Welcome to Partnology’s Biotech Leader Spotlight Series, where we highlight the remarkable accomplishments and visionary leadership of biotech industry pioneers. This series is about showcasing the groundbreaking strides made by exceptional leaders who have transformed scientific possibilities into tangible realities. Through insightful interviews, we invite you to join us in following the inspiring journeys of these executives who continue to shape the landscape of the biotech industry. This week we are recognizing:
Jian Zuo is Co-founder and CEO of Ting Therapeutics, a biotech startup developing therapeutics to prevent and treat hearing loss. Previously, Jian Zuo was Professor and Chair of Biomedical Sciences at Creighton University’s School of Medicine from 2018 to 2023. He received his Bachelor’s degree in Bioengineering from Huazhong University of Science and Technology, China (1985); and a PhD in Physiology from the University of California at San Francisco (1993). He joined the faculty at the Department of Developmental Neurobiology at St. Jude Children’s Research Hospital in 1998 until 2018. His primary research interests included mouse genetics and mouse models that illustrate mechanisms of hair cell regeneration to restore hearing, and screening small molecule compounds to preserve or restore hearing in preclinical models. He has been a member of the ARO since 1998 and has received the Bellucci Prize in Hearing Research in 2004. In 2023, he chose to leave academia to become the full-time CEO of Ting Therapeutics located in San Diego, CA.
When we last spoke in 2024, Ting was still building the foundation for its pipeline. What have been the biggest scientific and company-building milestones since then, and where does Ting stand today?’
Since 2024, we have taken several important steps to de-risk our lead program and advance it toward a Phase 1b clinical trial. One of the key developments has been creating a specialized extended-release formulation of our oral drug. This formulation allows for once-daily dosing rather than requiring patients to take multiple doses throughout the day, making it much more convenient. It also helps reduce the peak-related toxicities associated with the original drug, which we believe represents a significant improvement.
Second, and perhaps most importantly, we have identified the lowest effective dose of our drug for our new indication, cisplatin-induced hearing loss. Through preclinical studies, we determined that just one-tenth of the FDA-approved anticancer dose provides the most effective hearing protection. This significantly improves the safety margin compared to the original drug when used for cancer treatment.
These developments have laid the foundation for advancing our program through IND-enabling activities and into Phase 1b clinical trials.
In addition, we licensed our patent rights in China to a Chinese company that successfully raised funding to support the program’s development. Our partner has since completed the IND-enabling studies, received regulatory approval from China’s National Medical Products Administration (NMPA) to initiate clinical trials, and manufactured the drug product under current Good Manufacturing Practice (cGMP) standards.
Most recently, our partner also received Institutional Review Board (IRB) approval from the hospital that will conduct the Phase 1b clinical trial. With these milestones achieved, everything is now in place to move forward with the trial.
We are able to advance directly into Phase 1b because we are repurposing an existing drug with an extensively modified formulation and a significantly lower effective dose. This approach has helped accelerate our development timeline and transition into clinical testing. Looking back over the past two years, these have been the major milestones that have positioned our lead program for its next stage of clinical development.
Ting is increasingly focused on preventing hearing loss caused by cisplatin chemotherapy. What led you to prioritize this indication, and what do you believe differentiates Ting’s approach from other efforts in otoprotection?
Hearing loss is a complex condition, but it also represents a significant market opportunity. There are multiple therapeutic approaches being explored to address different forms of hearing loss.
In fact, at BIO 2026, we organized a special event called Invest in Hearing, which brought together a variety of stakeholders, including biotech startups, corporate investors, venture capital firms, and patient advocacy groups. One of the key takeaways was that we have seen significant advances in gene therapy for genetic forms of deafness in recent years. However, applying gene therapy across the many different causes of congenital deafness remains challenging.
More importantly, acquired hearing loss is far more prevalent than congenital genetic deafness. For example, age-related hearing loss affects more than half of individuals over the age of 70, while noise-induced hearing loss impacts a broad range of populations, including military personnel, musicians, construction workers, and airport employees, among others.
