It was a difficult year for biotechs with drops in the major biotech indices, fewer new drug approvals, and more than 125 companies announcing layoffs. But there were also triumphs to celebrate. We continue our annual tradition of ending the old year and ushering in the new one with Adam Feuerstein, Polk Award Winning journalist and senior biotech writer for STAT. We discuss the good, the bad, and the ugly of biotech in 2022; Feuerstein’s annual best and worst CEO list; and what’s ahead at JPMorgan and beyond in 2023.

Checkpoint inhibitors are not new, but Immutep is developing therapies that target LAG-3, a checkpoint discovered by its chief scientific officer. The LAG-3 gene codes for a protein that plays a role in the regulation of the immune system and is expressed on T cells. Immutep is seeking to target LAG-3 to both stimulate the immune system to treat cancers and suppress the immune system to treat autoimmune disease. We spoke to Marc Voigt, CEO of Immutep, about the LAG-3 checkpoint, the company’s lead experimental candidate, and its partnerships with GSK and Novartis to develop therapies for cancer and autoimmune diseases.

The ability to engineer biology is not only revolutionizing how we treat illness, but the way grow food, and produce goods as well. With this ability, though, comes an awareness of how the same technology can be used for nefarious purposes. We spoke to Matt McKnight, general manager of Biosecurity of Ginkgo Bioworks, about our increasing ability to engineer biology, the potential risks that come with that, and the steps we are taking to safeguard ourselves against those risks.

Cytokines control nearly all aspects of the immune system. As drugs, though, they have limited potential because of inherent drawbacks. Simcha Therapeutics is engineering versions of cytokines to activate various immune cells in the fight against cancer. Simcha’s most advanced program, ST-067, is the first in a new class of interleukin-18 based immunotherapies designed to overcome a key defense mechanism that the tumor microenvironment produces to prevent Interleukin-18 from doing its work. We spoke to Sanuj Ravindran, CEO of Simcha Therapeutics, about the company’s engineered cytokines, how they work, and why they may represent a powerful addition to the immunotherapy arsenal.

Arcellx is developing controllable cell therapies for the treatment of cancer and autoimmune diseases. It’s platform technology allows it to mark diseased cells within the body for destruction. Its cell therapies then destroy the flagged cells. We spoke to Rami Elghandour, chairman and CEO of Arcellx, about the company’s platform technology, how it works, and how it may lead to safer and more effective cell therapies.

Despite the large human and societal costs of neuropsychiatric disorders, many of these conditions have poor or no treatment options. And there has been a dearth of new mechanisms to treat major neuropsychiatric disorders for decades. PsychoGenics is seeking to change that with its unique approach to drug discovery for these conditions. Rather than rely on a target-based approach, the company has created high-throughput phenotypic screens using validated mouse models and artificial intelligence to detect behavioral changes. We spoke to Mark Varney, chief scientific officer of PsychoGenics, about the company’s use of phenotypic screens to discover new drugs for neuropsychiatric disorders, how it works, and the case for this approach.

Chronic, cancer-related pain affects between 30 and 50 percent of patients undergoing cancer treatment and more than 70 percent of patients with advanced disease. Linda Carlson, Enbridge research chair in psychosocial oncology at the University of Calgary Cumming School of Medicine, is working with digital therapeutics developer Rocket VR Health to study the potential of a virtual reality-guided mindfulness intervention program in adult cancer patients with chronic, cancer-related pain. The thinking is that mindfulness could mitigate chronic cancer-related pain by regulating both physical and emotional resistance to it and that virtual reality could create an immersive environment that could focus patients’ attention on present moment experiences making it easier for them to achieve mindfulness achieve more effective results. We spoke to Carlson about the problem of chronic pain in cancer, the case for mindfulness, and why the use of virtual reality might provide better outcomes for patients.

One reason immunotherapies can fail in cancer is that the tumor microenvironment can suppress activation of the immune system. Surface Oncology is using multiple platform technologies to discover new antibody therapies that activate both the innate and adaptive immune systems to improve how people with cancer respond to these medicines. We spoke to Rob Ross, CEO of Surface Oncology, about the tumor microenvironment, the approach Surface is taking to activate both the adaptive and innate immune system, and its lead therapeutic candidates in development.

The deepening understanding of the biology of aging is giving rise to a growing list of companies that seek not only to address diseases of aging, but find ways to extend the healthy years of life. LongeVC is a venture capital firm focused on seed and early-stage investment in longevity statups. It’s also built a community of like-minded companies to support startups, as well as an acceleration program for them. We spoke to Sergey Jakimov, founding partner of LongeVC, about the firm’s approach to investing, what constitutes a longevity play for it, and the network of companies it has assembled to help advance the startups it backs.

A subset of patients treated with checkpoint inhibitors respond particularly well to these immunotherapies. These so-called “elite responders” produce antibodies that modulate immune cells in the tumor microenvironment. OncoResponse is working to discover the antibodies these elite responders produce to develop a pipeline of cancer therapies. We spoke to Bob Lechleider, chief medical officer of OncoRepsonse, about the tumor microenvironment, how his company is studying elite responders to immunotherapies to discover new antibodies to modulate the immune system, and his company’s lead program in clinical development.