Smash Notes

Back to Thrive Capital's Bet on Neuralink, OpenAI & the Future of Medicine, with Nworah Ayogu.

What Do Drug Discovery Models Actually Get Right?

Drug discovery models have gotten better and better at the first job: choosing a molecule that binds a chosen target well. Nworah Ayogu said the work after a bind still has room to grow. The next models have to predict what the body does once a molecule binds, and which unwanted effects come with it.

People often point to companies like Isomorphic and Chai. A target is a molecule in the body, and hitting it changes something. Biological risk is whether the target is the right one. Upregulate it or downregulate it, and the open questions are whether a person gets sleepier, more awake, or loses weight. Off-target effects are the side effects to avoid, including nausea, a higher heart rate, and liver toxicity. The aim is the intended change without the rest. A molecule still has to be made to bind the target, and some molecules are easier to make than others. Undruggable means the pocket is small. The shapes are three-dimensional, so Nworah Ayogu said the molecule itself may move when part of it is bound and let something else bind, which is why people talk about hidden pockets. A model has to predict the shape in real time and how the shape changes over time.

Step one is the best thing to make so it binds. Step two is what happens after the bind. Step three is the unwanted effects. Binding well is the step the field has improved.

Transcript

Thrive Capital's Bet on Neuralink, OpenAI & the Future of Medicine ·

Sourcery

More from this episode

  1. Why Is Drug Discovery Moving Faster Than Ever?Nworah Ayogu said that, more so than at maybe any other time in history, the frontier of science and the frontier of what has been accomplished is moving…
  2. How Does Neuralink Give Paralyzed People Function Back?Nworah Ayogu said healthcare often does a very good job of extending life and does not do a very good job of improving quality of life or giving people life…
  3. Why Is Neuralink More Interesting Than SpaceX?Nworah Ayogu called Neuralink a more interesting company than SpaceX, because the brain is vaster than space. "A $3 trillion company?"
  4. How Did One Merck Drug Outearn Every Major Lab?Nworah Ayogu said Keytruda, one Merck drug, had 2025 revenue larger than the revenue of all the major labs combined. Biotech is already big business.
  5. How Did OpenEvidence Reach Two Thirds of Doctors?Nworah Ayogu said OpenEvidence spread because doctors wanted it. Nworah Ayogu said he had never heard doctors rave about a clinical tool.
  6. What Is the Price of One Child's Life?Nworah Ayogu said medicine can now treat rare genetic problems one patient at a time, and said a million and a half dollars to make and deliver a treatment is…
  7. How Did Oscar Health Recover From a 95 Percent Drop?Oscar Health, the first company Thrive ever invested in, fell 95% from its peak value in December 22. It then climbed back above its IPO price.

People

More answers like this

Related episodes

Plays from this note through the rest of the episode.

Weekly highlights

One letter a week.

The notes worth hearing, with the minute they were said.