2005 Outlook: Biotech I –

What’s amazing about Brook Byers isn’t that he co-founded the most famous venture capital firm. Or that he started the first life sciences practice at a venture firm. Or that he helped start more than 40 companies, over half of which went public, including four that he personally incubated and now have an aggregate market cap in excess of $8 billion. No, what’s most amazing about Byers is that after 33 years as a general partner at Kleiner Perkins Caufield & Byers, he still gets excited about his work. If you want to see his eyes light up these days, just ask him about “personalized medicine.”

You’ve been talking a lot lately about personalized medicine. What is it exactly?

It’s the right drug or device at the right time for the right person … as opposed to most medicine practiced today, which is to wait until there’s a crisis. Probably 90% of medicine today is “rescue medicine,” and that’s very expensive in terms of drugs, devices and services. When we can see disease coming earlier by looking at gene expression or biomarker patterns, we could do medical intervention earlier and handle it with fewer drugs and at a lower cost. Also, we could predict who would or would not benefit from expensive drugs or devices, and, therefore, save health care costs.

What kinds of developments on this front should we expect to see this year?

A In 2005 we’re going to see the emergence of molecular diagnostic tests that will bring the promise of personalized medicine to reality for the first time. Such differential diagnostic tests, which are more clinically useful than predisposition tests, will be launched in 2005 for breast cancer, organ transplantation, cardiology and drug metabolism.

Give me some examples.

One of our companies, XDx, is launching a blood test for organ-transplant patients that will replace the need for tissue biopsies and will save health care costs. Another one of our companies, Genomic Health, announced in December that it has run two confirmatory clinical trials that show that its 21-gene assay tests will predict which breast cancer patients have a high chance of recurrence or a low chance of recurrence as well as chemotherapy response. The test is done on the individual tumor tissue of a patient; it’s specific to the disease of that person. The reason this is important is that the doctor and patient need to decide whether the patient should have chemotherapy after surgery. This could cut health care costs if fewer patients opt for chemotherapy because of their low recurrence and low response profile.

How will the growth of personalized medicine affect VCs who specialize in biotech in 2005?

This new field, built on discoveries and tools only available in the past few years, will explode because it can improve the practice of medicine in a large number of specialties and disease categories. In addition to diagnostics businesses, this paradigm will affect therapeutics, as well, through targeted medicine and patient selection.

Which areas should VCs start to look at to take advantage of personalized medicine?

They can look at investing in our molecular diagnostics ventures-we have a few more in the works. (Laughter.)

Which areas should they stay away from?

The ones we’re avoiding. (Laughter.)