Last shot tr-4

by Gregg Hurwitz

  Dolan had always been taken not just with the medical ramifications of viral vectors but with the elegance of the mechanics. And over the past few years, under the auspices of his own Vector Biogenics, he'd made not one but two breakthrough contributions to the field. They had come in relation to alpha-1 antitrypsin deficiency, an obvious disorder to tackle, since all its complications arise from a single set of faulty genes. Other grails were out there, sure, cystic fibrosis, maybe even familial hypercholesterolemia after that, but for now his (and Vector's) hopes hung on perfecting a viral vector that could deliver a gene to correct AAT deficiency. A dire disorder, usually diagnosed in childhood. Instead of producing a protein that helps coat and protect the lungs, the liver of an afflicted patient generates an abnormal enzyme that accumulates inside the liver and eventually shuts it down.

  Dolan had chosen lentivirus and smallpox for his development models because they were nice roomy viruses, Mack trucks to the Mini Cooper of the more experimentally plumbed adenovirus. His first landmark vector-and still his pet project-had been born in relatively short order.

  Lentidra.

  The lentivirus vector (the latest model was code-named L12-AAT) had been his favorite from the gates because it seemed consistently to provide permanent integration of the transgene into the genome-one shot and the subject was cured. Optimistic from all theoretical indications, he'd handed over his creation to the study director who would conduct animal trials. But Lentidra's preclinical studies were abruptly suspended, after initial reports had come back riddled with problems. After this first, failed model, Dolan had to set his sights lower, temporarily relinquishing the dream of long-term gene expression and, at the board's urging, turning his focus to his redheaded stepchild, the smallpox vector (now known as X5-AAT and by its more marketable title, Xedral).

  Rather than integrating into the host's genome, Xedral allowed only for short-term gene expression; the DNA floated in the nuclei of the target cells, got expressed briefly, then faded. The treatment was effective-86 percent effective from trial indications-but not a cure, and it required a booster shot once a month for maintenance. Otherwise the subject would slide back into his failing condition. In animal studies, Xedral was looking to be safer than Lentidra and more effective. These trials showed a stability of transgene expression sufficient to bring Vector to the verge of FDA Phase I human studies. A number of volunteers, mostly children, would begin trials within the month.

  Dolan still mourned the loss of Lentidra. The idea of cure was tantalizing. Next to prevention, it was the best thing a medical scientist could deliver.

  In fact, the notion of long-term transgene expression was what had sparked Dolan's interest in the field. When, while coasting through UCLA as a biochemistry major, he'd first learned of the huge advances scientists were making using viruses to shuttle genes, he'd been possessed intellectually. Casting aside a (lukewarm) aspiration for medical school, he'd dived into research, fretting over mitochondrial-derived activators for a promising but uninspired senior thesis. He'd stayed in the department for a Ph. D., blissfully engaged in his research. He loved playing detective, tugging at analytical knots, plank-walking out to areas of specialization where he alone could generate answers to the questions he was posing. And, better yet, he was gifted at it, his dissertation work knocking the experimental frontier forward a longitude or two.

  Dolan's thoughts returned to the concern at hand, and he leaned forward, resting his elbows on his workstation. For all its sloppiness, his bench was organized precisely to his liking. It was the one place he felt at home. His machine-sharpened Faber-Castell number-twos, his DNA samples, his microfuge tubes.

  When he strayed beyond his bench, however, the particulars of ownership became a bit hazier. Beacon-Kagan, the pharmaceutical behemoth that was Vector's parent company, brought its influence to bear in imaginative and indirect fashion. Ostensibly, Vector had its own management, but it was a wholly owned subsidiary with plenty of Beacon-Kagan executives on loan and more cross-board memberships than would have been orthodox a few presidential administrations ago. In return for these unnegotiated concessions, Dolan, as the principal investigator and senior scientist, enjoyed a relative freedom from budgets and business concerns. He mostly kept to his domain, what others called research but he always called science, constructing his viral vectors in his sheltered corner of the lab.

