Ep 98: The Future of Alzheimer's Trials: Bringing Cutting-Edge Research to Every Community - John Dwyer, CEO of The Global Alzheimer's Platform

The quest to speed up clinical trials is personal for John Dwyer, CEO of the Global Alzheimer's Platform (GAP). A long-time UsA2 advocate, he’s been motivated by the generations of family members lost to Alzheimer's and Parkinson's disease. Dwyer shares with BrainStorm host Meryl Comer the critical challenges of NIH funding cuts by the Trump Administration, forcing many trial sites to shut down at a time of new FDA-cleared blood tests for early diagnosis.  Dwyer highlights GAP's innovations in improving the participant experience through streamlining visits, personalized feedback, and bringing mobile trials directly to small communities. This must listen episode reinforces clinical trial participation as a valuable care option while advancing research for millions affected by Alzheimer's and related dementias. 

This episode of BrainStorm is sponsored by Johnson & Johnson

Transcript

John Dwyer (00:01):

We can give back to patients a better understanding of their condition, whether they continue in the research trial or not. We can give them genuine insights into where their cognitive condition is on a real scale, healthy, normal, mild cognitive impairment, mild ad symptoms, or moderate ad symptoms. We can also give them blood test results now that we have clear tests and tell them what those results mean. 

Introduction (01:10):

Welcome to BrainStorm by UsAgainstAlzheimer's, a patient center nonprofit organization. Your host, Meryl Comer, is a co-founder 24 year caregiver and Emmy award-winning journalist and the author of the New York Times bestseller, slow Dancing With a Stranger.

Meryl Comer (01:27):

This is Sand I'm Meryl Comer. Our guest today is John Dwyer, CEO of GAP, The Global Alzheimer's Platform. For transparency, John is also a board member and a co-founder of us against Alzheimer's, which makes us colleagues for well more than a decade, so welcome John.

John Dwyer (01:47):

Thank you, Meryl. Great to see you today.

Meryl Comer (01:50):

John, let's level set. What personal experiences fuel your advocacy?

John Dwyer (01:55):

As you know, Meryl, Alzheimer's and increasingly neurological diseases near to the Alzheimer's category have really been the bane of my family's existence. My grandmother died of Alzheimer's. My father died of Alzheimer's. Six of his 11 siblings died of Alzheimer's or Parkinson's. In one case, we're not sure we're a neurological at risk family of some order of magnitude, and since I finished my career as a venture backed healthcare entrepreneur, this was my last endeavor to start a company and be part of a company that could really ideally make a big change in the trajectory of finding therapies for Alzheimer's and related dementias.

Meryl Comer (02:40):

John, when GAP was launched in 2015, the NIH was preeminent as the largest funder of biomedical research globally. What challenges were you addressing to solve in the us?

John Dwyer (02:54):

Well, the National Institute of Health and National Institute on Aging still remained two of the largest funders and pure research endeavors in the world, unparalleled in the world for many elements of research. One thing that plagued us and why we all met to discuss what else could be done to accelerate the discovery of therapies for Alzheimer's disease and related dementias was the speed at which trials were being conducted and the high failure rate of Alzheimer's clinical trials. We all met to discuss, and it was 10 years ago, the issues that might be addressed by a more nimble, small but focused endeavor. What can we do to re-engineer Alzheimer's clinical trials to realize better outcomes, shorter duration, and by virtue of that discoveries at lower cost.

Meryl Comer (03:49):

John, what's the current state of Alzheimer's clinical trials in the US versus globally? How are the two intertwined and impacted by the NIH funding cuts now reported over 40% for 2026?

John Dwyer (04:04):

I'll take the last part of that first. The fuel of discovery is early stage in the lab research, graduating from the bench to Main Street where we conduct trials with real people in real life situations to determine whether they're safe and effective. The delay in funding the NIA research, the NIH more broadly, really truncates what can be done in early stage research. It has a ripple effect that is measured in many years, not just one year 'cause of the way research works, and I personally fear that the most disadvantaged by current government policy are the new young creative researchers who are going to be the early recipients of smaller grants, more risky grants for them to go in directions that we haven't gone before. Right now, that is the biggest fallout from current government policy is that we're putting, whatever money we are putting out is going out in big chunks to support important, no doubt about it, but well worn research endeavors and not a lot of new high risk research is being funded. Most of what we are working in trials on right now are studies being undertaken by biotech and large pharma companies, many of which are well-known names, Lilly, Roche, Biogen, aci, Lubeck. These are not unknown to anyone who understands pharmaceuticals. Those are some of the biggest companies in the world, and as a consequence, they are really increasing their portfolio of neurology studies, really pushing hard on Alzheimer's disease.

