On September 17, scientists from academia and biotech in different locations were brought together in a virtual forum to learn about the latest preclinical and clinical approaches for effective therapeutics against COVID-19. The Therapeutic Pipeline for COVID-19 meeting was the second, in Bioinsider’s ‘Together as One’ COVID-19 Virtual Meeting Series, and brought together more than 100 researchers and featured 11 keynote presentations, focused on small-molecule and antibody-based approaches. The meeting also featured a special gathering for virtual speed networking and three intimate breakout discussions on 1) Drug repurposing, 2) Realistic and manageable drug treatment, and 3) Vaccines or anti-virals for COVID-19. The keynote presentations:
Two major themes emerged and were:
COVID-19 will most likely be a major problem in the near future (beyond 2021). First-generation vaccines will not sufficiently provide effective coverage to eliminate COVID-19 and, hence, therapeutics will be vital. Early vaccines will most likely be FDA-approved with as low as 50% efficacy; therefore, complete population coverage will be unfeasible. Therapeutics will be impactful in key areas. First, for patients that develop severe symptoms therapeutics will be required. Second, therapeutics will likely benefit when used as pre-exposure prophylactics. Three, post-COVID-19 symptoms in recovered patients will require targeted therapeutics.
Antibodies will dominate but small-molecules will be necessary. Speakers presented how they have shifted their laboratory research and through strategic biotech partnerships, have developed effective antibodies at incredible speed. The antibodies currently with the best preclinical and clinical efficacy are exclusively designed to target a specific area of the COVID-19 Spike protein important for receptor binding. However, recent advancements in studying the underlying biology of COVID-19 and the pathophysiological impact have shown that there are very promising targets against host cells that can be developed as small peptides or molecules.
Future. There is increasing interest in additional non-structural COVID-19 proteins that play roles in infection and evasion of the immune response. Antibodies, small molecules, and emerging therapeutics (nanobodies, siRNA/oligomers, interferons/biologics) are all important in this area. However, the pillars of pharmacology (PK, binding, ADME) must be maintained during development in order to not-rush early promising therapeutics.