This Scientist-Turned-VC Wants to Extend Life

Since he was a child, James Peyer has been obsessed with stopping aging. Now he has a fund — and a plan.

Peyer predicts the daily regimen of the future: a handful of pills that prevent cancer, Alzheimer’s, diabetes — and slow down aging itself. Illustration by Agata Nowicka

Delaying death remains the stuff of science fiction, but James Peyer, cofounder of Apollo Ventures, is convinced that it won’t be fantasy for much longer. He started the venture capital firm more than two years ago — when he was only 29 — to back early stage companies that he hopes someday will have the potential to slow aging. So far, it has invested $2 million to $5 million each in four companies, two of which remain in stealth mode. Apollo’s scope includes nine different areas of research with anti-aging potential, including rejuvenating stem cells, reversing problems with cellular energy, and manipulating telomeres, the caps at the ends of chromosomes that shorten with age.

Peyer, who trained as a stem cell biologist, is mindful of regulatory and commercial realities. Aging is not a disease, so the US Food and Drug Administration has never approved a drug to combat it. Peyer plans to support startups that begin by tackling a disease such as muscle wasting or diabetes. Once that succeeds, these companies can broaden their reach to slow or stop aging. But we still don’t know what causes aging, or have clear ways to measure whether it’s slowing down or speeding up, so proving that an anti-aging pill actually works will be another major challenge. Unlike some of the more exuberant investors in the anti-aging space, Peyer is clear-eyed about how hard that will be. Nonetheless, he’s optimistic about combating aging, a problem he’s been obsessed with since childhood. NEO.LIFE’s Karen Weintraub spoke to Peyer earlier this month over coffee at WeWork in Cambridge, Massachussetts. What follows is an edited, condensed version of their conversation.

What turned you on to the field of anti-aging biology?

I became a scientist because I felt like we were treating the diseases of aging the wrong way. We were waiting for people to get cancer or Alzheimer’s disease or something and then trying to do something about it, which felt totally backwards to me. By the time the diseases rear their heads they’re at such a level of complexity that biologically, walking them backwards is an enormous — and maybe in many cases insurmountable — challenge.

We still don’t know much about aging and how to stop it. Is it premature to start investing?

I think definitely not. Are we ready to administer new medicines to healthy people and help them live longer and prevent disease? The short answer is we’re not there.

But are new medicines that may eventually be able to do that ready to undergo clinical development for other diseases? Absolutely yes. And that’s exclusively what Apollo works on.

What is your vision for Apollo?

Creating a portfolio approach to aging. There’s not going to be one single pill that eliminates cancer, Alzheimer’s disease, and [every other disease of aging]. The vision I have is three [or more] things that we could eventually take the way we take vitamins or statins, that really, really make an impact on the risk of these diseases later on.

So one drug won’t be a cure-all?

Diseases of aging aren’t caused by just one type of damage, so in the long run to make us all healthier, we’re going to have to use multiple medicines targeted at the different types of damage. For example, in Alzheimer’s disease we may need to both break down unwanted aggregates [from misfolded proteins] and also regulate glucose levels to really beat the disease. Cancer might need increased immune surveillance and also better DNA damage repair. For this reason, I think we’ll see the serious benefits to healthy lifespan once we start combining multiple safe and effective therapeutics.

One of the companies you funded, Aeonian Pharma, deals with the so-called mTOR pathway. Can you explain a bit about that?

There’s a drug, rapamycin, that extends lifespan in mice by about 15 percent, with lower cancer, lower muscle loss. It’s like a healthspan increase. But the drug’s not safe. It’s an immunosuppressant, among other things. The first company we backed made a version of rapamycin that doesn’t have the side effects. But we’re not going to launch it in an aging trial first, because there happens to be a disease called tuberous sclerosis that has overactivation of this mTOR pathway. We’ll [try] it in that disease first. If it’s safe and effective, let’s talk about using this for muscle loss or neurodegenerative diseases.

Do you have a favorite path of research among the nine you’re pursuing, or do you think it’ll take a combination of the nine?

I don’t have a favorite since all types of aging damage can eventually accumulate enough to cause a disease and kill people. However, there are a few lower hanging fruits where scientists have made the most progress: in senescent cell biology [cells that stop reproducing, as well as cells that can’t regulate themselves] and nutrient sensing pathways. I expect that one of these is where the first human breakthroughs will come.