Despite the size of these markets, developing therapeutics for acquired hearing loss has been extremely challenging. One reason is the significant biological and genetic heterogeneity of these conditions. There are also substantial ethical and practical challenges associated with designing clinical trials.
For example, how do you ethically establish a placebo-controlled study for noise-induced hearing loss? You cannot intentionally expose individuals to harmful noise levels in a professional setting simply to evaluate a treatment. That creates significant challenges for clinical trial design.
Age-related hearing loss presents another challenge because it develops gradually over many years. Demonstrating that a therapeutic intervention can prevent or slow its progression could require an extremely long clinical trial, potentially spanning decades. That timeline is simply not practical for most pharmaceutical companies.
For these reasons, we believe cisplatin-induced hearing loss represents a much more manageable and compelling entry point into the hearing loss therapeutics market.
Globally, approximately one million cancer patients receive cisplatin chemotherapy each year, representing a substantial patient population. More importantly, we know precisely when patients will receive cisplatin, the timeframe in which hearing loss is likely to develop following treatment, and how different cisplatin doses correlate with the severity and type of hearing loss.
These well-defined parameters make it possible to design more targeted and efficient clinical trials. We believe this makes cisplatin-induced hearing loss one of the most accessible opportunities for developing and demonstrating the effectiveness of hearing loss therapeutics.
Another important advantage is that our lead drug candidate has demonstrated efficacy at a very low dose, significantly below the dose used for its original anticancer indication. This gives us confidence in its potential to provide hearing protection while minimizing the toxicity concerns associated with higher doses. Based on our preclinical findings, we believe our drug has the potential to be a best-in-class therapy for this indication.
Our long-term vision, however, extends well beyond cisplatin-induced hearing loss. Once we successfully establish the safety and efficacy of our drug in this initial indication, we believe there will be opportunities to expand into additional patient populations and indications, including pediatric patients, noise-induced hearing loss, age-related hearing loss, and potentially other forms of acquired hearing loss.
In fact, we have already generated and published preclinical data demonstrating the effectiveness of our drug in protecting against noise-induced hearing loss. This provides additional support for its potential application beyond cisplatin ototoxicity.
Ultimately, our strategy is to use cisplatin-induced hearing loss as our initial entry point into the market, where the clinical development pathway is more clearly defined and the unmet medical need is significant. From there, we hope to expand into broader indications that affect a much larger population.
We believe this approach gives us a practical path toward bringing our first therapeutic to patients while laying the foundation to address the much broader unmet need in hearing loss treatment.
One of the interesting things about Ting is your strategy of identifying and repurposing molecules that already have established clinical histories. How does that change the traditional drug-development equation in terms of risk, timelines, cost, and ultimately the path to patients?
This is really the foundation of our overall strategy, as I alluded to in my previous answers. Our approach is to systematically screen existing drugs to identify, in an unbiased way, those that can protect healthy, wild-type cells against cisplatin-induced cell death.
Through this screening process, we have identified a significant number of promising drugs, biological pathways, and therapeutic targets. From there, we prioritize the strongest candidates and pathways that we believe have the greatest potential for successful clinical development.
For example, one of the pathways we identified is the well-established EGFR signaling pathway, including downstream components such as RAS and ERK. These pathways have been extensively studied in cancer biology, and numerous drugs targeting them have already received FDA approval for cancer treatment.
What we discovered is that many of these drugs have well-characterized safety profiles from their use in oncology. More importantly, our research has demonstrated that several of these drugs can be effective for hearing protection at significantly lower doses than those required for their original anticancer indications.
We believe this is one of the key advantages of our drug repurposing strategy. Rather than developing entirely new molecules from scratch, we can leverage existing drugs with established clinical histories and reformulate them at lower doses with extended-release properties.
Our lead program followed exactly this approach. We developed a new extended-release formulation and identified an effective dose approximately one-tenth of the FDA-approved anticancer dose. These modifications have helped streamline the regulatory development process and support our IND application.
