What happens when the humanity of oncology collides with the creative engine of biotech? We sit down with Dr. Satya (Nanu) Das, a former gastrointestinal oncologist who left a thriving academic career to build the next generation of cancer therapies. He walks us through his turning points: carrying patients’ stories home, confronting the limits of “approved” treatments, and realizing that trial design (who gets included, what’s measured, and how fast signals are found) can change lives at scale.
We define biotech, from large biopharma to smaller startups, and how clinicians fit into two powerful tracks: clinical development, where protocols are designed and drugs move from first-in-human to pivotal studies; and medical affairs, where data becomes real-world practice through education and access. Dr. Das shares why oncology is inherently experimental, how phase boundaries are blurring, and why targeting biology instead of tumor labels opens doors for rare and understudied cancers. The conversation also gets personal: the emotional calculus of reconciling individual disappointment with collective success, and the courage it takes to “bet on yourself” when outcomes aren’t guaranteed.
If you’ve wondered whether a move from clinic to industry means leaving patients behind, you’ll hear a different story: one where debate beats hierarchy, evidence beats eminence, and collaboration is the default. We compare the instant gratification of patient care with the slower, high-stakes creativity of drug development, explore policy’s role in FDA consistency, and highlight how patient narratives can keep standards focused on what truly matters.
Subscribe, share with a colleague who’s biotech-curious, and leave a review! If you are a practicing clinician, a pre-health, pre-med, pre-pa or pre-nursing student, or someone who is interested in how our drugs are made, you'll want to give this a listen.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley Love (00:00):
Hello, and welcome to Shadow Me Next, a podcast
where I take you into and behindthe scenes of the medical world
to provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face, andwhat drives them in their
careers.
It's access you want andstories you need.
Whether you're a pre-healthstudent or simply curious about
the healthcare field, I inviteyou to join me as we take a
conversational and personal lookinto the lives and minds of
(00:43):
leaders in medicine.
I don't want you to miss asingle one of these
conversations.
So make sure that you subscribeto this podcast, which will
automatically notify you whennew episodes are dropped.
And follow us on Instagram andFacebook at Shadow Me Next,
where we will review highlightsfrom this conversation and where
I'll give you sneak previews ofour upcoming guests.
(01:03):
What happens when you discoveryour passion for medicine
expands beyond the exam room?
In this episode, I sit downwith Dr.
Sasia Doss, a former medicaloncologist who made a courageous
pivot into drug development.
We talk about carrying patientswith you long after clinic
ends, the tension betweenindividual loss and collective
(01:24):
progress, and what it means tofollow curiosity even when the
path forward is unclear.
He defines the biotech industryand he explains how courage,
creativity, and apatient-centered focus is still
possible, even when you stepoutside traditional clinical
roles.
Please keep in mind that thecontent of this podcast is
(01:45):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer, or company.
This is Shadow Me Next with Dr.
(02:07):
Satya Doss.
Thank you so much for joiningus today on Shadow Me Next.
I am thrilled to have thisconversation with you, primarily
because it is something that Iknow very, very little about.
So you are a former academicmedical oncologist, turned drug
developer.
And really, before we dive intowhat both of those roles mean,
(02:31):
think back a number of years.
Is this something you wouldhave predicted?
This shift, something that youwould have predicted when you
first entered medicine?
Dr. Satya (Nanu) Das (02:40):
You know, the funny thing is, um no, but
yes.
And what I mean by that is Ithink what led me to medicine
was I was always fascinated bythe mechanism of drugs.
I think, you know, I distinctlyremember as a young kid, um I
had a grandfather who passedaway from myelodysplasia.
Um, and this was 2530, 35 yearsago or so.
(03:01):
And so at that time, therereally weren't many treatments
outside of uh erythropoietin anduh blood transfusion.
So he'd constantly be gettingpoked and prodded.
And uh I remember almost like amap-like bruise, you know, on
his arm or extremity.
And I think even as a kid, Iwas like, I'm gonna come up with
a medicine that could maybetake care of that map because I
(03:22):
knew it was associated withdiscomfort.
So there's kind of breadcrumbsthroughout my career of what's
led me down that path, butcertainly not a linear one by
any stretch.
Ashley Love (03:33):
You know, it's it's a really interesting story and
it's a it's a fun thing toreflect on.
I think as children, um we seethese things.
Children are very aware.
And I like, for example, Iremember seeing Vidaligo for the
very first time when I was achild and thinking, as a kid,
wow, what a what a beautifulpattern on her skin, right?
