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Becker’s Healthcare Podcast
Advancing Monoclonal Antibody Innovation and Pandemic Preparedness with Marc Elia of Invivyd
00:15:41
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- [00:00]
Erica Carbajal
Hi, everyone. This is Erica Carbajal with Beckers Healthcare. Thank you so much for tuning in to this episode of the Beckers Healthcare podcast series. Joining me for today's discussion is Mark Alia, chairperson of the board at invivid. Mark has served as a member of Envivid's board since June of 2022 and as chairperson of the board since July of 2022. Mr. Alia, thank you so much for being here today.
- [00:27]
Mark Alia
Thank you for having me here.
- [00:28]
Erica Carbajal
Yeah. Excited to chat with you. To start us off, do you mind telling our listeners a little bit about yourself, your personal journey with COVID and how that aligns with your role at Invivid today?
- [00:41]
Mark Alia
Sure, I'm happy to. My role with Invivid actually predated my journey with COVID but for the bulk of my career, I've been in the biotech industry, in corporate, in, you know, strategic consulting, and then ultimately spent about the last 15 years in finance. So investment firms, my work devoted to biotech broadly. And around the year 2019, I decided to start my own investment firm. And at that same time, there was this mysterious pneumonia making its way across mainland China. And I had the sort of odd, odd congruence of having an investment firm devoted to biotech and looking at some opportunities in the then brand new Covid space. And this is April, May, June of 2020. And I think it was clear back then that coronaviruses don't reliably elicit durable immunologic memory, meaning those antibody titers tend to fade pretty quick. And so you get a very early propensity or at least a potential for reinfection. And so those data for the endemic coronaviruses were pretty well established back then. And so if SARS cov2 were to behave like the other viruses, you could kind of know that we're going to be in a little bit of a pickle immunologically. And so the point of all that was to point out, okay, then, even if there were vaccines, their efficacy would always be transient. For those reasons, I back then invested in a company that was devoted to Covid monoclonal antibody technology. And that company became Invivid. And it was around that time when I actually had my own experience with Delta Covid, thanks to my beautiful and amazing children who really routinely had to go out into the world and one day brought back Covid. I think I had at the time, this is November of 21, you know, kind of a mild to moderate Covid. And then on day nine, I woke up pretty certain I was dying with, I think, what they call, you know, an impending sense of doom clinically, which was a fascinating phrase to reflect on. And it's very, very real. And it turned out I had, you know, diffuse bilateral pulmonary emboli and I spent, you know, a few days in the hospital, you know, rapidly anticoagulated, and then for years since have struggled to some extent with Long Covid. And by some extent what I mean is, you know, there's people out there who struggle to get out of bed and I'm very, very grateful that that's not me. But I, I do have some measure of ongoing autonomic dysfunction and what I think the clinical community calls post exertional malaise, which is, you know, a tragic comic understatement for what it feels like if you push your body a little bit. And I used to be an athlete, right. So when I feel good, I'm inclined to move. And the consequence physiologically is pretty brutal. So all of that happened in fact before some of the shareholders asked me to come back to the board and help move the company into a place in which we are configured to address endemic long term SARS COV2. So over these last few years, we have worked to advance our first monoclonal antibody through FDA authorization and we are now commercializing that. And we use our tech platform to innovate and try to bring more contemporary, better form factor drugs. So you'll find us doing that work and then similar work increasingly for other viruses where we perceive that there's a real gap between what a vaccine can confer to broad population populations and what select populations we'll need actually require to stay well and not just alive. Which is I think, kind of roughly through to today. And probably more words than you cared for.
- [04:44]
Erica Carbajal
No. Oh my gosh, Mark, your, your remarks took me back really to that spring of 2020, that Covid crisis moment really that we, we all remember, you know, where we were in those, those first few months. And I think just your remarks really highlighted the real risk of reinfection that still is out there today and how much we're still continuing to learn about Long Covid and the risks there. Can you tell us a little bit more about Invivid and the technology platform behind the antibody?
- [05:14]
Mark Alia
Sure. So you know, antibodies are of course now relatively well trafficked pharmaceutical modality, but of course one of the, the sort of oddball features of most pharma mabs is they're directed against self targets. Right. And so what we have done at Invivid is to Try to build a technology platform that does its level best to move to places that are relatively, let's call them, immunorecessive, meaning the immune system, mammalian immune systems don't like to pressure these epitopes. And, and so you'll see over time and evolution, our epitope is pretty quiet, it doesn't move a lot, which is critical, right, because with a given antibody, your, your target site is fixed. So you want to be awfully careful about which, let's call it real estate, you pick. And so a huge amount of our work is devoted to characterizing that real estate, real estate, so to speak, and then drugging it rationally. And the way we do that is a little different. And I guess I would just say it's a form of directed mutagenesis at the antibody level in which we are trying to very delicately but consistently walk in a synthetic way, antibody binding to these areas. So if there's a secret sauce, it is in how we've conceived of the exercise and then the tools we use to go after it. And you know, our perspective is no Covid antibody is going to last forever, almost certainly. And so another, another side of what we've done is to try to work with the US FDA on the aspects of iterating antibodies. Because if you really want to step back and consider it, we are very comfortable as a society iterating vaccine antigens, right? Flu, we change depending on what's circulating. Covid we change, but we're uncomfortable or at least unused to iterating antibodies. Which if you think about it and just sort of juxtapose how human immunobiology works is at least a little bit perverse, right? Because I think every human being is born immunocompromised and loaded with monoclonals. We should be pretty comfortable with the concept and the idea of rational iteration against a moving target.