Meryl Comer (05:48):

John, to what extent do the delays or reductions in the NIH funding impact those individuals who are currently in these clinical trials,

John Dwyer (05:58):

Clinical trials being funded by the NIA and there are a number, some of them are just going to be discontinued. That is the blunt truth. There are several very specialized genetic subgroups that are in trials that have been going on for a decade or more that unless the last round of funding refunded them, they were stopped. They had lost their funding, and these are people that are absolutely going to get a form of Alzheimer's by virtue of their genetic makeup that the study of which not only can curtail their own personal risk, but also shed important light on the etiology and progression of the disease in people that don't have purely genetic driven Alzheimer's. That's what that funding delay does in the short term with very material adverse consequences.

Meryl Comer (06:49):

Joan, listening to you, what message does this send to those people who are currently in these trials for either very personal health or altruistic reasons?

John Dwyer (07:01):

I take that very important insight you just raised and then trumpet by saying there are 185 clinical trials in.gov that Jeff Cummings wrote about that are trying to get underway. Some of those are NIA funded. Most of them are not. They are exploring very important underlying agents and theories of what can treat Alzheimer's and related dementias. Not all of them are focused on the amyloid cascade, and there are so many of them, Meryl, that we're supposed to start this year that did not start this year. I'm a big proponent of look what we can control. Look what we can advance. Let's advance as much of it as we can because there are robust questions that can be answered to advance the health and welfare of people with Alzheimer's disease.

Meryl Comer (07:54):

John, inclusion and diversity remain a persistent challenge in clinical trial recruitment. What have been the most effective strategies? GAP is used to bring underrepresented groups into the research.

John Dwyer (08:08):

One of our hallmarks is bringing old fashioned common sense to a field that is endowed with great genius and complication, and the common sense approach we've taken is people of all walks of life. It's not just race and ethnicity want access to cutting edge research. They just don't want to travel a hundred, 200 miles to get to it. We have made a very intentional and strategic decision to make sure that we either open sites in communities that were not previously getting access to research and standing up already existing clinical presences so that they can be qualified to conduct that research in places where people are poor. In places where people have medical deserts that they reside in places where they're predominantly black, where they're predominantly Latino or Asian. In all its multiplicity of forms and not routinely and aggressively recruited into clinical trials. It's all about bringing the research to them over the years, especially in the current environment.

John Dwyer (09:12):

Question has been how important is this kind of endeavor to make sure we're getting a broader cross section of the American population in trials? Well, we know that the African American community writ large is two times more likely to actually demonstrate signs and symptoms equivalent to Alzheimer's disease. The Latino community 1.5 times more likely than European descent people in demonstrating signs and symptoms consistent with Alzheimer's disease, so our goal is let's get closer to a representative cross section of the country so we know that the drugs are being accessed by those folks and that the final results reflect results that will be applicable to all folks. We've been very successful.

Meryl Comer (09:59):

John, we're trying to make up for a lot of history with regard to recruitment for clinical trials in these populations. In fairness, do you think the public in general understands the distinction between research and treatment?

John Dwyer (10:15):

I think it's a great question. I don't think the distinction is well understood. I think that to your earlier point, all of us certainly gap all field is doing more to enhance the actual experience in clinical research so that it is more a care option as compared to a treatment and learning about your condition. Understanding your risk factor along with all the things you can do to mitigate the disease without a therapy are usually part of the research process. It's a really important question to ask if you're a family trying to assess your options to look to research as a potential option.

Meryl Comer (10:58):

John Alzheimer's clinical trials have a reputation of being lengthy and complex. How do you make trial participation easier and more rewarding for volunteers?

