A Conversation with Isabelle de Cremoux, CEO and Managing Partner of European Life Science VC Seventure Partners

Backing the Microbiome: The Investor Perspective

Life science research changes frequently, with new discoveries being published every day. Some of these discoveries form the basis of new biotech companies, but whether or not these companies will be successful can be hard to predict. Isabelle de Cremoux, CEO of French VC investment firm Seventure Partners, knows this only too well. Seventure was one of the first investment companies to recognise the potential importance of the microbiome to human health and to begin investing in the area. With several companies now at Phase III, and good results coming out of many trials, Seventure’s foresight seems to have paid off. The first microbiome-based therapeutics are set to enter the market this year, regulatory approval permitting.

After studying engineering, law and finance, de Cremoux began her career in 1991 with the consulting company Arthur Andersen in Detroit. After a few years she moved away from corporate finance and started working in business development for big pharma, namely Pfizer and Abbott before joining Seventure in 2001 to start a life sciences division. Since 2014 she has led the company as CEO, as well as continuing her life science investment work.

Isabelle de Cremoux
Isabelle de Cremoux

De Cremoux spoke to Inside Precision Medicine senior editor, Helen Albert, about her inspirations, the challenges involved in the unpredictable world of life science investing and about becoming an expert in the microbiome.

How did you get into biotech investing?

I’m from a family of entrepreneurs, my father is an entrepreneur and made leveraged buyouts in the telecom sector and my mother founded La Roche Posay, a cosmetic company. I thought rather than doing management accounting, let’s go into business development, let’s get into the real world of drug development and the core business of the company and that’s how I landed in biotech and pharma.I spent about 10 years in the pharma industry, and even though I enjoyed business development, doing it for large companies took me further away from the end product and operations. So, I thought, maybe going to venture capital would allow me to continue doing something very similar to business development, but allow me to become closer to the product and to the team and also dealing with smaller companies, which was where my heart was.

That’s how I jumped from Abbott, at the time, to Seventure. I interviewed with many venture capital firms and I chose Seventure because they had no life sciences department at all. They hired me to create it, which was a nice challenge. And so, I started with a blank page, building a strategy of investment in biotech, first with biotech and medtech and then moving on later to what we now call the microbiome.

We were smaller than the bigger established venture capital companies so we had to be different. There was a necessity that we had to be different to get the deals and to be able to fundraise and to deploy our funds. The team I have recruited has a unique USP in that we spend significant time analyzing the deals, prior to investing. We’re always thinking ahead and consider carefully what segments we want to invest in. We try to employ strategic thinking to predict how innovations could come to market, and also think about societal trends keeping in mind payers, patient and physician communities. This is the process we employ in identifying different investment segments.

Why is precision medicine important in your opinion?

Precision medicine covers many concepts but fundamentally it gives us a better understanding of many pathologies and indeed individual predisposition. This will help us unlock areas of unmet medical need, this multi dimensional approach is going to be critical to success. Second, of course, is stratification of patients, now we can segment patients, according to their pathologies, or indeed response to treatment. In cancer, where much of the work has been done in precision medicine, there are now many treatments tailored to subcategories of disease – there are companies who focus solely on different phenotypes and biomarkers assisting the physician choose which therapy is suitable for which patient. For us, it’s all of this.

Is a precision medicine approach something you look for when you invest?

Yes, some companies are developing treatments with this approach and many companies have enabling technologies that support this approach. There are others that are taking a diagnostics route, a stratification angle or adopting a patented biomarker strategy.

Enterome is part of our portfolio and their approach is segmenting patients for chronic diseases. They have identified that more than 70% of Crohn’s disease patients have a specific microbial pattern. They have stratified and treated the patients and are currently in phase II.  They also have a precision medicine approach in oncology with the same patterns of stratifying patients according to their response rates and microbiome profiles.

Axial Biotherapeutics also has a precision medicine approach. They are working in the area of autism, profiling the microbiome, identifying different patterns and treating accordingly. They’ve completed a clinical trial on 26 children and teens with spectacular endpoint results treating anxiety, and improving sociability.

As a company why do you have such a strong focus on the microbiome?

We don’t just invest in the microbiome, but the microbiome is unquestionably a main focus. We had read the research publications that were highlighting the link between not only food and drugs, which was our interest for more than a decade, but with the patient’s immune system. It seemed to us that the microbiome was actually the key factor linking all three. Once we understood the relationship between all three, we were like, ‘Wow, maybe this will open the door to solving many chronic diseases without current curative treatments’. The more we discovered and learnt about the microbiome, and the more publications there were, the more this thesis was confirmed. With some products now in Phase III, and that are filed for market authorization I think we reached a point where the science is showing its promise and we’re starting to see the validation and confidence in the market.

It must be satisfying to have predicted this correctly

Yes. I think we were pioneers in the field, because we just looked at the different pieces of the puzzle, and thought that they really clicked. I made the decision to invest time and resources and try to be ahead of the curve. But, as with any innovation in medicine, you only have an intuition and you make bets, but sometimes you lose those bets, because the publications can inevitably contradict your theory.

But in the case of the microbiome, it’s indeed very satisfactory to see that after a few years, most of the publications are moving in the same direction and have confirmed our assumptions. Of course, there have been a few clinical trial failures and this to be expected. In 2021, there were a few failures, which of course, raised doubts for the sceptics, but there were many successful clinical trials to counterbalance this. In late 2022, we will see two market authorizations in the field of the microbiome [for Seres and Fering/Rebiotix], and that will be a turning point…We also have MaaT pharma, which is a company to watch. It’s currently in Phase III, pretty quick for a company that we founded in 2014 from scratch.

In terms of investment, how has investment in this field changed over the last five years?

There has been ups and downs. In the early days there were very few VCs. Then some dipped their toes in the water and made a deal, to learn and to see. Then came some bad results last year, which blocked and froze most of the financial VCs, not the corporates, because they were playing longer term, but the VCs had to step back. When market authorization happens I think we’ll see them come back again but for this period, I think we’re ‘on hold.’

On a more personal note, what lessons have you learnt since becoming CEO?

One lesson I think you learn in the venture capital industry is that the natural tendency of this field is to increase the ego of the investor. Because, of course, as in any buyer role, it’s always more difficult to be a vendor than to be a buyer. When you have the money, there’s a tendency of many venture capitalists to lose their personal curiosity and their personal humility. It’s more difficult to be an entrepreneur than to be a venture capitalist, but sometimes venture capitalists tend to forget that. And the lesson that I learned through this journey is if you want to be a really good investor, you’d better not lose this intellectual curiosity about new businesses. If you think you’re better at execution and strategy than the entrepreneur, you may be preventing them from developing ideas and growth. You want to avoid sterilizing innovation where you’ve invested, this is completely counterproductive.

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