We accelerate (AI) breakthroughs that will define human health + civilization for the next century. Founded by @ShahramSN. RTs/likes ≠ endorsements. 🩺 🧬 AI

San Francisco, CA
RT @ShahramSN: Congratulations to the team at Convergent Genomics on their $180M acquisition by @Veracyte! This is good news for the 85,00…
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Step 1: be an amazing person and enroll in a PhD in #bio at @Cambridge_Uni Step 2: get accepted into the elite @CivilizationVC Fellowship program, then become a CV Analyst Step 3: write for @WorksInProgMag (@Stripe) and publish your OpEd in @nytimes You *CAN* change the world! 🧬 🌍 Go @RuxandraTeslo 🚀
We are on the cusp of a wave of new therapies for some of the worst diseases. But the world won’t benefit unless the US fixes its drug regulatory system. My new essay for @nytimes, on how slow clinical trials are now the biggest obstacle to curing cancer. nytimes.com/2026/09/04/opini… - I interviewed dozens of researchers, especially oncologists at leading U.S. centers. A striking consensus emerged: science is no longer the main bottleneck to new cancer drugs. It is our ability to test discoveries in patients through clinical trials. - The cost of starting a Phase 1 trial in America has roughly doubled over the past decade. As a result, companies increasingly take early trials abroad: Australia’s Phase 1 trial volume has nearly doubled in a decade, driven mainly by U.S. companies. - Unfortunately, the underlying incentives are badly asymmetric: Institutions can be blamed for harms caused by moving too fast, but almost no one is blamed when patients deteriorate during avoidable delays. One doctor called the emerging system “ritualized safety over actual risk assessment.” Or as, @DavidHongMD put it: "We often forget that the biggest risk is the cancer itself." - This problem is becoming more urgent because medicine itself is changing. Sequencing, biological engineering and A.I. make increasingly personalized therapies possible. But our regulatory system was mostly built for standardized drugs tested in large populations. - @sytse, the co-founder of GitLab, shows what personalized medicine can achieve: after relapsed osteosarcoma and being told there were no options left, he pursued a highly individualized approach and has now been cancer-free for a year. But doing so required extraordinary resources and regulatory expertise. - Pierce Ogden’s father was less lucky. After molecular analysis identified a drug that might target his glioblastoma, the manufacturer agreed to provide it. But administrative barriers delayed access until it was too late. “My dad was ready to try anything,” Pierce told me. “But the system is paternalistic.” - The A.I. revolution is making this bottleneck more important, not less. A.I. relies on relevant data. Information from early-stage trials could compound with A.I. tools to achieve truly revolutionary medicines. Without the data, this is far less likely to happen. - Another important shift is that innovation increasingly comes from academic labs and small biotech companies rather than Big Pharma. These small companies find it far harder to unable to absorb delays and regulatory barriers. - Apart from cancer, China is the biggest winner from America's outdated medical regulations. China has a much faster trial system, with testing often starting a full year earlier. This allows Chinese pharmaceutical companies to experiment and improve medicines while American companies play with mice. Today, half of all drugs licensed by major pharmaceutical companies originate there, up from less than 5 percent only a decade ago. - But we don't need to copy China. The best model is Australia: lots of on-site scientific and ethics reviews, and requirements that are proportionate to small, early-stage trials. Phase 1 studies there begin roughly 6–12 months faster, without any notable increases in adverse safety events. - Operation TrialBlazer, a 2026 HHS initiative is a good start in this direction, but we need legislative action by Congress to truly make Phase I trials faster and more efficient! I want to thank everyone who helped me with this article: everyone I interviewed and the amazing editors at the Times. This is the result of a months long journey of extensive interviews and research. Special thanks go to those who came on the record. One of the features of the system is an atmosphere of fear, where practitioners are afraid to publicly come out and explain these issues. So anyone who does is a hero in my book!
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@CivilizationVC founder Daniel leading on AI x Dx.
