Five Questions with…Carsten Linnemann

Today, cell therapy is starting to drive real clinical benefit, but we still face barriers to widespread adoption in cancer. Here, in the first of my ‘Five questions with…’ series, I discuss some of the opportunities and challenges in cell therapy with Carsten Linnemann , Co-founder and CEO of Neogene Therapeutics, a member of the AstraZeneca group.

Mark: You played a pivotal role in the development of some of the first TCR-Ts – so my first question is, what are the most significant science advances that have enabled cell therapy?

Carsten: I think there are two things over the last decade that have propelled cell therapy to where it is today. One is our ability to edit and insert genes into cells, which has dramatically improved due to technologies leveraging viruses and DNA nucleases, and a range of other techniques; something that was incredibly hard to do in the early 2000s is now routine. The second thing is we have a much better understanding of what a good, engineered therapeutic T cell must look like, and how to make it.

Mark: I couldn’t agree more, technology underpins everything we do. This leads me on to my second question – what do you think the cell therapy treatment landscape might look like 10 years from now?

Carsten: It’s been an incredible journey to reach where we are today, seeing some cures in hematology and the emerging potential of cell therapy in solid tumors and autoimmune diseases. I think over the next 10 years, we will see cell therapy becoming a more accessible and routine treatment for patients. I think we’ll see it being used to treat a wider range of tumor types and diseases, and in earlier line treatment.

Mark: Absolutely, in the last 25 years the field has progressed from effectively being a science project through to delivering approved medicines and driving changes in standard of care. Even so, challenges remain. What do you think are the most critical hurdles we need to overcome to unlock the transformative potential of cell therapy?

Carsten: Two areas are top of mind for me. First, I think we have to become even better at understanding how to use these kinds of therapies in different kinds of diseases. How can we make this truly work for solid tumors? How can we make this work for as many autoimmune diseases as possible? For example, by designing ways to enable cell therapies to resist the hostile, immune-suppressive tumor microenvironment. Secondly, if we want to improve access, we need to find ways to turn cell therapy from a very complex treatment, into something that is readily available off-the-shelf to patients when they need it. Finding ways to advance allogeneic cell therapy products that are manufactured in batches is one of the most critical hurdles we need to overcome.

Mark: I completely agree with you, and it's really exciting to be at a company that allows us to invest time and resource into solving some of these problems. In your view, what are the unique strengths that AstraZeneca has in the field of cell therapy?

Carsten: What makes me super excited to be at AstraZeneca is its unique blend of experienced people who are very dedicated to cell therapy; it's rare that this density of talent comes together in one place. We also have access to the critical technology, including in-house capabilities in CRISPR and TALEN gene editing, that we need to drive cell therapy forward. Having the people and the technology together in one place doesn't always happen, and it's always a gift when you can be part of it.

Mark: I completely agree, and of course, we've got a broad oncology portfolio that we can lean on as cell therapy becomes more combinatorial with other therapies. My fifth and final question – and this is the tricky one – if you weren't working in cell therapy, what would you be and why?

Carsten: I have a deep passion for history and in fact, I almost studied Politics and History before my Chemistry teacher talked me into biochemistry, so I would probably be looking at some ruins in Greece or Egypt!

Mark: I was not expecting you to say that! Thank goodness she did, I think the ancient ruins of Rome are one thing but I'm glad that you're investing in the future with your career!