- [07:35]
Erica Carbajal
Mark, you started to mention some of the challenges earlier, just in infectious diseases. One being the reinfection risk, the constant, especially with COVID Can you talk a little bit about how Envivid is helping to address some of the ongoing challenges with infectious diseases and pandemic preparedness more broadly?
- [07:53]
Mark Alia
Yeah, sure. And I, you know, I think the challenges are thankfully at some level becoming less and less technological every year. All of these infectious diseases make a central point over and over again, which is in terms of finding scaled protection fast. You, you essentially can't beat a good vaccine. A good vaccine is a miracle. But they're not all good, right? Or at least they're not all good enough. And so in that gap you can consider vulnerable populations and the benefit they can get from a great monoclonal. I think, you know, there's, there's an opportunity in this sort of very interesting and dynamic time in infectious disease medicine and federal regulation and so forth to simply make the point. These technologies are very complimentary and probably as a society we've over indexed to some extent purely to active immunization and maybe under indexed to passive prophylaxis or so called antibody use. And so I think whether we're talking about some next pandemic or whether we're talking about very ordinary day to day infectious disease medicine, we all know the good news is the technology is I think getting better every day to the point where we can consider scaling some of these more traditionally sort of complicated toys. The bad news is some of it's probably clouded and lost underneath much bigger, let's just say, you know, social debates going on right now in ID medicine. I think I'm just hopeful that technological evolution can open that aperture more and more over these coming years.
- [09:44]
Erica Carbajal
Yeah, certainly. Thanks, Mark. Can you tell us about just the need as well to have the patient voice heard amidst all of the changes that are also taking place at the fda?
- [09:55]
Mark Alia
I guess what I would say is that over the last couple of decades we have seen I think a little more interest in the actual needs and wants of highly informed patients in terms of regulatory decision making. And I suspect some of that is to do with the fact that here in 2025 we all have access to much more information. It feels maybe a bit like medicine and regulation of medicine and might be moving in a slightly more libertarian direction, if I could say. Libertarian means reflecting the wishes of a informed, consenting patient and his or her care team. And I think that's a good thing. But I think for example, persons who deal with long Covid and again of whom I am one, have real views and real opinions and I think all of our hope be that the FDA takes those views seriously when they think about drug regulation. So you know, again, I don't, I don't have a whole lot more to say on the topic because I don't work at the fda, but I do think what we're seeing is sort of encouraging along those lines.
- [11:08]
Erica Carbajal
Yeah, and to your point, I think, you know, familiarity of antibodies like among the general public has definitely grown, especially amid Covid and in the last few years with rsv. So we'll be interesting to see how that that continues to grow and continues to show up. Mark, what else would you like to leave listeners with? What else should they know about Invivid in the pipeline over the next year?
- [11:30]
Mark Alia
Gosh, I think only that I would double underline. I think sort of the point you're making, which is sometimes new medicines are obscure. Right? The technology is complex, the words are big, and oftentimes people learn about this stuff while they're simultaneously having the worst day of their life together with a physician and a care team. But I think, like a lot of things that are new when they're based on unreal, just first principles, human immunobiology, we ought to be embracing them maximally, Meaning Invivid has some pretty trick technology. Okay. It's not easy to do what we do, but the thing that we're doing is, of course, shamelessly and joyfully ripping off mother nature who has done this work first and best. And to the extent that there's a little limitation left behind, you know, we're simply looking to augment pharmaceutically the work that is the result of, you know, billions of years of evolution that have arrived at us. And so while these things are new, I don't think that should make them scary. I don't think it should make them unfamiliar. I'm looking forward to a world in which I don't have to choose between an infection I don't want and a vaccine that scares me a little. Right. And that's not an indictment of the vaccine. I'm saying as somebody with a clear predisposition to thromboembolism, a person like me could really use an option. And today I don't have one. And I don't know that that's well understood across, you know, key stakeholders in the clinical and regulatory communities. But it ought to be, because there are answers to these problems.
- [13:15]
Erica Carbajal
Yeah, absolutely. Mark, to close us out, if you could fast forward a decade into the future, what would success look like for Envivid and for you personally?
- [13:26]
Mark Alia
For me, at this point, personal success looks a lot like staying on the right side of the grass and feeling good about that professionally. And for Invivid, I'd like to see us move with all haste and high acumen toward identifying and filling gaps in the preventative and in the therapeutic armamentarium for especially viruses, but other maybe pathogens, microbes, where human beings face an innate hardwired liability. Right. We have a deficit, in effect, in our immune suite. I'd love to fill it rationally and I'd love us to scale so that, you know, we're not making in the future niche products at high priced for just the maximally vulnerable. But rather we are able to democratize access to these tools because, you know, Covid rsv, you know, human metapneuma virus, holy cow, measles. If things keep going the way they've been going, you know, these are not niche diseases and it's very hard to know if you're going to have a bad outcome in advance, but you'd really rather not think about it at all. And so I think for me, for Envivid, success would be building the power and the reach and the scale of what our technology can do to just protect as many people as we possibly can and create the most commensurate medical value. But for now, I think we're just laser focused on getting as many people the maximum benefit our technology allows.
- [15:06]
Erica Carbajal
Mark, I think those are great points. Such important ones around access, expanding access and just options for people with immunocompromising conditions or who are more at risk for a lot of these viruses that certainly aren't going away anytime soon. Mark, thank you so much for being on today. We appreciate your insights.
- [15:24]
Mark Alia
Well, thank you for having me. It was a pleasure.
- [15:26]
Erica Carbajal
We also want to thank our podcast sponsor today and Vivid and listeners. You can tune into additional episodes of the Becker Podcast by visiting the podcast page on our website at beckershospitalreview. Com. Thank you everyone.