  Having assumed the lease at the board's insistence from a failing digital-TV company, Vector occupied the ground floor of the twenty-six-story Beacon-Kagan building in Westwood, located just below UCLA on Wilshire. In his private moments, which were many at work and few at home, Dolan likened Beacon-Kagan to a twenty-five-story ogre perched on his shoulders. But what a rich infrastructure for Vector to flourish in. And flourish it had-thanks to Xedral-to the brink of a closely watched IPO. Watched from the Street and from above.

  Dolan pivoted now in his barstool-height architect's chair, working up the nerve to confront the board's pet study director (in title at least, Dolan's employee) about the aborted Lentidra trials. Casting nervous glances across the lab through the two glass walls into the test-subject suite, he waited for Huang's head of shiny black hair to appear. It was early-6:00 A.M. early. Any Beacon-Kagan employees (and that meant any Vector employees) who didn't want to wither in the corporate culture started their days before their days.

  Huang finally swept into view, wearing his knapsack, an accessory-like the Trek twenty-one-speed he "commuted" on-that Dolan had always thought an affectation of youthfulness. Dumping the knapsack onto his desk, Huang tugged his lab coat from his chair back and slipped into it, completing his transformation into authority figure. Sipping a Starbucks, he pulled himself to his monitor.

  Dolan stood, trying to override unease with indignation. Why shouldn't he confront Huang? After all, wasn't it Dolan's company? Vector Biogenics wouldn't exist were it not for him. As the father of the process and the senior scientist, wasn't he entitled to a few simple information requests?

  He started for the door, muttering to himself, drawing curious gazes from the junior researchers. His resentment flared, putting an uncharacteristic conviction into his step. He gowned up and passed into the baking heat of the production room, a massive incubator where thousands of bottles rotated slowly on racks lining the walls. Made of polypropylene, a plastic on which cells readily grow, the roller bottles were filled with a red medium liquid. This growth fluid created a wet environment for the genetically altered smallpox to reproduce. In the batch currently spinning all around Dolan like living wallpaper, a mere three days into production, the virus had already swollen the cells and begun to bud out of them. A few more days and the production team could pour out the infected liquid and filter it. Once the Xedral was purified, it could be formulated, dispensed into vials, and freeze-dried, just like a standard vaccine. After that, just add purified water and inject.

  Dolan stepped into the airlock, then out into the test suite, the monkeys grunting and banging their cages in greeting. With relative ease, Dolan had designed a viral vector to "knock out" the AAT gene, so that Huang could create an animal test group that simulated humans with alpha-1 antitrypsin deficiency (destroying-especially when it came to genetics-was always easier than repairing). Rabbits, mice, pigs, and woodchucks had all come and gone before Huang hit upon cynomolgus macaque monkeys, whose clinical presentation of the deficiency was sufficiently comparable to that of humans to make them useful in determining the effectiveness of Lentidra and Xedral. Simple intravascular injections, like flu shots, were administered, and thirty-six hours later the test monkeys no longer had functioning AAT genes. Their livers started to shut down; they lost weight; their sclera yellowed. Dolan had created the problem to fix it. And fix it he had.

  How permanently his viral vectors could keep that fix in place was another question. The recovery of the monkeys had been staggering to witness. An added advantage in using higher animals was that the trials could continue longer; it wasn't until the
eighth month of L12-AAT's second trial that Huang had caught the complications that had made the board pull Lentidra from development.

  Dolan arrived at Huang's side, but the study director continued tapping at the keyboard, the monitor's glow reflected back in his glasses. "Just a sec, D."

  Waiting, Dolan offered a salute to Grizabella, and she bared her teeth kindly and returned the gesture. One of 128 composing the final longitudinal Xedral study, Grizabella was the gentlest and (on those rare occasions when Dolan ventured into the test-subject suite) his favorite. Huang had started with 130 macaques but lost two to simian hemorrhagic fever, which was common enough in monkeys imported from the Philippines and, thankfully, harmless to humans.

  Huang sent an e-mail with a flourish of his hand and spun on his chair to face Dolan. He flashed a boyish grin. "Herr Direktor."

