Thread by @matthewherper

So I wanted to talk a little bit about Geron ($GERN, for the stock ticker types.)

The morning had some positive data this morning, which was ably covered by STAT's @Jasonmmast.

Story here: statnews.com/2023/01/04/ger…

But it also, as Jason notes, has a history. 🧵

TLDR on the data: the drug has some activity against myelodysplastic syndromes, but also safety baggage.

But I want to talk about something else: the way big ideas in biology often turn into small, very incremental innovations.

This is a common thread in biotech history.

$GERN, in 2000, was a small company with world-changing ambitions. It was one of the companies focused on embryonic stem cells as a treatment. It was also focused on an enzyme called telomerase, which was the longevity fad of its day.

It also had a cult following on Wall Street. A $GERN investor was the first reader to write me hoping that I would get cancer. Guy would have fit in on Twitter.

The drug results today come mostly out of the telomerase work. But they're also a far cry from the fountain of youth hype.

And this isn't just something that's happened once!

I'm reminded of the drugmaker Clinical Data, which was going to pair antidepressants with genetic testing -- what they got was a new antidepressant that got the company bought out for $1.2 billion, but didn't really have a lot of huge advantages.

What happens is that the big idea yields some promise, but less than expected. And then companies hold on, throwing good money after bad, until they finally get some success. This is one reason pharmaceutical innovation is so expensive -- and why we're often disappointed with it.

I don't have a solution. Do we really want to abandon medicines that will eventually work? I don't know.

But biotech often means setting your sights on the stars and hitting the moon.