Somalier is the canonical relatedness estimator used across genomics, but a single character bug silently corrupted long-read results. 3megabytesofhotram on the @GamowLabs team fixed this subtle off-by-one error in a dependency, unlocking Somalier for long reads for all. Big thanks from the genomics community! github.com/brentp/hileup/pul…
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Announcing Montana ETRB Montana opens up for biotech acceleration. Infinita has formed the first-ever ETRB (experimental treatment review board) under Montana law. The review board’s role is oversight for access to treatments before FDA approval. For a $12.5k fee, you can submit a post-phase-1 therapy to our review board (submission link below). What is a Montana ETRB? Montana’s model is a major regulatory innovation. National regulators typically review treatments one by one, which causes years-long bottlenecks. In Montana, registered ETRBs do treatment reviews, licensed specialized clinics (ETCs) provide treatments. The state receives reporting and can take away licenses. That’s smart regulation. Competitive, efficient, with oversight. That’s what American biotech needs. First Montana ETRB Members We are honored to welcome highly esteemed scientists, physicians and bioethicists on the first Montana ETRB: - Matt Kaeberlein, PhD (@mkaeberlein) - a biologist internationally recognized for research on the basic mechanisms of aging and translational interventions to extend healthspan - Felipe Sierra, PhD - a biochemist that served as Director of the Division of Aging Biology, NIA/NIH, where he developed the concept of Geroscience. - Jessica Flanigan, PhD - a bioethicist who is is the Richard L. Morrill Chair in Ethics and Democratic Values at the University of Richmond, where she teaches leadership and healthcare ethics - Jamie Justice, PhD (@j_n_justice) - is Executive Vice President of the Health Domain at XPRIZE and Executive Director of the XPRIZE Healthspan Prize - James M. Burke, MD - is a hematologist and oncologist with more than three decades of experience in cancer drug development and patient care Each review submitted will have to pass their judgement on adequate safety characterization. What will the ETRB look for? An ETRB’s legal mandate is safety-only. Risks need to be disclosed to patients for informed consent properly, and treatments need to have a safety profile equivalent to a successful phase-1 trial. After that it’s up to the doctor and patient to decide. ETRB will compete for reputation. They are free to approve or not approve according to their assessment. If they wanted, they could even ask for efficacy data as a basis for approval. Our Montana ETRB has a set of governance principles that guide its decisions beyond the legally required minimum floor, as a guide for its decisionsmaking. Congratulations to Montana Thanks to the leadership of Sen. Kenneth Bogner (@KennethBogner), Montana now has the most forward looking medical access law in the country in SB 535. Montana’s department of health and human services (DPHHS) provided a tight and comprehensive set of rules for clinic licenses and review boards. Montana is becoming a biotech frontier. Towards Clinical Trial Abundance The FDA has led the world for decades, gating the largest and most innovative biopharma market in the world. But the US’ competitive advantage is evaporating. Regulators in Australia and China have made clinical trials far more cost- and time-competitive. Patients are going to offshore clinics in Mexico and the Caribbean. High-agency patients like Sid Sijbrandij (@sytses) take matters into their own hands, and use multiple available jurisdictions. The FDA needs to modernize, and lots of federal efforts to this end are underway. We support federal reforms, however these efforts often fall short or are slow. Let US states innovate. The states can be as a source of regulatory innovation. In states important learnings can take place, and inform better federal policy. Montana is leading the charge in biotech. New Hampshire is following suit. Utah, Texas and Florida have opened up to stem cells and many states are improving conditions for individualized treatments. FDA / HHS should give explicit safe harbor to such responsible state medical access programs, to encourage a regulated market forming vs. gray markets. How to Get Involved We’re looking for state and federal policymakers to advance this regulatory innovation, clinicians to be the patient-facing stewards for responsible access, scientific reviewers to partake in ETRB oversight, biotechs to provide their novel treatments to these programs to collect valuable data, and ultimately for patients to benefit from potentially life-saving access. Get in touch! Mine and @righttotryguys DMs are open
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@CivilizationVC now officially has its first 50x return fund - these are realized returns! There's money to be made in the #lifesciences even through the #biotech winter of 2021-25 that's now over. Our good fortune was due to a #diagnostics company no one had heard of in 2017 when I made the first invesment: @BillionToOneInc 🩸🧬🚀 Who said diagnostics is a dirty word? ... oh the lemmings
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Tahoe’s vision is becoming real! It is exciting to see @iamjohnnyyu, @nalidoust, and the @tahoe_ai team bring years of focused building to this point. I have watched firsthand how many pieces had to come together to make this possible. This team took the platform we built in the lab and transformed it into something that operates at a fundamentally different scale. Tahoe-100M was an early manifestation of that effort, and it is the part most people know. What is less visible is the enormous amount of data the team has generated across increasingly sophisticated cellular models, creating the experimental foundation for a new kind of biological intelligence. Progress in science is not limited by the number of hypotheses we can generate… we already have many of those. The limiting step is rapid evaluation and verification. In mathematics, software, and engineering, major advances have been enabled by tight feedback loops. Biology has largely lacked that capability. At @tahoe_ai's scale, those feedback loops become possible. If I hypothesize that drug A acts through pathway B, then C, then D, to produce molecular phenotype E, Tahoe’s data often already contains perturbations that target genes within pathways C and D and should converge on the same phenotype E. Those perturbations become independent lines of evidence that immediately strengthen or weaken my hypothesis. More importantly, when pieces are missing, Rhaister and other models Tahoe has developed leverage the massive scale of data available to infer the missing relationships within seconds, turning observations into a more coherent and continuous biological world model. To me, that is the real breakthrough. Tara is not an AI copilot that generates hypotheses on demand; it is a true AI scientist, one that turns Tahoe’s experimental scale into biological knowledge that is immediately actionable and generalizable.