  "Chris, I took a spin through the preclinical reports you got me from the last Lentidra trial. I'm still having trouble reconciling the figures with the results. I'd like to take a look at the raw data."

  "Again? We've gone around on this a few times now."

  "And every time I found inconsistencies in what you submitted to me. I'd like all the raw data so I can rerun them myself. Top to bottom."

  Huang blew out his cheeks. "Well, we're focused on Xedral now, right? We've got a functional model, and we're readying to hit market."

  "Xedral's more or less autopiloting to Phase Is next week." Dolan set his fists on his hips, Superman style. "My work there is done."

  "So don't we need you to move on? Lentidra didn't pan out."

  "Exactly. But, you see, everything I oversaw on Lentidra did bear results-"

  "In a petri dish."

  "Which is why I want every piece of data since my vector crawled out of my petri dish and into your monkeys."

  Huang laughed. "Fair enough. It's a ton, though. I'll need some time to pull it together."

  "What's the challenge? Attach it to an e-mail and click 'send.'"

  Huang jigged the chair back and forth so it gave off little squeaks. "Look, the board's been clear where we need to be putting our focus. Don't you think-"

  "The board doesn't want to burn resources chasing a failed model for the sake of the senior scientist's ego. I get it."

  A tension-releasing laugh. "You said it, not me."

  "But you've got to remember, this company's based on vision, not just corporate expediency. The upside to Lentidra-permanent transgene integration-is huge. It's worth devoting a small percentage of our resources to backtracking and troubleshooting. I hate to sound like a commercial, but if I get a handle on the problem, I think I could engineer an alternate Lentidra design that would offer us the best of both worlds-the stability and safeness of Xedral with long-term genetic expression. If we nail it, who knows what the other applications will be?"

  "Okay. I'm with you. I'll help. But we're all working late. And early." A gesture at the computer-screen clock. "We've still got limited time, and time-as our CEO is so good to remind me in our now daily meetings-is our most valuable capital. Based on what I'm getting from upstairs, obsolete vectors are not where our aim is right now. Our aim is the IPO. As soon as we get through the next few weeks, I'll dig out all the old data. Then we'll start breaking it down together in our copious spare time." Huang offered a hand and a smile. "Deal?"

  Dolan did a quick translation: In his zeal to serve the board, Huang had put all his focus into Xedral, leaving the other data in sloppy condition. Though Dolan couldn't relate to Huang's lack of curiosity, he'd found it all too common in corporate researchers.

  Dolan returned the handshake but not the grin. When he turned, Grizabella extended her hand through the bars and slapped him a solemn five. He passed through the automated glass sliding doors into the hall, Dean Kagan's pious oil portrait beaming down at him.

  Chapter 16

  Maintaining a disciplined stillness at the head of a preposterously long conference table, Dean Kagan held his executives' pained attention a moment longer. The tip of his tongue poked into view, wetting his lips. "Permit me to list the excuses so we can skip the whining phase this morning. Consumers are pissed off about climbing prices. The AARP is on the warpath and has allies on the Hill. Canada's undercutting our supply and pricing. The pipeline's not what it was. Twenty-eight states and counting have passed legislation to regulate drug pricing. I know. Your job is not to reiterate the obvious but to come up with creative solutions. I'd like each and every one of you to hear me on this point." A creaky shift forward and then a firm finger jabbed across the grain of the mahogany. "I'll be pushing up daisies before I permit this company to backslide on its P amp;E multiple. I want blood from a stone. And I want it staining our next quarterly sales estimate. Booked sales will be up before the shareholders' confab in November. I am not having another week's golf at Wailea rained on by those Wharton clones from the pension funds."

  Twenty faces stared back at him, male and female, black and white, doughy and chiseled, but attentive to a one. Dean scrutinized them, amused by himself, the market challenges, the tension in the room. His hair, silvered but as yet unthinned by age, was short and expertly styled. A forty-five-hundred-dollar suit disguised his softening athlete's build, enhancing his shoulders, firming his posture, creating a more tapered waist. Dean Kagan had never been forthcoming about his age, but an average of the conflicting public-record accounts put him at seventy-three.

