From Oncology To Biotech and Drug Development: Courage, Patients, And Progress | Dr. Satya (Nanu) Das

What happens when the humanity of oncology collides with the creative engine of biotech? We sit down with Dr. Satya (Nanu) Das, a former gastrointestinal oncologist who left a thriving academic career to build the next generation of cancer therapies. He walks us through his turning points:  carrying patients’ stories home, confronting the limits of “approved” treatments, and realizing that trial design (who gets included, what’s measured, and how fast signals are found) can change lives at scale.

We define biotech, from large biopharma to smaller startups, and how clinicians fit into two powerful tracks: clinical development, where protocols are designed and drugs move from first-in-human to pivotal studies; and medical affairs, where data becomes real-world practice through education and access. Dr. Das shares why oncology is inherently experimental, how phase boundaries are blurring, and why targeting biology instead of tumor labels opens doors for rare and understudied cancers. The conversation also gets personal: the emotional calculus of reconciling individual disappointment with collective success, and the courage it takes to “bet on yourself” when outcomes aren’t guaranteed.

If you’ve wondered whether a move from clinic to industry means leaving patients behind, you’ll hear a different story: one where debate beats hierarchy, evidence beats eminence, and collaboration is the default. We compare the instant gratification of patient care with the slower, high-stakes creativity of drug development, explore policy’s role in FDA consistency, and highlight how patient narratives can keep standards focused on what truly matters. 

Subscribe, share with a colleague who’s biotech-curious, and leave a review! If you are a practicing clinician, a pre-health, pre-med, pre-pa or pre-nursing student, or someone who is interested in how our drugs are made, you'll want to give this a listen. 

Transcript

Welcome And Show Purpose

Ashley Love 0:00

Hello, and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor, and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face, and what drives them in their careers. It's access you want and stories you need. Whether you're a pre-health student or simply curious about the healthcare field, I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations. So make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped. And follow us on Instagram and Facebook at Shadow Me Next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests. What happens when you discover your passion for medicine expands beyond the exam room? In this episode, I sit down with Dr. Sasia Doss, a former medical oncologist who made a courageous pivot into drug development. We talk about carrying patients with you long after clinic ends, the tension between individual loss and collective progress, and what it means to follow curiosity even when the path forward is unclear. He defines the biotech industry and he explains how courage, creativity, and a patient-centered focus is still possible, even when you step outside traditional clinical roles. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer, or company. This is Shadow Me Next with Dr. Satya Doss. Thank you so much for joining us today on Shadow Me Next. I am thrilled to have this conversation with you, primarily because it is something that I know very, very little about. So you are a former academic medical oncologist, turned drug developer. And really, before we dive into what both of those roles mean, think back a number of years. Is this something you would have predicted? This shift, something that you would have predicted when you first entered medicine?

Dr. Satya (Nanu) Das 2:40

You know, the funny thing is, um no, but yes. And what I mean by that is I think what led me to medicine was I was always fascinated by the mechanism of drugs. I think, you know, I distinctly remember as a young kid, um I had a grandfather who passed away from myelodysplasia. Um, and this was 2530, 35 years ago or so. And so at that time, there really weren't many treatments outside of uh erythropoietin and uh blood transfusion. So he'd constantly be getting poked and prodded. And uh I remember almost like a map-like bruise, you know, on his arm or extremity. And I think even as a kid, I was like, I'm gonna come up with a medicine that could maybe take care of that map because I knew it was associated with discomfort. So there's kind of breadcrumbs throughout my career of what's led me down that path, but certainly not a linear one by any stretch.

Life As A GI Oncologist

Ashley Love 3:33

You know, it's it's a really interesting story and it's a it's a fun thing to reflect on. I think as children, um we see these things. Children are very aware. And I like, for example, I remember seeing Vidaligo for the very first time when I was a child and thinking, as a kid, wow, what a what a beautiful pattern on her skin, right? Of course, it's very artistic to me. Um, and then not really realizing that there was quote unquote people thought there was something wrong with her skin. To me, it was just it was beautiful. And and in your case, you associated the pattern on your grandfather's skin with pain because, like you said, it was due to numerous sticks and pokes and things that kids really um are averse to. So it's so interesting, you know, the way we're exposed to medicine as children and and what becomes of that ultimately. Let's talk about your career as a medical oncologist. Um, I believe your specialty was gastroenterology, is that correct?

Dr. Satya (Nanu) Das 4:25

That's right. Yeah, gastrointestinal cancer. Yeah.

Ashley Love 4:28

Really difficult things that you had to um to walk patients through. Describe what that looked like. What was the day in your life as uh as a medical oncologist?

