The former president of AstraZeneca UK and the ABPI has given up big pharma to join biotech Redx. We speak to her about what prompted the change, how she thinks British life science will fare in the coming years, and how the UK can help smaller companies like Redx to thrive

Tell us a bit about your background and why you decided to join Redx.

I was at AstraZeneca for almost 20 years in different roles. Most latterly I was president for AstraZeneca UK, and for the last two years I was president of the ABPI, although I stepped down in July.

I’ve spent quite a large portion of the last couple of years working with government – particularly on the Life Sciences Strategy – partly because of my ABPI role and partly because of AstraZeneca. Through that, and also through AstraZeneca’s move to Cambridge, I’ve  done quite a lot of work with UK life sciences and worked with  a lot of companies.

I do feel quite passionately that the UK has very strong science, but I don’t think we always grow very strong companies out of that – I think a lot of that goes over to the US. I thought a career move into biotech suited me, but also that I could make a difference with my leadership and experience to leverage UK science to create a growing, strong company.

Although Redx is a small company it has some very interesting science, and I felt it was the sort of company that could use some leadership and a bit of a relaunch – last year the company went into administration through a financial issue, but the good news is that it exited administration, which not that many companies do.

What does Redx have in its pipeline?

Redx is quite an early stage company, focused on discovery, and its strengths are in the capability to design precision drugs against a specific target.

The programme that is in the clinic now is a porcupine inhibitor  called RXC004, a cancer drug that inhibits the WNT pathway. We also have two programmes in fibrosis, which focus on a target called ROCK.  They’re not in the clinic yet, but we hope the first one will get to the clinic  by early 2020.

Historically Redx was in quite a lot of therapy areas, including  anti-infectives, but those units are now shut and we’re focusing  on oncology and fibrosis precision medicines.

What is the mechanism of action for these drugs?

The WNT pathway is a very central and important pathway in controlling cell proliferation. Because of that, there is a concern about unwanted effects if you switch it off.

The reason we target porcupine is that we think it acts like a regulatory switch that dials the pathway up and down; it’s not a complete on or off switch, which is important because you still need some activity in the pathway.

The WNT pathway has also been shown to control the immune microenvironment around the tumour, across 22 different cancer types. That means it could potentially make patients sensitive to treatment with immuno-oncology drugs that they haven’t been sensitive to before.

So that give us two options to develop RXC004, one is the direct anti-cancer agent on the tumour; the other is to make a tumour sensitive to immuno-oncology drugs.

RXC004 is in phase 1 clinical development. The study is currently paused, as after dosing the first patient there were a number of side effects, as there was a much higher dose in that patient than we had anticipated. It turned out that  the elimination of the drug out of the body was much  slower than we had expected, which means that your exposure to the drug is much higher for a given dose.  The plan is to go back in with a significantly lower dose  and we’re hoping to restart the study in the first half of  next year.
For fibrosis we’re not in the clinic yet, but we have some really interesting programmes. One is called ‘Soft ROCK’. Historically ROCK inhibitors have had a lot of hypertension issues. But this drug is highly selective and only impacts the ROCK in the gut, which will make it a promising candidate for the treatment of  Crohn’s disease. As it gets
absorbed it degrades before it enters the main body system, meaning it doesn’t cause hypertension.

Is there anything you’ve picked up from being president of the ABPI that you can take into your new role?

Obviously it’s quite a different focus and scale of operation but it’s interesting to see how all the policies that are aimed at helping British science to thrive and create companies actually work in practice on the ground. I’m passionate about Redx and seeing what we can do, but I’m also interested in seeing how that actually helps us create  good UK companies.

I’ve also come to see that there needs to be a good ecosystem for biotech companies in the UK. You need to work with all sorts of companies to make this business model work; I think that’s probably the biggest thing I’ve taken away from the ABPI. We want to grow Redx into a great UK biotech company, but that will require partnership with many other companies such as large pharma and other biotechs.

What do you think will be the biggest challenges for the UK industry in the next couple of years?

Getting beyond Brexit is probably the biggest challenge. Having said that, I think the government’s Life Sciences Strategy is a great blueprint, although the challenge is making sure it is implemented properly, which isn’t always the UK’s strength.

It will need everyone in the ecosystem to implement – government, industry, the NHS, academia. Small companies like Redx have a role to play in that, big companies like AstraZeneca have a role to play, charities like CRUK have a role to play, so you need all of those players committed to really delivering the Strategy.

I think the UK punches above its weight in science, and that’s why I’m excited about companies like Redx because I think we have great science, and if we can turbocharge the environment we can create some very successful companies.

How do you think pharma’s relationship with the NHS should progress in the next couple of years?

I think it’s a really critical relationship, and it’s important that people understand that you don’t get medicines by accident. You need to have clinicians in the NHS talking, discussing with the pharma industry how to develop drugs, because otherwise drugs wouldn’t get developed. So it’s important that the public trust the relationship between biotech and pharma companies and clinicians.

If I look at the collaboration Redx has with the NHS for a phase 1 product, we’ve been able to work extremely closely with some phenomenal investigators in the health service. But if I contrast that with some of my experience of launching drugs for use on the NHS, it’s much harder to get them into mainstream usage.

I would contend that the NHS and UK industry actually work really well together, so we need to make sure that we’re not only good at early stage, but we’re also good at partnering through all stages of medicines development. But that also means the industry needs to be responsible in its pricing and partnerships. The relationship between the industry and the NHS is probably the most important success factor for the Life Sciences Strategy.

You’ve previously worked in the US. Is there anything you think the UK can learn from the US industry?

I think where the US benefits is that they have a lot of companies that really thrive because they adopt innovations very quickly, and they are prepared to  invest in those companies as well as invest in the innovations when they come to market. They are more innovation-friendly.

Using an example from AstraZeneca and a UK developed drug, the minute it was approved by the FDA there was a massive effort to get it to the first patient in a matter of hours, but in the UK it sat around for nine months being evaluated and re-evaluated, and three years later it’s still not fully available for patients – and the drug only took three years to develop in the first place.

What else could be done in the UK to encourage more innovation?

Innovation is there in the science, so we have to make sure that we capitalise on that, make sure that science like Redx’s get funding in the UK so that we can develop it fast. I have no doubt that we have some great phase 1 investigators and we do a fantastic job in the UK for that, but when it comes to phase 2 and 3 development and taking it to market, that will probably happen in the US, and arguably maybe some of the investment and funding for the company would come from the US, so it would be nice to see that some of those things were available in the UK.

It would be good to have more investors in the UK that really understand what drug development is, as well as what the risks and the potential benefits are, but also have a market that is innovation-friendly.