Earlier this month, the ELRIG Drug Discovery USA 2026 conference was steeped in scientific discussion about new biotech targets, such as therapies that use molecular glues or aim at malfunctioning proteins. For clinical laboratory professionals sitting afar, a reasonable assumption is that eventually, these novel therapies will require companion diagnostics to be successful.
Who will help standardize these assays as they move closer to hospital and community labs? The answer is not clear, although to one veteran observer, it may fall to biotech and pharmaceutical firms.
“That is a challenge that it is becoming real because these targets are now approaching late-stage development into the clinic, going from the preclinical to clinical,” Swarna Balasubramanian, PhD, told Dark Daily at ELRIG Drug Discovery USA, which took place in Cambridge, MA. She is director of business development for search and evaluation of respiratory and immunology at AstraZeneca.
“If companies are leaders in a specific area—like AstraZeneca is a leader in respiratory—they would have to take that challenge on,” Balasubramanian added. “Sometimes we might bring a partner along who may have capabilities in different indications … or an academic partner. If pharma doesn’t do it, you're never going to have a disease modifying drug.”
Molecular glue and protein-based assays show promise
Much of the discussion during the ELRIG Drug Discovery USA event centered on the ability to “drug the undruggable”—in other words, finding ways to target elusive problems that contribute to diseases.
Molecular glues are one such technology. Tim Wigle, PhD, vice president of lead discovery at TRIANA Biomedicines, noted during a session that molecular glue can get rid of disease targets by “gluing” them to a cell's natural disposal system. TRIANA focuses on cancer therapies.
“New therapies are always needed … and chemotherapy is the last option for those patients, so we wondered, can you [introduce] a molecular-glued degradator?” Wigle said.
In another session, Daniela Crespi, PhD, scientific research manager at Axxam, agreed with Wigle’s view that biotech and pharma have a strong need for new therapies.
Crespi talked about using TDP-43-based assays to fight amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. In most ALS cases, normal TDP-43 proteins malfunction, leading to toxic buildup.
How companion diagnostics fits into the discussion
Much of what Crespi and Wigle focused on had a precision medicine flavor to it. Balasubramanian said many biotech companies have noted the success of precision medicine in oncology.
“Everyone is aspiring to be that because they realize that one drug is not going to work across a disease,” she explained. “A disease can be so heterogeneous and so multifaceted that there is a subset of the patients where a drug is really working well, and for others it's not. So, rather than, just having one drug thrown at many people, we need have it more targeted.”
For clinical laboratory professionals, these early-stage biotech advancements represent the next wave of complex testing. As molecular glues and protein-targeting therapies advance through clinical trials, the medical community will increasingly rely on clinical labs to perform the companion diagnostics required to identify eligible patients.
However, transitioning these specialized assays from pharma to hospital and community laboratories remains a bottleneck. Lab leaders and others should monitor these emerging drug pipelines, as standardization of such novel assays will ultimately determine the success of precision medicine outside of academic medical centers.
