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Rho Chi Talks: Interview with the CEO of Cullinan Oncology

Featuring: Nadim Ahmed, President and CEO, Cullinan Oncology

By: Sairah Skeikh, PharmD Candidate c/o 2024

Nadim Ahmed is the President and Chief Executive Officer at Cullinan Oncology. He has always had an interest in oncology and the opportunity to help cancer patients and their families, which is demonstrated in his extensive prior experience working in oncology in the pharmaceutical industry.

What has your career journey been like?

I’ve always had an interest in science. So, I did pharmacology as my undergraduate degree at University College London. I’ve also always had an interest in computing, so then I went on to do a master’s degree in information technology in the UK. Then, I started out my career at GlaxoSmithKline (GSK), which, at the time, was Wellcome. I joined Wellcome in the UK on the research and development side and became quite interested in the business side of the industry. So, I then landed a role in medical affairs. I had experience there, and most of my experience, both in clinical and medical affairs, had been in oncology, and that’s the area that I am in today. Then, I was asked if I wanted to come and work in the US for GlaxoSmithKline. After a discussion with the family, we decided to make the move and take that leap of faith. So, I joined GlaxoSmithKline in the US in oncology in global marketing. I did that for a while and worked across a range of different cancer medications that were approved. Then, I also wanted to get some specific experience in US marketing, and the opportunity opened for me to take a role in US marketing, which was much closer to the physicians, customers, etc. I did that role for a while and really enjoyed it. Then, I joined Celgene Corporation in global marketing. I was involved in launching new medications for that disease, and it was a time when the company was growing very rapidly. We were building out the organization and building affiliates in countries across the world. We were doing new medicines and new launches, and it was an exciting time to be there. That was in 2010. Then, I became the general manager of our US business. Next, I was president of worldwide markets, so I had all the general managers of the various affiliates around the globe reporting to me. And then, my last role at Celgene Corporation was head of the global hematology/oncology business, which was probably 90 to 95% of our revenue in the company at the time. Then Bristol Myers Squibb (BMS) acquired Celgene Corporation, so I decided to join Bristol Myers Squibb’s executive team as the president of hematology, which included cell therapy and all the blood cancer-related medications across the globe. I did that for about a year and a half. Then, the opportunity came along at Cullinan Oncology, which is where I am now. And so, between Celgene and BMS, I’d worked or reported directly to the chief executive officer for about five years. So, I thought, maybe I want to try this myself. And that’s what ultimately happened. I have been CEO since October of 2021, so it’s just come up on my two-year anniversary here. And as the name suggests, we’re in the oncology business. We have six products in the clinic that are currently undergoing clinical trials. Hopefully, we can get those in the future through regulatory approval and ultimately commercialize them and bring them to patients. So that’s my career journey.

What does your day-to-day look like as the CEO of Cullinan Oncology?

I think one of the things that’s important for a CEO is to make sure I continue to bring the external voices into the company because, often, within the company, you can become very internally focused. So, part of my role is to make sure that we’re also thinking about the external environment. Therefore, I communicate with investors and make the case for why they should invest in Cullinan Oncology versus other companies. Another important role is making sure my leadership team gets the support that they need. So, making sure that all the programs that we’ve got in clinical trials are moving forward and are being executed quickly is important. And what I mean by that is, at the end of everything we do, there’s a patient waiting, so we’ve got to have that sense of urgency to make sure that we’re bringing meaningful medicines forward as quickly as possible. Another part of my role is making sure we’re keeping things on track through research, development, and then, ultimately, commercialization when we get these drugs approved. Building a strong company culture is something else that is important to me, like incorporating diversity and inclusion so that everybody has a voice at the table. It is important to look at the best ideas and bring those forward, which we can only do if we have a diverse organization. It’s also important to make sure we have good development plans for all our employees so that they continue to stay at Cullinan Oncolothat we allow people to have rich and fulfilling careers at the company. So, it’s a mixture of all those things.

