i'm bullish on biotech

It's easy to get distracted by the noise -- FDA leadership changes, layoffs, China headlines. But once in a while I like to step back and look at what's actually been accomplished. Here are a few things from 2026 so far that I'm really proud of.

A new drug modality crossed the finish line. In May, FDA approved Arvinas and Pfizer's VEPPANU (vepdegestrant) for ER+/HER2- metastatic breast cancer with ESR1 mutations. It's the first PROTAC ever approved, a protein degrader that hijacks the cell's own machinery to destroy disease-driving proteins instead of just blocking them. Beautiful to see decades of work come together to impact patients.

Crossing the blood-brain barrier. In March, FDA approved Denali's AVLAYAH for Hunter syndrome, the first medicine to use the transferrin receptor to cross the blood-brain barrier. For decades the BBB has kept us from treating most neurological disease. The same platform now sits underneath Denali's Alzheimer's and FTD programs. If this generalizes, the implications for neurology are insane.

Pig kidneys headed to trials. United Therapeutics is running a 50-patient trial of gene-edited pig kidneys in end-stage renal disease. eGenesis got its own FDA clearance for a Phase 1/2/3 trial. The second human pig-kidney recipient, Tim Andrews, lived nine months without dialysis. The Mass General team's stated goal is to "ban dialysis as a long-term treatment." ~100k Americans are on the kidney waitlist. We're watching xenotransplantation become real.

So much more to come...