Often, while reading a book, you feel that it makes you angry and you feel the urge to quit it, but at the same time it also illuminates perspectives that have not previously been obvious to you and this makes you want to keep reading till the end. This was the case with Anthony Caluzzo and “Le mythe de l’entrepreneur: défaire l’imaginaire de la Silicon Valley”.
The author aims to deconstruct the entity of the charismatic entrepreneur and states that some of the most iconic people that we know (and their companies), were just the result of a mature ecosystem, where all the pieces of the puzzle had already been in place and they “just” had to connect them. However, this does not answer the question, why it was the specific person X and not the person Z who succeeded, while both were at the same place and time. Or why some companies grew in the 70s and are still here, but some others have been lost in time.
However, he is very accurate to observe that when giants like Apple and Microsoft started in mid 70s, there was already a strong ecosystem of multiple companies, who had the expertise to produce high performance electronics, at large volumes and at low cost. These companies, however, developed their technology after Second World War and their biggest client was the US Army that provided significant cash (and not just research grants) to support their growth. And going back, this knowhow and technology was an outcome of the strong research activity in Silicon Valley, which started before the First World War. Yes, some people saw the opportunity, had a vision and they were gifted enough to make all necessary connections in terms of scientific development, business development and commercial success.
Coming to Radioligand Therapy (RLT), we are now experiencing a boom in the field. But if we go back in time, we will see that nowadays we again have an ecosystem, more mature than ever before. Until almost 2020, nuclear medicine was mostly a diagnostic technique, so not a first priority for most pharma companies. Even the diagnostic accuracy was dependent on the medium quality and high cost of clinical scanners. At the same time, many oncologists were not considering SPECT/PET as a priority study and in many countries the health system did not support their spread use. Also, preclinical systems were rather expensive and low performance, making preclinical research more complicated, limited to just few academic centers.
But how does the ecosystem look today? Pluvicto, Xofigo and Lutathera were a great success and raised the interest of both pharma companies and investors in the field. Research labs now have access to a variety of new radioisotopes, and state of the art equipment to study new molecules and targets. There is a mature mindset in academia for protecting IP and creating spin-offs that can undertake the risk for screening new ideas. There is access to early-stage funding and tenths of companies have raised several millions to assess new technologies. A number of CROs offer the infrastructure and know-how to undertake these demanding studies and provide high quality preclinical data. Clinical CROs can design Phase 0, Phase 1 and more advanced studies, aiming to demonstrate the clinical value of these drugs. Big pharma companies invest in internal programs, create synergies with smaller companies or do direct acquisitions. As production and supply of radioisotopes remain a challenge, we also witness big investments in this field. We should not neglect the progress in big data and AI, which allows to better exploit and if needed revisit this huge amount of data that is produced, especially as new tools in the near future can uncover valuable information, which is not obvious today.
For sure, there are still several challenges, but we live in very interesting times. There is an active ecosystem and this is the result of small and big steps that have been made in different fields over the past 50 years. Any new development can influence multiple players; it might be a new generator for producing isotopes, a new radiolabelling approach, a new promising target, an increase in computer storage and processing capacity, a new data analysis approach. Each new small victory motivates more people to keep trying to move the field a step forward.
Luckily, there is a synergetic spirit in this ecosystem, as we understand that no one can do all this alone. And if one wins, usually many will win. Still -and going back to the Caluzzo’s book- scientists and entrepreneurs in RLT may not be iconic figures, but they are not an obvious result of the ecosystem. There is tremendous scientific knowledge, combined with entrepreneurial skills and vision. For sure, it is not for all!