A conversation with Ryan Confer, President & CEO of Genprex
What if the key to fighting cancer wasn’t attacking the disease — but restoring what the disease took from you?
That’s the premise behind Genprex, a clinical-stage gene therapy company working on one of the most counterintuitive ideas in oncology: that some cancers don’t just grow out of control — they succeed because a critical piece of the body’s own defense system goes missing. Put it back, and the body can start fighting again.
Ryan Confer, President and CEO of Genprex, joined The Human Code to walk us through the science, the entrepreneurial journey, and what it really takes to build a company at the frontier of medicine.
From Finance to the Frontier of Biotech
Ryan’s path to leading a gene therapy company wasn’t linear. He started in finance and technology — managing a $500M fund, consulting through UT Austin’s IC² Institute, and serving as VP at KaiNexus, a healthcare continuous improvement platform. He was drawn to problems that sat at the intersection of complex systems and human impact.
He co-founded Genprex in 2009, long before gene therapy became a mainstream conversation in biotech. For over a decade, he helped build the company’s scientific and business foundations before stepping into the President & CEO role in May 2024.
That background — finance, operations, tech — shapes how he thinks about building in biotech. “You have to be willing to make bets that the market doesn’t understand yet,” he says. “The science can be right and the timing can still be wrong. You have to build for both.”
The Core Idea: Restoring What Cancer Steals
Genprex’s lead program centers on a tumor suppressor gene called TUSC2.
In healthy cells, TUSC2 acts as a molecular brake — it tells damaged or cancerous cells to stop dividing and, when necessary, to self-destruct. But in cancer, that brake gets removed.
Research shows TUSC2 is depleted in 82% of non-small cell lung cancer (NSCLC) patients and 100% of small cell lung cancer (SCLC) patients. Without it, cancer cells proliferate unchecked.
Genprex’s therapy — branded REQORSA® — reintroduces functional TUSC2 directly into the tumor environment. The delivery mechanism is Oncoprex®, a lipid nanoparticle system that encapsulates the gene and delivers it systemically (intravenously, not surgically). Critically, these nanoparticles are engineered to target cancer cells at 30 times the rate of normal cells, dramatically reducing off-target effects.
Once inside the cancer cell, the restored TUSC2 gene activates multiple mechanisms simultaneously: triggering apoptosis (programmed cell death), reducing drug resistance, and disrupting the tumor’s ability to generate new blood vessels. It doesn’t replace chemotherapy or immunotherapy — it’s designed to work with them, making existing treatments more effective.
Clinical Results: What the Data Shows
Genprex’s Acclaim-1 clinical trial tested REQORSA® in combination with the immunotherapy drug atezolizumab in patients with advanced NSCLC who had already failed prior treatment.
The results were notable — not just for efficacy, but for tolerability. One patient achieved more than two years of stable disease, a meaningful outcome in a population where options are limited. The safety profile was favorable compared to standard chemotherapy and immunotherapy combinations, with patients maintaining quality of life throughout treatment.
The trial is informing the design of Acclaim-2, the next phase of the program, as Genprex advances toward broader clinical validation.
A Second Frontier: Reversing Diabetes at the Source
Gene therapy for lung cancer would be enough for most companies. Genprex is also pursuing one of the most ambitious programs in diabetes treatment.
Their second platform, GPX-002, targets a fundamental problem in both Type 1 and Type 2 diabetes: the loss or dysfunction of beta cells, which produce insulin. Rather than replacing insulin externally (the standard approach), GPX-002 attempts to create new insulin-producing cells from within the body.
The mechanism: GPX-002 converts alpha cells — which are abundant in the pancreas and normally produce glucagon — into beta-like cells that produce insulin. The therapy is delivered endoscopically (through a scope procedure, not surgery), directly into the pancreatic duct.
The program was licensed from the University of Pittsburgh, where the foundational research was developed. Genprex plans to spin it out into a dedicated subsidiary, allowing it to be developed and funded independently from the oncology programs.
If it works, it would represent a fundamentally different approach to diabetes — not managing a chronic condition, but addressing the cellular deficiency at its root.
What Entrepreneurs Can Learn from Biotech
Building in biotech is a masterclass in long-term thinking, and Ryan’s experience offers a few lessons that apply well beyond the life sciences.
Strategic pivots aren’t failures — they’re data. Genprex has evolved its clinical strategy multiple times. Early trials tested REQORSA® as a standalone therapy. Later work moved to combination approaches. Each pivot wasn’t a retreat — it was the scientific process working as designed. Ryan frames these shifts as business decisions backed by evidence, not admissions of defeat.
Find your foundational partner early. One of Genprex’s most important assets is its long-standing collaboration with MD Anderson Cancer Center and Dr. Jack Roth, one of the world’s foremost thoracic surgeons. That relationship didn’t just provide scientific credibility — it shaped the entire research direction. “Having the right scientific foundation changes everything,” Ryan says. “It’s not just about the IP. It’s about the people who believe in the work early.”
Parallel programs create resilience. Running a lung cancer program and a diabetes program simultaneously is not inefficiency — it’s strategic diversification. If one program hits a regulatory or clinical obstacle, the company has another platform advancing. For investors and for patients, that optionality matters.
Move before the market agrees with you. Gene therapy for lung cancer wasn’t on most investors’ radars when Genprex was founded. The science came first. The market is catching up. “If you wait for consensus, you’re too late,” Ryan says. “The companies that matter are the ones that moved when the idea still looked crazy.”
The Bottom Line
What Genprex is doing sits at the edge of what medicine can currently accomplish — and what it might be able to do in the next decade. The idea that the body already contains the tools to fight cancer, and that the right therapy can simply restore those tools, is both elegant and radical.
Ryan Confer’s journey from finance to the frontier of gene therapy reflects something The Human Code explores in every conversation: that the most important breakthroughs often come from people willing to work in the space between disciplines, between certainty and possibility, between what’s proven and what’s next.
This episode of The Human Code is available on YouTube and all major podcast platforms.