Of course, it's very artisticto me.
(03:54):
Um, and then not reallyrealizing that there was quote
unquote people thought there wassomething wrong with her skin.
To me, it was just it wasbeautiful.
And and in your case, youassociated the pattern on your
grandfather's skin with painbecause, like you said, it was
due to numerous sticks and pokesand things that kids really um
are averse to.
So it's so interesting, youknow, the way we're exposed to
(04:16):
medicine as children and andwhat becomes of that ultimately.
Let's talk about your career asa medical oncologist.
Um, I believe your specialtywas gastroenterology, is that
correct?
Dr. Satya (Nanu) Das (04:25):
That's right.
Yeah, gastrointestinal cancer.
Yeah.
Ashley Love (04:28):
Really difficult things that you had to um to
walk patients through.
Describe what that looked like.
What was the day in your lifeas uh as a medical oncologist?
Dr. Satya (Nanu) Das (04:36):
Yeah, absolutely.
So I was fortunate to be um, Iwas at Van Devil when I was uh
in clinical medicine.
And so it's a big researchinstitution.
And so that was one of thethings that led me to medicine
was that I could be part of umboth the bedside experience, but
also be part of the experienceof trying to bring new new
treatments to patients.
Um, as you know, GI cancers,particularly pancreatic cancer,
(05:00):
stomach cancer, bile ductcancer, these were some of the
cancers that I focused on.
Still, we haven't made muchprogress.
And so uh unfortunately,there's a dire need.
And so for me, it kind of fitum like a hand in glove because
naturally doing GI cancer meantthat I would have to be involved
in experimental treatments.
And so for me, my I would saymaybe my week was split between
(05:24):
um clinical care and clinicalresearch.
And so I would do about twodays of full clinic with
patients.
Um I'd see maybe 20 to 25patients on those two days.
Um, these are patients that arenew patients coming in that
were referrals.
Um, sometimes as you build up areputation, people actually
come from all over, which iswhich is so humbling for people
(05:46):
to truly make an odyssey to comesee you to get advice.
Um, and then also some of myreturning patients who were
diagnosed in the area, and I wasfortunate to encounter them
early on in their journey.
Um, and then the other threedays was actually spending on
clinical research.
So I was um early phasetrialist, so I was writing early
phase trials.
Um, I worked with the NationalCancer Institute quite a bit.
(06:09):
And um the National CancerInstitute still to this day is
kind of this amazing place wherepharma companies can also
deposit new drugs and you cankind of create new combinations
through the National CancerInstitute.
Um, and that is the bug uh thatgot me actually in fellowship
to stay in academia during mymedical oncology career.
(06:29):
So those other three days, I'dbe either working on trial work
um or doing other types ofresearch.
And I think that's maybe alsoan important point to raise is
that research doesn't come inone flavor, right?
I think um everybody, at leastin medicine, wants to do trials.
Um and that's don't get mewrong, that's uh probably the
highest level of evidence, andthat's a very uh admirable goal
(06:51):
to do.
But there's also so manydifferent types of research that
you can do with things thathave been published.
So what I found myself doingtoo was taking literature that
already had been published andanswering important questions,
doing systematic reviews ofdrugs that had already been
approved in the last three tofive years to see that, hey, are
they really making a differencein the field?
So um, in that research time, Ialso taught.
(07:13):
Um, I worked with fellows, Iworked with med students, I
worked with residents.
Um, and so it wasn't as muchclassroom teaching, but they
would shadow me actually in theclinic or have uh come to me as
a research advisor and we'd havesome projects.
So um that was a little bit ofan overview of what I did in
that past life.
Ashley Love (07:32):
Oh, what an incredible overview.
Thank you so much fordescribing that.
There's a couple of things thatI want to circle back to.
Um the first thing you saidthat just by nature, GI cancer
means you'd be involved inexperimental treatments, right?
Are there other areas?
So let's say somebody hearsthis and they think, oh my gosh,
that that sounds sointeresting.
Um, I'm not sure.
GI is right for me.
(07:53):
Are there other areas ofmedicine that that are similar
where if you are involved inthis medicine, you can almost
guarantee that you're going tohave to be looking at some type
of experimental drugs orexperimental um uh treatment
modalities?
Dr. Satya (Nanu) Da (08:06):
Absolutely.
I'll say this.
I mean, I'll say this with alittle bit of bias because as an
oncologist, oncology bydefinition is experimental,
right?