If you develop a drug for a rare disease, it will be very expensive. So if it also works as an anti-aging therapy, will it only be affordable to the rich?

Drug prices can always come down to match a market. Let’s say our drug starts out as chronic treatment for an orphan disease [one that is very rare]. Our next trial would be to prevent Alzheimer’s or early stage Parkinson’s or something like this, in which you give it chronically to a large number of healthy or nearly healthy people. If it succeeds, the price point for that drug will have to drop really sharply to match the market.

And theoretically, a drug that helps people live longer and healthier will reduce medical costs and save our health system lots of money, right?

Something that can increase the median healthy lifespan of a population, even if it’s just for a year or two years, already approaches the value of a miracle cure for cancer. Even if it’s a quarter of a cure for cancer, it’s still a massive deal. I get relatively excited about that possibility, even though I think that’s still a ways off.

Any thoughts about whether or when will people routinely live to 100 without chronic disease?

This is always a hard question to answer. Living to a healthy 100 will likely require a combination of good preventative therapeutics, and it’s too early to tell how easy or hard that will be. Hopefully as we see the enormous societal gains from adding a decade or so of healthy life from these drugs, it will lead to a sort of “longevity space race” to prevent chronic disease. The major thing holding us back right now is the question, “Can this work?,” and our industry is trying to show the world that indeed it can.

“Hopefully as we see the enormous societal gains, it will lead to a sort of ‘longevity space race’ to prevent chronic disease.”

Are there side effect concerns with anti-aging therapies, such as a fear that by helping cells live longer, for example, we could trigger cancer?

This is going to be a major challenge. Some approaches to slowing the damage of aging have very few unwanted side effects in mice, such as enhancing autophagy [cellular recycling] and routinely clearing senescent cells. When we start talking about stem cells, DNA repair, and telomeres, however, we have to get more careful. Part of the reason that those systems decline as we age was an evolved mechanism to protect us from cancer, so that means we have to be very thoughtful about how we target these things to promote regeneration but avoid increasing the risk of cancer.

What can a firm like Apollo do to advance this field?

With a few million of investment, which my small fund is able to do, we can get a drug ready for phase 1 clinical trial in just a couple of years. A standard oncology drug, by comparison, takes $20 to $40 million. I think there’s a very real argument to be made saying that even leaving aside the anti-aging potential of these drugs, these companies are undervalued. The science is quite far along.

Anything that keeps you up at night when you think about anti-aging treatments?

We’re all affected by the diseases of aging. Because there’s so much emotional appeal in this space, it has been easy to raise money for companies by just appealing to “this is going to reverse aging.” I’m worried about this, because whenever it’s too easy to raise money, you get situations where ideas that shouldn’t be seeing the light of day receive too much hype, too much money and then can create large-scale failures that set back the field as a whole.

Is that happening?

We’re not necessarily at that stage just yet, but I really don’t want to see it go in that direction.

“Whenever it’s too easy to raise money, you get situations where ideas that shouldn’t be seeing the light of day receive too much hype.“

You’re 31. Do you do anything to improve your own odds of living longer?

I take metformin. There’s a lot of circumstantial evidence suggesting that metformin can slightly shift back risks of Alzheimer’s and cancer in addition to diabetes [for which it is an approved treatment].

I take NAD [a coenzyme used in energy production and DNA repair]. We’ve looked pretty deeply into the NAD space. There is clearly some benefit to augmenting production of NAD, especially later in life. The degree of that benefit is still to be determined.

And I take spermidine, a component of sperm. This is one of the under-reported life-extending supplements. When you dose mice with it, they live a lot longer. You have comparable results to rapamycin with almost no side effects.

Don’t you get nervous about taking combinations of drugs that haven’t even been tested separately in humans?

The effect sizes and doses are pretty small. They’re pretty gentle. I certainly wouldn’t advocate for every 35- or 40-year-old to get on all these things right now. Some will. I think that’s okay, too.

What about the basics? Do you get enough sleep?

Not enough good sleep and too much time on airplanes shifting time zones. The circadian rhythm data is quite compelling in a way that makes me very worried, because my circadian rhythm is never adjusted. I remember seeing this sleep disruption data for mice — and holy crap did those mice fall apart! So I get a little worried there.