OIS@ASRS Reporter’s Notebook: Three Things Learned at OIS@ASRS About What Funders Want, Going Global, and AI

CHICAGO – This year’s OIS@ASRS jam-packed into one day presentations from early and late-stage retinal treatment developers, panels from key opinion leaders in industry and in practice, insights into hot topics, and overviews on three research projects being funded by Foundation Fighting Blindness. The full agenda is available (as are some of the slides) online at OIS.

As usual, Emmett Cunningham Jr., MD, PhD, MPH, senior managing director at Blackstone Life Sciences, noted this year’s approximately 300 attendees mostly originated with start-up or emerging growth companies from 23 states and 13 countries, most of whom were in attendance seeking financing. We’ll feature more on these participants in upcoming newsletters, but this week, we’re highlighting two of the panel discussions: one on financing, the other on artificial intelligence.

Getting Financed

Pravin Dugel, MD, of Retinal Consultants of Arizona, moderated a panel on just what investors are looking for in companies when they choose to invest (be it Series A or direct investment).

“This is really an exciting topic, because when I was in training, there really was no financing, because there really was no innovation,” Dr. Dugel joked. That has radically changed, as members of the panel noted (Blackstone Life Sciences, for example, invests anywhere from $50 million to $500 million in various ophthalmic ventures). Firas M. Rahhal, MD, has been a partner in ExSight Ventures since its inception in 2014. The group invests solely in ophthalmology, Dr. Rahhal said, and earlier in the development process (typically $250,000 to $500,000 as an initial amount).

InFocus Capital Partners boasts a 90% mandate in ophthalmology; since its inception, the group has made six investments to date. “We’re looking for seasoned management, disruptive product, and a reasonable time to monetize,” said managing partner Ron Weiss, MD.

Michael Keyoung, MD, PhD, managing director and head, North America at C-Bridge Capital, does not streamline investments to just ophthalmology, but invests throughout healthcare (typically around $20 million to $30 million). “We look across the globe for innovation,” he said.

Calling his group “agnostic” to the therapeutic area and stage of research, Ash Khanna, PhD, venture partner at Pivotal bioVenture Partners, a $300 million therapeutics-only fund, said typical investments are between $15 million and $20 million. The group recently made its first ophthalmic investment in Oculus.

Going Global

Panelists agreed getting their attention is more about having a product, therapeutic, or diagnostic that addresses an unmet need. Further, Dr. Rahhal noted, companies must understand the regulatory pathway “and the inflection points we see as investors.” If a company cannot navigate through the regulatory minefield, Dr. Keyoung recommends they become familiar with it. His group will invest in companies that have rights in China, as that is “probably” the largest OUS market.

“Japan and China are the only two countries in the world where you need your own studies. Most others will accept a well-run FDA study,” he said, although if at least one arm has been conducted in Asia, pan-Asian regulatory approval may be easier to access.

Dr. Cunningham, on the other hand, said his company prefers to invest with a commercialization in North America or the European Union.

Timelines are equally important, with three-to-five-year exit strategies common among the panelists (although Dr. Keyoung will go as far out as 10 years).

Artificial Intelligence and Retina

Timothy G. Murray, MD, founding director and CEO of Murray Ocular Oncology & Retina, moderated the panel on groundbreaking developments in AI and imaging. In medicine, AI is narrow, he said, with its concentration on algorithms “to do something comparable or potentially better than humans,” with broad approaches to machine learning and deep learning.

Panelists included Netan Choudhry, MD, co-founder and medical director, Vitreous Retina Macula Specialists of Toronto; Szilárd Kiss, MD, director, clinical research and chief, retina service, Weill Cornell Medicine; and Darius Moshfeghi, MD, professor of ophthalmology and director of retina at Stanford University School of Medicine and co-founder of Pr3vent.

AI is “definitely here to stay,” Dr. Kiss said, and clinicians should expect this area to grow exponentially as more data become available to be analyzed.

Dr. Murray noted there are as many publications on the topic in the past six months as there had been in the previous six years, and big-name players (such as Google) are now getting involved in ophthalmology. There already exists an integrated AI package in retina, but there also seems to be a delay in impact, which Dr. Kiss said may have to do with practice modernization. “How to continue the compensation model is the issue, not the technology,” he said. “Who will pay for the technology, who is the customer?”

But that is the point of disruptive technology, Dr. Murray said. Panelists encouraged more development in AI, as they viewed it as “streamlining who really needs to be in the office,” said Dr. Murray. Interpreting the data and images is what will continue to be the “bread and butter” of retina.

Dr. Moshfeghi noted that large corporations are concentrating on the technology, not the patient who can benefit from it; and developers are focused on the business and exit strategies.

Dr. Choudhry agreed that the salient features of these devices “will help me fine-tune my practice and be more efficient,” especially if the technologies can evolve to find key biomarkers that will allow more patients to be recruited into specific clinical trials.

With the “devil in the details,” more information without knowing what to do with the information will be the challenge, Dr. Murray said.

“We’re evolving in how we diagnose and what the meaning is,” Dr. Kiss said. “Getting physicians involved and having a buy-in will be the key to its success.”

For questions about this article, please contact Michelle Dalton at mdalton@dalton-and-associates.com.