Ruxandra Teslo
Geneticist by training and writer on science, medicine and policy. She holds a PhD in genomics, writes at Ruxandra's Substack and for Works in Progress, and co-founded Clinical Trial Abundance, a project arguing that the binding constraint on new medicines is how trials are run rather than how drugs are designed.
Ruxandra Teslo did not write this page.
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Their wordsAs someone coming from a biology background, who considers “curing disease” as a very noble mission, I still believe that the vague promise of “curing disease” is fundamentally not worth it if it comes with a form of permanent deprecation of most humans’ existence.
- 6 weeks earlier
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Their wordsI told him what I believe: that in the age of AI, medicine will be bottlenecked more than ever by regulation and the grind of clinical trials, and that billions poured into faster pre-clinical research won’t touch that problem, unsexy as it is.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 1st of 6 in this piece
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Their wordsTake Eroom’s Law: the number of new drugs approved per dollar of R&D has fallen for decades, even as our scientific tools have grown vastly more powerful, the exact opposite of what the existence of more raw capability would predict.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 2nd of 6 in this piece
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Their wordsIn biomedicine we have a problem called target herding: most companies chase the same biological targets because they are de-risked, which means we explore far less of the biological space than we could.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 3rd of 6 in this piece
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Their wordsThat is mostly in the realm of chemistry and is intrinsically far more tractable and predictable; given a validated target, good teams usually reach a decent molecule.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 4th of 6 in this piece
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Their wordsThe patent system then further disincentivizes companies from taking target risk, because it rewards novel chemical matter, not novel biology.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 5th of 6 in this piece
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Their wordsA capability existing is not the same as a capability being absorbed into institutions, and, perhaps most important of all, translated into outcomes people care about.
↗Intelligence is not the main bottleneckwritingruxandrabio.com 6th of 6 in this piece
- 6 weeks earlier
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Their wordsExcessive manufacturing requirements are a pervasive problem, especially in the field of cell and gene therapy and they are killing countless of promising medicines before they ever reach patients.
↗Manufacturing requirements are killing cell and gene therapywritingruxandrabio.com 1st of 2 in this piece
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Their wordsUntil manufacturing and regulatory risks become easier to underwrite, capital will keep drifting away from one of the most promising technologies of the last century.
↗Manufacturing requirements are killing cell and gene therapywritingruxandrabio.com 2nd of 2 in this piece
- 3 months earlier
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Their wordsThe current success rate for a drug entering clinical trials is only about ten percent, meaning 90 percent of all drugs fail.
↗A response to Dario Amodei on AI & clinical trialswritingruxandrabio.com 1st of 5 in this piece
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Their wordsEven if AI can help design more effective drugs, timelines will not compress until we solve the operational and regulatory bottlenecks of trials.
↗A response to Dario Amodei on AI & clinical trialswritingruxandrabio.com 2nd of 5 in this piece
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Their wordsTrials serve two distinct functions: validation — confirming whether a drug works and is safe — and learning, or generating biological data to refine our understanding of a disease, a compound, and the relationship between the two.
↗A response to Dario Amodei on AI & clinical trialswritingruxandrabio.com 3rd of 5 in this piece
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Their wordsLastly, the duration of a clinical trial does not merely determine how fast an individual therapy reaches patients. It also shapes which diseases attract serious investment and which do not.
↗A response to Dario Amodei on AI & clinical trialswritingruxandrabio.com 4th of 5 in this piece
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Their wordsBut remember that such data can only come from trials in people (mice are nice, but most animal results simply do not translate.)
↗A response to Dario Amodei on AI & clinical trialswritingruxandrabio.com 5th of 5 in this piece