Dr. Satya (Nanu) Das 4:36

Yeah, absolutely. So I was fortunate to be um, I was at Van Devil when I was uh in clinical medicine. And so it's a big research institution. And so that was one of the things that led me to medicine was that I could be part of um both the bedside experience, but also be part of the experience of trying to bring new new treatments to patients. Um, as you know, GI cancers, particularly pancreatic cancer, stomach cancer, bile duct cancer, these were some of the cancers that I focused on. Still, we haven't made much progress. And so uh unfortunately, there's a dire need. And so for me, it kind of fit um like a hand in glove because naturally doing GI cancer meant that I would have to be involved in experimental treatments. And so for me, my I would say maybe my week was split between um clinical care and clinical research. And so I would do about two days of full clinic with patients. Um I'd see maybe 20 to 25 patients on those two days. Um, these are patients that are new patients coming in that were referrals. Um, sometimes as you build up a reputation, people actually come from all over, which is which is so humbling for people to truly make an odyssey to come see you to get advice. Um, and then also some of my returning patients who were diagnosed in the area, and I was fortunate to encounter them early on in their journey. Um, and then the other three days was actually spending on clinical research. So I was um early phase trialist, so I was writing early phase trials. Um, I worked with the National Cancer Institute quite a bit. And um the National Cancer Institute still to this day is kind of this amazing place where pharma companies can also deposit new drugs and you can kind of create new combinations through the National Cancer Institute. Um, and that is the bug uh that got me actually in fellowship to stay in academia during my medical oncology career. So those other three days, I'd be either working on trial work um or doing other types of research. And I think that's maybe also an important point to raise is that research doesn't come in one flavor, right? I think um everybody, at least in medicine, wants to do trials. Um and that's don't get me wrong, that's uh probably the highest level of evidence, and that's a very uh admirable goal to do. But there's also so many different types of research that you can do with things that have been published. So what I found myself doing too was taking literature that already had been published and answering important questions, doing systematic reviews of drugs that had already been approved in the last three to five years to see that, hey, are they really making a difference in the field? So um, in that research time, I also taught. Um, I worked with fellows, I worked with med students, I worked with residents. Um, and so it wasn't as much classroom teaching, but they would shadow me actually in the clinic or have uh come to me as a research advisor and we'd have some projects. So um that was a little bit of an overview of what I did in that past life.

Where Experimental Medicine Lives

Ashley Love 7:32

Oh, what an incredible overview. Thank you so much for describing that. There's a couple of things that I want to circle back to. Um the first thing you said that just by nature, GI cancer means you'd be involved in experimental treatments, right? Are there other areas? So let's say somebody hears this and they think, oh my gosh, that that sounds so interesting. Um, I'm not sure. GI is right for me. Are there other areas of medicine that that are similar where if you are involved in this medicine, you can almost guarantee that you're going to have to be looking at some type of experimental drugs or experimental um uh treatment modalities?

Dr. Satya (Nanu) Das 8:06

Absolutely. I'll say this. I mean, I'll say this with a little bit of bias because as an oncologist, oncology by definition is experimental, right? I think I think this is such an amazing time to go into the field because I really think we're at the cusp of a number of breakthroughs that are really gonna change the paradigm and maybe actually change quality and quantity of life for patients. But I think oncology, just by definition, is inherently all trial-based because our standards of care, to be very frank, have been very modest and meager. And so we're always trying to pitch the envelope. So oncology is one, but I will say there are so many other disciplines too, um, in especially as drug development. I think oncology, and I would say cardiology have kind of bidden the poster child's. Um, you know, certainly cardiology with a lot of the um diabetes and obesity medications, there's been a renaissance in drug development there. But I see that there are other disciplines too, like psychiatry, for example, where there hadn't been new drugs invented in the last 30 or 40 years that efforts are going into. So I think you can actually pursue drug development in any path of medicine. But I will say that certain disciplines, perhaps like oncology and cardiology, are a little bit more inherent. Um, because one, in oncology, we need to improve the standards of care. And in cardiology, uh, cardiovascular disease touches such a broad swath of patients that you can conduct these massive studies to try to improve long-term outcomes.

