Industry Insider is a timely chat with an ophthalmic industry thought leader.

Christopher Brittain, MBBS, MBA, joined Genentech in 2016 and was named as the company’s vice president, global head of ophthalmology product development in 2019. Genentech is currently developing the Port Delivery System with ranibizumab (PDS), a refillable eye implant about the size of a grain of rice that is designed to deliver a customized formulation of ranibizumab over a period of months.

Ophthalmology Management: What update can you give us on the PDS?

Christopher Brittain, MBBS, MBA: We recently started the Phase 3 Pavilion trial to evaluate PDS with ranibizumab for treatment of diabetic retinopathy (DR) in patients without diabetic macular edema. Its goal is to analyze outcomes for patients who have the PDS refilled every 9 months, and it complements the ongoing Pagoda study, which is studying the PDS in patients with diabetic macular edema. We’re excited to see what the results for Pavilion will be, given the positive results of our Phase 3 Archway study; that studied the effects of PDS in patients with neovascular or “wet” age-related macular degeneration (nAMD) with refills every 6 months.

OM: Do you think the pandemic has reinforced the need for an extended drug delivery solution like PDS?

CB: Yes I do, and the way I see it, there are two groups of patients this could potentially help. The first is those who are undiagnosed with nAMD and are in the community — they’re not getting treated or referred because they’re not seeing a doctor, partly due to fear of contracting COVID-19, partly because clinics are closed down and partly because they don’t want to start a therapy with a very frequent regiment. PDS can play a small but vital role in this undiagnosed group.

But I think it can be an even bigger help for patients already diagnosed with nAMD. We’ve seen statistics where as many as 25% of patients started missing doctor appointments as the pandemic worsened, and if patients are missing visits then they’re losing vision. So, giving these patients a means to receive that continual medication over several months is something that would be a great benefit.

OM: You led the development team for the PDS and before that the team for lampalizumab. How did that prepare you for your current role?

CB: Starting with lampalizumab, which was investigated for geographic atrophy treatment, I joined that team in 2014, just in time for the first investigator meeting at the start of the Phase 3 program. From that time, I had the experience of building up relations and collaborating with global investigators, communities of patient organizations and the hundreds of colleagues within the company who work so tirelessly to make these studies happen. Even though the study results for lampalizumab were negative, the experience still developed a strong sense of compassion for both my colleagues and the patients who had committed to receiving treatments every month for over 2 years. We also gained a wealth of data from those studies on geographic atrophy, which have significantly improved the scientific understanding of that field.

Regarding the PDS, that is a complex project as it required us to combine our knowledge of the drug ranibizumab, the surgical technique needed to install the implant and the implant itself.

OM: You spent several years practicing as an ophthalmic surgeon. How did that prepare you for therapy development?

CB: I practiced in the United Kingdom for 4 years as a general ophthalmic surgeon, and there were two things I really took home. The first is the impact of sight loss on patients — it can be very hard to break that news. I remember having to tell an elderly gentleman that his vision loss was irreversible, so having compassion and empathy for our patients is very important to me.

The second is the humbling gratitude of patients who have had their sight restored. They’re so phenomenally grateful, even if the treatment is very routine as is the case with cataract surgery; that has made me want to continue my career in ophthalmology for as long as I can. OM