Former CEO, Vir Biotechnology
Interview: Kosmas Zakynthinos
« The advances in basic science, medicine, and data sciences, including machine learning and artificial intelligence, have been incredible over the last 10 years. And I think the advances we’ve seen so far will seem small by comparison with what we will see over the next decade. If we give adequate support to academic scientists and have a reasonable regulatory environment for companies, we can expect to see treatments for all of the diseases that currently affect us. »
Dr. Scangos since you recently stated that: “Having the opportunity to bring life-saving medications to patients around the world has been the greatest privilege of my career” While looking back in your career, could you please share with us the most important milestones you can recall?
There have been many important milestones –playing a role in a leading drug for kidney and other cancers at Exelixis and new treatments for Multiple Sclerosis at Biogen. Two events stand out for me. First was the development of Spinraza at Biogen. It is a drug that can slow or stop the neuromuscular degeneration in a disease called Spinal Muscular Atrophy. The most severe form of this disease affects babies. The babies are apparently normal at birth but symptoms first become apparent at just a few months of age and most do not survive beyond 2 years. It is a tragic situation for the affected families. Spinraza can slow, stop, and in some cases reverse the progression of the disease. Being able to help families in such a desperate situation certainly was one of the highlights of my career.
The second highlight is the development of sotrovimab for treatment of Covid-19 at Vir. As a new, small company we discovered the antibody in January of 2020 and together with our partner GSK, it was authorized in May of 2021 –a period of 15 months. Over 2 million doses of sotrovimab have been distributed in over 40 countries around the world. In the clinical trial, sotrovimab reduced the rate of hospitalization and death by 80%, so it likely has saved the lives of many people around the world.
Besides the numerous success stories during all those years, there might have also been disappointments and undesirable scientific deliverables. Can you describe any stories that didn’t go far?
There are so many. Making medicines is hard and most projects fail along the way. Human biology is complicated. Drugs are designed to change that biology in a specific way to treat a disease. Sometimes our incomplete understanding of the biology means that the molecule we are testing does not have the effect that we had hoped. Sometimes, even if it has that effect, it may also have other undesirable effects. It is good when the limitations of a prospective medicine are identified early in the process. However, sometimes they are identified late in the process, thereby wasting 10s or hundreds of millions of dollars and of course resulting in disappointment for patients and for people working on that project. The biggest disappointment in my career was the failure of a drug that we were testing for ALS, a devastating neurological disease. The data from a phase 2 trial were encouraging but the definitive phase 3 study was completely negative – not even a hint of a benefit to patients. Making drugs to treat devastating diseases is emotional, and when we learned of the failure, there were 30 people sitting around a table with tears in their eyes.
Your contribution is much appreciated by the industry worldwide by recognizing you as a veteran biotech executive who has run multiple publicly-traded companies while having contributed establishing two start-ups. Being still an active member of this community how do see biotech’s evolution in the upcoming years?
This question makes me wish that I were 30 years younger. The advances in basic science, medicine, and data sciences, including machine learning and artificial intelligence, have been incredible over the last 10 years. And I think the advances we’ve seen so far will seem small by comparison with what we will see over the next decade. If we give adequate support to academic scientists and have a reasonable regulatory environment for companies, we can expect to see treatments for all of the diseases that currently affect us. We’re already seeing the beginning of that in the new treatments for Alzheimer’s disease. Other neurological diseases, genetic diseases, diseases like diabetes and cardiac disease, all will have effective treatments and preventatives. Gene therapy and crispr will lead to the correction of genetic defects. And AI and machine learning will help bring the right drugs to the right patients.
By your leadership since 2017, Vir company ambitiously covered a significant therapeutic category range. What are the company’s goals targeting for 2023 and what can we expect regarding the new pipeline regulatory approvals and distribution?
2023 is an exciting year for Vir. One Vir program is designed to provide better protection from flu than is provided by the available vaccines. This program is currently being tested in over 3,000 people. Once this flu season is over, we will compare the incidence and severity of flu in people who were treated with the antibody to people who received a placebo. We will have those data in early summer.
We also have an interesting phase 2 trial targeting a cure for hepatitis B. We will have data from this trial later this year. Hepatitis B is a major disease that affects over 300 million people around the world and greatly increases the risk of liver failure and liver cancer. A cure for this disease would be a major public health achievement and we are eagerly awaiting the results of this trial.
A third clinical program is targeted at hepatitis delta, which is the most severe form of hepatitis. Again, we will have data later this year.
If any of these trials are positive, we will move into larger phase 3 trials, and if those are positive we will work with regulatory agencies to make the drugs available to patients. The phase 3 and regulatory processes take time, so availability of any of these potential medicines is some years away still.