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Protectionism will not work in #biotech (it certainly won't rescue companies that have no product and whose shares are down 98% from their highs). What it will do is raise costs, slow innovation, and ultimately cost lives. The United States should focus on strengthening its competitive advantages: 🔬 Invest aggressively in scientific R&D, startups, and clinical trials. 💊 Launch a modern "Manhattan Project" to secure domestic #manufacturing of critical pharmaceutical ingredients and medicines. ✂️ Cut unnecessary regulations while maintaining rigorous safety standards. 🧲Improve immigration laws to retain the world's best #scientific talent. 🌎 China, Latin America, India, Europe: competition is everywhere. It's called capitalism. America wins not by building walls around innovation, but by out-innovating everyone else.
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@CivilizationVC in das Haus here in Berlin talking AI and #bio innovation!
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@tahoe_ai team doing what they do best! A key takeaway from VCC’25 for us was that in the current data regimes, elegant statistical models match if not surpass far more complex transformer-based architectures! “Going back to the basics” is such a great title for this… to say nothing of the 2M cell dataset! Kudos…
Today we release Rhaister, an elegant statistical model that predicts drug phenotypes in new contexts w/ accuracies comparable to experimental assays. And dropping Emerald Bay, a 2M cell dataset measuring long time-course phenotypes across 1000s of drug-cell line interactions.
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Such a rich convo => @ShahramSN is trying invest in ChatGPT at the cellular level. The future of biotech is in the data, and how companies can use to feed and train models to excel in medical diagnostics and beyond with his fund @CivilizationVC. To hear the full interview search for "First Funders" on Spotify, YouTube, Apple Podcast and more.
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1. Increase gov't spending in R&D — DOUBLE the NIH, NSF, and other spending. Heck, TRIPLE it! 2. Streamline regulation for clinical trials (don't abolish, improve) and upgrade clinical trial centers globally. We should increase the size of the FDA with an expanded "international force" that can rigorously spread what works to other nations willing to invest resources in their clinical trial capabilities, and unleash the true internationalization of clinical trials. Part of this is collecting more and better patient data, under proper standardized protocols, so you can easily go from a Phase 1 abroad to a Phase 2 in the US or vice versa. This will help US biotech win globally. 3. Increase cross-links and investments from US to China. You heard me right. (I'm referring to private sector investments, not public. All US gov't money should stay 100% in the US. We're not going to fund Wuhan 2.0.) We'd all be sitting in front of our brick Ericsson phones if Foxconn hadn't built our iPhones. Let's let China — with US funding and support — build our drugs! Not exclusively, of course, but lets let the market drive it. The profits flow back to our pockets if we invest in, acquire, and trade Chinese companies and stock! This applies to VCs as well as public stock market investors. Everyone can benefit. The medicines come back to us to save our lives. What exactly is the downside? We are one species living on one planet, all facing the same diseases. Remember, we're still going to race hard with our own biotech industry — MORE gov't R&D, MORE culture of innovation, MORE company creation and investment, with appropriate tariffs to reciprocate any restrictions China (or others) place on US goods. We should be embracing innovation from all corners, while fortifying our own industries at the same time. Yin and yang. If we don't, we're going to spawn a medical tourism industry where rich Americans make it to Europe or China (or Canada?) for drugs they can't get here. We'll be stuck with inferior drugs here... and they will cost lives. We'll be the biggest losers. That's my solution. Thanks for reading! Thoughtful comments below - rude posts deleted. ---- Disclaimer: I founded @CivilizationVC, and we don't have any investments in China. I'm writing this independently because I think it is sensible policy.