I think I think this is such anamazing time to go into the
field because I really thinkwe're at the cusp of a number of
breakthroughs that are reallygonna change the paradigm and
maybe actually change qualityand quantity of life for
patients.
But I think oncology, just bydefinition, is inherently all
(08:28):
trial-based because ourstandards of care, to be very
frank, have been very modest andmeager.
And so we're always trying topitch the envelope.
So oncology is one, but I willsay there are so many other
disciplines too, um, inespecially as drug development.
I think oncology, and I wouldsay cardiology have kind of
bidden the poster child's.
Um, you know, certainlycardiology with a lot of the um
(08:50):
diabetes and obesitymedications, there's been a
renaissance in drug developmentthere.
But I see that there are otherdisciplines too, like
psychiatry, for example, wherethere hadn't been new drugs
invented in the last 30 or 40years that efforts are going
into.
So I think you can actuallypursue drug development in any
path of medicine.
But I will say that certaindisciplines, perhaps like
(09:11):
oncology and cardiology, are alittle bit more inherent.
Um, because one, in oncology,we need to improve the standards
of care.
And in cardiology, uh,cardiovascular disease touches
such a broad swath of patientsthat you can conduct these
massive studies to try toimprove long-term outcomes.
Ashley Love (09:29):
Oh, it's so interesting to me.
Thank you for breaking thatdown.
You know, it's it's like youmentioned, um, research doesn't
just come in one flavor.
Well, obviously, there are somany different flavors of
medicine as well.
And within each of thosespecialties, too, you can really
diversify it pretty strongly.
Another thing you mentionedthat I love so much is this dual
relationship that you had inpractice with clinic and with
(09:52):
research, right?
Which I counsel students onthis a lot when it comes to
choosing their specialty.
But I'm speaking of it moreclinic and surgery, um, because
that's my background, is is uhmy background is clinic and then
um most micrographicdermatology surgery.
And um, and I love it, youknow, I love it because I can
form these relationships with mypatients and speaking with them
(10:15):
and evaluating them, but then Ican also really address the
bottom line, and that's removingskin cancer with my supervising
physician and doing things withmy hands, which is just a whole
nother um way to providepatient care.
I would love to break down thisrelationship that you have,
which is just a little differentwith clinic and with research.
And I think I want to start itwith how does how did your
(10:39):
relationships with yourpatients, which I think is
something you feel very stronglyabout, um, how did that inform
your research?
Dr. Satya (Nanu) Das (10:48):
Yeah, I think the it raises the urgency,
right?
I think you're constantlyconfronted by uh, you know, I
think as all physicians, butparticularly oncologists, um, we
carry a lot of ghosts with usof people, um, of loved ones
that we've encountered.
Uh, these are patients thatbecome family right over time
because you see them week in andweek out over the course of
(11:10):
their journeys.
And you're always confronted bythe fact that um most likely at
some point you're gonna have tobreak bad news to this person,
even in the midst of joy andthem doing well.
And so I think the urgency forme was every day I was in
clinic, I was confronted by thatbecause I would encounter a
situation that either didn'tfall within the existing
(11:32):
therapy.
So there's a lot of gray.
I think um it's fascinatingwhen you go through medicine and
you're in medical school, youthink everything is black and
white.
Yet actually, as you become aseasoned physician or uh more
seasoned in in life in anyhealthcare profession, it's all
gray, right?
And I think I began to realizeas I saw more and more patients
that how many patients fell intothe gray, that they didn't fall
(11:54):
cleanly into this setting orthat.
And, you know, maybe there's adrug for pancreatic cancer,
maybe there's a drug for coloncancer, but the small bowel,
which kind of sits in betweenthem, no one studied that,
right?
And but I've had numbers ofpatients with small bowel
cancer.
So that kind of raised thelight bulb that, you know what,
we need to also look at raretumors and understudied diseases
(12:17):
and perhaps look atcommonalities.
Maybe it's not so much, andthis is certainly something that
we are approaching in drugdevelopment today.
Maybe it's not so much aboutthe cancer as it is about the
target, right?
Because if you have a targetthat's expressed across multiple
cancers, then you can get themby targeting that particular
receptor.
And you don't have to worryabout, hey, shoot, um, this this
(12:40):
patient didn't have a cancertype that didn't quite fit in
the trial.
They have a target which wouldthereby make them eligible.
So that was one piece.
