Bridging the Gap, Accelerating the Path to Cure with Strategic Funding Solutions

Welcome back to an all new season of Cut the Chat: Life Science Insider Podcast. Season 2, Episode 1 is hosted by Seuss+ CEO and co-founder Sabine Hutchison. Cut the Chat promises to facilitate the conversations that you've been dying to hear and tackle the real crux of our industry's challenges.

So let's get this new season started, and let's get this episode underway. Let's cut the chat.

So welcome to the first podcast of 2024. We have some exceptional guests lined up for you this year, and I'm delighted to start the season with a very informative and engaging conversation with Stephanie Oestreich. Today's session is "Bridging the Gap: Accelerating the Path to a Cure."
So let me share with you a bit about the Myeloma Investment Fund. It's a specialty fund that invests in promising companies, clinical assets, and technologies in oncology to drive the development of new therapies in multiple myeloma. The MIF collaborates closely with its portfolio companies to help them advance multiple myeloma research. And this evergreen fund is supported entirely by philanthropy — all profits will be reinvested back into research for more effective treatments, until there is a cure for every patient.
So let me introduce you to our first guest, Stephanie Oestreich. She's the managing director of the Myeloma Investment Fund, the MIF. She serves on the boards of the German American Business Council in Boston and the Harvard Kennedy School's Women's Network, and is the chair of the McCloy Alumni Association. She's on the faculty of MIT, a member of the Launchpad Venture Group, where she's an adviser to numerous organizations, including Invitris, CART Company, Celine TX, and the drug development investment company Orange Grove Bio.
Additionally, she works on the W20 Enterprise Task Force, the official engagement group of the G20. Stephanie has held leadership roles in biotechs, including chief business officer at Galecto, vice president at cell therapy company Mnemo Therapeutics, venture partner at RA Capital, and executive vice president at Evotec, where she built its North American investment arm and started an incubator with Samsara BioCapital. She has worked as an international business leader at F. Hoffmann-La Roche Ltd., and for Novartis in business development and in commercial.
Stephanie conducted the research for her PhD in biochemistry in the lab of a Nobel Prize winner at Harvard Medical School, and obtained an MBA from the Harvard Kennedy School. And another interesting bit of information about Stephanie is that she's a semi-professional violinist, performing with philharmonic orchestras at Carnegie Hall and other international venues, and conducting workshops with live orchestras. She loves the idea of demonstrating the similarities between teams and leadership in music and management.
So, Stephanie, thanks very much, and I'm so excited to have you on the first episode of 2024. Thanks so much for taking the time to be with us today.

It's wonderful to be with you, and I'm very excited to tell the listeners about the Myeloma Investment Fund.

Really excited to get into this as well. We were fortunate that we had the chance to actually sit together in San Francisco at JP Morgan this year, so it was nice for us to actually meet face to face, because I think all of our engagement thus far has been virtual. So it was great to actually sit with you, and the MIF is a very interesting fund. What I'm really curious about — maybe we'll start the conversation with this — is: what are some of the biggest challenges you're facing, especially in myeloma research funding, and how is the MIF working to overcome these?

Let me start by giving you a little bit of the history, and some connections. The Multiple Myeloma Research Foundation was started 25 years ago by a patient who is actually still alive and doing well. The foundation provides information for patients about this devastating hematological, or liquid tumor, disease — so it's a cancer, but not a solid tumor, a hematological tumor — and what the foundation does is provide information to patients, but it's also financing and operating clinical trials. With that, we have very good relationships with the experts in this disease area, a lot of the key opinion leaders, and also the different centers in the United States where patients are being treated.
About five years ago, the Myeloma Investment Fund was started, because there was a notion that there wasn't actually enough emphasis on this still-devastating disease from a research standpoint. There was a notion that there are a lot of therapies already on the market, a lot of therapies being investigated in research and clinical trials, and some were saying we're at, quote-unquote, "peak myeloma" — we don't need additional therapies. But that's totally not true, because unfortunately patients still advance in their disease and ultimately die, and that's why we're trying to get a cure for every single patient through additional research, development, and therapies.
So the Myeloma Investment Fund is providing financing for seed-stage and Series A-type companies, and we currently have 11 active investments. We have two exits — one company was bought by a pharma company, and another went public. We're looking into many new investment opportunities right now, and we also want to support our portfolio companies further with additional investments. We're very much appreciated for our knowledge in this complex disease area, our connections to the experts, not just for our financing — and that's really the advantage of being a specialty fund.
And coming to your question, the challenges are still that patients progress, they relapse, and they need novel therapies that ideally address some of the issues in the disease. For instance, many patients ultimately have T cells that are, quote-unquote, getting exhausted, and they progress because of that. So therapies that keep the T cells able to keep the cancer in check long term are really important, and really long-term, innovative therapies are very much needed in this disease area.

