🧠 Rethinking Brain Disease: Cuong Do on Inflammation, Innovation & the Future of Neurodegeneration

🎙️ Guest: Cuong Do, CEO of BioVie

“Imagine a world where an Alzheimer’s diagnosis isn’t a life sentence.” — Cuong Do

👋 Episode Overview

In this episode, Brandon speaks with Cuong Do, CEO of BioVie, to explore the intersection of infalmmation and neurodegenerative diseases. Drawing from his remarkable journey from Vietnam to McKinsey to biotech entrepreneuriship, Do shares insights on drug development, clinical trials, and the future of CNS therapeutics.

🧭 Top Takeaways

✅ Inflammation may be the common root cause across CNS diseases. TNF-α–driven inflammation links Alzheimer’s, Parkinson’s, and Long COVID — and bezisterim directly blocks TNF-α at the right place and time.

✅ Crossing the blood–brain barrier is the real unlock. Unlike large antibodies (e.g., amyloid drugs), bezisterim crosses into the CNS almost 1:1 with plasma — a potential game-changer.

✅ Objective, rapid endpoints make Parkinson’s and Long COVID efficient to study. Muscle control (Parkinson’s) and cognitive fatigue (Long COVID) change faster and more measurably than Alzheimer’s cognition metrics.

✅ Biotech is facing its worst funding market in modern history. If early-stage companies die now, mid-stage innovation will not exist 3–5 years from today.

✅ Success should be a bigger part of how we talk about innovation. Cuong argues we focus too much on downside risk and not enough on what the world could look like if new drugs work.

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🔑 Key Topics Covered

Guest Background

• Left Vietnam at age nine; developed an early passion for immunology through self-study.
• Began conducting medical research at age 14 after a professor mentored him.
• Dartmouth alum with degrees in biochemistry & economics; completed an MBA; accepted to Stanford Med before pivoting to consulting.
• Spent 17 years at McKinsey as a senior partner, helping build the healthcare, high-tech, and corporate-finance practices.
• Held major executive roles at Lenovo, Tyco Electronics, Merck, and Samsung’s Global Strategy Group.
• Serial biotech founder & early investor, including a successful Pompe disease drug acquisition.
• Joined BioVie after helping structure the acquisition of its CNS asset.

The Problem He’s Solving

• Inflammation as a root cause: Chronic TNF-α–driven inflammation links Alzheimer’s, Parkinson’s, and Long COVID by triggering insulin resistance, amyloid production, and neuronal dysfunction.
• Limitations of current Alzheimer’s therapies: Antibody approaches have difficulty crossing the BBB, require extensive monitoring, and address downstream pathology rather than underlying inflammatory drivers.
• Challenges in trial endpoints: Cognition fluctuates significantly day-to-day, making Alzheimer’s studies long, expensive, and highly variable.

Innovation & Contributions

• Advanced bezisterim, a small-molecule TNF-α inhibitor that freely crosses the blood–brain barrier and blocks inflammation at its source.
• Identified bezisterim’s CNS potential after early data showed reversal of insulin resistance and strong upstream activity on inflammatory pathways.
• Positioned bezisterim as a candidate for Alzheimer’s, Parkinson’s, and Long COVID based on shared inflammatory mechanisms.
• Designed BioV’s clinical strategy around indications with faster, objective endpoints (Parkinson’s and Long COVID) while pausing Alzheimer’s trials until funding improves.
• Advocates for trial designs that minimize variability, use quantifiable metrics, and improve translation across CNS diseases.

Challenges & Barriers

• The biotech funding crisis: Cuong describes 2024–2025 as the “worst funding environment” he has seen — LP pullbacks, VC paralysis, and investor refusal to engage without Phase II data.
• Pipeline risk: If early-stage biotechs die now, the industry will face severe mid-stage innovation shortages in 3–5 years.
• Scientific inertia: Amyloid has dominated NIH and academic funding for decades — making alternative mechanisms, like inflammation, harder to resource.

Vision for the Future

• Upstream inflammatory targets will redefine the next era of CNS drug development, shifting focus earlier in the disease process.
• Small-molecule CNS drugs could make treatment more accessible by reducing reliance on infusions, imaging, and high-burden monitoring.
• Improved endpoint design in diseases like Parkinson’s and Long COVID will accelerate proof-of-concept.
• A neuroscience renaissance is emerging thanks to new regulatory precedents and improved BBB-crossing technologies.
• A reimagined world: Alzheimer’s no longer a life sentence; Parkinson’s no longer a path to inevitable motor decline; Long COVID patients restored to daily function.

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💬 Speaker Spotlights

On leadership:

“Surround yourself with people smarter than you are — then get out of their way.”

On startup reality:

“Every biotech takes twice as much money and three times as long as you think.”

On inflammation:

“One molecule — TNF-α — links Alzheimer’s, Parkinson’s, and Long COVID.”

On the amyloid era:

“The field mistook correlation for causation. Amyloid became a monster that steamrolled everything.”

On biotech funding:

“If early biotechs die now, you won’t have mid-stage biotechs in three years.”

On success:

“We don’t ask enough: what does success look like? Imagine Alzheimer’s not being a life sentence.”

💡 Keep Exploring

🎧 Listen to the full episode on:
👉 Spotify
👉 Apple Podcasts

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