Patients Shaping Research Questions

Ashley Love 9:29

Oh, it's so interesting to me. Thank you for breaking that down. You know, it's it's like you mentioned, um, research doesn't just come in one flavor. Well, obviously, there are so many different flavors of medicine as well. And within each of those specialties, too, you can really diversify it pretty strongly. Another thing you mentioned that I love so much is this dual relationship that you had in practice with clinic and with research, right? Which I counsel students on this a lot when it comes to choosing their specialty. But I'm speaking of it more clinic and surgery, um, because that's my background, is is uh my background is clinic and then um most micrographic dermatology surgery. And um, and I love it, you know, I love it because I can form these relationships with my patients and speaking with them and evaluating them, but then I can also really address the bottom line, and that's removing skin cancer with my supervising physician and doing things with my hands, which is just a whole nother um way to provide patient care. I would love to break down this relationship that you have, which is just a little different with clinic and with research. And I think I want to start it with how does how did your relationships with your patients, which I think is something you feel very strongly about, um, how did that inform your research?

Trial Phases And Patient Altruism

Dr. Satya (Nanu) Das 10:48

Yeah, I think the it raises the urgency, right? I think you're constantly confronted by uh, you know, I think as all physicians, but particularly oncologists, um, we carry a lot of ghosts with us of people, um, of loved ones that we've encountered. Uh, these are patients that become family right over time because you see them week in and week out over the course of their journeys. And you're always confronted by the fact that um most likely at some point you're gonna have to break bad news to this person, even in the midst of joy and them doing well. And so I think the urgency for me was every day I was in clinic, I was confronted by that because I would encounter a situation that either didn't fall within the existing therapy. So there's a lot of gray. I think um it's fascinating when you go through medicine and you're in medical school, you think everything is black and white. Yet actually, as you become a seasoned physician or uh more seasoned in in life in any healthcare profession, it's all gray, right? And I think I began to realize as I saw more and more patients that how many patients fell into the gray, that they didn't fall cleanly into this setting or that. And, you know, maybe there's a drug for pancreatic cancer, maybe there's a drug for colon cancer, but the small bowel, which kind of sits in between them, no one studied that, right? And but I've had numbers of patients with small bowel cancer. So that kind of raised the light bulb that, you know what, we need to also look at rare tumors and understudied diseases and perhaps look at commonalities. Maybe it's not so much, and this is certainly something that we are approaching in drug development today. Maybe it's not so much about the cancer as it is about the target, right? Because if you have a target that's expressed across multiple cancers, then you can get them by targeting that particular receptor. And you don't have to worry about, hey, shoot, um, this this patient didn't have a cancer type that didn't quite fit in the trial. They have a target which would thereby make them eligible. So that was one piece. Um, I think the other thing was just the fact that uh what I was constantly confronted by was even these so-called wins and FDA-proof therapies that we had, um, not that patients didn't benefit, but it's always too short, right? I think, you know, when we're looking at these Kaplan Meyer plots of survival and we say, wow, you know, five year survival has been extended to 30% from 5%, right? That's that's great, but that's not enough time, right? And I think when you're on the patient side, you're always confronted by the other side. Um, and and in fact, you know, one of the pieces um that that it is is that I had worked on was a small piece called The Other Side of the Waterfall, right? And it was actually highlighting a case of a patient who's actually on a very promising treatment, a treatment that was actually ended up being approved, was considered a game changer, but they didn't benefit from the treatment, right? And so how do you reconcile individual disappointment with collective success, right? And so these were questions that I think constantly fueled my research efforts because that kind of created the bug for me to continue to push to think that you know we have to do better, we have to look more broadly at cancer as a whole rather than individual diseases, um, and a lot of led a little bit to my pivot down the road.

Ashley Love 14:13

How do you reconcile individual disappointment with collective success? I mean, it it's it's the weight of being in your role, and it's a really miserable burden to bear, I would imagine, at some point. But but how motivating. And, you know, thank you for describing the fact that as clinicians, first of all, but also as a researcher, you do carry the weight of these patients and their diagnoses and their deaths deeply, you know, and I think that uh it is one of the gifts that we have being human in medicine is the fact that we do feel those things. And that is what is going to make us irreplaceable um by robots in the future.

Dr. Satya (Nanu) Das 14:55

Definitely empathy, empathy. Um, but I think it's also how do we protect ourselves too, right? From our humanity, and how do we not lose that humanity? Or, you know, I'm sure you can attest to this, those cases that stick with you that you're bringing home. And um, and for me, it was it was a it was a toll, and and you know, in many ways, this path allows me to be invested, but maybe one step removed as well. So um, because you're right, it's uh you can't just turn on and off, and and nor should you, right? That's that's kind of part of the burden that that you carry. Um and I would just say one other thing too about patients participating in trials. I mean, at least I can speak to oncology experience, is that um patients are so altruistic and uh truly heroic, right? I mean, so many of my patients, because I did phase one, meaning first in human, our early phase.

Ashley Love 15:45

Wow.

