If the recent crop of companies emerging from stealth is any indication, innovators are doubling down on opportunities to join the juggernaut weight loss market while exploring fresh opportunities in immuno-oncology and pain management. Investors appear eager to back their efforts, pouring hundreds of millions into these new initiatives. The flow of capital reflects overall market trends.
Global spending on cancer medicine is predicted to increase from $223 billion in 2023 to $409 billion by 2028, for example.
But many of these biotech hopefuls will also face intense competition for market share, particularly in weight loss, where the pipeline contains more than 150 clinical-stage assets, including several in phase 3, according to a recent IQVIA report.
“As these assets progress through the pipeline, innovators will need to navigate an increasingly crowded field and seek differentiation on multiple dimensions, including efficacy, tolerability, convenience, durability and quality of weight loss that distinguishes between fat vs. lean mass,” the report states.
Here’s a look at some of the most recent startups to emerge from stealth and the innovations they’re bringing to the table.
The obesity race
Three new startups are advancing drugs that could earn them a cut of the blockbuster GLP-1 market, now on track to become the best-selling drug class in history.
Helicore Biopharma announced itself in January, backed by $65 million in series A financing. The company is looking to build on the success of GLP-1 drugs by adding a second target — the glucose-dependent insulinotropic polypeptide (GIP) receptor — and creating a dual action approach that researchers believe could enhance weight loss. Helicore is also betting that the combination will help it sidestep one of the main drawbacks of GLP-1 drugs: muscle wasting. In preclinical studies, its lead asset, HCR-188, appeared to preferentially target fat over muscle.
Kailera Therapeutics came out of stealth last year with more than $400 million in investor dollars. It is also focusing on the GIP pathway, with a suite of four clinical and preclinical drugs for weight loss and metabolic conditions that the company acquired from Jiangsu Hengrui Pharmaceuticals. Its lead injectable medication, a GLP-1/GIP combination, is now in phase 2 trials for both obesity and type 2 diabetes.
Metsera also arrived on the obesity scene last year and hopes to innovate itself ahead of the competition with a portfolio of oral and injectable therapies, including GLP-1s, drugs using alternative non-incretin pathways and combination approaches. The company’s portfolio has attracted investors, garnering $290 million in initial funding and another $215 million in November. Phase 2a results show its lead product was well tolerated and patients in a 12-week trial saw as much as a 20% reduction in their body mass. The study also supported the feasibility of a monthly dosing schedule, which could give it a competitive advantage over current weekly GLP-1 shots.
Rising immuno-oncology contenders
Leveraging the immune system to treat cancers continues to be a major focus for drug developers.
Ottimo Pharma, headed by former Seagan CEO David Epstein, threw its hat into that market in October with its investigational drug, jankistomig, a PD1-VEGFR2 bifunctional antibody that it hopes can rival Merck’s blockbuster checkpoint inhibitor Keytruda. The drug is a checkpoint inhibitor that also aims to inhibit angiogenesis, the formation of blood vessels that cancers need to grow and spread. Ottimo has been testing the molecule in preclinical trials for the past three years and is looking to file an IND at the end of 2025.
Nuntius Therapeutics also emerged from stealth last year and announced a partnership with Taiho Pharmaceutical to develop mRNA-based cancer immunotherapies. Taiho will use Nuntius’s unique mRNA delivery platform, which helps avoid some of the drawbacks of current mRNA delivery technologies. Its cell-specific peptide dendrimer- and lipid-based nanocarriers appear less likely to trigger an immune reaction and may be more effective at reaching targets outside the liver. The company is also developing mRNA therapeutics that target cancers, and lung and neurodegenerative diseases.
The pain push
In the wake of the opioid epidemic, many companies, including Tris Pharma, SiteOne Therapeutics and Latigo Biotherapeutics, have strived to develop safer pain treatment alternatives.
The field got a boost when Vertex scored a win in January with its first-in-class non-opioid painkiller Journavx, which analysts predict could top $10 billion in sales.
And Maxoma, another newcomer advancing an option to manage pain without the addiction risks, came on the scene in February. The company is developing a non-opioid, non-NSAID oral therapy to tackle both acute and chronic pain. The primary ingredient in its candidate is nefopam, a prescription medication already used for pain in some European countries and East Asia. The company announced good safety results from a phase 1 trial, and hopes the drug could eventually become the first triple monoamine re-uptake inhibitor approved for acute pain in the U.S.
