Tell me about some of your early career ambitions
I have always loved science, but I originally expected to stay in academic research. I studied in the UK, completing my PhD at Durham University. During my PhD, the Stem Cell Network in Canada reached out to the UK Stem Cell Network and invited students to visit Canada for its annual meeting and spend time in a Canadian lab. I applied, spent two weeks working in one of the labs, generated some data, and took it back to Durham. We combined those results with work from my PhD and published a paper together.
At the end of those two weeks, my professor, Molly Shoichet, offered me a job in Toronto, which I accepted. My plan was simple: spend a few years there, then head back to the UK, become a professor, and continue in academic research.
But things evolved from there. We were working on stem cell transplantation for stroke patients, combining stem cells with a gel that could be injected into the brain and studying recovery in stroke-injured mice. It was very exciting work. Dr Shoichet then asked, “Do you want to build a company around this?”
This is how AmacaThera started. One milestone led to another, and every time we reached one, another opportunity appeared. What was meant to be a two-week trip has now turned into almost 18 years.
Looking back, I can see that I was surrounded by startups as a student. During my undergraduate degree, I spent a summer internship in a lab in Durham where the professor had a startup company. It was there that I first saw how much fun it could be to build a company based on science. My PhD was also funded through a Wellcome Trust program that included an industry component with a startup company in Newcastle. I did not plan that path, but seeing those environments had a huge influence on where I ended up.
Could you tell me about AmacaThera’s core technology, and what led you to focus on pain management?
The technology behind AmacaThera, which was invented in Dr Shoichet’s lab at the University of Toronto, is a gel that is shear-thinning and inverse thermal gelling. To explain the shear-thinning, imagine ketchup. It does not flow until you shake the bottle and apply shear to make the ketchup move, but once it is on your plate and the shear is removed, it holds its shape rather than spreading like water. The second property is inverse thermal gelling. When you make jelly, you apply heat to create a liquid, and then it forms a gel as it cools. This material does the opposite: it forms a gel as it moves from room temperature to body temperature. Together, those two properties mean you can inject the material, and once it is inside the body, it will stay in place, whether that is a surgical incision, a tumor, or muscle.
At its core, the platform is about keeping a drug localized, which opens up a wide range of possible applications. In the lab, we reviewed everything from stem cell transplantation and spinal cord regeneration to oncology, small molecules, and other indications. But in 2014, we spoke with around 100 surgeons and anesthesiologists to understand where the unmet need was. Post-operative pain, and specifically non-opioid post-operative pain management, was the prevailing answer.
This was before the opioid epidemic had reached the large scale that then occurred, but clinicians could already see that things were moving in the wrong direction. It was those conversations with surgeons and anesthesiologists, and understanding what they needed, that led us to initially focus on post-operative pain.
How would you describe the current landscape for non-opioid post-operative pain management?
In many surgeries, surgeons will inject an anesthetic around the incision using a solution-based approach, but that effect can wear off relatively quickly. Once it does, the standard approach is often to prescribe patients opioids to take when they are in pain, which obviously comes with many issues.
There have been efforts to develop sustained anesthetics, with two currently on the market for local injections. One is Exparel, a liposome-encapsulated anesthetic made by Pacira BioSciences. It is still a solution, but the liposomes provide slow release. The other is from Heron Therapeutics, which uses a polymer-based drug delivery system to deliver the anesthetic.
Pacira holds the majority of the market and is also the partner working with AmacaThera on our lead program AMT-143, an investigational long‑acting, non‑opioid anesthetic addressing a major unmet need for post‑operative pain management. We have already run a Phase I study on the hydrogel alone, followed by another Phase I human clinical study combining hydrogel with an anesthetic. With Pacira, we are now preparing for a Phase II study focused on the post-operative pain program.
What role could localized pain management technologies play in reducing reliance on opioids after surgery?
There are some surgeries where patients will be in so much pain that they require opioids. If someone has had a major thoracotomy, for example, where the chest cavity is opened for heart surgery, they are going to be in significant pain. For procedures like that, there will still be a place for opioids.