Yeah, and I can imagine that's obviously one of the challenges as well — to really stay on the cutting, innovative side of the research. And because you're so focused, and you have that specific therapeutic area, and you're looking at portfolio companies, I guess two questions: one, do you struggle to find companies or organizations to fund? And then, as you become aware of the organizations, what are some of the criteria you use in determining whether you're going to fund them?

Luckily, we have no shortage of interesting, innovative investment opportunities through our network in the biotech field, but also in the investment community. We're focusing on innovative therapies — so no generics, no repurposing of drugs — we're focused on, for instance, innovative CAR T, we're also very interested in RNA splicing, we're interested in ADCs, or antibody-drug conjugates, so a novel way to also target novel types of cancer. So really a vast amount of innovative therapies. Our criteria is that the companies we invest in have to already have a program active in multiple myeloma, and then we can help progress the therapy with our investments.

And do you also look at organizations that have a multitude of therapeutic areas, potentially in oncology, where you would just potentially pick one program — that they don't need to be just in myeloma research?

Yes, many of the companies have a portfolio, and we invest either in the entire company, or if the company would like to prioritize the multiple myeloma program, we can also specifically designate our funding towards that worthwhile program — but we don't specify that from the get-go, so our approach is really to have the whole company being successful.

Okay, well, let's expand a bit on that. If we look at the way various funding companies or VCs engage with their portfolio companies — some we see are very much involved, sitting on the board, a very active part of the organization, whereas others are less involved, more of a hands-off approach — how do you engage with your portfolio companies? Is there a typical collaboration style?

Fortunately, I have experience having worked in large pharma companies operationally, at biotech companies, at startups, but also on the venture side. So I've both been a board member and I've also worked with boards, and my view here is that you have to really be very strategic. Operational responsibility lies with the company management, but at the Myeloma Investment Fund we have some board roles, we have observer roles, and we also stay very close to our companies by providing advice to them in different areas. It's on the scientific side, because of our specialty and very deep knowledge on the scientific and also clinical side, but we also provide connections to our scientific experts and to the centers we're working with, but also on the strategic side — I have some experience on the portfolio management side and also good contacts to many venture capitalists, so we're introducing our portfolio companies to other investors and providing value in that way, beyond just our investment.

So potentially less operational, because you do give that to the team, and then more from the strategic and advisory level, then?

Yes, but we're really — we're all a team, and we're working on it together, and we also discuss challenges and find solutions together.

And one thing I found really interesting is that when we saw each other in San Francisco, you were in the process of preparing to go visit a site — and I know you can't share the details around that, because it's for a particular study. But I'd be curious to hear what that experience was like for you, being that close, seeing patients and being in the clinic.

I had the good fortune to observe one of our physicians and his team during a day at the hospital, and that was both incredibly insightful and also very humbling. I was able to see how the team — and it's really a team, it takes a village, the team of doctors, nurses, physicians, clinicians, researchers — prepares for the day, looking at the patient records for the patients they have to see that day. And the diversity was really very insightful. I then had a chance to spend some time with our physician when he was actually seeing patients, and it was wonderful to see that many of them were actually living for a very long time, with a decent quality of life. But there were also some at the end of their lives. I also saw some minority patients, and there was a translator, so it's really a very diverse set of patients, and to see how much it really depends on the clinical team to have a positive outcome for the patient was very insightful.

Interesting. And did anything stick out? Because we often see challenges around putting the trial together, the protocol, how patients and sites deal with those potential challenges, because everything is complex, especially with oncology, of course. Any insights there, or things you take back with you now and think, "okay, this is something I can definitely share in the next studies," or insights in general?

