An under-the-radar Wuhan-based biotech startup says that its gene therapy for an inherited form of vision loss has generated early but promising results in a handful of patients.
The startup, Zhongmou Therapeutics, has attracted little public notice in the West and appears to have raised only a fraction of what is typical for Western companies working on gene therapies.
But in a small trial of people with retinitis pigmentosa who were legally blind, the company said that seven of nine patients treated with the injected gene therapy showed a clinically meaningful improvement in vision. The participants were able to better navigate a simple maze, and some even experienced improved ability to see colors — something the company believes its therapy may be the first to do.
The one-year results were shared exclusively with
Endpoints News
and have not been published or presented previously.
Retinitis pigmentosa can be caused by hundreds of mutations in dozens of genes, the majority of which are incredibly rare. Luxturna, a gene therapy sold by Roche, treats one narrow form of the ailment by replacing a broken gene. But Zhongmou is using an experimental approach known as optogenetics to develop a universal therapy that could help anyone with the condition, which causes the breakdown of the eye’s light-sensing cells.
“We really focused on how we can find good tools, put them in the retina, and then with just one shot of AAV, it can bring the light,” Zhongmou founder and CEO Yin Shen told
Endpoints News
in an interview.
In a video, the company showed Endpoints, one patient in the trial who was unable to walk through a simple maze before treatment was able to swiftly navigate it four weeks after treatment, even at much dimmer light. (The maze was rearranged to prevent memorization). Another video showed a patient riding her bicycle in the evening, something she couldn’t do before.
Zhongmou was founded in 2019 by Shen, who is director of the Eye Institute of Wuhan University. Shen has studied retinal diseases for more than 20 years, including a stint in the US at the Albert Einstein College of Medicine in New York and then at Stanford, before moving back to China in 2011.
The company kept a low profile until this year, when it began presenting early glimpses from its investigator-initiated study at ophthalmology and gene therapy conferences in the US. In July, it
announced
new financing “worth tens of millions” of Chinese Yuan. (¥10 million is roughly $1.4 million.) But it wouldn’t specify how much it has raised or where the money came from. Alvin Luk, who previously served as head of clinical research and operations at Luxturna developer Spark Therapeutics, chairs Zhongmou’s scientific advisory board.
Zhongmou’s emergence comes during a year of record dealmaking between Western pharma companies and Chinese biotechs. While many of the deals center
on crowded, well-understood drug targets, Zhongmou falls into a small but growing set of Chinese companies working on
cutting-edge
cell and gene therapies that, in some cases, are
pulling ahead
of elite US competitors.
Zhenghong Gao, the startup’s chief strategy officer, told Endpoints the company is in talks with bigger drugmakers to help develop the therapy in the US. It’s also working with Stanford to start a Phase 1/2 trial in the US next year.
When Luxturna was approved by the FDA in 2017, eye doctors hoped it would spur the development of many more gene therapies for other forms of the disease. But progress has been slow, and sales of Luxturna have been uninspiring.
Luxturna replaces a single broken gene, RPE65, that impairs the eye’s photoreceptors. But Zhongmou, instead of working through the long list of mutations linked to blindness, is one of a handful of companies taking a broader approach.
While the photoreceptors are responsible for seeing light, two other kinds of cells downstream of them process the signals and transmit them to the brain. Zhongmou’s therapy essentially rewires that visual circuitry by giving those other cells the ability to sense light themselves.
To pull off that trick, the company uses an AAV gene therapy to deliver instructions for a light-sensitive protein called channelrhodopsin, derived from a marine alga. The approach, broadly known as optogenetics, was first developed two decades ago, but making the proteins sensitive and fast enough to be useful for restoring vision has been difficult.
Zhongmou believes that it has solved that problem with a new channelrhodopsin
engineered in Shen’s lab
. In mice, the protein restored the electrical signal from eye to brain
,
and now it appears to work in humans too. Zhongmou believes its approach could partly restore vision in all forms of advanced retinitis pigmentosa and even in advanced AMD, where photoreceptors have died.
“We can cure all those photoreceptor degeneration diseases. Not only RPE65, but all the mutations,” Shen said.
Zhongmou tested its treatment, called ZM-02, in an investigator-initiated trial. Those IIT trials, which have become common in China, are overseen by a research hospital rather than national drug regulators and can quickly speed experimental therapies through the first steps of human research.
The company recruited 12 patients with advanced retinal degeneration caused by mutations in a number of different genes. Two patients got a low dose injected into one eye, seven patients got a high dose, and three got a sham injection.
According to data the company shared with Endpoints, all nine treated patients had some improvement in vision, and seven had clinically significant improvement in their vision, measured on a scale known as best-corrected visual acuity, or BCVA. On average, patients who received the gene therapy improved by around 30 letters on an eye chart. Patients in the placebo group didn’t improve.
Remarkably, Zhongmou also said that patients went from seeing in almost entirely grayscale to being able to perceive colors. Their perception of those colors was far from perfect and it was based on the company’s own custom-made test, but Gao said he believes that this result may be unique among gene therapies.
Zhongmou has submitted its clinical data to a medical journal, Shen said.
There were no serious adverse events or dose-limiting toxicities, according to the presentation, but some patients had mild transient inflammation that cleared up with topical medication.
Zhongmou will face competition from other companies developing one-size-fits-all approaches, including Nanoscope Therapeutics, which has already asked the FDA to approve its optogenetics gene therapy. In Nanoscope’s
pivotal study
of its treatment, seven of 18 patients experienced clinically significant improvement in BCVA.
In addition, two other companies, Ocugen and SparingVision, are working on their own gene therapies. Bayer subsidiary BlueRock Therapeutics
treated
its first patient with a stem-cell-derived therapy this summer. And the San Francisco-based Science Corporation has developed a tiny electronic implant that mimics photoreceptors. The approach
restored the ability to read
in some people with advanced AMD.