However, there are many smaller or relatively minor surgeries where pain can be managed with local anesthetics. In those cases, we should avoid opioid use where possible, and instead aim to deliver the drug locally to reduce overall opioid use.
One of the major areas we are looking at is knee surgery. Joints like the hips and knees can be very painful, but the pain is often localized and can potentially be controlled with local anesthetics. In cases like these, we could potentially eliminate the need for opioids entirely.
How did you find the transition from academic research to building a company?
When you are in a lab, the biggest problems often concern the science itself and negotiating for use of equipment, both of which can be managed relatively easily. When building a company, however, you are suddenly negotiating contracts with CDMOs and contract research organizations, including Phase I trial sites. You are also manufacturing GMP material, thinking about regulatory strategy, and generally dealing with areas that require a completely different skill set.
These were areas I had never dealt with before, so we brought in advisors with decades of industry experience, which made a huge difference. I was very fortunate to work with excellent consultants and advisors, including people with deep regulatory and manufacturing expertise.
Having the right team is critical. You need the right advisors and the right people around you to be able to help push things forward. But you also must be honest about the technology. We’ve made mistakes, but one thing I think we have done well is understand how our technology works, what it can do, and how it is differentiated in the marketplace.
This journey really started back in 2014. We incorporated in 2016, and now, a decade later, we are still working on it. You really must believe in the science, and the science itself has to be robust. Otherwise, you can waste a decade of your career and a lot of money trying to accomplish something that ultimately will not work.
Looking back, what are the biggest lessons you’ve learned from building a company?
One major lesson has been fundraising – you must keep investment coming in to keep the lights on. Over the last 10 years, the funding environment has been tumultuous, to say the least. Around 2020, investors were putting a lot of money into biotech, but in recent years capital has become much harder to access, and now we are seeing a lot of investment shift toward AI.
There are always cycles where investors become excited about different areas. Pain has not always been fashionable with investors or pharmaceutical companies. One piece of advice I was given early on was to stay on the course. We believed in the program when we started developing it, and we did not change direction every time a new trend captured people’s attention.
In hindsight, that was absolutely the right decision. Pain came back into focus at exactly the right time; we had developed the program to the right stage, and the timing worked in our favor. Sometimes the stars align, but you have to be there when they do.
What would success look like for AmacaThera over the next 5-10 years?
First and foremost, success would be getting our lead post-operative pain program approved and into the hands of clinicians so that patients are actually benefiting from it. For me, that is the exciting part of AmacaThera: taking something developed at the bench and moving it toward patients.
Beyond that, I would like to see more partnerships. We are currently working with a number of large pharmaceutical companies that are providing us with their assets. By combining those drugs with our next generation hydrogel platform, we can help develop new products together. That is another route to getting therapies through the regulatory process, onto the market, and ultimately to patients.
For pain management more broadly, the first thing I would say is that pain itself is important. It is a vital protective mechanism; if you touch a hot stove, pain makes you pull your hand away. The issue is unnecessary pain, such as post-surgical pain, which does not serve the same protective purpose. Finding better ways to manage that pain is therefore really important.
I do not believe there is a one-size-fits-all solution – different approaches will suit different procedures and different patients. With that in mind, I think success is about having a portfolio of differentiated pain therapies available, rather than relying on a single solution.
Are you optimistic about the future of pain management and the role drug delivery could play?
There are two elements to that. First, it is an exciting time with Pacira advancing our lead program through the clinic and generating the clinical data needed to get the product approved. Having them on board has increased our chances of success enormously. They have the team and the capital needed to develop this efficiently, and that gives us real confidence that it can move through development, reach patients, and help reduce opioid use.
The other part is drug delivery as a whole. Historically, investors have not always seen drug delivery as especially exciting. It can sometimes be viewed as simply mixing drugs into a formulation, which I think is unfair. What we are seeing now is more interest from pharma companies looking for formulation support and thinking about drug delivery technologies earlier in development.
Over the decade we have been working on this, drug delivery has become a more serious area of focus for pharma partners, and I think that shift is happening globally.
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