Defining Biotech And Career Paths

Speaker 1 15:46

And so many times I remember the resonance of a patient saying, um, doc, I I know this may not help me, right? But I hope it helps someone else, right? But boy, would it be nice to have a patient benefit from an early phase study, right? And I think that's why oncology is pivoting so beautifully, is that we're now not long no longer phase one, which is phase one is traditionally just looking at safety of a drug. Phase two is where you look at effectiveness, and phase three traditionally had been where you compare against the standard of care to get it approved. But the paradigms are getting blurred in oncology. Now we know that with the diagnoses that patients carry, it's not enough just to look at safety in phase one. You got to start looking for signals. And so now phase one and two are being blended together. So um, with some of these newer approaches, um, they the goal is to benefit patients. The goal is always to benefit patients, but now I think we can say that a little bit more definitively with the way trials are going and with the way some of these new treatments are going too.

Ashley Love 16:46

And that's got to be really comforting for you as the clinician or or perhaps the the person who's conducting this trial to be able to look at the patient and say, thank you for your altruism, thank you for your selflessness and your heroics. But you know what? Let's help you too.

Dr. Satya (Nanu) Das 17:00

Yes.

Ashley Love 17:00

That's got to be so nice.

Dr. Satya (Nanu) Das 17:02

Because I've never, I've never had a patient um ever say no when I've proposed a study to them because of the therapy. So it's a it's a you have an obligation, right? You have an obligation as a clinician, and then now in biotech or in industry, we have an obligation to put the best trials forward so that when that patient who is going to be saying yes, that you know, this is something that can really um has a shot to to help them in a in a deep way.

Ashley Love 17:29

Incredible. Okay, we've dropped it a couple of times. Now it's time to really open it up and explore it. Biotech. We have said this word a couple of times now. Number one, what is that? What does that mean? And where um where can we find ourselves as as clinicians in this biotech universe?

Who Thrives In Industry

Dr. Satya (Nanu) Das 17:47

Yeah, absolutely. So biotech is is such a broad term, but really it corresponds to the biopharma or biopharmaceutical industry. And uh the discipline of biotechnology, it's usually split. This is a very simple way to look at it, but the way I think about it is that there is large biopharma, and then you have smaller biopharma. So large biopharma, oftentimes uh public companies, the companies that you see that you see many of the commercials for it, the Mercs, the Pfizers, the AstraZeneca's, uh, biotech and are typically smaller biopharma or private companies. So companies that have a concept, uh uh a drug or two that they're working on, but they haven't gone public. And so they are still remaining on a on a smaller scale. And so biotech actually constitutes that entire spectrum of both large biopharma and also small biopharma. And each of them, and I I would say I've had an opportunity to work in both, and I've kind of settled on the small biopharma side, but there are pluses and minuses to each, and it really depends on what aspect of medicine you prefer. Is it truly discovery and kind of first in human signal seeking, which may be smaller biopharma? Or is it more taking a drug that's already picked up momentum and developing it into a commercial drug that can ultimately get approval, which may be more of the path in larger biopharma? So that is a little bit about kind of the biotech industry. So when I started as an academic, gastrointestinal cancer doc, um, I didn't know how much I'd fallen in love with clinical trials. But, you know, as I told you, the reason I went into medicine was to work on new drugs, right? And I think I quickly began to realize that all of the new drugs, um, and I'm not saying this is good or bad, but so much of drug development is now industry-facing, um, all of the innovation in terms of the resources, the ability to pursue new targets and to actually come up with new therapies are coming from the biotechnology side. And so what I quickly realized was, you know, even three or four years in, into my faculty position, if I really wanted to pull the strings and develop and design the trials that I wanted that could change practice, I would probably have to do it. On the biotech side. And so at that time, I had also had a few mentors who had transitioned for clinicians going into biotech. And under I was always under the notion that listen, you have to wait, gotta do 10, 15 years in this life, and then go, right? But all my mentors who had gone and said, if this is what you really want, and clearly you're somebody who is driven by the passion to develop a drug, and you write your own studies and that that uh that motivation that you have to truly help patients come now, learn biotech biotech industry from the ground up, rise, and then you can influence it in so many different ways. So that was kind of when the light bulb clicked for me that okay, it's not something one that you can just you take on as a later career path. It's not just something that, you know, you do your time in academia, you become established, and then you go. There's no such prescribed path. I think if you have the curiosity and the and the courage to leave behind an established path, you can really go anytime. Now, I I would always recommend individuals thinking about the transition, though, to do some clinical time because you have to spend time with patients, you have to understand what are the gaps, right, in current treatments and also what are the needs, right? And you always have to bring that patient-centric lens in. So I think having a few years of patient experience is always important. But then I think considering um transitions is definitely there. Um, and then as far as what your role is in biotech, it's it's a little bit of choosing your own adventure, honestly. It's um because you come in with such a unique skill set as a clinician that as long as you're willing to learn, you can fit in in any path. So typically in biotech, there are kind of, I would say, uh two major paths that clinicians usually fall under. Um, one is clinical development. So that actually pertains to development of drugs, writing trials, um, and actually pursuing the drug from phase one to phase two to phase three. And that's that's what I'm involved in because um that's really what makes me tick. The the other piece of it is medical affairs, which is actually circulating the knowledge that your trials have gleaned. Or let's say you have a drug that got approved, then you actually engage with the community at large. How's this drug going to fit in? Uh, you actually engage with uh insurance payers to talk about why your drug is meaningful and should it be covered. So medical affairs is kind of, I would say, the dissemination of knowledge, and I would say clinical development is the creation of knowledge. And that's kind of the way that I look at them.

