Genentech’s Adamis Speaks on Ophthalmology’s Importance and a Professional Hero

Anthony P. Adamis, MD Senior Vice President and Global Head of Ophthalmology, Immunology, Infectious Disease & Metabolism, Clinical Science at Genentech, recounts the influence famous researcher Judah Folkman, MD, one of the earliest advocates for industry-academic collaboration, had on his career. He also updates us on Genentech’s growing ophthalmology pipeline. Watch this OISTV for the entire interview.


Anthony Adamis

Anthony P. Adamis, MD

Anthony P. Adamis, M.D. is Senior Vice President and Global Head of Ophthalmology, Immunology, Infectious Disease & Metabolism, Clinical Science at Genentech, a member of the Roche Group. Dr. Adamis is best known for his co-discovery of the role of VEGF in ocular disease.

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Tom Salemi: This is Tom Salemi from OIS TV. We are here at OIS@ASRS. I’m joined by Dr. Tony Adamis, Senior Vice President of Clinical Development at Genentech Roche. Thanks for joining us.

Tony Adamis: Thank you.

TS: So before we get into talking about ophthalmology, one of – hero would be too strong, but person who’s always fascinated me was Judah Folkman just for his role in bridging the gap that was between clinical science and corporate science or corporate development.

TA: So hero is not too strong a word.

TS: Good. I didn’t want to overstate it.

TA: And he was a big influence on my life. I actually went and heard him lecture, and decided after that lecture I was going to change the course of my career and I wanted to work with him.

TS: Wow.

TA: And so I approached him about working in his laboratory. And he was gracious enough to accept me. And he was a very warm mentor in the sense that he wanted to advance his people. He wanted them to get credit for their work, and he provided any support that he could. So he made introductions to important people and allowed the early VEGF story to flourish within his laboratory.

TS: And we’re here at an event where we’re bringing together researchers and KOLs and corporates and investors. It’s sort of kind of the interaction I think that he would have suggested was healthy for innovation.

TA: I fully agree. So he was the first Harvard lab head, first full professor to establish a relationship with a pharmaceutical company, with a corporate entity. It was Monsanto.

TS: That’s right.

TA: And at the end, he was an iconoclast, and he was actually on the receiving end of a lot of negative press, particularly from his fellow academics. And it was the president of Harvard University who almost had to come to his rescue. But long story short, Judah recognized that it was the companies that ultimately got the drugs to patients and that there had to be a collaboration between academia and industry to make sure that the medicines ultimately will reach the patient.

TS: That’s fantastic. And now you’re here with Genentech Roche, so you’re sort of completing that cycle yourself. Where does ophthalmology sort of fit into Genentech Roche’s priorities?

TA: So it’s becoming increasingly important. The development time, you know, for drugs and devices is long. But we’re now finally in the clinic with a number of what we hope to be important therapies for patients. So we’re in phase 3 with lampalizumab, which is our complement inhibitor, factor D inhibitor for patients with geographic atrophy. We’ll get data on that next year. We’re in phase 2 with the next generation drug, we believe, for wet macular degeneration. That’s the VEGF ANG 2 program.

TS: That’s fantastic.

TA: We’re also in phase 2 with our long acting delivery program, the Ladder trial, where we’re looking to see if we can extend out dosing to every 4 or 6 months. So there’s a number of programs that are moving forward and now are going to be publicly available to people.

TS: That’s a really robust pipeline. Moving into ophthalmology, given all your experience in other specialties, were you able to leverage a lot of that expertise in ophthalmology and sort of accelerate the development of a pipeline in this space?

TA: Yeah. I think by virtue of the fact of treating patients with the diseases, I was able to, together with all the people I work with – there’s a lot of people behind the scenes who really deserve the lion’s share of credit – sort of identified what the unmet needs are in ophthalmology, and that helped us focus on those diseases. Where are the biggest unmet needs?

TS: And going over again some of your programs, and one of them is giant cell arteritis. Am I saying that right?

TA: Yes.

TS: What is that? That was specifically called out on your website. What is your effort in that space?

TA: Giant cell arteritis is also known as temporal arteritis. It’s an inflammation of medium size vessels. And ophthalmologists see these patients because they literally can go blind overnight. So the blood supply to the eye is cut off, and there’ll be a sudden and irreversible loss of vision. To date, the mainstay of therapy for those patients has been oral corticosteroids, or in the most acute cases, systemic IV corticosteroids. But patients very often can’t be weaned off those drugs. And the disease recurs very frequently. So we tested Actemra, which is an IL-6 receptor inhibitor. It’s a molecule that we originally had approved for rheumatoid arthritis, but the science led us to believe that IL-6 inhibition would play a role in this disease, giant cell arteritis. And the phase 3 data recently were announced, and showed superior efficacy to oral corticosteroids and also sustained efficacy. So we’re quite excited about those results.

TS: And are your drugs, are they aimed at the general population of ophthalmology patients? Or are you looking to sort of look at specific patient populations with certain genetic criteria that could benefit from a drug?

TA: So we’re moving to personalized therapy. So as a company, Roche and Genentech was one of the pioneers with herceptin and breast cancer. So we would only treat patients who were HER2 positive because the antibody blocked HER2. So we’ve been always focused on giving the drug to the patient in whom it will work. We’re doing that now with our phase 3 trial with lampalizumab. We’re genotyping all the patients. And the patients who we believe have the most mutations or SNPS in their complement genes are the ones that potentially will have the greatest benefit from the drug. Ultimately, we’ll see when the phase 3 data is read out.

TS: And what opportunities do you see in drug delivery?

TA: So big opportunities. One thing we’ve learned in the current anti-VEGF era is that patients in the real world are not obtaining visual acuity results that we saw in the phase 3 trials and others have seen in the phase 3 trials. That’s because it’s very difficult for patients to comply with the monthly injections or the frequent injections, if they’re not monthly. So long acting delivery I think will help increase adherence to the medication and ultimately improve outcomes for patients.

TS: That really is such an important issue, and one that I think we’re addressing today. There’s a lot of discovery about delivery today, but you can deliver the best treatment in the world, but if you can’t get it to the patient, you can’t benefit that patient. Will crossing that gap, building a bridge across that chasm – what kind of impact will that have on patient treatment?

TA: I think it’ll have a significant impact in that they’ll be treated as needed, as opposed to when they’re able logistically to get into the doctor’s office. The average age of wet AMD patients is 79 years old. And oftentimes they need a loved one or caretaker to bring them in.

TS: Sure.

TA: So if you could really decrease that treatment burden for patients, I think compliance goes up and visual acuity results go up.

TS: Terrific. And you’ve got – you went over your pipeline earlier, a lot of later stage products. Looking ahead two years from now, what sort of successes, milestones, maybe challenges do you see yourself facing and overcoming?

TA: So the big one we just talked about is drug delivery. We’ll have phase 2 data which will tell us proof of concept, whether our drug delivery platform, the first one entering the clinic, works. We’ll also know whether complement inhibition using the factor D inhibitor that we’re developing will work. And we’ll also get a good sense of the VEGF ANG2 molecule, whether that’s really going to be the next generation of wet AMD drugs. So we have a data readouts coming out, so the next couple of years are going to tell us exactly how much impact we’re going to make on vision loss and blindness.

TS: Terrific. Well, thank you for taking the time. Thanks for lending some insight about Dr. Folkman and I’m glad that the term hero is not misapplied with him. You have to admire someone who believes in something so strongly and is willing to take an unfair and inordinate amount to make that point. And I think millions of people are benefitting from it.

TA: Yeah, he had courage. So thank you for the opportunity.

TS: Great. Thank you.