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articles, Community, February 2016, GSC career events, Mentoring & Outreach

Contributing to the Healthcare Ecosystem through Evidence-based Investing

February 10, 2016 Kofi E. Gyan

In an effort to continually explore the interface between science and business, Tufts Biomedical Business Club recently caught up with Dr. Zach Scheiner, an Associate at RA Capital Management, for a discussion about his experience in the healthcare investment industry.

RA Capital Management is a crossover fund manager dedicated to evidence-based investing in public and private healthcare and life science companies. Prior to his current role at RA Capital, Zach worked as a Science Officer at the California Institute for Regenerative Medicine, where he managed a portfolio of research programs concentrated in translational neuroscience. He holds a BS in Molecular Biophysics and Biochemistry from Yale University, and a PhD in Neurobiology and Behavior from the University of Washington.

As an Associate for RA Capital, Zach’s efforts are realized through the team’s core research division, TechAtlas. This division is a scientifically trained team that maps out competitive landscapes in a continual effort to survey the landscape and identify emerging therapeutics and technologies that will reshape how physicians treat disease. The interview is edited for brevity and clarity.

Tell me about the career path that led you to your job. How did you become involved with RA Capital Management?

My interest in biomedical science and research began as an undergrad, when I had several summer research internships and was exposed to a few different fields of research. At the same time I had my first opportunity to teach science classes at a local high school and quickly realized that I also had a passion for teaching. After graduating, I decided to teach middle school science and math for a year (which turned into three) before returning to research and going to grad school.

I attended the Neurobiology & Behavior graduate program at The University of Washington in Seattle. My thesis work focused on the molecular basis of memory and drug addiction. Though I enjoyed my time as a graduate student, by my fourth year I began to realize that the academic career path and spending more years at the lab bench were not for me. I really enjoyed reading primary literature, planning experiments, and reviewing/analyzing data, so as I finished up graduate school I began looking at alternatives where I might be able to incorporate these interests as well as leverage my scientific background in a non-research capacity.

I found a great opportunity at the California Institute for Regenerative Medicine (CIRM) in San Francisco. CIRM funds stem cell research at institutions throughout California with the goal of advancing promising stem cell based therapies into clinical trials and ultimately to patients. I began as a science writer and quickly moved to a position managing a portfolio of translational research programs. In this position, I worked closely with funded scientists to help set milestones and success criteria, assess progress, and, however possible, facilitate success. In my six years at CIRM I learned a tremendous amount about the drug development process, gained experience reviewing and analyzing data, and developed management skills, all of which have been invaluable in my current role at RA Capital.

My move to RA Capital was the result of my wife being offered an assistant professorship at Brown University. In preparation for the move from one coast to the other I reached out to everyone in my network, including an old lab-mate I had stayed in touch with from graduate school who was now an Associate for RA Capital. I had a long-time interest in biotech investing, nurtured by my dad, and had been learning about this part of the industry in my spare time. Luckily, RA was hiring and the rest is history. For me, RA Capital was a perfect fit. I can put my communication and analytical skills from teaching, grad school and CIRM to good use and I love staying immersed in cutting-edge science while learning more about the investment side of the biotech industry.

What are the duties/functions/responsibilities of your job?

As an Associate with RA Capital, my primary role involves creating dendrograms (mind-maps) of specific diseases or capabilities within the healthcare industry. These comprehensive landscape maps take all the available drugs, both on the market and still in development, and put them into the context of current standard of care and unmet needs. They help our team fully appreciate and contextualize the market potential of assets and companies before making investments. Mapping out a disease landscape is a research-intensive process that involves surveying the literature, meeting with companies with assets in the space, speaking directly to physicians, attending scientific conferences, and analyzing data. The process can take several months to complete but the maps are never truly finished. Therapeutic landscapes are constantly evolving, new data are released and new licensing and acquisition deals are made. Our maps are equally dynamic and a lot of my time is spent staying up to date with the latest news and data coming out in the areas I cover.

In addition to mapping, Associates also join the investment team in diligence projects on specific investment opportunities. Our maps are a great way of contextualizing drugs and their competitors and can help our team identify potential new opportunities but it’s always critical to dig deeper before making an investment. One of the most rewarding parts of my job is seeing all the work I’ve put in researching and understanding a therapeutic space pay off with insights that are potentially investable, or that directly benefit a diligence project.