  The air smelled of linseed oil and leather, still new-car strong though twenty-seven years of weekly 6:30 A.M. "stratcom" meetings had passed through the war room since it was constructed. The impressive plane of wood on which rested elbows, reports, and various mugs of designer coffee was Bolivian mahogany, acquired for a pretty penny before the import laws clamped down. The brass fittings of the cabinets were polished to a boot-camp gleam, and the window that stretched the length of the north wall, providing a twenty-six-story view of Westwood and the smog-shrouded Santa Monicas beyond, was spotless.

  The solid-core oak door had been calibrated to bulletproof, as had been the door leading into the anteroom, one of many details put into effect by the same overpriced Beverly Hills firm that had sent contractors to secure the oil fields of Kirkuk. Stem-cell research that Beacon-Kagan sponsored on three continents had led to increased threats, but there'd be no shoot-em-ups here, nor at the Kagan estate, where the windows were tactical glass and Dean's security adviser-who lived full-time in a guesthouse-was always within handgun range. The master suite even had a walk-in closet that converted to a safe room in case of burglary or attack. Dean had cut a swath through the world of international commerce over the past half century, and he wasn't going down because some mouth-breathing crusader with a hair-trigger twitch couldn't shake a fit of empathy over the treatment of his primate brethren.

  Beacon-Kagan had sprung up fast and hard in the late seventies, stealing talent from the universities and competing corporations and developing a slate of solid but unexceptional meds that kept the company reasonably profitable from the start. As it grew more innovative and reactive, it began to reap higher dividends. Beacon-Kagan had added its name to the roll of the Pharmaceutical Research and Manufacturers of America, at last muscling up to the table with Merck, Bristol-Myers Squibb, Pfizer, and its other better-regarded, higher-market-cap competitors. Over the past several decades, Dean had driven the company-and its stock-north with relentless focus and vigor, Beacon having long fallen out of the picture, slumped into his potatoes au gratin at a corporate luncheon in his fifty-ninth year with a blown aorta. Today Beacon-Kagan was poised not only to compete but to trailblaze.

  Dean punched an intercom button built into the desk. The door creaked open, and a nervous assistant stood in the gap, her hands clenched before a tasteful charcoal skirt.

  "My coffee," Dean said.

  The assistant relayed the message to someone out of sight, and a demitasse, gold rimmed, appeared almost instantly through the gap. She delivered it to Dean and backed away, ready to
respond if he chose to make eye contact.

  The leather chair cocked under his weight. "Now," he said, with the relish of a football coach assigning a particularly grueling hitting drill, "let's trot out the workhorses."

  The senior VP of Sales and Marketing ruffled her notepad, then pulled off a stylish pair of glasses and set them on the table. Jane Bernard was a tenacious, steely woman with handsome features and a shell of coiffed gray hair. "Why don't we begin with Midachol?"

  Dean tipped his head in a nod.

  They'd added their own statin to the cluster behind the counters and, with aggressive promotion, managed to squeak out an 11 percent market share to the tune of a billion and a half a year. To approve a new drug, the FDA demanded only that it be shown superior to a placebo, not to other drugs. In Beacon-Kagan-conducted trials, Midachol had beat a sugar pill at lowering cholesterol nine times out of ten.

  The young man across from her looked up from his BlackBerry and shot Jane a wink. In an approximation of an arranged marriage, he was engaged to her daughter, currently back east finishing a clinical social work degree at Smith. Chase Kagan returned to his e-mail, holding the wireless device in both hands like a GameBoy. His navy jacket hung over the back of his chair, freeing him to display the rich colors of his madras shirt. A knee, clad in artfully rumpled linen, was propped against the table's lip. His eyes were small and pale, set in pouches of loose skin accented by lashes so light they disappeared unless the sun hit them. He carried an air of uninterest-not apathy but boredom, as if he knew all the answers before the questions had been asked. A precocious but well-earned affectation for a twenty-eight-year-old a few promotions out of B-school.