Navigating microbiome innovations: Strategic partnerships in Live Biotherapeutic product development

Aaron B Cowley
Chief Scientific Officer at ReciBioPharm

LBPs represent a paradigm shift in the approach to healthcare. Unlike traditional pharmaceuticals, LBPs harness the power of live microorganisms to influence and rebalance the intricate mechanisms of the microbiome within the body. Their impact extends beyond conventional drug modalities, with the potential to address underlying causes and mechanisms associated with complex conditions.

As LBPs are living organisms, ensuring consistency in microbial cultures and maintaining viability during production and storage presents formidable obstacles. The development of LBPs is a complex process that requires expertise and capabilities in the microbiome space.

Challenges in LBP production

The microbiome field has dramatically matured over the past 10 years and the processes, analytical development and manufacturing of LBPs have progressed alongside it. When LBPs were first emerging, there was no definitive regulatory pathway for approval and an absence of contract development and manufacturing organisations (CDMOs) catering specifically to LBPs left the landscape largely uncharted. The increasingly realised potential of this therapeutic class and the subsequent need for specialised support to develop and manufacture them has led to a rise in companies providing LBP-related solutions.

Although advancements have progressed the microbiome therapeutics field forward, critical requirements stand in the way of achieving scalable and cost-effective production along with attaining stability, efficacy and safety of the final LBP product:

  • Navigating the intricate and evolving LBP regulatory landscape

The lack of clearly defined regulatory pathways stems from the complex nature of the microbiome field. The novelty of LBPs and their unique mechanisms of action contribute to regulatory ambiguity and often demand a nuanced understanding of constantly changing compliance standards. The absence of a well-established precedent amplifies challenges, requiring an agile approach to interpretation and adaptation. Engaging regulatory experts or partnering with specialised consultants becomes pivotal in navigating and interpreting evolving compliance standards for LBPs.

  • Developing robust manufacturing processes

Efficient and scalable manufacturing processes are key to ensuring the viability, consistency and stability of LBPs — presenting unique and inherent challenges to microbiome therapeutics. Due to their living nature and sensitivity, LBPs need precise and controlled environments to maintain viability and functionality throughout the manufacturing process.

In comparison with conventional biologics, LBPs require distinct handling protocols to sustain the viability of these living entities, starting from fermentation or cultivation through downstream processing and formulation. Scaling production while maintaining quality and cost-effectiveness becomes a delicate balance, using tailored approaches, stringent quality controls and specialised infrastructure, catering specifically to the intricate demands of live microbial medicines.

  • Defining expectations to ensure clinical trial success

Conducting rigorous clinical trials to demonstrate efficacy and safety is another critical challenge. Establishing safety and efficacy endpoints for LBPs requires a nuanced approach due to the variability inherent to live microbial medicines — defining endpoints to capture therapeutic effects on a dynamic microbiome ecosystem adds to the complexity.

Additionally, aligning data requirements with regulatory expectations for live microorganisms necessitates tailored methodologies and a deep understanding of the interaction between the administered microbial strains and the host microbiome.

Strategic collaboration with research partners and regulatory experts plays a pivotal role in ensuring robust validation aligned with regulatory requirements. This collaboration is essential not only in designing and executing trials but also in establishing standardised methodologies for LBP evaluation.

Overcoming these multifaceted challenges in LBP production demands access to in-depth knowledge, ample capacity and a strong infrastructure. The most timely and cost-effective way to access such expertise and capabilities is often through strategic partnerships that provide outsourced manufacturing and consultative insight.

The strategic role of CDMO partnerships in LBP production

Partners with microbiome expertise have emerged as pivotal allies, providing consultancy and technical capacity in key areas. This is where the strategic significance of partnerships pays dividends in driving successful LBP development by overcoming the hurdles inherent to producing microbiome-based therapeutics. e

Microbiome-focused expertise encompasses a deep understanding of the nuances of cultivating, maintaining and preserving live microorganisms such as LBPs. It involves a commitment to stringent regulatory adherence and the operation of specialised infrastructure tailored for LBP manufacturing. These traits aid process optimisation, ensuring compliance and achieving consistent and viable LBPs crucial for clinical validation and market accessibility.

CDMOs can provide the necessary expertise and specialised infrastructure dedicated to optimising manufacturing processes tailored to LBP production. Their knowledge in cultivating live microorganisms enables the fine-tuning of production methods, streamlining processes in the manufacturing cycle.

Navigating the intricate maze of regulatory frameworks is a daunting challenge in LBP production, and strategic partnerships offer invaluable regulatory insights essential for compliance. With a deep understanding of evolving regulations specific to LBPs, CDMOs provide strategic counsel, ensuring adherence to stringent standards. Their adeptness at interpreting and implementing regulatory requirements minimises compliance risks and accelerates the regulatory approval process, expediting the journey from development to commercialisation.

Core to effective collaborations is the consultative side of partnerships,  transcending technical expertise alone. Transparent communication, active involvement with all stakeholders and a collaborative mindset enable joint problem-solving and optimised processes critical for successful LBP production and eventual market access. This synergistic approach supplies invaluable guidance in navigating regulatory landscapes, optimising production processes and ensuring scalable commercialisation.

The impact of partnerships on LBP production

The ultimate goal of developing biologics is for the medicines to reach patients who need them. Achieving regulatory approval is a vital step in the LBP development journey that partners with experience can assist with. In addition, the successful approval of LBP medications to treat conditions such as CDI should improve the perception of medicines in this burgeoning area of biologics and enhance familiarity in patient circles and across healthcare systems.

The recent FDA approval for VOWST, the first and only orally administered microbiome therapeutic to prevent CDI recurrence, is an example of how strategic relationships between CDMOs and biotechs can lead to LBP breakthroughs. This marks a significant step towards addressing the pressing healthcare concerns of recurrent CDI while presenting another tool to combat antimicrobial resistance.

The future of LBPs and CDMO partnerships

The evolution of LBPs is anticipated to bring pioneering breakthroughs in scientific understanding, innovative technologies and the restructuring of regulatory frameworks. Advancements like the approval of LBP products for preventing CDI recurrence mark a pivotal milestone in regulatory recognition and underline the transformative potential of LBPs in addressing critical health concerns.

The intricate and promising landscape of LBP development can be traversed by combining the insights gained from strategic partnerships with effective manufacturing expertise and capabilities. CDMOs leverage their specialised knowledge to assist in optimising manufacturing processes, ensuring viability, stability and consistency of LBPs, and navigating the intricate regulatory frameworks governing production and commercialisation. This can allow LBP developers to realise the transformative potential of these therapeutics and expand the scope of LBPs for the benefit of patients in need.