What are your top three priorities as CEO?

The first one, I would say, is making sure that we continue to bring forward medicines that are really going to make a big difference. So, our mission is to develop new standards of care for patients with cancer, and that means that we’re bringing forward those medicines that are going to have a huge impact on patient outcomes. We need to continue to take promising molecules and turn them into meaningful medicines for patients. Second is making sure that all our stakeholders, especially external stakeholders, understand the company’s story, promise, and value proposition so that they can see what we’re doing and that when they have a choice to invest in various companies, they choose us first. So, part of my role is to tell the story of why people should invest in companies from Cullinan Oncology over other companies. Third, I will make sure that I continue to provide inspiration and motivation for my leadership team so that we’re attracting bright talent to come into the company. When we bring in great talent, we make sure they stay with the company and understand there’s an opportunity to have a very rich and rewarding career within the company.

What are some of the projects that Cullinan Oncology is working on?

The molecule that is the most advanced is zipalertinib, and it’s a tyrosine kinase inhibitor that focuses on a specific form of lung cancer. It’s for patients that have the exon 20 insertion mutation, which is anywhere from 3% to 5% of lung cancer patients, and patients who have this mutation often have a poor prognosis and have only months to live. So zipalertinib is a molecule that we’re partnering with Taiho Pharmaceuticals for, and we did a deal with them last year. It’s currently in pivotal trials, and we recently announced that we’re going to complete patient recruitment into our pivotal study by the end of 2024. So, it’s going to be exciting to see the kind of data the study shows, and our early results looked good. This is a study that we would take to the FDA for regulatory approval. So, this is an area where we can really make a direct impact. That’s the lead compound, and we have a range of other molecules. I’ll talk about one of them for which we recently presented data, which is called CLN 619. It doesn’t have a generic name yet because it’s still quite early. And that one, it focuses on a novel pathway called the MICA/MICB pathway. The MICA/MICB is a ligand for the NKG2D receptor that you find on immune cells, especially NK cells and subsets of T cells. Now, MICA/MICB isn’t normally expressed in normal cells. However, when cells undergo stress, whether it’s a viral infection, malignant transformation, etc., those cells then express MICA/MICB, and once they express MICA/MICB being a ligand for the NKG2D receptor, they send a “kill me” signal to the immune system. They essentially flagged those cells for destruction. That is a normal physiological process. Now, what happens with cancer is that it is clever and finds ways to inhibit the immune system. So, those tumor cells express MICA/MICB in the tumor microenvironment because they’re undergoing stress. Proteases in that tumor microenvironment come along and cleave that MICA/MICB off the surface of those tumor cells, so then that makes them invisible again to the immune system. So that’s the way they evade the immune system and continue to proliferate. What CLN 619 does is it’s an antibody that binds to MICA/MICB on the cell surface and keeps it on the cell surface so that the immune system can re-recognize those tumor cells and flag them for destruction. So, it’s a very novel scientific pathway. We shared the data earlier this year at the American Society of Clinical Oncology meeting, where we were able to demonstrate tumor shrinkage in certain types of tumors. That’s going to be a cool program for us that we’re continuing to advance in clinical development. Behind that, we have four other promising molecules, some of which will report data out next year. We have a range of molecules across solid tumors and hematologic cancers, and we’re really excited about the opportunity to bring important medicines to patients with cancers.

What do you think about the broader business environment, and how do you see the next 12 months?