Courage To Pivot And Bet On Yourself

Ashley Love 22:41

I literally did not know any of that. That is so cool. Like you could probably tell by my face. I'm thrilled by this information. Um, and that's primarily those are clinicians. The clinical development and the medical affairs are really is that all MDs? Or do you see other um other members of the healthcare team doing this too?

Dr. Satya (Nanu) Das 22:59

Absolutely. So I think that's the also one of the coolest things about um the biotech industry that I loved is how democratic it is, right? And and and you know, as you know, coming up in medicine, there's a bit of a hierarchy, right? And sometimes positional. Um, and and even when sometimes I remember in the hospital setting, um, whatever you say is a doctor goes, right? Because people aren't, but in but in biotech, that's not the case. Everyone has a voice. So your CEO could be a farm D, they could be um a PA, they could be an RN, they could be somebody who has a bachelor's and just did an MBA and came to it. It's all about your experience and your lens. So I think that's the great thing is um so many of my former colleagues who are farm Ds have had incredibly successful careers transitioning over to kind of the medical affairs side because that's what they do. They talk about drugs and how it impacts patients, and and they can do that. And then I've also had people, um, PhDs, um, RNs who are amazing clinical developers. Um, and and some of my bosses have been people from all disciplines. So it's been really cool to see that it doesn't really matter what path you come from, as long as you're grounded in clinical medicine, uh, you bring that skill set into this arena. And then you have to learn drug development as well, which is uh, you know, its own, its own discipline.

Ashley Love 24:21

I think there's something very much, something huge to be learned by this right now, the fact that everyone has a voice, and yet this field is exploding with advancements and is from what it sounds like a very well-oiled machine. And perhaps hierarchy is inhibitory. And we will not dive into this because we will be here for five hours if we have this conversation. But you know, it's something that is worth, it's something that's worth a look, and it gives me a lot of hope for this field to hear how, like you said, how democratic it is, how much respect is is being really being shared. So so cool. Thank you for describing all of that. You mentioned courage. It was just it was squeezed right into the middle of one of those sentences when you're describing your transition. Um tell me a little bit about that. Break that down for me. This does seem like it would be quite a scary transition for somebody who maybe is comfortable in clinic or comfortable in in research, but feels drawn to something more.

Dr. Satya (Nanu) Das 25:21

Absolutely. I think that, you know, I always tell, and even I'm unfortunate to now work with some mentees at different stages, and and I always tell them don't settle. You have to follow what you love, right? We live this life once, right? To the best of our knowledge, right? And I think it's a shame and a disservice to not pursue that. And sometimes that requires being comfortable, being uncomfortable, right? And making taking a leap. Um, I can say from my own personal experience, you know, a lot of people, yeah, even mentors and friends and and well-wishers, you know, looked at me a little bit side-eyed when I talked about this. They were like, you're about to take off in your career. You know, I was at a point where I was fortunate to have built a research program, uh, really creating a niche. Uh, and they're like, You really, you're gonna go now? Um, you're gonna try to maybe start over, right? But I think what I would say is that there's no, there's never starting over. You take the experience of what you have and you bring that with you to the table. And making this jump and the courage to make that jump was was the best thing. You have to bet on yourself, right?

Quality Question

Ashley Love 26:30

Now, Dr. Doss and I did not get a chance to discuss a quality question, which is an interview question that can help you prepare for your own interview. But something that he said would make a fantastic interview question. And it's this describe a time that you bet on yourself even when the outcome wasn't guaranteed. This question is not about confidence, it's about courage. When interviewers ask this, they're listening for how you tolerate uncertainty, how you make decisions without perfect information, whether you take ownership of your own path, and how you grow when the results are unclear. Strong answers are not about winning. They're about choosing yourself with intention. Keep in mind that there's more interview prep, such as mock interviews and personal statement review, over on ShadowmeNext.com. There you'll find amazing resources to help you as you prepare to answer your own quality questions.

