Al Sandrock’s retirement didn’t last long.
The well-known scientist and biotechnology executive had just left Biogen after two decades there, during which time he is credited for identifying three of the drugmaker’s top-selling medicines. But his tenure had ended in disappointment and controversy following the contentious approval and disastrous launch of Biogen’s Alzheimer’s medicine Aduhelm.
In November 2021, five months after what was supposed to be a career-capping achievement, Sandrock was out and searching for his next step.
“I was going through a personal journey,” Sandrock said in an interview last week at the J.P. Morgan Healthcare Conference. “I still had in me that I want to be an operator, work with a team and make drugs.”
After some soul-searching, he settled on the chief executive post at Voyager Therapeutics, a gene therapy maker that in recent years had gone through multiple CEOs, clinical setbacks and strategic resets.
While Voyager’s fortunes were in decline, Sandrock thought he could help turn things around and was drawn in by technology that the company claims can get gene therapies into hard-to-reach organs like the brain.
“A lot of people may have looked at my decision and said ‘what is he, crazy?’” Sandrock said. “But I look at the data myself. I have to be true to what I think. And I think this is the dawn of a renaissance for neurological therapeutics.”
Since becoming CEO last March, Sandrock has sought new partnerships to supply Voyager with enough cash to weather a market downturn and advance its own research. Already, there’s been some progress, most notably a new alliance with Neurocrine Biosciences the company announced at the J.P. Morgan conference last week.
“It has gone through a lot,” Sandrock said of Voyager. “But I feel like it’s my company now.”
Still, the road ahead is long. Voyager’s latest research is preclinical and it’s aiming at diseases like Alzheimer’s and ALS that are notoriously challenging to treat. Its partnership with Neurocine, meanwhile, has competition from a rival program being advanced by Eli Lilly.
BioPharma Dive spoke with Sandrock about his decision to become Voyager’s CEO and take on a turnaround project. The following conversation has been lightly edited and condensed for clarity.
BIOPHARMA DIVE: What was it like after you left Biogen last year?
AL SANDROCK: When you retire and step back, you get a feel for what’s going on out there. I was getting tons of incoming, ‘Hey, do you want to join our board?’ So I joined a bunch of boards, and it occurred to me that the key issue in neurological drug development is delivery.
When I first entered the industry 25 years ago, we didn't really know what the targets were. Now we have very good targets. The problem is that there are many that small molecules cannot address.
When we first started doing antibodies for brain targets, people laughed at us and said, ‘Antibodies don't get into the brain.’ Well, they actually do, [but] in small quantities. Then there’s nucleic acid-based therapies. The problem with those is that you have to inject them intrathecally and get high exposure in certain parts of the central nervous system just so you can get enough exposure in the parts you want to access.
Then I saw what Voyager had done. They’d figured out a way to get [a gene therapy] into the brain.
Why step in and run Voyager, though, rather than just advise it as a member of its board?
SANDROCK: I felt like I had to. I was going through a personal journey, [wondering] am I really cut out to be a CEO? Do I want to be a CEO? All my friends were telling me, ‘Don't do it.’ But I didn't like just being an adviser. I enjoy my board roles, but I still had in me that I wanted to be an operator, work with a team and make drugs.
I'm a doctor. I started off as a neurologist and I couldn't help most of my patients. I used to watch them degenerate in front of me and die. I remember the patients I couldn't help more than ones I could, because a lot of them reminded me of friends or family members. That's why I'm in this industry.
Voyager’s had setbacks. Why take on a challenge like that?
SANDROCK: I always feel that if the science is good, there's always going to be a way. When I first joined, I was asking a lot of questions, and the board didn't give me a clear path to success. But I was just so amazed at the science.
If anybody knows the issues with gene therapy, it's Voyager. They’ve faced reality. They did experiments, they went into the clinic, but the data [on their original Parkinson’s program] showed it wasn’t going to work. Luckily, there was a small group of scientists in the background who had been working on this [delivery] platform for years, and they made a breakthrough.
A lot of people may have looked at my decision and said, ‘What is he, crazy?’ But I look at the data myself. I have to be true to what I think. And I think this is the dawn of a renaissance for neurological therapeutics.
Still, there’s considerable skepticism about the actual impact some of these new therapies, most recently the Alzheimer’s drugs Aduhelm and Leqembi, are having. Many consider their benefit marginal or modest.
SANDROCK: This is a fatal disease. And before you die, it's pretty brutal for the family. These patients desperately need treatment. I like to remind people that, in the field of multiple sclerosis treatment, we started with interferons that were 30% effective. In almost every situation, you don't start off with a home run. This is not going to be a cure. But look at the situation in MS now. We have 20-plus drugs, and we're well north of 30% in terms of efficacy. So I hope [Leqembi] gets reimbursed and patients can get access.
As Voyager’s CEO, how do you navigate through a difficult time like this for biotech without cutting back on research, as other gene therapy companies have?
SANDROCK: Partnerships. We did a partnership with Pfizer before I joined the board, then after I joined we did one with Novartis. We just did one with Neurocrine. These provide a lot of non-dilutive revenue at a time when it's really hard to raise capital. We've got a cash runway. We can weather the storm that we're in now, I believe.
The downside is you can give too many things away though. Neurocrine now owns more of your programs.
SANDROCK: I have to admit that when we got a lot of incoming inquiries about [the Parkinson’s] program, my first reaction was, ‘No no no, that's our baby!’ But we have the ability to opt back in for 50% and, in the meantime, they take all the expenses off our books.
During the storm that we're in, that's a very nice thing. And there are also a lot of targets that are well known and validated now. We can take [the Parkinson’s] program, which is about to incur some real costs, and instead do early research programs which are much less expensive.