On a day-to-day basis I also survey industry news and the scientific literature not only to keep up with the science but to search for new investment opportunities that could be licensable for an RA Capital portfolio company or even form the basis for a new company. I also enjoy being involved in the recruiting process at RA and playing a small role in shaping the future of the company.

What is the most rewarding part about your job?

Personally, the most rewarding part of my work is knowing that we are investing in companies that are developing therapies for patients that really need them! These companies often have no marketed drugs and need capital to advance their assets through clinical trials and into the hands of patients. When I think about the work that I do, I know I am helping to identify great science, underappreciated drugs, and promising new opportunities. And I hope that by influencing where RA Capital’s dollars are invested, I’m impacting the whole healthcare ecosystem in a positive way.

What experiences best prepared you for your job?

I think all of my previous work experiences helped prepare me for RA Capital, the first of which was teaching. Communication is such an essential skill and getting an opportunity to develop this early in my career has been a huge benefit. Having controlled a classroom every day for three years definitely makes communicating with colleagues, companies and scientific experts a little easier. Effective communication is a vital part of this job.

The second experience is my time spent as a graduate student. In graduate school I learned how to rigorously analyze data, both my own and from the literature. I developed my critical thinking and analytical skills and the ability to quickly identify key questions, design key experiments, and understand the limitations of a study.

Lastly, at CIRM I learned the process of moving a drug from the lab to the market and everything in between. I also regularly participated in grant review meetings with panels of scientists, clinicians, and patient advocates. These meetings gave me the opportunity to learn what was truly important to each group. While the views and opinions would often vary between the groups, one key takeaway was that for a drug to succeed, doctors have to want to prescribe it and patients have to want to use it. My experience at CIRM taught me to evaluate drugs with the patient perspective in mind; new therapies are worthless unless patients will use them, and sometimes improvements that appear marginal can be very meaningful to patients.

What skills or personal characteristics do you feel contribute most to success in this industry?

Very often, investment firms require that applicants have a background in finance, an MBA, or prior experience in the industry. That is not the case at RA Capital. I wouldn’t say any particular background or degree is required, but there are certainly skills that are critical. Analytical skills, for example. The ability to rigorously analyze data and quickly get to the “meat” of primary literature or a clinical data set is invaluable. Another key skill is effective writing and communication. Much of my day is spent writing and talking. I am continuously expressing my thoughts and providing analysis and it is important to do so concisely and effectively.

In terms of personal characteristics, I would highlight skepticism. Being skeptical is a common trait among scientists due to the nature of research, but this skill is especially important when meeting with companies. Every company is trying to convince us that their assets or data are the best. Skepticism is required to separate the pitch from the quality of the science.

Humility is another important personal characteristic. To put it simply, in something as complicated as drug development, it’s easy to be wrong! There are so many variables to consider, and science changes so quickly; it’s essential to have an open mind and be humble about everything you do not know.

What are the biggest challenges you face as an associate for RA Capital Management?

I think the largest challenge I face is simply the pace of the industry and science itself. There is new data coming out all the time; from company press releases, new primary literature, scientific conferences—the amount of information can be overwhelming. Developing the ability to quickly assimilate and analyze new information is the biggest challenge. But it’s also one of the things I enjoy most about my job. In this field you have to enjoy constant learning and also get good at processing information quickly enough to inform an investment decision. The fast pace is challenging but exciting.

What are some other opportunities within RA Capital Management for scientists aside from the TechAtlas Research Division?

Most opportunities for PhD trained scientists are within our TechAtlas research team. This team is made up primarily of PhD trained scientists in either Associate or Scientific Writer positions. The Science Writers work closely with the Associates as they build the story of their map, acting as a thought partner to develop the key insights for standard of care, unmet needs, and investable opportunities for each disease. As members of the research team gain experience, they can specialize in one of several areas, including early-stage assets, strategic analysis of licensing and partnerships, and equity analysis.

For somebody interested in pursuing this career, what would be your advice to best prepare them?