For example, when we submitted our IND-enabling data to China’s National Medical Products Administration (NMPA), including chemistry, manufacturing, and controls (CMC) information and toxicology studies, the regulatory agency did not raise any significant concerns. As a result, we were able to move through the IND review and approval process much more efficiently than we initially anticipated.
One of the major benefits of repurposing an existing drug is that we can build upon its established safety and toxicology data rather than starting entirely from scratch. By demonstrating that our proposed therapeutic dose is substantially lower than the approved anticancer dose, and that the extended-release formulation produces a lower overall systemic exposure, or area under the curve (AUC), in our preclinical models, we can provide additional evidence supporting the safety of our approach.
This can potentially reduce the need for certain additional toxicology studies, depending on the formulation and regulatory requirements, and significantly accelerate the IND-enabling process.
Another advantage is manufacturing. Because we are working with established small-molecule drugs and conventional solid oral tablet formulations, the cGMP manufacturing process is relatively straightforward compared with developing an entirely new therapeutic platform. This allows us to shorten manufacturing timelines and move more efficiently toward clinical trials.
Similarly, having an established safety profile and a well-defined clinical development plan has helped facilitate the Institutional Review Board (IRB) approval process at our clinical trial site.
Ultimately, all of these advantages stem from the same fundamental concept: identifying existing drugs that demonstrate protective effects at substantially lower doses than those used for their original indications, and optimizing their formulations to improve convenience and potentially reduce toxicity.
This approach allows us to leverage years of existing drug development and clinical experience while pursuing entirely new therapeutic applications. It is also why our regulatory development process has progressed much faster than I originally expected.
As you prepare to move the lead program into the clinic, what are the key questions you hope the first clinical study will answer, and what would you consider a meaningful early proof of concept?
This is an important consideration in the design of our Phase 1b clinical trial. We have strategically selected specific cancer patient populations that tend to be younger, where cisplatin-induced hearing loss can have a particularly significant impact on quality of life.
For example, patients with head and neck cancer or testicular cancer are generally younger than patients with certain other cancers, such as lung cancer. Because these patients may have many years of life ahead of them, preserving their hearing can be especially meaningful. We believe this provides a strong incentive for patients to participate in a clinical trial focused on hearing protection.
Another important factor is that the natural history of cisplatin-induced hearing loss in these patient populations has been extensively studied. We have a good understanding of the standard cisplatin treatment regimens, the doses patients typically receive, and the types and severity of hearing loss that can develop without a protective intervention.
This existing clinical knowledge provides a valuable foundation for our trial design. By introducing our once-daily oral drug alongside standard cisplatin chemotherapy, we can evaluate whether patients experience less hearing loss than would otherwise be expected.
Because this is the first clinical trial of our new extended-release, low-dose formulation, our primary objectives in Phase 1b are to demonstrate its safety and characterize its pharmacokinetic (PK) properties in patients. These are the two most important endpoints at this stage of development.
However, we have also designed the study to explore preliminary evidence of efficacy. The trial will enroll approximately 46 patients, including 38 patients receiving our investigational drug across four escalating dose levels and approximately eight patients in a placebo control group.
By incorporating this placebo-controlled component, we hope to gain an early indication of whether our drug can provide meaningful protection against cisplatin-induced hearing loss.
Of course, a Phase 1b study of this size is not intended to establish definitive efficacy or provide sufficient evidence for regulatory approval. However, if we observe encouraging signs of hearing protection, those findings would provide valuable support for advancing into larger clinical trials.
Ultimately, we hope to achieve three key outcomes from this Phase 1b study: establish the safety of our new formulation, understand its pharmacokinetic profile in patients, and generate preliminary evidence of hearing protection.
Together, these results would represent an important milestone in validating our therapeutic approach and guiding the next phase of clinical development.
Hearing loss is a large market, but it’s still an emerging category from an investor perspective. When you’re talking to investors today, what part of the Ting story resonates most—and where do you still find yourself having to educate the market?
