How Lineage Cell Therapeutics Is Advancing Regenerative Medicine Through Cell Replacement

Vision Gains in Dry AMD

Dry AMD has long been considered irreversible. “It is referred to in the textbooks as being an irreversible disease because you only get worse with time,” Brian explained. Patients progressively lose RPE cells, and the damage is permanent.

The data reported by Roche and Genentech this past June with the investigational allogeneic cell therapy challenges that assumption. “After a single surgical procedure which takes about 30 minutes of transplanting the cells to the back of the eye, we were able to increase vision in a handful of patients. And that increase in vision has lasted out now to three years. And that’s unprecedented in this disease.”

The results showed not only functional improvements but also structural restoration. “The anatomical structure of the eye was improved, and again, that persisted for three years,” Brian said. He acknowledged the sample size is small, but stressed that spontaneous recovery is unheard of in this disease. With four independent groups — led by Roche and Genentech and Lineage — reporting vision gains, evidence for the approach is building.

Expanding Beyond Ophthalmology

Encouraged by its success in ophthalmology, Lineage has extended its replace-and-restore model into other conditions where cell loss drives disability.

In spinal cord injury, the aim is to replace cells destroyed by trauma. “These are individuals that suffer accidents, typically car accidents or maybe sports or biking accidents. And when the spinal cord is damaged, you no longer have the ability to use your muscles. And so, quadriplegia can occur following a spinal cord injury,” Brian said. The company hopes functional cell replacement could restore mobility.

In audiology, Lineage is manufacturing auditory neurons. “This is the second line of cells in your ear after the hair cells that are picking up the vibrations, those hair cells hand off vibrations. So, the auditory neuron, which passes it ultimately into the brain so that you can make sense of the sounds that you’re hearing,” he explained. Losing these neurons leads to hearing impairment, and replacing them could preserve or improve hearing.

The company recently secured $12 million in funding for its hearing loss program and announced plans to expand into diabetes. “It’s already been shown if you can transplant islet cells to someone who has severe diabetes, that that can be curative,” Brian said.

Where Breakthroughs Are Likely Next

Looking at the next five years, Brian sees regenerative medicine poised for breakthroughs in several areas. Dry AMD remains the most advanced opportunity, but he notes diabetes and Parkinson’s are also compelling areas where proof of concept has been established.

In Parkinson’s disease, he explained, “They’re using dopaminergic neurons. So you’ve got the one area of the brain in Parkinson’s, it’s called the substantia nigra [a brain region that helps control movement], where a certain number of these cells die off. If you can manufacture them in the lab and deliver them to that location, you may be able to essentially reverse that condition or at least halt its progression.”

Lineage is also exploring other opportunities, which currently remain undisclosed for competitive reasons, but Brian suggested that a handful of attractive conditions could soon demonstrate results that surpass traditional small molecules or antibodies.

“I think what we are basically going to see is an explosion in this area, it’s a new branch of medicine. I think we’re going to see an explosion in the cell transplantation, in the replace and restore approach.”

Lessons in Leadership and Long-Term Vision

As a leader, balancing scientific ambition with financial reality is the sobering sentiment Brian reflected on.

“At the end of the day, no matter how great your ideas are, you really can only do what there’s funding available for,” he said. Even the best ideas, he added, will not advance without capital. Early successes are important to keep programs moving and to maintain investor confidence.

Looking five years ahead, Brian hopes Lineage can leverage momentum from its retina program to accelerate other initiatives. “If we’re still an independent company five years out, I would really hope that we would have somewhere in the neighborhood of 10 or 12 really excellent ideas, all based on our platform technology, moving into, toward or through clinical testing.”

The company’s long-term vision is to refine therapies that replace the specific cells lost in disease, rather than relying on generic stem cells.

Cell replacement therapies are beginning to show results once thought impossible, from vision restoration in dry AMD to early signals in neurology, hearing loss and metabolic disease. For Brian, the focus is not just on one therapy, but on building a platform capable of consistent, scalable cell replacement across conditions.

This interview reflects on Lineage’s efforts to address manufacturing hurdles and durability in patients, situating these advances within the broader progress of regenerative medicine.