Regarding the Covid-19 pandemic which are the lessons we learned and what has changed both in the scientific and corporate fields?
The first thing we learned is that we were not prepared for a pandemic like this one, even though we thought we were. Now governments have recognized that we need to be better prepared and are taking steps to promote the research and development of drugs and vaccines that may help to prevent or at least to lessen the severity of future pandemics. Vaccines can now be developed faster and it is possible to make and stockpile drugs that can treat future pandemics. We know that the next pandemic is likely to be caused by one of a few types of viruses –Viruses like Covid, like flu, like Zika and a few others. Drugs and vaccines that are effective against these viral families has a good chance of being useful in future pandemics.
The second thing we learned is that effective cooperation between drug developers and regulatory agencies can shave years off of drug development times without an impact on patient safety. Some of these lessons can be applied going forward.
The third thing that I learned is that scientists all over the world –in companies and universities– selflessly gave up what they were doing to bring forward medicines and vaccines that saved millions of lives. This is a shining moment for science and for companies.
During your recent web conference with the Greek prime minster, recognized Greek diaspora members as well as top biotechnology managers that presented survey results regarding the creation of an innovative biotechnology ecosystem in Greece. Do you think this is a viable project in a reasonable timeline?
Greece has some of what it takes to have a meaningful biotechnology industry –it has a tradition of scientific thought and a lot of excellent scientists. Still, it does not have any academic centers of excellence that are globally competitive and generate scientific results that can form the basis for the foundation of innovative biotech companies. This can be fostered, but it will require significant reforms as well as time. So the development of biotechnology in Greece will have to be done thoughtfully. A good way to start is with process development and manufacturing of biological products such as antibodies and proteins. This capability requires a modest investment in infrastructure, a site with access to clean water, experienced people, a low cost-base, and a suitable package of tax incentives. Greece has or can easily develop all of those capabilities. Right now, there is a world-wide shortage of manufacturing capacity so if Greece can move quickly, it can play a meaningful role in this aspect of biotechnology. From there it will be easier to branch out into other areas.
By your experience what are the obstacles that make it difficult for foreign investment to come to our country and how could this change?
The primary reason why there is not more foreign investment is that there is very little foreign investment. By that I mean that Greece is new territory for biotechnology without an experience base to demonstrate its capabilities. Greece has to compete internationally with countries that have long experience and where there is less perceived risk in investing. So Greece has to make clear its advantages and capabilities. Manufacturing is a cost-sensitive aspect of biotechnology. Manufacturing costs are dependent upon the cost of the facilities and the salaries of the people working in those facilities. Greece may have an advantage there. Having one or two experienced operators who are willing to help get something off the ground in Greece also will help. But Greece first has to show that it is willing to commit to reforms that will create a business-friendly environment.
You are of Greek descent, on your father’s side, growing up in the Greek neighbourhood of Lynn, Massachusetts. Do you have active relations with our country?
I am of Greek descent on both my father’s side and my mother’s side. Both families came to the US. I used to have close relatives in Athens but they have unfortunately passed away, so I no longer have close relatives in Greece. We do have a house on Skyros where we spend time in the summer, of course I attend the Biotechnologia conference organized by Stelios Papadopoulos and Spyros Artavanis, and usually have one or two other reasons to visit, so I am often in Greece. I have been working on improving my Greek since I have the vocabulary of a 5 year old and it is slowly improving, but unfortunately not yet good enough to write this in Greek.
Do you believe that if you started over, based in Greece, you would enjoy the same career development?
That is a difficult question to answer. Since we all are products of our genes and our environment, any major change in environment would inevitably have an impact on my career. There are some things that would be the same. The curiosity, the view that the establishment does not always have the right answers, the confidence to pursue a career in a risky environment, all were imparted by my parents who lived in the US but heavily Greek in their view of the world. So in some sense I may have been born into very lucky circumstances –born in an entrepreneurial country with virtually unlimited potential, but heavily influenced by Greek culture that shaped my thinking and my view of the world.
At this year’s Prix Galien Greece, you are about to receive the prize of “Outstanding Greek Leader” of the global pharmaceutical industry, recognizing your leadership skills and personality. What does this distinction mean to you?
This award is deeply meaningful to me. To be recognized as an outstanding leader and to be included with the previous group of awardees is an incredible honor. I love Greece, the people, the culture, so this award has special meaning for me. I am very happy to be here and thank you so much for the award. As with all of us, there are certain people who have had a major impact on my career and I also want to thank Stelios Papadopoulos for introducing me to biotechnology in the first place and for his friendship and counsel over the years, and Spyros Artavanis whose friendship and advice has been a treasure for me.