Dr. Satya (Nanu) Das 27:25

I think in medicine, regardless of what avenue we come from, we're all lifelong learners and we have demonstrated already. I think sometimes what I would say is we have a nearsighted view. We're like, oh, we can't make this transition because we don't know what's next. But if we actually look back at the path we've travailed to get to where we have, we've already crossed much bigger gaps and much more uncertainty already. So sometimes it's remembering the journey that we've already made that can give us the courage to pursue that further. So to me, it was the courage to make the jump. But then also I did biofar uh large biopharma for a year. Again, very successful company. I made a jump because I felt that I wasn't being as creative as I could, right? And again, people are like, you really want to lose this place? There's like, um, yeah, I said, you know, what makes me tick is I want to be molding. I want to have an imprint on this, right? And and I can tell you, the the move beyond the move, that's the right one. As long as you keep chasing what makes you tick, um, given the skill set that clinicians have from their past lives, you'll never be out of demand, certainly in biopharma. I think honestly, biopharma is going to get better as we get more clinicians in this discipline. We want people like us in the boardrooms, because when there are decisions being made, we want there to be a patient-centric lens. We want there to be something that we know from the clinic is going to be palatable or not palatable when you write it into a study. We want that to be incorporated. And I feel like um it's been such a gift because I feel like all of my fire past is now sort of aligning with my present. And so uh I think the courage to take that jump, what lies on the other side is is sometimes great promise. Um, and again, you're never, you're never losing your clinical expertise. So let's say you do make a jump and it turns out to be something it's not for you. That's fine. People transition back and do great, right? You're never closing one door by exploring this one. And so I think that's what I would say is that that's kind of one theme that um I've tried to embody. And I think now I've kind of been been forced to with recent transitions is just that don't be afraid to have the courage of your conviction to follow what makes you tick, um, because there is promise there.

Collaboration And Decision Making In Startups

Ashley Love 29:44

It is courageous, especially at the height of your career. You know, that's when people are are really getting to you know buckle in and settle down and say, let's let's keep this going. But for you, it was that big, that big pivot that obviously just gave you so much life. And I'm so glad to hear that. So for the person who's listening who says, Wow, well, I have courage, and this is interesting to me. I think I might want to do this. What maybe describe one or two of the challenges and successes that you saw working in clinic and research compared to the challenges and successes that you're finding now in biotech? Are they are they similar? Are they vastly different? What could that person be looking forward to if this is something they ended up choosing?

