mRNA code vaccine maker, is also working on
Speaker 1: an autoimmune disease project. Moderna is also working on mRNA
Speaker 1: based cancer vaccines andicistic fibrosis treatment, as well as the
Speaker 1: treatment for heart disease, and it has a broad palette
Speaker 1: of other potential mRNA vaccines for infectious diseases, everything from
Speaker 1: zeka and FLEW to HIV. I caught up with one
Speaker 1: of the early investors in BioNTech, a German venture capitalist,
Speaker 1: in Matthias Cromeyer, at a conference in Berlin to find
Speaker 1: out more about the broader field. And you need to
Speaker 1: keep in mind that m RNA is at the center
Speaker 1: of any biological process. I mean, any gene that gets
Speaker 1: expressed is expressed via m RNA. Matthias's firm, MiG Capital,
Speaker 1: gave BioNTech about fifteen million dollars in seed money in
Speaker 1: two thousand eight. It was migg's best investment ever. Now,
Speaker 1: he says the approach could be useful in any kind
Speaker 1: of genetic disorder where the body doesn't make something that
Speaker 1: it should, from diabetes to hemophilia or rare diseases. But
Speaker 1: the first chance to see the proof of the pudding
Speaker 1: will be the cancer trials oncology. It's definitely oncology because
Speaker 1: this is where the company's are most advanced. So I
Speaker 1: would expect for approvals um provided that these these studies
Speaker 1: work out nicely. First approvals in twenty four or twenty five.
Speaker 1: That's a lot longer than it took to get the
Speaker 1: COVID vaccines approved. But in drug development terms, it's actually
Speaker 1: pretty fast. It just takes longer to see whether an
Speaker 1: experimental treatment can help cancer patients then it does to
Speaker 1: see whether a vaccine can stop a virus from making
Speaker 1: people sick. First of all, you can't recruit twenty cancer
Speaker 1: patients in in a couple of weeks time. Secondly, the
Speaker 1: endpoint in in in the COVID are In the COVID
Speaker 1: nineteen um immune immunized population, it took only weeks to
Speaker 1: reach the endpoint um of a number of events in
Speaker 1: oncologies usually years that you need to wait until people
Speaker 1: have survived or not. So this is why it takes longer.
Speaker 1: It's not because people weren't working as diligently as into
Speaker 1: COVID lntine vaccination areas. If you talk to some of
Speaker 1: the early pioneers in m r and A, sky is
Speaker 1: the limit for what else the technology could do. Remember
Speaker 1: Derek Rossi, the Harvard stem cell scientists who did important
Speaker 1: early experiments with m RNA and founded Materna. He says
Speaker 1: his original vision for the company wasn't vaccines at all.
Speaker 1: Vaccines have been in production for you know, you know,
Speaker 1: a hundred years, and they work. Uh and uh so
Speaker 1: why reinvent the wheel? Well there's turns out, as we
Speaker 1: now know, there is good reasons for that. It's a
Speaker 1: faster technology, it's a more precise technology, it's a better
Speaker 1: technology for vaccination, It's true. But what I imagined was
Speaker 1: application towards genetic disease. Derek tells me there are six
Speaker 1: thousand genetic diseases. He says that six thousand mutations in DNA,
Speaker 1: which leads to bad mr and A, which leads to
Speaker 1: a problem with the protein, leads to disease. Derek's idea
Speaker 1: was to use mr and A vaccines to spur cells
Speaker 1: to make the right proteins instead. Wherever protein is needed,
Speaker 1: it can be applied. So um, that could be six
Speaker 1: thousand genetic diseases. Uh. Oncology, cancer, mutated genes. Projects to
Speaker 1: study how MR and A therapy can be used to
Speaker 1: treat genetic disease are also in the works. In fact,
Speaker 1: Drew Wiseman, the University of Pennsylvania professor who worked with
Speaker 1: Catalan Kerry Co to answer vital early questions around m
Speaker 1: R and A research, is now working on an m
Speaker 1: R and A vaccine for sickle cell anemia, one of
Speaker 1: the most common genetic disorders. The Bill and Melinda Gates
Speaker 1: Foundation is sponsoring the research. Drew tells me some two
Speaker 1: thousand people are born every year with sickle cell disease,
Speaker 1: most of them in Sub Saharan Africa. There's a here,
Speaker 1: but it's way too expensive for a lot of these patients.
Speaker 1: And what they do is they take a patient, they
Speaker 1: take out a lot of bone marrow, they infect the
Speaker 1: bone marrow with a lenty virus, and then they give
Speaker 1: it back. That's probably a half a million dollar per
Speaker 1: person costs for for a cycle cell cure. You can't
Speaker 1: do two hundred bone marrow biopsies in Sub Saharan Africa.
Speaker 1: So Drew's lab has figured out how to target bone
Speaker 1: marrow stem cells with an m R and A treatment.
Speaker 1: It inserts a new gene into the genome of the
Speaker 1: stem cells. Instead of removing a patient's bone marrow, doctors
Speaker 1: would simply need to give them an IVY injection. To
Speaker 1: me that that changes the world, because now you can
Speaker 1: do gene therapy with a simple injection. We should make
Speaker 1: this clear. Program isn't in human trials yet. It's being
Speaker 1: tested now in mice. As Drew has told us several times,
Speaker 1: success in mice doesn't necessarily translate to humans. Drew's lab
Speaker 1: has a laundry list of other projects as well. He's
Speaker 1: working with BioNTech on a range of infectious disease vaccines,
Speaker 1: and he's working on a pan coronavirus vaccine with Duke University,
Speaker 1: the University of North Carolina, and the National Institutes of Health.