John Dwyer (11:09):

We can give back to patients a better understanding of their condition, whether they continue in the research trial or not. We can give them genuine insights into where their cognitive condition is on a real scale, healthy, normal, mild cognitive impairment, mild ad symptoms or moderate ad symptoms. We can also give them blood test results now that we have clear tests and tell them what those results mean. If you go under the test cut off, you do not have amyloid consistent with Alzheimer's disease in adequate concentration to be a concerned person at this time for getting Alzheimer's disease that's fresh off the FDA clearance list. We didn't have that even five years ago, anything like that. We also have a whole trophy case now of clinical blood plasma tests that will allow me to say to people, not me personally, but my organization, here's where you are in the journey with your underlying proteins associated with Alzheimer's. Doesn't mean you have Alzheimer's just means you're at higher risk because you have a concentration of some of these proteins or you don't, or you have a elevated test for neurodegenerative disease more broadly, but you don't have Alzheimer's disease, and we can do that with minimally invasive process called a blood draw and give back that information to patients as they go through the research process and say, now you have a much better handle on where you are.

Meryl Comer (12:41):

John. Candidly, the notion of sharing that level of personalized information back with the research participants has not been the traditional norm and is relatively new.

John Dwyer (12:53):

It is with that level of granularity and the genuine picture we can draw for where they stand both cognitively and from a progression of proteins related to Alzheimer's. That's all very new.

Meryl Comer (13:06):

How much does GAP rely on the feedback from trial participants in the design of future studies or support services?

John Dwyer (13:14):

There are a lot of things from my own family experience and from all the many patients we've interacted with about what they want to avoid or what they want more of out of the clinical trial and the clinical therapy that we're trying to prove, but it all boils down to more time. This is my personal view. I wanna remember my children's names, the way I remembered my children's names or my grandchildren's names five years ago. Give me more time to be like I was back then. I wanna be able to drive my car or remember my password. Those are all important lifestyle questions, but if I can just help the pharma community and biotech and my organization dedicates itself to doing this, to bring therapies forward that are going to buy more time for people and away from the progression of the disease, it lifts all boats.

John Dwyer (14:06):

Now the other part of that question though, we listen a lot to our participants about what do you mean you're going to gimme five cognitive tests? No one cognitively normal impaired can take a battery of five cognitive tests over a couple hour period and give quality answers and have a quality experience being challenged and probed that way from the neck up over that duration of time. We don't do that. We pride ourselves and really encourage sponsors to make more visits if necessary, of shorter duration. 'cause You just see such a degradation in performance if you try to get it all done in one or two visits. Similarly, our personal best is 40 minutes for a screener. Imagine that even a doc in a doc office can't get them in. Take the history, get the meds, take a cognitive test, do a blood draw, and give next step advice in 40 minutes. But that's our best model. John,

Meryl Comer (15:04):

What I also hear you saying is that CAP is working to manage and mitigate the angst of people about cognitive testing. In general, our care partners screened for their willingness and ability to support the patient through a lengthy research project.

John Dwyer (15:22):

The burden of someone taking off work or just leaving their daily routine to allow their loved one to participate in trials is another thing we really worry about. Well, on our way to planning things that address caregiver needs, like giving them a respite environment, while we're busy with the participant, we really understand what the rest of the journey is. We don't always do it as well as we'd like, but we're always striving to hit balance that advances the dyads needs as much as our own.

Meryl Comer (15:54):

Our guest has been John Dwyer, CEO of Gap, the global Alzheimer's platform. In part two of our conversation, we talk about the research challenges when studying asymptomatic populations and the promise of ai.

John Dwyer (16:10):

We are striving to create relatively pristine, helpful data sets that will allow you to train AI on the true elements of early MCI or mild ad that might be detected with greater sensitivity and specificity by ai.

Meryl Comer (16:27):

The bottom line is that clinical trials are essential for developing new treatments for Alzheimer's, dementia and other brain disorders. By participating, you may access cutting edge treatments early while helping create breakthroughs for millions of others. Us against Alzheimer's Brain Guide clinical trial connector makes it easy to find studies in your area. Take the first step and find a clinical trial near you@mybrainguide.org. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.

Closing (17:04):

Support for BrainStorm by UsAgainstAlzheimer's comes from Johnson & Johnson. Johnson & Johnson is committed to creating a healthier future for patients where complex diseases are prevented, treated and cured. Subscribe to BrainStorm through your favorite podcast platform and join us for new episodes on the first and third Tuesday of every month.