Evidence Over Eminence And Debate

Dr. Satya (Nanu) Das 30:28

Yeah, it's a fantastic question. I I would say in the clinic, the the beauty of clinic and the success of the clinic is the instant gratification. Um, as you know, Ashley, there's no better feeling than taking care of someone in a time of need, right? And that satisfaction and that joy is instantaneous. So you will get that, right? And that's what clinical care is. I think if you're drawn to people and motivated by taking care of people, there's no sweeter satisfaction than that immediate gratification. I would say the challenge is, and and maybe this is to your point from a little earlier, maybe this is where our robots and our AI can help us is in the administrative burden, right? Which is documentation, which is making patient flow or organizing our clinic schedules so that we don't have to, or that we're not spending half our time being administrators in addition to clinicians, right? Um, so some of that is definitely there. I think we're fighting the system a bit on the clinic side. I think one of the challenges is that that I always felt, even though I was fortunate, um, you know, I was at a referral center, I wasn't seeing like in private practice, um, a cancer doc sees 35, 40 patients a day. Each patient's a story, right? How do you synthesize uh even just a return visit? It's just 15 minutes. That's impossible, right? So I think the challenge is you're always fighting the clock. Um, and that's one thing. Um, I think as you get seasoned, you you figure out ways, but um one of the challenges is is that it does eat into some of your time. You you can't color between the lines if you're going to be a passionate clinician, because patient care doesn't have the same boundaries that even you know a clinical eight to five does, right? Like you're gonna be staying a little later. There is there are gonna be patients that you're where you're gonna be running late, right? Because you had to care for someone or they had a progression and you needed to spend five extra minutes holding their hand to reassure them, right? So that that's definitely, I would say, the challenge on that side. In biotech, I would say the challenges are a little different. The challenges are uh patience, because and I'd say patience here that waiting, because you don't get the same instant gratification, right? Even if your drug's working amazingly, you're hearing about it through a telephone or you know, through a third-person communication. You're not seeing that patient in front of you that's you know went from feeling like uh, you know, feeling like crap to feeling amazing or doing something with their family. You don't get to see that. Um, and and you have to wait longer, right? Because you you don't get the readouts uh in a clinical day. You have to wait a few months, right, to actually see if your drug is working or not. So the challenge is the patients, and I think the challenge is a bit of that inherent uncertainty, right? Because no matter how well you develop the trial, how well you write it, you're ultimately beholden to your drug, right? And and I think um the data is now changing, but the truth is that even the drugs that make it to clinic, and I'll tell you, there's a whole swath of compounds that are incredibly promising that never even get to the clinic because they never get out of the lab, because they're either too toxic or you can't formulate them into a drug. So I'm even talking of the winners, only 10% make it, right? Now we're hoping to change that number, but you have to be willing to embrace failure in biotech. And I think that's a challenge. So if that you can do everything right, and the drug may still not be able to benefit patients. And and that's okay. You have to pivot, you move forward, um, you keep pushing, but you have to be willing to accept that that side of things. Um, as far as the successes go, I would say the creativity um is absolutely incredible. Here, you actually take a concept, you write the study, you talk about the populations you want to benefit, you open sites, you get to talk with PIs. So you're really straddling both sides of the aisle. You know, I get to work with former colleagues and and collaborators, but now as a sponsor, right? Where um I have the credibility of having walked in their shoes, but they also know that, you know, we're we're coming with a drug that really has some potential. And this trial has been designed in the in the right way to show something that could potentially impact patients. And so that creativity, uh, and I would say that excitement of when you actually get the data and no one else in the world has seen it, and you're seeing that graph pop up, the waterfall plot showing the tumor shrinkage or how long patients are living, there's nothing like that feeling. But to be fair, you know, I will say one point is that you can also still find ways to, even if you transition to um industry. Uh, I know colleagues that have maintained uh, you know, a half day of clinic at a nearby institution. I personally didn't just because I wanted to kind of delve in fully into this side, but I still do um some patient consults through platforms, second opinions, um, family friends. And so I've found ways to keep that patient focused or patient-facing interface still still alive on this side. Um, so you're not closing that door, and I think that's also important to remember.

Policy, FDA Consistency, And Patient Stories

Ashley Love 35:42

Incredible. And you know, it's something uh something that you mentioned, and it was something I wanted to ask as well. Because you go from a situation, as you previously described in clinic, that was so collaborative. You worked with other clinicians, you worked with patients, you worked with residents, you worked with nice the list went on, right? To um to biotech, which in I think maybe stereotypically, I'm thinking of you sitting alone in a room with a bunch of papers and textbooks and computers. But you mentioned a PI, which is a principal investigator, right? Which it reminded me that this probably isn't a very isolated job. I would imagine there's a team of people. Is that true? Is it still very collaborative?

Dr. Satya (Nanu) Das 36:20

Absolutely. I would say, like, you know, here in in smaller biopharma, I mean, we're say under 50 people. Um, you know, we're popping into offices all the time. My CEO is right there, my CSO is right there. So we're having hallway conversations, drawn on whiteboards, having strategy meetings, taking all our large calls together as a group. We have team meetings two to three times a week with our entire core from our scientists to our um our data individuals to our safety and pharmacovigilance. So it's actually very much a team game. And and I would actually say, interestingly enough, this I would say industry is I would say inherently even more collaborative than the academic side. Because sure, in clinic, yes, you're with tons of people and I'll say RNs, PAs, uh, PharmDs, incredibly instrumental people as well as part of the clinical team. But then actually, when you're going into your office and so forth, it is a little bit more lonely to speak of. Here, by definition, I can't do anything. I mean, I there's roles, but I really can't do anything in terms of the decision alone. So I have to bring in people. And I think that's the really cool part is it's all collective decision making. And it's about um, it's not just about you have to prove your points, which I love. Uh, you know, you're telling someone something, back it up, right? And I think that's what I really love. Um, as part of this collaboration, is there is, um, we were talking about earlier, this democratic feedback, and and people push back. And I think it's important to challenge one another, um, obviously respectfully, but I think that exchange is so, so important. And I and I see that so much on the industry side. And I think that was very eye-opening to me. I didn't know how much of the decision making was collaborative and how much, I would say almost the purest form of debate that I've encountered happens on this side of the aisle.