I would highly recommend that PhD candidates supplement their education in three areas: biostatistics, clinical trials, and FDA regulatory pathways. These topics are not always emphasized or even addressed in many graduate programs. A working knowledge of biostatistics goes a long way; being able to understand statistical pitfalls and the pros and cons of different analyses is invaluable. I would also recommend becoming familiar with clinical trials: the general FDA requirements for advancing drugs into Phase 1 trials and the typical development path for new therapies in your field of interest. Few graduate students get exposed to these areas. I would strongly suggest looking beyond the specific questions of own research project to get an understanding of the broader context: the standard of care for the disease, unmet needs, and competing approaches. If your research isn’t disease or therapy focused, choose a disease of interest or imagine potential applications of your work and research those. Putting new research and data into a broad context is a lot of what we do, so the earlier you can start practicing, the better prepared you will be.

articles, Community, February 2016

Qualifying Exam Survival Toolkit: Faith, Trust, & Post-Its

February 9, 2016 Kayla Gross

I read my drafted email with the attached qualifying exam proposal for the fifteenth time, hit send, and then I felt like I was going to throw up.

It was March, the snow outside was half-melted and tinged gray with grime, and I had just submitted my qualifying exam proposal. Three weeks of carrying highlighters in my pockets, drinking tea morning to night, and rarely parting from my computer, and it all came down to the click of a button. At the time, it felt like the most deciding thing I would ever do during my PhD, and that was terrifying. Looking back, it was probably just the irregular sleep hours and too much takeout that had me feeling slightly nauseous.

So, my advice, first and foremost: buy a lot of groceries and do your laundry ahead of time. I sound like a parent, I know, but still: do it. Good food and clean clothes–as well as having those tasks checked off your list in advance–really can save you in the midst of spirals of self-doubt or experimental design frustration. And you will have those moments, but it is important to know they will either pass eventually, or you will beat it by finding a way to prove yourself wrong.

Everyone–and I do mean everyone–told me, with fond amusement: you’ll be fine, it won’t be that bad, no one is out to get you. And I can tell you, with complete certainty, that is true in retrospect. I have become the older student whom I regarded with respectful but extreme skepticism this time last year. Like they said, I ended up being just fine. Still, I remember the stress and the worry, the cycle of figuring out a problem in my proposal to only have that create yet another problem, and so it went, on and on. So I will avoid telling you what most others will and instead advise this: trust your knowledge and your intuition, even if you try to convince yourself otherwise, because you do know what you are talking about. Have faith. You are going to be your own worst enemy in this four weeks of research and writing, planning and designing, but at least it is an enemy you know well. Use that to your benefit: trust your doubt, because it will help you find holes in your work where others will as well.

And there will be holes; you can’t catch them all. This is where help from older students comes in. Your practice talk with them will be one of the most valuable experiences in this process. Be prepared for your 10-15 minute talk to take an hour, or probably two, to be critiqued by your peers. You may not be able to answer all of their questions, but those are questions you then will be able to answer in your exam if they get asked. Their advice on layout and presenting style is also invaluable; they have gone through this before, and their experiences and mistakes in their own exams will be your gain. Take full advantage, even if you have to bribe them to attend with baked goods (just kidding!).

Lastly, invest in some post-its. Keep them everywhere–by your desk, by your bed, in your bag. When an idea or a question or a worry strikes, you’ll have somewhere to record it, especially if you don’t have time to deal with it at that moment.

Faith. Trust. Post-its.

Good luck!

articles, February 2016

New Dietary Guidelines focus on longevity of healthy eating habits

February 9, 2016 Kayla Gross 2 Comments

This year, Valentine’s Day may end up being a little less sweet, at least for those following the new 2015-2020 Dietary Guidelines for Americans. This most recent report on the current status of nutritional health in the U.S. suggests reduction in sugar intake as one major priority for improving the diet of the American public. While not a particularly unexpected suggestion, sugar overconsumption was emphasized more than in past reports, which primarily focused on decreasing total calorie consumption as well as sodium and saturated fat intake. While the report also dictated that these latter two troublesome nutrient groups also be consumed less, it was sweet versus savory that emerged as the one of the more challenging adversaries to healthy diet that needs to be faced in coming years.

This eighth edition of the guidelines was released at the start of the new year by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). Updated every five years since its introduction in 1980, this report not only outlines the current state of nutritional health in the U.S. but also provides standards for improvement over the next five-year period. Each report encourages changes in Americans’ diet to improve overall health and prevent disease by suggesting key recommendations for beneficial food and beverage consumption as well as methods that organizations can use to enforce their implementation.