Speaker 1: That's a shot that could work against all types of coronavirus,
Speaker 1: is not just stars Kobe two. The idea would be
Speaker 1: to have a vaccine that could cover whatever variant pops
Speaker 1: up in the future, maybe even something that's ready to
Speaker 1: go for the next pandemic. And they're working on an
Speaker 1: MR and a vaccine against HIV. If it succeeds, that
Speaker 1: would be transformative to HIV. The virus that causes AIDS
Speaker 1: has alluded vaccine efforts for decades. It mutates so quickly,
Speaker 1: the way it infects cells is very different. It forms
Speaker 1: a long, live, latent reservoir that's hard to get rid
Speaker 1: of um, and it has so many ways of avoiding
Speaker 1: immune responses. Again, the HIV vaccine is a long way
Speaker 1: from completion. Juice Team is also working with Duke and
Speaker 1: ni H on this project. He says it's due to
Speaker 1: start human trials next year. HIV is a much more
Speaker 1: difficult virus, so that that's going to take a lot
Speaker 1: more work to get it to work correctly. None of
Speaker 1: these new MR and A vaccines and treatments will have
Speaker 1: the same speedy trajectory as the COVID vaccine last year.
Speaker 1: That's partly because the circumstances are so different. As we
Speaker 1: saw in last week's episode, the pandemic was in some
Speaker 1: ways the perfect use case for MR and A vaccine.
Speaker 1: The vaccine makers could draw on years of prior work
Speaker 1: from virologists on what would be the best bit of
Speaker 1: a coronavirus to use for a vaccine. They could run
Speaker 1: relatively quick patient trials. With COVID circulating around the globe.
Speaker 1: There was no shortage of scope for testing the vaccine,
Speaker 1: and the stars Cove two virus is a lot more
Speaker 1: straightforward than cancer or HIV. Now, the companies that raced
Speaker 1: to get COVID vaccines on the market are going to
Speaker 1: need to start playing a more complicated game. They'll need
Speaker 1: to reassure investors that their billions and revenues won't just
Speaker 1: be a one off. They're grappling with a tremendous pace
Speaker 1: of growth. Moderna in particular, has struggled to set up
Speaker 1: a global distribution network without a big partner like Visor.
Speaker 1: It recently said it wouldn't be able to ship as
Speaker 1: many COVID vaccine doses as expected this year. Meanwhile, smaller
Speaker 1: startups around the world are also working on m R
Speaker 1: and A vaccines and treatments. When I asked Helmet Juggla,
Speaker 1: the BioNTech chairman, about the biggest challenges ahead, he says
Speaker 1: the company has to be careful to stay focused. We
Speaker 1: just need to be careful that we don't go after
Speaker 1: too many things at once, and we really need to
Speaker 1: rule Lan's work focus. Um Helmett says he thinks bion
Speaker 1: Tech will have more MR and A products on the
Speaker 1: market in a few years. It reminds me of the
Speaker 1: song by the Hungarian rock singer who appeared on that
Speaker 1: radio interview with Catle and Currico, the pioneering MR and
Speaker 1: A researcher in Budapest. We played some of it in
Speaker 1: episode six. The song is about how you need to
Speaker 1: work hard and stay the course to achieve your goals.
Speaker 1: The diamonds and gold have a nice shine, but you
Speaker 1: have to dig deep to get it. Catalan says her
Speaker 1: favorite part of the song is about what happens when
Speaker 1: you finally hit your target. The lyrics roughly translated from
Speaker 1: Hungarian are but when you reach your goal and could
Speaker 1: be happy, you're already thinking about a new plan, already
Speaker 1: embarking on a new road, and that's the beauty of life. BioNTech,
Speaker 1: MODERNA and their competitors have new plans too, and it's
Speaker 1: all about m R and A. Next week on Breakthrough,
Speaker 1: we'll talk with the public health leaders and scientists who
Speaker 1: are preparing for the next pandemic. Even before this one
Speaker 1: is over. COVID has shown us health vulnerable or health
Speaker 1: systems really are? Will we be ready when the next
Speaker 1: pandemic comes? They are a very moder threat that emerges
Speaker 1: from the way we have organized our societies, and they
Speaker 1: represent a critical threat for the century. This episode of
Speaker 1: Prognosis Breakthrough was written and reported by me Naomi Krasky
Speaker 1: So for Fourheads and Nagus Hendrickson, our senior producers. Carl
Speaker 1: Kevin Robinson Jr. Is our associate producer. Our theme music
Speaker 1: was composed and performed by Hanness Brown. Philip Corne did voiceover,
Speaker 1: and Bob Langrath and Sultan Shimon contributed reporting. Rick Shine
Speaker 1: is our editor. Francesca Levi is the head of Bloomberg Podcasts.
Speaker 1: Be sure to subscribe if you haven't already, and if
Speaker 1: you like this episode, please leave us a review. It
Speaker 1: helps others find out about the show. Thanks for listening.