As COVID-19 began to spread rapidly across the world in March 2020, Tillman Gerngross and a team of highly regarded scientists founded Adagio Therapeutics — a spin-off of Adimab — to tackle the pandemic and related coronaviruses that may emerge in the future. "We live in a time where there are normal years, and there are COVID years. Everything is compressed, and it's remarkable how the scientific community has rallied around this problem and been so productive," says Tillman. GV invested in Adagio in 2020, and I'm fortunate to be a board observer.

Early on, the company saw an instrumental role for monoclonal antibodies to fight SARS-CoV-2 and other potentially emergent coronaviruses, and designed several antibodies to be used as therapeutic and durable prophylactic treatments. "Our strategy was, how do you deal with a class of viruses that have evolutionarily found a way of exploiting a specific human receptor that is present on epithelial cells? How do you block that coronavirus family, not just SARS-CoV-2?" he asks.

The team had the foresight to develop antibodies to address not only the current SARS-CoV-2 pandemic and emerging resistance variants but also future pandemics — a novel approach that my GV Life Sciences colleagues and I find extremely promising. "We're not the only ones who thought antibodies could play a role; we just approached it with a very different strategy," Tillman explains. "These SARS-like viruses have been spilling over into the human population for decades now. There is no reason to believe that all of a sudden it's going to stop. We anticipated variants and new forms of viruses would emerge at some point in the future."

Adagio CEO and co-founder Tillman Gerngross Adagio CEO and co-founder Tillman Gerngross

The sheer speed at which Adagio assembled its diverse leadership team — six out of eight of its executives are women — enabled the company to respond quickly to the growing global pandemic. In March 2020, Adimab engineered a broadly potent antibody for beta-coronaviruses, and by July, Adagio was formed as a spin-off to develop and commercialize ADG20. In just eight months, the company dosed the first patient and headed into clinical trials last month.

"That indeed is fast, but I have to admit it didn't feel fast," Tillman says. "Over that period, half a million Americans died. An American died every minute. It felt really slow, actually."

Unlike some cocktail approaches that combine complementary neutralizing antibodies, Adagio has generated a targeted approach with its lead candidate ADG20. In vitro and in vivo data demonstrate that ADG20 shows similar or higher potency against SARS-CoV-2 compared to other monoclonal antibody products in clinical development — while offering neutralization against a range of related coronaviruses that pose potential threats to humans.

"I'm a bit of a strange beast," he reflects. "I love the freedom academia gives you, but twenty years ago, I realized there are certain limitations for what you can do to impact things. I wanted to be able to point to drugs and technologies that touch people's lives."

Part of the reason Adagio could succeed is because Tillman continues to find his entrepreneurial courage time and again. As an inventor and scientist, he jumped from a successful academic career in the late 1990s to serial entrepreneurship. He co-founded five different pioneering life sciences companies, including Arsanis, Alector, and Adimab, one of GV's first investments when we launched in 2009. Tillman's biotech companies all have a goal of discovering and developing novel therapeutics for neurodegenerative disorders, cancer, and rare diseases. To this day, his companies continue to make an impact.

"I'm a bit of a strange beast," he reflects. "I love the freedom academia gives you, but twenty years ago, I realized there are certain limitations for what you can do to impact things. I wanted to be able to point to drugs and technologies that touch people's lives."

Tackling the next phase of the pandemic takes resolve. There have been multiple coronavirus variants found in the U.S., and the threat of these variants is unclear. "The truth is we see a disease caused by many different variants. We see cocktail approaches run into serious headwind, and there is no effect against the South African and Brazilian variants," he remarks.

As to what's next in lessening the severity of COVID-19, Tillman offers some perspective. "There are eight billion people on the planet. We will not vaccinate ourselves out of this problem. Our view is that this is an endemic virus, and you need treatments, including vaccination," Tillman says. "Keep vaccinating, but we need to be aggressive about developing new therapeutic options."