To make these recommendations, a Dietary Guidelines Advisory Committee consisting of leading nutrition scientists and medicals experts reviews available nutritional data in the form of existing literature reviews, committee-generate literature reviews, national data from federal agencies, and food pattern modeling analyses. From there, they summarize the scientific evidence and the corresponding proposals for dietary changes to pass off to a combined HHS and USDA policy contingent that assembles the final report. Professionals from federal and private organizations can then use this report to direct and shift public perception and practices regarding nutrition. The ultimate goal is to have these changes then improve public health in relation to diet and overall well-being.

Currently, about 60% of the U.S. population over two years of age exhibits a healthy eating index, while only around 20% meet physical activity guidelines. However, this is contrasted by the fact that over half the population of American adults has one or more diet-related chronic diseases. Thus, this year’s report framed its key recommendations in the context of being necessary to reduce chronic disease; specifically, they highlighted how a healthy diet can reduce the risk or progression of obesity, type-2 diabetes, and cardiovascular disease. It argues that encouraging disease prevention through healthy diet would not only improve quality of life, it would also reduce national medical expenses by a significant amount. Chronic disease focus was an expansion of previous years’ disease prevention aims, which centered on weight and obesity alone.

“This edition of the Dietary Guidelines focuses on shifts to emphasize the need to make substitutions—that is, choosing nutrient-dense foods and beverages in place of less healthy choices—rather than increasing intake overall.” – 2015-2020 Dietary Guidelines for Americans.

As such, the key recommendations in previous reports emphasized calorie intake in addition to calorie balance (intake versus expenditure of calories) as crucial to maintaining health-beneficial weight. In contrast, this year’s report instead put the term eating patterns in the spotlight, with emphasis on variety within food groups and nutrient density, as part of their five key recommendations (see Box 1). While earlier editions of the guidelines also encouraged these three principles, the 2015-2020 Dietary Guidelines push them front and center as a way to encourage the American public to make more long-term, and thus hopefully longer lasting, changes to their diets.

Box 1: Terms to Know

Eating pattern: The combination of foods and beverages that constitute an individual’s complete dietary intake over time.

Nutrient dense: A characteristic of foods and beverages that provide vitamins, minerals, and other substances that contribute to adequate nutrient intakes or may have positive healthy effects, with little or no solid fats and added sugars, refined starches, and sodium.

Variety: A diverse assortment of foods and beverages across and within all food groups and subgroups selected to fulfill the recommended amounts without exceeding the limits for calories and other dietary components.

The revised Dietary Guidelines themselves are not particularly different than past years and are what you would expect. Lots of veggies and fruit, some dairy, protein and grains, with limited amounts (<10% of overall calorie intake) of salt, fat, oil, and sugar is the recommended pattern of eating for the U.S.-style diet plan. Two alternatives were also described, where the Mediterranean-style plan contains more fruit and seafood and less diary while the Vegetarian plan obviously eliminates meat, poultry, and seafood while emphasizing legume, soy product, and whole grains intake.

In addition to listing daily intake amounts and limits for the food groups, each plan also frames these recommendations in the context of weekly amounts and limits. The unique aim of this dual description is to encourage more flexibility in adhering to the guidelines. It will hopefully allow Americans to recognize even if they cannot consistently meet daily quotas of appropriate nutrient and food group intake, they still can adhere to a healthy eating plan on a broader time scale.

The report also placed heavy emphasis on considering the nutrient density of consumed food. For example, a glass of juice serves as a fruit serving, but eating ‘whole fruit’ such as an apple or orange is better, as is eating whole grain bread over other types. The lack of variety in food groups—especially vegetables and protein—consumed by Americans was also a concern. Specifically, more range in veggie types (dark green, red and orange, legumes, and starchy) as well as a shift away from meat and poultry towards seafood was encouraged. Again, these are suggestions that have been made previously by the USDA and HHS, but combined with the flexibility from the newly emphasized weekly guidelines and eating patterns as a whole, the hope is to increase specifically the ease of following these nutritional recommendations.

The report also warns to keep an eye out for hidden sources of nutrient groups that should be ingested in limited amounts and have been linked by moderate to strong evidence to chronic disease (such as sugar, saturated or trans fats, sodium, and oil). For example, many types of meat are a source of high saturated fat, and yogurt can often contain high amounts of sugar, with processed foods and mixed dishes (such as burger or pasta plates) at restaurants typically containing significant amounts of salt. Given that the average American consumes almost twice the recommended levels of both sugar and salt in their diet, shifting eating patterns to lessen intake of these disease-linked food groups would be one significant way of improving general health.