There were trial nurses who were part of the team, so they were very integrated into the whole process, and they were then bringing that information back to their own team, so that was definitely very helpful. Another insight I'd love to share is the health equity aspect — it's still a challenge that, unfortunately, minority patients don't experience the same outcomes for a variety of reasons, and that's also something that we at the Multiple Myeloma Research Foundation are working on, to help and mitigate. At the very least, we're very aware of it.

That is definitely a huge — yeah, a very significant point. You're right, with health equity, I think so many organizations are looking at how to improve and have a bigger impact, especially on minority patients. Great, well, thanks. It must have been really great to be at the site, to have that experience and see how it's really being translated into novel therapies, because I also had the chance to speak with researchers who are working with some of the data — so to see how it was really leading from bench to bedside and back was really insightful as well.

Yeah, fantastic, great experience — probably more people should do that. I think it would have a big impact in general on how we work, and again, it brings it back to the point of the patients, so key. And it's very important, I think, for the researchers as well, because — having worked in large pharma companies, you often get so involved in the spreadsheets and the PowerPoint presentations, but having had this experience to meet some of the patients who were able to be treated puts a face to the disease, and that was, and still is, an incredible motivator. So when you have to work hard on your next PowerPoint presentation, I don't have that in mind — I have the patient's face in mind, and that's really the North Star, to provide a cure for this patient and all the others with multiple myeloma. That's really what we strive for.

Yeah, that's great, great story. So if you look at the MIF's approach to funding companies — I think you said five years for the fund, correct? Obviously the organization's been around for 25 years, but the fund's been around for about five years, and I'm interested to hear, in that period of time, and looking forward, has your funding, and the way you approach portfolio companies and the organizations you look for, changed?

We're trying to be at the forefront of innovation, and so the therapies being developed are also advancing. So what I'd say has changed is the complexity has changed — there are many, many more therapies for clinicians to choose from, so clinicians now have to be almost like chess players, they have to think in advance about what therapy they're going to give this patient, not just at first line, second line, but in third, fourth, fifth, and maybe even later lines. So the decision, both on the side of the clinicians but also the researchers and investors, has changed. We've seen amazing advancements on the CAR T side — there are now several generations of CAR T therapies on the market, but there's still innovation in this field. And having personally done my PhD in the lab of a Nobel Prize winner on RNA, I'm very excited to also see RNA splicing making it not just into research but also into the clinic. So I'd say the biggest change is the complexity, and that's also why a specialty fund like ours is so important, to really know the landscape — and that's also what we do with our portfolio companies, and I believe that's why we're being valued by them and by our fellow investors, because we really know the landscape very well. We can help consult on clinical trial development, on competitive positioning. So, being a specialty investor, we're really being valued for our knowledge in this area.

I can imagine, and for the portfolio companies you're working with, the value to them is immense, thinking about the network, the KOLs, just the knowledge base you have — it must be invaluable for them. So, moving on from that — in the industry too, you talked about the trends that are happening. Is there anything else — you mentioned CAR T, there's a lot happening in the industry in this space as well — is there one you're particularly more interested in funding or looking at, or is it just innovation in general?

It's like picking your favorite child, in a way — there are so many very, very cool novel therapies. Just having seen CAR T advance the way it has, both on the scientific side, on the design of the CARs, but also, as I mentioned before, the importance of really devising a therapy that can reliably, and over a longer period of time, develop memory T cells. That's the big issue here still — the T cells get exhausted; initially they're able to fight the cancer, but that sort of wanes over time. So having that maintained for a longer time — that's, in many ways, the Holy Grail. There are obviously other advancements as well, but if I had to pick one, that would probably be the pinnacle.

Thanks — so, your favorite child, you're right, that's a tough one. When we talk about the success of portfolio companies and funding organizations, we think about exits, we think about collaborations, but when you look at the success of your portfolio companies, how do you measure that success?