I think one of the biggest challenges is that although hearing loss represents a significant unmet medical need and a potentially enormous market, as I mentioned earlier, it has historically received relatively little attention from investors.
I believe there are several reasons for this, including some longstanding misconceptions about hearing loss and its treatment.
The first is the perception that hearing loss has already been adequately addressed through hearing aids and cochlear implants. Because these technologies exist, some investors assume that the problem has largely been solved and that there is limited opportunity for new therapeutics. I strongly disagree with that perspective.
For example, the recent advances in gene therapy for genetic forms of deafness, including Regeneron’s work in this area, demonstrate that there is tremendous potential for innovative therapeutics to restore or preserve hearing. These developments reinforce the idea that hearing loss remains an important area for medical innovation.
Another challenge is that some people view hearing loss primarily as a lifestyle issue rather than a medical condition that requires therapeutic intervention. I wouldn’t necessarily call this a misconception, but rather a difference in perspective. It can be difficult to change those deeply held beliefs, particularly among investors who have not traditionally focused on this therapeutic area.
Beyond these perceptions, the hearing loss therapeutics field has also faced significant scientific and clinical setbacks. Over the past 12 to 20 years, numerous clinical trials have failed, and in many cases, we still don’t fully understand why.
Those failures could be attributed to several factors, including the efficacy of the drug itself, inappropriate patient selection, challenges in clinical trial design, or limitations in the preclinical animal models used to predict clinical outcomes.
Collectively, these setbacks have dampened investor enthusiasm and created skepticism about the feasibility of developing successful hearing loss therapeutics. I believe this is one of the primary reasons why attracting investment to the field has been so challenging.
Recognizing these barriers, I made the strategic decision to reposition our lead program around cisplatin-induced hearing loss as part of supportive cancer care.
By focusing on the prevention of chemotherapy-induced hearing loss, we can position our therapeutic approach within the broader oncology market, where investors are already familiar with the significant unmet needs associated with cancer treatment and its side effects.
This allows us to engage a broader pool of potential investors, including those who may not have previously considered investing in hearing loss therapeutics but recognize the value of improving outcomes and quality of life for cancer patients.
Since making this strategic pivot over the past six months to a year, we have seen increased investor interest, which I believe validates the direction we are taking.
That said, we have not yet secured all the funding necessary to fully support our clinical development plans. Fundraising remains a challenge, but I believe positioning our program within supportive oncology care gives us a stronger foundation for attracting investment and ultimately advancing our therapeutic approach into the clinic.
If Ting is successful with its first program, how do you envision the company five years from now? Is the larger opportunity to build a pipeline across different causes of hearing loss, or could Ting’s approach ultimately extend beyond hearing into other cisplatin-related toxicities?
As I mentioned earlier, our long-term vision is to expand beyond cisplatin-induced hearing loss into additional indications, including pediatric patients undergoing chemotherapy, noise-induced hearing loss, and potentially age-related hearing loss.
We also see opportunities to address other chemotherapy-related toxicities. For example, our lead compound has demonstrated the ability to reduce cisplatin-induced acute kidney injury by up to 70% in preclinical studies. This suggests that our approach could have broader applications in protecting patients from the harmful side effects of cancer treatment.
I’m particularly excited about the potential in age-related hearing loss. Hearing loss is increasingly recognized as an early indicator of age-related decline, and there is growing interest from major technology companies, healthcare organizations, and pharmaceutical companies in the relationship between hearing health and healthy aging. If we can demonstrate that our drug effectively prevents or reduces hearing loss, we believe there may be opportunities to explore its application to other age-related conditions.
These opportunities represent substantial markets, and we hope to attract investors and strategic partners focused on supportive cancer care, age-related diseases, and healthy aging.
However, our immediate priority is to establish clinical proof of concept in cisplatin-induced hearing loss. I often describe our strategy as starting with the lowest-hanging fruit. By demonstrating success in an indication with a clearly defined patient population and a more manageable clinical development pathway, we can build the foundation to pursue broader applications and ultimately benefit a much larger patient population.
