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On a sunny September day in 2023, scientists at CRISPR Therapeutics invited me to peer through their microscopes. Through the lens were liver cells, part of the company’s work to gear up for a clinical trial using CRISPR to permanently reduce cholesterol. And that was just a start, CEO Samarth Kulkarni told me. Recent research was pointing the way to another 10 targets in heart disease, promising to save millions of lives with a one-time treatment.

A decade ago, when CRISPR’s gene-editing technology had just been invented, it would have been hard to imagine a biotech executive talking casually about tinkering with DNA to help prevent a common condition — particularly one that can largely be treated with existing drugs, many of them cheap generics.

But in the years since, there had been an explosion of new startups and money had poured in. Gene editing seemed ready to usher in a new era of medicine, and inside the company’s glistening new seven-story headquarters, Kulkarni talked about his plan to “build the next great Genentech.” Seventy years after cracking the genetic...