Exclusive: Eli Lilly boosts inflammatory disease pipeline, licenses three candidates from TRexBio

Eli Lilly is adding three new preclinical candidates to its immune and inflammatory medicines armory through TRexBio, a Bay Area biotech that specializes in T regulatory cells, or Tregs.

In exchange for global licenses on the candidates — TRB-051, TRB-031, and TRB-041 — TRexBio will get $55 million upfront. All in all, TRexBio could get over $1.1 billion when factoring in downstream milestones. According to TRexBio’s website, TRB-051 is the furthest along, in the IND-enabling phase.

Laura Berner

As to what the three candidates target, TRex COO Laura Berner declined to comment. But Berner did note TRex focuses on developing large molecules, like antibodies, that manipulate Treg pathways.

Tregs are a subset of T cells that can suppress the immune system. By targeting their pathways, such as IL-2, new drugs can treat autoimmune diseases, including ulcerative colitis and Crohn’s disease.

Other Big Pharmas have also made plays in this arena. In 2021, Merck bought Pandion Therapeutics for $1.85 billion, picking up a suite of autoimmune candidates, including a Phase I prospect for ulcerative colitis. In 2022, AbbVie paid nearly $50 million upfront to Waltham-MA-based biotech Cugene to push forward an IL-2 program.

Likewise, for these inflammatory and autoimmune conditions, Lilly already has a number of candidates in the works. Lilly has submitted its IL-13 inhibitor lebrikizumab — which it acquired in its $1.1 billion buyout of Dermira — to the FDA for atopic dermatitis, according to its 2022 third quarter report. Last year, Lilly also reported its IL-23 inhibitor mirikizumab passed a Phase III study in ulcerative colitis, after it abandoned plans for the candidate in psoriasis.

Lilly has been involved with TRex from the biotech’s inception. In 2018, when TRexBio first started out, Lilly joined as both a shareholder in the biotech and a collaborator looking for new targets, TRex CEO Johnston Erwin said, adding that this new licensing deal builds on that previous pact. Erwin himself spent 36 years at Lilly, and before joining TRexBio, he was the Big Pharma’s VP of corporate business development.

In 2021, TRexBio raised a $59 million Series A with a number of pharma backers, including Lilly, J&J, and Pfizer. Early in 2022, TRex also signed a deal with J&J’s Janssen, though the upfront and downstream payments were not disclosed.

At TRexBio’s core is a platform that maps Treg behavior in tissue to identify new targets in cancer and autoimmune diseases. The biotech’s internal pipeline is likewise preclinical. When asked about timeline, Berner didn’t give specifics, saying, “We can say that our lead internal program is nearing candidate selection. And we’re going to continue to focus on driving that program forward and also leveraging our platform to identify new targets for interrogation.”

The inspiration for the name TRexBio came from the son of co-founder and SV Health Investors managing partner Houman Ashrafian. According to Erwin, Ashrafian was telling his son about his new company studying Tregs. “And the son said, ‘Hey, that’s super cool. I know what Tregs are.’ And he ran to his room and ran back and he was holding a T-Rex dinosaur,” Erwin said. So Ashrafian decided to name the company TRexBio.

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