The Many Lives of Alexandria Forbes

Pictured: Alexandria Forbes/Getty Images, modified by Nicole Bean for BioSpace

One of the most memorable events of Alexandria Forbes’ life is being four years old and incubating a clutch of lizard eggs in her kitchen. A naturally inquisitive child, Forbes found the eggs outside and kept them in a paper cup until they hatched.

“I’ve always had this very strong curiosity and acute observation of life, and that probably underlies my interest in biology as opposed to physics or engineering,” Forbes said.

The MeiraGTx CEO was born in the West Indies and quickly developed a love for exploring the region’s beaches and gardens. What began as a penchant for observation would eventually lead Forbes to found the clinical-stage gene therapy company in 2015.

This year, Forbes was named to Forbes Media’s 50 Over 50 class in the innovation category, and she said she was delighted to be recognized both as a woman scientist and as someone who didn’t have a “standard” career path.

“I had a very successful academic career, but then I did something else, and then I had a very successful financial career, but then I did something else,” Forbes said.

Leading a biotechnology company was not something Forbes anticipated.

While attending school in the United Kingdom, Forbes excelled in every subject, including science. Despite this, she didn’t plan on pursuing the sciences until her teachers encouraged her to take science A-levels. Forbes took A-levels in biology and chemistry instead of English and history as she’d originally planned, and later matriculated to the natural sciences program at the University of Cambridge. At that time, the human genome had not been sequenced yet.

“I decided in my last year [of undergrad] that the thing I wanted to do was understand the way cells work,” Forbes said.

Deciding what to do after graduation was a different story. England’s financial industry was booming in the late 1980s, and Forbes considered becoming a trader before ultimately deciding to pursue a PhD in molecular genetics at the University of Oxford, where she researched signaling pathways in fruit flies. Her doctoral training would later come into play when she began working with MeiraGTx, particularly when it came to developing the technology the company would be built on.

After stints at Duke University, the Carnegie Institute at Johns Hopkins University and the Skirball Institute of Biomolecular Medicine at NYU Langone Medical Center, Forbes shifted from research to finance in 2000 when a former Cambridge colleague encouraged her to take an interview as a buy-side analyst. She worked as a healthcare investor at Sivik Global Healthcare from 2000 to 2008 and Meadowvale Asset Management from 2008 to 2013. She eventually became senior vice president of commercial operations at Kadmon Holdings, Inc., which provided some of the necessary resources to launch MeiraGTx.

While working in investment, Forbes managed a biotech fund, and she said she learned more about drug development from this experience than she would have learned working at a pharmaceutical company that focused on a handful of drugs. It also gave her a “real understanding of risk and reward” for biotech companies, she said.

“You never forget why you were wrong. And that decade, I was wrong many, many times,” Forbes said.

Through this work, Forbes saw an opportunity to finance a company in the growing gene therapy arena, and she founded MeiraGTx in 2015 with “a vision of building a unique, end-to-end, vertically integrated approach to gene therapy,” she wrote in an email to BioSpace. The company went public in 2018, a choice guided by Forbes’ and co-founder Richard Giroux’s familiarity with public investors. MeiraGTx’s initial clinical programs were selected because they already had human proof-of-concept; the company develops treatments for diseases of the salivary gland, eyes and central nervous system. It also decided to focus on localized gene therapy delivery to minimize safety and manufacturing issues.

MeiraGTx therapies rely on adeno-associated viruses, which can carry genetic material, and riboswitches, which regulate gene expression. The latter technology was invented by the company.

“One of the things I learned during my PhD is that when you want a really sharp signal or a really sharp on/off, you tend not to get that by trying to switch something on,” Forbes said of riboswitches. “What we did is repress the repression of something, and in life, particularly in developmental biology, that’s how it works.”

MeiraGTx also built its own manufacturing facility, and then a second in 2021 that also functions as a quality control facility.

This planning made the company’s later ventures possible. Having manufacturing in-house allowed MeiraGTx to partner with Janssen for clinical development, Forbes said, which has led to Phase III studies and the opportunity to file Biologic License Applications for the company’s products. Working with other companies has also allowed MeiraGTx to refine how it approaches Investigational New Drug applications and other aspects of the regulatory process, Forbes said.

“I learn every day doing this job, right?” Forbes said. “How to deal with people, how to deal with failure, how to deal with success, all of those things—every day I learn to do something new, and maybe that’s why I’ve done three different careers. Because I like learning new things.”

Nadia Bey is a freelance writer from North Carolina. She can be reached at beynadiaa@gmail.com.