That's a great question, because it's very important to have criteria by which you measure success — I'm a very quantitative person, and I believe very much in setting goals and evaluating your progress. For us, the North Star is really to eventually provide a cure for multiple myeloma patients, and with that, we're very happy that four of our companies now have multiple myeloma projects in clinical trials — that's definitely one of the most important criteria for us. The exit options really depend a little bit on the economic environment — you might know the biotech environment is currently improving. At JP Morgan, there was cautious optimism after the last two years, where we haven't seen a lot of early-stage funding for startups, and a lot of exits in the form of IPOs, acquisitions, or even collaborations with pharma companies. We're starting to see more of that — the general economic environment is also starting to improve, interest rates are stable and might even go down this year, so we're cautiously optimistic the IPO window might open again and provide other exit opportunities for our and other portfolio companies. But again, for us, the most important criteria is whether the companies are able to advance their research projects into actual clinical trials, and then ultimately into successful treatments for multiple myeloma patients.

That is the biggest success, you're absolutely right. We tend to look at the monetary side of things, but ultimately, you're right, it's the patients and the cure we're moving towards.

And the two are really not mutually exclusive — if we develop really good therapies that are able to treat the patient, there will also be financial success that we can then use to reinvest into hopefully even better treatments for the patient. So there's really no, quote-unquote, conflict of interest here for me — you need to do both.

I mean, best, yep. Absolutely, yeah — that's such a good point.

It's because, as you know, drug development research is very, very costly — it takes about a couple of billion per successful drug, and there are many, many failures. So about one in 10,000 early-stage research projects makes it to the market successfully, gets approved, gets reimbursed. So for all of this, you also need a financial return.

Yeah, absolutely, and I think that's so — so many individuals, especially outside our industry, just aren't aware of that: the investment, the time, the years it takes, and how many fail, to your point, for one to be successful. So true.

Yeah, and the immense intellectual capacity you need to pivot if you have a negative experimental result — that's also what we're trying to do with our portfolio companies. If something doesn't go as planned, we learn from it, and we help devise a plan that hopefully will be successful for all involved.

Yeah, no, absolutely. And if you look into the future — if you had your crystal ball, where do you think myeloma research is heading in the next few years?

So I'm making a very bold prediction here — with the complexity of multiple myeloma we're seeing, patients have a number of different mutations, translocations, very different outcomes. I would predict that if we speak again on the podcast in five years, multiple myeloma will not be one disease, but several diseases. If you remember, just a few years ago lung cancer was lung cancer, but now you have non-small-cell lung cancer, small-cell lung cancer, and various biomarker-positive subtypes — so many different types that you can also target with targeted therapies, in a precision-medicine type of approach.

True. Yeah, no.

I believe we will learn much more about multiple myeloma, how to diagnose patients better and how to treat them better — so that's for the multiple myeloma field. But I hope that our fund is going to grow, both in terms of size but also in terms of portfolio companies, that we can help advance these therapies into the clinic, that we can partner with pharma companies who can then advance the clinical trials and provide the marketing expertise they have, and that we ultimately will be able to provide a cure for as many multiple myeloma patients as possible.

Absolutely, that is the ultimate goal. And I'm assuming your vision to be part of that is obviously to be able to invest in more and more, as the organization continues to grow and evolve?

Of course, and it will obviously be easier if we have success, and we can reinvest the proceeds from our exits into other, hopefully successful, companies — that's really why we're striving to build an evergreen fund that can support itself. But we're also incredibly thankful to our donors, who are incredibly instrumental in making all of this happen, and also to our scientific advisors and board members, who provide so much great input — many of them are really touched by multiple myeloma themselves, or through their families, and that provides such an important motivation for us to strive toward that ultimate goal of a therapy that cures multiple myeloma.

To your point, we forget about some of those people as well, right? It does take a village to bring success, and it sounds like you have a strong village behind you.

Yes, definitely — that's where we, as the Myeloma Investment Fund, benefit from the expertise of the Multiple Myeloma Research Foundation, but also our KOLs, the researchers we're close to, and the centers we're working with.

Yeah, yeah, fantastic, thanks — it's been really, really insightful. And if any organizations are interested in speaking with you, we'll definitely have your details available, so feel free to reach out.

Of course, yeah, very happy to speak with you and tell you a little bit more about many other topics — the emergence of so many other philanthropic funds, and also the fact that more and more women are on the investment side. I'm very glad to report that my associate is also female, and building a female-led investment fund is also really a joy, to contribute to female entrepreneurship.

Yeah, fantastic — well, that's something that's definitely close to both of our hearts, right? We spend a lot of time on this too — you do a lot as well on this topic, and I volunteer too, because it's just crucial for the future. We want to get more and more young girls and women moving forward, because that has to be the future.