To shift American diet towards a healthier nutritional composition, the guidelines helpfully provide a wide variety of suggestions in how to make this change. To incorporate more fruits and vegetables, they suggested skewing the balance of mixed meals towards these groups. For example, making an omelet for breakfast or a stir-fry for dinner that is composed of more vegetables than meat or poultry. They also give specific examples of how to make healthier exchanges in other food choices: celery and humus instead of chips and salsa, baked chicken over fried, an apple or unsalted nuts instead of commercially made granola bars, and oil instead of butter or shortening for cooking. It emphasizes that small modifications, when combined with one another, can compound into large changes to diet that, if maintained, can lead to beneficial improvements in health.

One outstanding gender-specific suggestion included reduced meat consumption by teen and adult males, who tend to over-consume that food subgroup. Additionally, adolescents and young adults as a whole typically demonstrate the worst adherence to past guidelines. This report’s heavy focus on how to shift eating patterns towards more nutrient-dense options hopefully will encourage adoption of healthy nutrition at a young age that will then be preserved into adolescence and adulthood.

Improving access to healthy food both outside and inside American homes was a major hurdle that the Dietary Guidelines identified in implementing these shifts in eating patterns. Grocery store development and access to other sources of food such as farmers markets, shelters, food banks, and community gardens or cooperatives were specific examples provided for how government and private sector professionals can make that challenge smaller. Household food insecurity—defined as the lack of consistent maintenance of healthy food choices within a home—was also a major concern, especially for families or individuals who struggle financially. Educational and nutrition assistance programs would need expansion and increased penetrance into communities to combat this issue in a more effective manner, especially given this report’s focus on healthy diet patterns that have longevity.

More than anything else, the Dietary Guidelines, 2015-2020 heavily emphasizes cementing long-term healthy eating habits by encouraging variety and flexibility in food choices over counting total calories or quantifying diet by calories alone. Directing changes to national nutrition in this way will hopefully begin to address the significant need for large changes in American diet required to reduce chronic disease in our population.

articles, December 2015

Caroline Genco, PhD, awarded Arthur E. Spiller, M.D. Professorship

December 10, 2015 Nafis Hasan

Caroline Genco, Ph.D. (Source – Sackler website)

On Tuesday, Dec 1, 2015, Dr. Caroline Genco, chair of the Integrative Physiology & Pathobiology, was installed as the inaugural Arthur E. Spiller, M.D. Professor This professorship was made possible by an estate gift from Dr. Spiller and this fund is meant to support “an outstanding biomedical researcher and educator at Tufts University School of Medicine who demonstrates expertise in the field of genetics”.

Dr. Genco completed her Bachelor’s degree in Biology at State University of New York (SUNY-Fredonia) and did her graduate work in microbiology at University of Rochester School of Dentistry & Medicine. She went on to work as a postdoctoral scholar at Center of Disease Control (CDC) and later, walked the path of an academic that led her to Boston University School of Medicine (BUMC) prior to Tufts. At BUMC, she was honored with the Lifetime Achievement Award for Research & Service (2012). She has also served on numerous NIH study sections, worked with & advised several pharmaceutical companies, and has mentored a host of graduate students and postdoctoral scholars throughout her career.

Dr. Genco’s research spans basic, translational and global health in relation to mucosal pathogens, with a particular interest in genetic elements of host-pathogen interactions in systemic inflammatory disease states. Some of her notable works include establishing the connection between oral mucosal bacteria and their role in atherosclerosis and plaque formation. Her current work focuses on innate immune responses to mucosal pathogens, regulatory mechanisms in bacterial pathogens and the association between the microbiome and chronic inflammation, with an interest in pancreatic cancer. More details are available at her Sackler webpage – http://sackler.tufts.edu/Faculty-and-Research/Faculty-Research-Pages/Caroline-Genco.

Besides her academic accomplishments, Dr. Genco also serves as the President and Treasurer of the Christina Clarke Genco Foundation, Inc. This non-profit was established in honor of Christina Genco, who passed away in a tragic biking accident in 2011. This organization embodies the values of late Ms. Genco and seeks to empower young adults so they can make a difference in their communities. In addition, the organization also focuses on improving biking safety, providing scholarship to female athletes and assisting affordable housing initiatives.