Genomics Revolution returns +65.57% over 12 months*
Performance is for period 3 August 2019 to 3 August 2020. Performance calculations are based on exit prices with distributions reinvested, after ongoing fees and expenses but excluding individual tax, member fees (if applicable).
The Genomics Revolution
Medicine has made incredible strides in the last 100 years treating and curing diseases that were once “death sentences” and totally eradicating others. However, the next 100 years will not be simply a cumulative progression of medical knowledge but rather an age of explosive disruption as new discoveries in genetic editing, immunotherapy / immuno-oncology, genomic sequencing, personalized medicine, liquid biopsy, and the digitization of healthcare literally turn the industry on its head. As one commentator has said ”the next century will look more like science fiction than contemporary medicine”.
At Macrovue, we see this as a compelling investment theme. Why? Well we are clearly in the very early stages of some very significant discoveries, there is a large universe of companies to choose from, both large and small, and we believe the potential upside is considerable for long term investors.
So what types of companies will Macrovue be looking at?
The majority of the companies in this Vue will be Biotechnology companies, but some will come from the technology sector, as well as life sciences, and the medical device industry.
We intend to focus on the following sectors:
Next Generation Genomics
The Human Genome Project (HGP) — which established the sequence of the first whole human genome — was completed in 2003 and while immensely critical to advancing science, has proved that tying DNA structure to curing disease was more complex than originally expected. However, over the past decade, the pursuit of tying an individual’s genomic makeup to disease has made significant advances due to the incredible computing power and speed of the latest sequencing machines. As our understanding of the genomic makeup of humans increases, so does the ability to manipulate genes and improve diagnostic treatments and outcomes. Next-generation sequencing also makes personalized medicine possible. Since individual patients possess unique genomes they can be affected differently by the same disease or therapy. The ability to genetically sequence all patients, along with the viruses, bacteria, and cancers that affect them has the potential to better match the therapy each patient receives. Genomic sequencing underlies the majority of the new therapies described below.
Gene Therapy and Editing
Crispr or “clustered regularly interspaced short palindromic repeats” is a family of DNA sequences found within the genomes of prokaryotic organisms such as bacteria and is considered by many to be the “Holy Grail” of Modern Biomedicine. This is the technology that can permanently change the genetic code of a living organism, including human beings, and has huge significance for modern medicine. CRISPR/Cas9 can be customized to insert, remove, or replace a target DNA sequence for therapeutic purposes. For example, a disease-causing gene can be neutralized through disruption or deletion and corrected via the replacement of a nucleotide sequence. This technology can be applied ex vivo (edits to cells made in the lab and then administered to the patient) or in vivo (editing cells in the patient)
Immunotherapies /Immuno- Oncology / CAR-T
Cancer is the developed world’s second most common cause of death, accounting for a quarter of all deaths and with an economic cost estimated to be in the trillions of dollars. Immunotherapeutic approaches leverage the patient’s immune system to eliminate or slow the growth and spread of cancerous cells with the potential to dramatically improve the economic and medical outlook for cancer patients. One of the most promising approaches is CAR-T (chimeric antigen receptor T-cell therapy) a type of treatment in which a patient's T cells (a type of immune cell) are changed in the laboratory so they will bind to cancer cells and kill them.
Epigenetic breakthroughs are creating a tool box of powerful drugs to treat cancer and many other potential indications. Epigenetics incorporate changes in the genome other than just mutations in the underlying genetic code. Importantly, epigenetic drugs, which can switch genes on and off, may materially increase the percentage of patients likely to experience profound increases in survival in response to immunotherapy. Several epigenetic drug classes may materially broaden and deepen the efficacy of cancer immunotherapies, such as PD1 antibodies which enhance the body’s immune response to tumors. Low dose inhibitors of the enzyme catalyst DNA methyltranferase (DNMT) may improve immune priming by triggering the transcription or copying of repressed viruses long embedded in the human genome.
A key requirement in the fight against cancer is access to better diagnostic testing capabilities that can improve the ability to detect and monitor tumors. Blood-based genetic testing, known as a liquid biopsy, is showing signs of filling that need and has the ability to dramatically improve cancer care in the coming years. With liquid biopsies (“LBs”), clinicians are searching for trace amounts of tumor DNA (“ctDNA”) circulating in the bloodstream that, when sequenced, can guide treatment decisions. While still in development, liquid biopsies will be tuned not only to detect cancer in its earliest stages but also to monitor patients in remission.
Many biotech companies are now developing therapies with the goal of extending the human “healthspan” — defined as the portion of life lived free of age-related disease. Age-related conditions are the leading causes of death and health-care costs. Reducing the rate of aging would have enormous medical and financial benefits. Companies are exploring a number of potentially transformative approaches, including circulating youth factors, mitochondrial dysfunction, and the elimination of a specific cell type called “senescent cells”.
Another emerging medical technology is microbiome. The microbiome comprises all of the genetic material within a microbiota (the entire collection of microorganisms in a specific niche, such as the human gut) and focuses on microbes such as bacteria, viruses, and fungi that live inside humans. New research suggests that these microscopic organisms play a critical symbiotic role with their hosts thus a more complete understanding of this area may result in better treatments for cancer, intestinal diseases, and immune systems.
Big Data / Digitization of Healthcare
The electronic health record initiative and increasing consumer use of wearables has turned healthcare into a data problem. In 2013, at the onset of Meaningful Use, approximately 153 exabytes of healthcare data were produced. Looking forward to 2020, more than 2,310 exabytes of healthcare data are projected to be produced, creating a broad playing field for opportunities in these robust data sets for both the technology and life sciences industries who will also use artificial intelligence and machine learning in data reconciliation and interpretation. At the same time, rising costs in healthcare (~18% of U.S. GDP), an aging population, and the shortage of clinicians all create a need to monetize this data and bend the cost curve. Global consultancy McKinsey estimates these innovations could reduce healthcare spend by $300–$450 billion.
For more information on how to invest in Genomics Revolution call 1300 720 292.