when they can and should take on something their own, when they can partner, when they can bring other people in. They recognize the cycles the industry has, and when things are good, they may not be good forever. You take the money sometimes when it’s on the table, for example—this IPO market may not continue forever.
X: What are the biggest red flags in a biotech?
ES: The real X-factor sometimes, the real key ingredient, the must-have, is the quality of the leadership, the quality of the people. It’s sometimes a hard thing to assess fully, but it’s a big red flag if you’re really not sure of how you come down on that.
X: What’s the biggest adjustment you’ve had to make so far?
ES: I had to learn how to deal with an iPhone. I bought an iMac and an iPhone, I already had an iPad, now I’m all Apple integrated (laughs). And I’m actually happy to do a lot of things myself so I have a better idea of what’s going on. But seriously, you have to learn that sometimes an infrastructure and a big organization is a crutch, and this is an opportunity to be without it. I’m enjoying that. And I have the luxury of the pace to enjoy that. And I’m at home a bit, I kind of have to get used to that.
X: What type of science now interests you the most?
ES: This whole field of immuno-oncology, and allowing your own body’s immune system to fight, and in some cases eradicate, the invading tumor, is the beginning of a major, major wave of change in what we consider possible cures for cancer, new thresholds for new treatments, and new avenues for therapeutics. Dementia—perhaps Alzheimer’s in particular—it’s such a societal burden. And even though there have been failures in what we will look back [on as] the early attempts, I think the new science is still so exciting. And it might be at the interface of academic groups with small companies where there might be some breakthroughs—I’m following that area. Another area I think is going to be ripe for a lot of activity is in congestive heart failure, which is probably the new cancer. People don’t realize that 50 percent of patients with congestive heart failure die within five years. We’re making progress on the right side of that in cancer, but we’ve not budged that number in heart failure. And there are more and more molecular insights into how we might approach that.
X: What about technologies?
ES: Gene therapy is back, and it will have certain select applications. Stem cell technology is going to be ripe in the coming years. I think there’ll be advances in how to deliver antibodies. They may have multiple targets rather than a single target, and it may be possible to deliver antibodies and other biologics orally, instead of injecting them. These are some of the areas that I’ve scouted out that I might become more closely associated with. Can’t do them all though.
X: What science might pay off further down the road?
ES: I wouldn’t want to say it’s hype, but this new technology of gene editing which goes under the acronym of CRISPR is very, very interesting. We’re also achieving some cures [for cancer] by modifying the T cell for an individual, and then putting that in a patient with illnesses. Both of these areas are extremely exciting, but they’re at the early stage. So I think we have to have reasonable expectations, and a long-term view.
X: What are some of the regrets you have over your time at Bristol?
ES: The one failure that I really felt I had at Bristol was in the area of neuroscience, which has been very, very hard for many companies. Many companies have withdrawn. I would’ve liked to make more strides in the area of retarding the progression of dementia. I think that’s a big issue. It wasn’t for a lack of trying. We had a lot of in-licensing opportunities and a very active in-house program. We had some failed Phase II studies and we decided not to [take them] into Phase III. Bristol has a wonderful program in hepatitis C. It wasn’t even named when I was in medical school, now they are curing that disease. We had a number one position at one point, but we fell back to a number two position because an acquisition we made [Inhibitex] did not go well. But we also had some advances in immuno-oncology that went better than ever expected, and Bristol has become the lead company in [that] area. So everything has balanced net positive.
X: And looking back, some of the most significant challenges you faced as an R&D chief?
ES: I think when people get done with this career, the hardest thing they say to themselves is, did I put this right person in that role? Picking the right person for the right role, or [not] funding something that had higher risk at the time than I felt I could take, yet eventually it worked out. The last thing I did was to make sure we had a good successorship. R&D leaders often stay too long, and don’t often plan enough for succession. I hope people look back and say that I got those two right.