Ashley Love 38:18

I was just gonna say that. It reminds me very much of debate, which I think we have turned into such a nasty word these days, but it is just, it just it lights me up. I mean, I hate debating. I I I hate disagreeing with people. But how else are you going to sharpen someone's idea? And how else are you going to investigate and get deeper? And, you know, we say play devil's advocate, but is that really what we're doing? Or are we playing that person's advocate and helping them to kind of explore and identify even deeper concepts to their even deeper concepts of their idea that they even realized was their um, oh, I wish we did that more in medicine.

Dr. Satya (Nanu) Das 38:54

I agree and pressure testing, right? And I think what I love is so much of medicine, you know, we have this notion that is evidence-based, but so much of medicine is still eminence-based, right? Someone notable said something, and it takes a decade, right, to disprove that. Um, there's so many examples, you know, of that. And what I love here is it's it really is evidence-based. Um, and and uh, and as you said, yeah, you have to um pressure test everything because someone even questioning your own assumptions, you become a more thoughtful person, you become a more creative thinker and a more mature thinker. So I think I've grown quite a bit, and now it's been three years on the industry side, but I I feel like, yeah, I've grown a lot even in that period of time.

Ashley Love 39:39

I uh I've started reframing um those conversations as challenges, but not a negative challenge, a positive challenge, right? Um and I think that that reframing has really helped the way I approach those conversations, not as you know, a response to being attacked, but as an invitation to explain. Explain even further, right? Which is um exactly very it's so very cool. Okay, last question. And this is this might be a bit of a big question. So feel free to you know parse it down if you need to. But of course, to wrap it up, what role does healthcare policy play in drug development? And because I think this is important to speak to, how can patient stories influence this process?

Closing Reflections And Listener CTA

Dr. Satya (Nanu) Das 40:25

Yeah, it's a fantastic question. So um healthcare policy is instrumental in setting the framework for how drug development works, right? And I think, you know, what we've seen, irrespective of what side of the aisle we're on, I think turnover is not great, right? And I think unfortunately we see so much turnover in the FDA. And I think what worries us as drug developers is is that going to introduce inconsistency in how drugs are assessed? Because the last thing you want to introduce for drug developers, right? I already talked about how much inherent uncertainty there is. If you change the goalposts or you're moving the standards, right, we have to be consistent in what is a meaningful benefit for a class of drug and let's stick to it, right? Let's have our interactions, um, let's have the same bars, the same metrics, so that we can all be judged equally and let the best drugs win, right? Because at the end of the day, the patients will win, and that's what we all want. But when we have so much turnover in regulatory agencies, it just creates inherent uncertainty because we don't actually know how decisions are being made. Why was it that one drug that had very similar data or a development path got rejected, whereas another didn't, right? And I think that's so I think healthcare policy trickles into all of our lives. And obviously, as clinicians too, you know, we can, again, probably talk for five hours of how healthcare policy is influencing not just academic centers, but the practice of medicine at large. But it is so important to not lose sight of the main thing, which is the patient. So I think we can use patient stories as a very powerful lens. So almost every, let's say, investor talk that I'm talking at, or even with a PI or with an advisory board, I start with the patient anecdote because that's how that's how I was I learned medicine, right? We talk about the patient's stories to frame our narrative. And I think that is the most important piece because lost in the shuffle of policy and sometimes just disagreement for the sake of disagreement, is that the patients are the ones that suffer because either meaningful or promising drugs are delayed or a drug that could have been a real game changer falls through the cracks, right? And that's kind of the worst aspect. So I think it's we're um as healthcare providers, whether it's in um biopharma clinicians, um, we have a deep responsibility to continue to tell our patient stories at every avenue we get and be involved in policy discussion. So if there are opportunities to go to Washington um to advocate on behalf of our respective disciplines, it's super important to do that. But use the patient story um as our tool because I think um that distills so many complicated things to a very simple thing, right? Is how do we do right by the patient? We think of we, you know, I thought about that in clinic every day. That's what you're thinking about. And I still think about that every day uh as a developer. And I think we need our policymakers to think about how we do right by patients every day as well.

Ashley Love 43:37

The perspective is so important. And I think as clinicians in this role in biotech, it is our greatest gift, really, is to be able to offer that perspective. Nanu, it has been such a pleasure speaking with you today. Thank you so much for being so willing to um not just define some of these topics first, but actually really describe them and infuse humanity into these situations that I think people really think are just automated nowadays and they're not. I mean, there's so much, there's so much thought that goes into this, and um, and you've described it beautifully. Thank you so much.

Dr. Satya (Nanu) Das 44:10

Thank you so much, actually. It's such a pleasure.

Ashley Love 44:12

Thank you so very much for listening to this episode of Shadow Me Next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday. As always, if you have any questions, let me know on Facebook or Instagram. Access you want, stories you need, you're always invited to Shadow Me Next.