In the biotech space, it’s been a tough couple of years. Capital has not been as readily available as it was when I first joined the company. Fortunately, we are in a position where we have a strong cash position. So fortunately, I have the capital to kind of keep these programs moving forward. A lot of companies don’t. Over the last couple of years, a lot of biotech companies have closed down, and people have lost their jobs, which is unfortunate. As I think about the macro environment over the next 12 months or so, I don’t know that it’s going to change overnight. Often, economists talk about whether there is going to be a recession or a soft landing in the US. We don’t quite know yet. And so, the thing that I tell my team is, there are things we can control, and there are things we can’t control. My team can’t directly control the stock price of my company, so there’s no point in worrying about that too much. But we should take charge of the things we can control. And that’s why I talk about execution. So, we can continue to focus on flawless execution and bringing great medicines to patients. And if we do that, when these economic cycles correct themselves, and they will at some point, we’re going to be in a very strong position because we’ve continued to execute. And we’ve continued to manage the things that we can really manage. Then, over the next year or so, we will have quite a few important clinical data readouts from some of our important programs. And so, hopefully, those data readouts are good so that will continue to strengthen the profile of the company, and people, including investors, can say, okay, these medicines look really promising, and so Cullinan Oncology is a place that I want to invest in. So, we’ve got an important and exciting 12 months or so coming up.

What do you envision the future looking like for cancer treatments and research?

We have seen tremendous advancements in recent years, especially in the field of immunotherapy, where you take a patient’s immune cells, reprogram them, and then they’re using their own bodies to destroy cancer. So, you can think about checkpoint inhibitors, you know, Car T-cell therapy, the evolution of antibodies to ADCs T cell engagers by specific antibodies. The pace of innovation has been rapid. And so, I expect that we’ll continue to see advancements there so that we can continue to address a whole range of cancers and make sure we do even better in terms of patient outcomes. I think the therapies will continue to get better, and I think the science will continue to get stronger, and we’ll continue to innovate. So, I think the pace of innovation has been amazing. Also, AI is touching every part of our lives, so thinking about artificial intelligence in terms of its applicability in medicine, such as drug discovery processes, imaging, and detecting the risk of patients developing cancer, is important. On the commercial side, we can think of how we engage with healthcare practitioners using AI to make sure that we meet those folks where they want to be met in terms of appropriate content that they want to discuss and engage in. So those are some of my ideas regarding the future of cancer treatments and research.

What do you see as the biggest challenges facing the industry?

Sometimes, well-intended legislation can have undesirable effects. So, one example I would say is in the Inflation Reduction Act; I’m sure there were well-intentioned plans to create a piece of legislation that would address the issue of patient affordability. Unfortunately, the actual practicality on the ground is that it probably is going to negatively impact innovation. And so, I think that’s an example of people starting out with good intentions but not really thinking through the consequences of those sorts of things. The other things that I think are challenges are how we think about making medicines accessible to the global patient population, especially in underdeveloped countries, where oftentimes, even if you gave the drugs free, they wouldn’t get to patients because there isn’t an infrastructure there to be able to deliver those medicines. So, I do think addressing health equity, internationally and in the US, is important. In the US, often communities of color are disproportionately affected by access to medicines. And I do think that, sometimes, clinical trials don’t always represent the patient populations. And so, I do think we’ve got to find a better way to make sure that we’re getting the diverse patient populations in all the communities that we serve into our clinical trials. We know drugs affect different people in different ways, so if you truly want to understand how a drug works, you’ve got to make sure that you test it in all the populations to whom it’s going to be given, and so I think that’s another area that’s really important. It can be a challenge to get people enrolled in clinical trials, but it’s even more difficult to get people of color to enroll in clinical trials. And, of course, there’s a very sordid history of the African American community and how inappropriate and unethical trials were conducted in the past, such as the Tuskegee Study. And so, there’s a trust issue there, too, and rightly so. We’ve got to make sure that we support investigators of color and physicians of color so that we can bridge those kinds of trust gaps. I think that’s a challenge that, hopefully, as an industry kind of we rise to and turn into an opportunity. I would say, though, despite all those challenges, the promise of science has never been brighter, as we went over in the previous question, with developments like immunotherapy. We’ve made great advancements, but there’s still room for improvement. Another challenge is with cancer screening techniques. Unfortunately, most patients who present with advanced cancer today are probably going to die from the cancer. So, we need better screening techniques so that we can detect cancer earlier and intervene. For example, moving from very invasive biopsies today to blood tests in the future, where, by taking a blood test, you can predict the risk of a patient getting cancer across a range of different cancers. That’s a field that’s really an exciting area of research. And so, of course, if we can pick these things up earlier, we can affect the survival outcomes of cancer patients. So, I think that’s an exciting field.

