Atavistik Bio has signed an agreement with Swiss drugmaker Roche potentially worth nearly $2 billion, including milestone payments, to develop oral treatments for cardiovascular, kidney and metabolic diseases. Atavistik will receive $70 million upfront and could earn up to $1.9 billion in research, development and commercial milestones, along with royalties on sales of approved drugs. The companies will use Atavistik’s proprietary technology to identify hidden pockets on disease-causing proteins, including sites outside a protein’s main active site that regulate its function. The approach is intended to reach targets that conventional methods have struggled to address and could support more selective treatments with fewer unintended effects. Atavistik will lead early discovery and research, while Roche will conduct later laboratory and human testing, regulatory filings and commercialization. Atavistik will continue developing treatments for rare blood disorders, including hereditary hemorrhagic telangiectasia, a condition involving malformed blood vessels. The companies did not disclose how many targets are covered or provide development timelines.