Civilization VC

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

[Shahram Seyedin-Noor @ShahramSN]

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. ...👇

[Civilization VC @CivilizationVC]

@bradloncar @Nicole_Paulk @ShahramSN @SirenBio @BiotechTV what a journey!

[Shahram Seyedin-Noor @ShahramSN]

Go Niki!!

@Nicole_Paulk @SirenBio @CivilizationVC

[Shahram Seyedin-Noor @ShahramSN]

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!

[Shahram Seyedin-Noor @ShahramSN]

📢 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: https://t.co/U82PiugFos

[Civilization VC @CivilizationVC]

This is exactly what we back, and why we back it.

Check out our diagnostics portfolio: https://t.co/VmSaP2dx3W

[Shahram Seyedin-Noor @ShahramSN]

We’re super jazzed about this team and their mission. @CivilizationVC

[Shahram Seyedin-Noor @ShahramSN]

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 💊💉���

[Civilization VC @CivilizationVC]

This is exactly what we back, and why we back it.

Check out our diagnostics portfolio: https://t.co/VmSaP2dx3W

[Patrick Collison @patrickc]

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!

[Shahram Seyedin-Noor @ShahramSN]

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. https://t.co/PVjIG1m4r6 via @WSJopinion

[Shahram Seyedin-Noor @ShahramSN]

ADCs (antibody drug conjugates) are an increasingly potent weapon against #cancer. Nice interview @bradloncar.

Big win for @Tubulis_GmbH as @GileadSciences slaps down $5B.

Dominik + team @Tubulis_GmbH – herzlichen Glückwunsch dazu, dass ihr das Feld der Krebsmedizin voranbringt, und zu eurer herausragenden Akquisition! 🎉

We at @CivilizationVC have a few ADCs up our sleeves that we'll discuss in the coming months. 😇

[Shahram Seyedin-Noor @ShahramSN]

What if #autism and #Alzheimer’s are two expressions of the same underlying biology and disease of the brain across a lifetime? And treatments for one could implicate cures for the other?

The divide between developmental and neurodegenerative #brain disorders is blurring: autistic individuals have >2x higher risk of Alzheimer’s.

Why?

🧬 ~150 shared genes b/w the two conditions shaping neuronal synapses that build brain circuits early in life, and break down later.

🧠 disregulation of the brain's “cleanup system” in both, including the glymphatic + mTOR/autophagy: when waste clearance 🧹 fails 👉 proteins misfold 👉 connections degrade 👉 disease emerges

"Surprising links between autism, Alzheimer’s could change how we treat both" https://t.co/s4DoakMC5H

[Civilization VC @CivilizationVC]

@brian_armstrong 100% follow our portfolio for insights Brian!

[Civilization VC @CivilizationVC]

We are pleased to announce that our portfolio company @RocketPharma has obtained FDA approval for a gene therapy that treats a severe form of a rare immune disorder called leukocyte adhesion deficiency-I (LAD-I)!

We honor founder/CEO Dr. Gaurav Shah @gshahrocket + his incredible team on this big achievement! 🚀🧬🩸

Another step forward for the field of genetic medicines.

"For the first time in the history of our species, we are discussing not just effective treatments, but potentially total cures at the genetic level, which is the deepest essence of who we are as physical living beings.”
- Dr. Shah

[Shahram Seyedin-Noor @ShahramSN]

Today is a BIG day for @RocketPharma — and for my firm @CivilizationVC!!! An FDA approved drug. 🚀🧬

The FDA granted accelerated approval to Rocket gene therapy for the severe form of a rare immune disorder called leukocyte adhesion deficiency-I (LAD-I).

"LAD-I is caused by mutations in the ITGB2 gene and leads the immune system to stop working properly. Patients with severe disease face serious and potentially deadly bacterial and fungal infections. Currently, the only potential cure is stem cell transplant from a donor, but that bears its own serious risks.

The gene therapy involves extracting a young patient’s own blood stem cells and modifying them in the lab to introduce functional copies of the gene. Patients then receive conditioning to clear out their bone marrow, after which the modified cells are infused back in hopes of giving them a working immune system."