What are some tips for success in your field?

One tip is to be open-minded. If you have a very clear idea of what you want to do, then go ahead and go for it. However, most people don’t always have an idea of exactly where they want to go. So for me, I didn’t start out my career wanting to be a CEO. I’ve always just wanted to be in roles where I continue to grow and continue to learn. So, I think having that learning curiosity can be very important. Secondly, I would say to seek out mentors who can help you and give you objective advice about how to shape your career. When you have mentors who are senior folk who have a lot of career experience, they can really give you good advice about how to think about growing professionally. I got a good piece of advice early in my career that I’ve followed to this day. It was one of my previous managers who said to me, look, Nadim, as you think about developing your career, don’t think about your next role, but think about the one after it. So, thinking about the role of the next one really helps me think about my career, and it also helps me think about how I would get into the more commercial side of the business. I outlined my career so I knew that I couldn’t go straight from clinical development to marketing or the commercial side. I knew I had to go through medical affairs, and the only reason I did that was because I was thinking about the role of the next one. Another tip would be that it’s okay if you don’t know exactly what you’re going to do five years from now; there will be things that will happen, and there will be opportunities that open. Just make sure you’re placing yourself well in order to seize those opportunities. Continue to show initiative and use the example of mentorship. You’d be very surprised at how few people that will approach somebody senior and say, look, I’d like you to mentor me. It doesn’t happen as frequently as you might think. And when you do that, it really shows good initiative on your part. And it allows you to develop a relationship that can really help drive and build your career. And then the final thing I would say is to continue to make sure you develop a network. When promotions are being discussed, if you have a broader network, then you can have people to advocate for you. And so that’s an important way to grow your career, to make sure you expand that network so that you can continue to grow as well. And you can ask people to advocate on your behalf when you’re not there.

What is your vision for the company?

When I joined the company in 2021, we had 35 people in the company, which was very different from my last role at Bristol Myers Squibb where I was managing thousands of people. So, it was a much smaller scale, but I really liked it. Since then, we’ve more than doubled the size of the company in two years. When I joined the company, we had one program in the clinic. This year, we have six programs in the clinic. So remarkable execution by the team. We’ve gone from a research-based company to now a development-based organization that has clinical development, and ultimately, the aspiration is to become a commercial-stage biotech company. So that’s part of bringing these new molecules, turning them into meaningful medicines, and getting them through regulatory approval with bodies like the FDA and around the world. And so that’s what I would say my vision for the company is—for it to become a commercial-stage biotech company.

What have been some of the most fulfilling moments in your career so far?

I have been fortunate to have a range of exciting roles that I’ve worked in. I remember I was working on a molecule that was being developed for lymphoma. And I met one of the patients who was in one of the early clinical trials. He was somebody who had failed multiple treatments like chemotherapy, all the things that typically were used in lymphoma. He had basically been told by his doctor to get his affairs in order because he didn’t have much time left. Then, he enrolled in one of our clinical studies and had an outstanding response to treatment. So, he had been given weeks, possibly months, to live. And here I was talking to him two years later, and he was able to have some amazing milestone events, including his family’s graduations and birthdays. And I think, for me, that was a seminal moment. Since then, I’ve been very fortunate to have met many patients who have been involved in clinical trials or commercial products for whom those medicines have really made a big difference. So, I would say those moments were absolutely gratifying and exemplifies the mission. Secondly, I really enjoy leadership. And so, I think the stories of impacting people’s development are really fulfilling. I find it gratifying to know that people who have worked for me and with me have gone on to bigger and better things in the industry or in other areas. I still keep in touch with many folks who have worked with me and gone on to have really fantastic careers.

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