Yeah, we want to provide some role models here. Personally, I'm also involved in the W20, which is the women's organization of the G20, bringing more women into entrepreneurship and also into STEM, and really showing them that this is not only possible, but really a great success — because we're 50% of the world's population, and we're really driving a lot of the outcomes here. So I'm very excited to contribute to that.

Absolutely. Thanks for what you're doing, and what the organization is doing — it's crucial, and incredible to hear the details around, yeah, a specialty fund, because we hear a lot — we've talked to lots of organizations, and they have a wide portfolio reach, so it's been really interesting to hear your approach, and the way you work with your organizations to help support them and bring success. I have another question, hopefully it's okay that I go there. When we met, you had a violin on your back — you were about to go and practice with, I think, some individuals in San Francisco. And I'm curious, you're also going to be at ASCO, I think you're going to play something there? I don't know if that's a secret — hopefully that's not a secret, we'll have to cut that out if it is.

No, no, no, no, no — I hope it will not stay a secret.

Yeah. So, you spend your time playing the violin, and also with some colleagues in the industry, I understand?

Yeah, so first of all, thank you, Sabine, for the opportunity to talk a little bit more about the Myeloma Investment Fund, and very happy — anybody who wants more information, feel free to reach out to speak with us. The violin has been part of my life since I was five years old. I've been — I am a professional-level violinist, grew up in Berlin, in Germany, and when I was ten I got into a youth orchestra, and then played at a professional level with professionals pretty much all over the world — played with the Boston Philharmonic, at Carnegie Hall. Music is something that's very close to my heart, because it provided so many learning opportunities for me — I'm very comfortable being on stage, speaking, presenting, I've learned a lot about time management through all of that. And even as a young teenager I saw so many countries, worked with international people, which really instilled in me this curiosity for different countries and cultures that I've kept up to this day — I speak several languages. For me, music is also a way people can grow together, and even though I still play at a professional level, with individuals but also in orchestras, I'm more and more thinking about it as a connector for me — music touches very deep sides of everybody's heart. But there are different types of music — I'm a classically trained violinist, but there's so much wonderful modern music, and through that I play more and more with bands. I played with a band at BIO, and I'm very excited that I'm now playing with the Checkpoints — the house band that plays at ASCO and also at SITC — and that's going to be in Houston. I'm going to be the Texas fiddler there, and it's...

Well, everyone that's going to be there will get to see you live — fantastic!

Yeah, I hope you can come. Music is such a wonderful connector, and I'm excited to connect with all the amazing Nobel Prize winners in the band, and with the audience members. And providing music also for patients — I'm super excited about that.

Now, fantastic — ah, nice story, thanks for sharing that. I'm sure you'll end up in some videos, some YouTube video, because I'm sure people will be recording that — we'll have to make sure we watch that when it comes out.

Yeah, definitely — the band already has a website, I'm not on it yet, but hopefully relatively soon.

Yeah, fantastic — again, what an inspiration: a scientist, a violinist, and a financial expert. So incredible — we can do it all.

We can do the things we love, and we can do them very well — that's one of my most important learnings, it's about trying to be the best you can be. And, having been blessed with a lot of different qualities, I'm really trying to be the best connector and musician I can be, trying to be the best investor in multiple myeloma companies that I can be. It's not so much about comparing myself — of course, I'm competitive, and I do also try to be that in a comparative way, but it's really about doing the best for all of those around me. So, having tried to be academically excellent, but also on the business side, I'm always trying to keep the most important outcome in mind, which is providing a cure for patients with multiple myeloma — that's really the North Star here.

Well, thank you — thanks for sharing your North Star with us, and a bit about yourself and the organization. Wishing you a wonderful weekend ahead, and let's see, maybe in a few years we'll have to get together again and do a recap, and see how things have shifted and changed in this therapeutic area.

I'm sure they will — change is the only constant. But being a lover of change, and being supported by so many amazing professionals, and also by people like you, who I had the fortune to meet, and also to meet, in San Francisco, someone who's helping us spread our story — I'm really appreciative of that, and hope to connect through that with many others who can help us fulfill our mission of providing a cure for multiple myeloma patients.

Absolutely, it's been a pleasure. Thanks, Stephanie.

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