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My short X essay: Enter The Dragon! 🐉 💊🩺 You have questions. I have answers. #China #biotech. 🧵1/3 Let's start with a little historical context on how China has ascended. It's a superpower that has methodically taken over key industrial categories, one by one. 1. Renewables, solar, EVs, batteries (CATL, BYD): they beat Germany (Q-Cells), US (SunPower), South Korea (LG, Samsung), Japan (Sharp, Mitsubishi, Panasonic). 👉 Tesla would never have made it without massive US loans, EV tax credits, sellable reg credits (ZEV) and would now crash in the US market w/out massive tariffs on its Chinese competitors (100%-250%)... this was never a "free market". 2. Chemicals: China went from 4% to controlling 40%, leaving Germany (BASF, Bayer), the US (Dow, Dupont) in its dust. 3. Computers, electronics, telco: I feel ancient for once owning a Nokia (Finland), an Ericsson (Sweden), and Panasonic (Japan) phones (not at the same time of course 😁). Now it's all made in China (Foxconn, Taiwan owned)... but Huawei did get banned in the US due to espionage. There is no mobile revolution in its current form without China. 4. Factory automation/robotics: China bought a controlling stake in Germany's KUKA and taken the lead over Japan and the EU in this critical sector. 5. So now (finally...) the latest conquest: #biotech. ...👇

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𝐀𝐒𝐆𝐂𝐓 𝟐𝟎𝟐𝟔: @SirenBio recently has seen two INDs cleared for its AAV based gene therapy for oncology. Founder @Nicole_Paulk discusses how they are prepared to enter the clinic shortly. Full video: biotechtv.com/post/asgct-202…
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Today, we achieved a humbling milestone at @CivilizationVC — our realized returns to investors hit $150M, meaning we have returned far more capital than we have invested to date. This milestone is doubly meaningful given the malaise that the #biotech and #health sectors are only now emerging from. How did we do it? First, we think different. While nearly all #biotech funds focus primarily on therapeutics, we go beyond and back the convergence of technologies like #AI, genetic engineering, and multi-omics insights powering new #diagnostics, software, and drugs. This contrarian strategy has supercharged our returns and 17 exits. Second, we're all about the #founders. In traditional bio investing, young first-time founders are often overlooked in favor of "seasoned" executives. We, by contrast, embrace emerging leaders—first-time founders and CEOs—who have gone on to transform industries. We provide them with everything we can to build their unfair execution advantage. It is to our founders that we give our deepest gratitude!
Made with AI
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📢 Big @CivilizationVC news 👉 We are honored to announce our partnership with one of #Japan's 🇯🇵preeminent #biopharmas, @KyowaKirin_US, through its newly established Cowellnex arm. We are especially excited about what this partnership unlocks for our #founders leading the future of #biotech, #medicine, #diagnostics, and health #AI, now with access to our growing global network! 🌏🚀 You can read more about our partnership here: kirinholdings.com/en/newsroo…
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This is exactly what we back, and why we back it. Check out our diagnostics portfolio: civilizationventures.com/
I'm lucky enough to have a great doctor and access to excellent Bay Area medical care. I've taken lots of standard screening tests over the years and have tried lots of "health tech" devices and tools. With all this said, by far the most useful preventative medical advice that I've ever received has come from unleashing coding agents on my genome, having them investigate my specific mutations, and having them recommend specific follow-on tests and treatments. Population averages are population averages, but we ourselves are not averages. For example, it turns out that I probably have a 30x(!) higher-than-average predisposition to melanoma. Fortunately, there are both specific supplements that help counteract the particular mutations I have, and of course I can significantly dial up my screening frequency. So, this is very useful to know. I don't know exactly how much the analysis cost, but probably less than $100. Sequencing my genome cost a few hundred dollars. (One often sees papers and articles claiming that models aren't very good at medical reasoning. These analyses are usually based on employing several-year-old models, which is a kind of ludicrous malpractice. It is true that you still have to carefully monitor the agents' reasoning, and they do on occasion jump to conclusions or skip steps, requiring some nudging and re-steering. But, overall, they are almost literally infinitely better for this kind of work than what one can otherwise obtain today.) There are still lots of questions about how this will diffuse and get adopted, but it seems very clear that medical practice is about to improve enormously. Exciting times!
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We’re super jazzed about this team and their mission. @CivilizationVC
10x Science has raised a $4.8 million seed round to help pharmaceutical researchers understand complex molecules. spr.ly/6013BBDOJR
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Fun fact: @CivilizationVC has put 10 drugs into human clinical trials. 🩺 Of those, 1 has already received @US_FDA approval. 🏁 🏆 ⚕️ We're here to back life-saving, life-extending 💊💉🏥
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What do you think — should the FDA have rejected this cancer drug that appeared to work (despite no control arm given it was for late stage patients)? leave comments👇 "Patients with metastatic melanoma who stop responding to other immunotherapies typically die in less than a year. In Replimune’s trial, tumors shrank in nearly all patients and vanished in one of six. About a third went into remission. FDA staff were so impressed by the results that the agency designated RP1 a “breakthrough therapy” in November 2024 to expedite its review. As we’ve reported, Dr. Prasad last summer overruled career staff to reject RP1. The agency’s main criticism was that its trial lacked a control arm, though this would be unethical in late-stage patients who failed to improve on other therapies. Oncologists around the world lambasted the FDA. Melanoma World Society president Axel Hauschild wrote to the FDA that a randomized control study “would be considered as unethical” in his home country of Germany. Drs. Makary and Prasad tried to deflect criticism by blaming the rejection on Richard Pazdur, then head of the FDA oncology center." Vinay Prasad is leaving the FDA, but he’s kicking patients with late-stage melanoma on his way out. wsj.com/opinion/replimune-me… via @WSJopinion
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