Congratulations to the Rocket team on this milestone!

FDA approves Rocket's gene therapy for ultra-rare immune disease - https://t.co/6eL0oLkl4p

[Shahram Seyedin-Noor @ShahramSN]

Today is a BIG day for @RocketPharma — and for my firm @CivilizationVC!!! An FDA approved drug. 🚀🧬

The FDA granted accelerated approval to Rocket gene therapy for the severe form of a rare immune disorder called leukocyte adhesion deficiency-I (LAD-I).

"LAD-I is caused by mutations in the ITGB2 gene and leads the immune system to stop working properly. Patients with severe disease face serious and potentially deadly bacterial and fungal infections. Currently, the only potential cure is stem cell transplant from a donor, but that bears its own serious risks.

The gene therapy involves extracting a young patient’s own blood stem cells and modifying them in the lab to introduce functional copies of the gene. Patients then receive conditioning to clear out their bone marrow, after which the modified cells are infused back in hopes of giving them a working immune system."

Congratulations to the Rocket team on this milestone!

FDA approves Rocket's gene therapy for ultra-rare immune disease - https://t.co/6eL0oLkl4p

[Shahram Seyedin-Noor @ShahramSN]

The best in the business strike agAIn! ⚡️

@iamjohnnyyu @genophoria @nalidoust

[Shahram Seyedin-Noor @ShahramSN]

#AI per Marc Andreessen @pmarca is just getting started.

This has ramifications for #venture in #biotech and #pharma as well (and techbio, as some call it).

Stay tuned as we @CivilizationVC have big plans... :)

[Civilization VC @CivilizationVC]

This is BIG. 🚀

[Shahram Seyedin-Noor @ShahramSN]

Honored that @CivilizationVC — the fund I founded barely 8 years ago as a solo GP in the heavily conservative #lifesciences space — has now cracked the Top Quartile as a force in #biotech!

No other firm of our size + vintage came even close.

Thanks @JohnCendpts and @endpts for the analysis.

OrbiMed jumps to number one on the top 100 list of biotech venture investors - https://t.co/JDNtOKLS7J

[Shahram Seyedin-Noor @ShahramSN]

Top 3 reasons why #founders fail in #biotech / #Health tech/ #HealthcareAI :

1. They lack FOCUS
Our successful founders are maniacal about focusing only on the things that matter.

When it comes to PRODUCT, that's even more important.

A smart founder may have an idea a minute, but s/he only pursues one goal at a time until it's achieved before moving on to the next. They state their goals and lead a team only in the direction of that goal.

2. They don't work HARD enough
Early stage founders that succeed don't spend time on yachts, in #Davos, traveling to exotic destinations "where the money is".

If you're in Silicon Valley, there's money on every corner, a new fund pops up daily.

Successful founders don't consider a financing round or good PR "the milestone", but rather a step on the path. They don't take 3 week vacations after raising money, or disappear to Europe for the holidays leaving their team in the lab.

They lead by example and are the hardest workers on their teams.

3. They are not HONEST with themselves/others
Integrity is underrated. You can't "fake it till you make it" in bio, especially since the real moment of truth in therapeutics is human data that's a decade away.

So you have to be ruthless in assessing the viability of your product and path at every turn, reading your own data in the most skeptical light possible.

Spinning data, covering up mistakes, overlooking inconvenient signs that your Dx or Rx isn't working... you're just fooling yourself.

In software, it's a bit easier since product market fit (PMF) is often staring you right in the face (or not), but even here I've seen teams delude themselves by pretending that 1 big account paying big dollars is evidence of PMF, where it in fact may only show that you've become the outsourced dev team for the client.

Bonus: if you're spinning data in healthcare/bio, not only will your company fail, but you may end up in prison on top of that.

What are your Top 3?

[Shahram Seyedin-Noor @ShahramSN]

The thing about being contrarian is that by definition you will be “proven wrong” over the short term.