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MARCH 20 (^20) FORBES.COM
S
omerville, Massachusetts–based Finch
Therapeutics is one of the most prom-
ising startups developing microbiome
drugs. Cofounder Mark Smith, 33, was a
microbiol ogy grad student at MIT when
the 20-something C. diff patient begged him for help. “I had
to tell him, I’m a microbiologist, not a doctor,” Smith says.
The patient’s ordeal motivated Smith to create Open-
Biome, the equivalent of a public blood bank for human
feces, while Smith was still at MIT in 2013. The Cambridge,
Massachusetts, nonprofit, the first of its kind in the world,
has since supplied stool for more than 53,000 transplants
in 1,200 hospitals and clinics.
Inspired by the demand for transplants, Smith cofound-
ed for-profit Finch (named for the diverse group of finches
Charles Darwin discovered in the Galápagos Islands) in
2016 to develop an FDA-approved C. diff pill. Currently,
most doctors perform fecal transplants through a colonos-
copy, which can cost as much as $5,000. The procedure is
not FDA-approved or reliably covered by insurance.
Smith and his 80 employees occupy two floors in an in-
dustrial park that formerly housed administrative offices
and storage space for the Harvard Art Museums. Tall and
slender with piercing blue eyes, he welcomes the inevitable
jokes that come with being a human-feces entrepreneur. On
Halloween he wore a poop-emoji costume (“I was a pooper
trooper”) to the office, where the copiers have names like
Squatty Potty and Magic Stool Bus.
But he has raised serious capital. Venture funds have put
in $130 million, and Finch has a partnership with Tokyo-
based pharma giant Takeda
to develop drugs for ulcer-
ative colitis and Crohn’s dis-
ease, which together have
10 million sufferers world-
wide. Finch is also working
on an autism drug.
Traditionally, scientists
start with data gathered
through experiments on
mice. Finch is taking a “hu-
man-first” approach, skip-
ping the rodents and ana-
lyzing the stool of human
patients who have recov-
ered after receiving fecal
transplants. “We’re looking
at what works in patients
and figuring out how to
make our drugs from the
top down,” Smith says. “It’s
called reverse translation.”
For one of its C. diff drugs,
Finch is extracting what
Smith describes as the “full
spectrum” of bacteria in a
human stool sample from
a patient who has been suc-
cessfully treated, freeze-drying it and delivering the equiva-
lent of a fecal transplant in a single pill. It’s also working on
simpler drugs made from five to 10 key bacteria. It expects
results from its first Phase 2 trial (which demonstrates ef-
ficacy) of the full-spectrum C. diff capsule by the end of the
second quarter of 2020.
“Even if only a few of the microbiome therapies scientists
are working on come to fruition,” Smith says, “it will have a
huge impact on public health.”
A
nother MIT Ph.D., Bernat Olle, 40, is run-
ning Vedanta Biosciences, a nine-year-old
Cambridge, Massachusetts–based micro-
biome drug developer with $112 million
in funding, including $10 million from
the Bill & Melinda Gates Foundation. The Gates investment
supports preclinical research at Vedanta aimed at develop-
ing a gut bacteria–derived drug that would prevent child
malnutrition in the developing world. Nearly 200 million
children under age 5 suffer from either wasting or stunting,
resulting in at least 1.5 million deaths a year. “Malnourished
children struggle to gain weight even when fed enough,”
Olle says. “Emerging research suggests that this is because
their gut microbiota develop abnormally, and that benefi-
cial gut bacterial strains may help correct this imbalance.”
Vedanta also has two partnerships with big pharmaceuti-
cal companies, including Bristol-Myers Squibb, to develop
drugs aimed at boosting the effectiveness of immunotherapy
to treat melanoma and colorectal and gastric cancers. Like
Finch, Vedanta is developing a drug to treat recurrent C. diff.
Drugs From Bugs
Bernat Olle, cofounder and CEO of Vedanta Biosciences, in one of Vedanta’s labs
in Cambridge, Massachusetts. “I don’t think there’s any other field of medicine today
that holds as much promise for the future of medicine as the microbiome.”