Um, I think the other thing wasjust the fact that uh what I
was constantly confronted by waseven these so-called wins and
FDA-proof therapies that we had,um, not that patients didn't
benefit, but it's always tooshort, right?
(13:01):
I think, you know, when we'relooking at these Kaplan Meyer
plots of survival and we say,wow, you know, five year
survival has been extended to30% from 5%, right?
That's that's great, but that'snot enough time, right?
And I think when you're on thepatient side, you're always
confronted by the other side.
Um, and and in fact, you know,one of the pieces um that that
(13:23):
it is is that I had worked onwas a small piece called The
Other Side of the Waterfall,right?
And it was actuallyhighlighting a case of a patient
who's actually on a verypromising treatment, a treatment
that was actually ended upbeing approved, was considered a
game changer, but they didn'tbenefit from the treatment,
right?
And so how do you reconcileindividual disappointment with
(13:49):
collective success, right?
And so these were questionsthat I think constantly fueled
my research efforts because thatkind of created the bug for me
to continue to push to thinkthat you know we have to do
better, we have to look morebroadly at cancer as a whole
rather than individual diseases,um, and a lot of led a little
(14:11):
bit to my pivot down the road.
Ashley Love (14:13):
How do you reconcile individual
disappointment with collectivesuccess?
I mean, it it's it's the weightof being in your role, and it's
a really miserable burden tobear, I would imagine, at some
point.
But but how motivating.
And, you know, thank you fordescribing the fact that as
clinicians, first of all, butalso as a researcher, you do
(14:37):
carry the weight of thesepatients and their diagnoses and
their deaths deeply, you know,and I think that uh it is one of
the gifts that we have beinghuman in medicine is the fact
that we do feel those things.
And that is what is going tomake us irreplaceable um by
robots in the future.
Dr. Satya (Nanu) Das (14:55):
Definitely empathy, empathy.
Um, but I think it's also howdo we protect ourselves too,
right?
From our humanity, and how dowe not lose that humanity?
Or, you know, I'm sure you canattest to this, those cases that
stick with you that you'rebringing home.
And um, and for me, it was itwas a it was a toll, and and you
know, in many ways, this pathallows me to be invested, but
(15:16):
maybe one step removed as well.
So um, because you're right,it's uh you can't just turn on
and off, and and nor should you,right?
That's that's kind of part ofthe burden that that you carry.
Um and I would just say oneother thing too about patients
participating in trials.
I mean, at least I can speak tooncology experience, is that um
patients are so altruistic anduh truly heroic, right?
(15:39):
I mean, so many of my patients,because I did phase one,
meaning first in human, ourearly phase.
Ashley Love (15:45):
Wow.
Speaker 1 (15:46):
And so many times I remember the resonance of a
patient saying, um, doc, I Iknow this may not help me,
right?
But I hope it helps someoneelse, right?
But boy, would it be nice tohave a patient benefit from an
early phase study, right?
And I think that's why oncologyis pivoting so beautifully, is
that we're now not long nolonger phase one, which is phase
(16:09):
one is traditionally justlooking at safety of a drug.
Phase two is where you look ateffectiveness, and phase three
traditionally had been where youcompare against the standard of
care to get it approved.
But the paradigms are gettingblurred in oncology.
Now we know that with thediagnoses that patients carry,
it's not enough just to look atsafety in phase one.
You got to start looking forsignals.
(16:29):
And so now phase one and twoare being blended together.
So um, with some of these newerapproaches, um, they the goal
is to benefit patients.
The goal is always to benefitpatients, but now I think we can
say that a little bit moredefinitively with the way trials
are going and with the way someof these new treatments are
going too.
Ashley Love (16:46):
And that's got to be really comforting for you as
the clinician or or perhaps thethe person who's conducting this
trial to be able to look at thepatient and say, thank you for
your altruism, thank you foryour selflessness and your
heroics.
But you know what?
Let's help you too.
Dr. Satya (Nanu) Das (17:00):
Yes.
Ashley Love (17:00):
That's got to be so nice.
Dr. Satya (Nanu) Das (17:02):
Because I've never, I've never had a
patient um ever say no when I'veproposed a study to them
because of the therapy.
So it's a it's a you have anobligation, right?
You have an obligation as aclinician, and then now in
biotech or in industry, we havean obligation to put the best
trials forward so that when thatpatient who is going to be
saying yes, that you know, thisis something that can really um
(17:26):
has a shot to to help them in ain a deep way.
Ashley Love (17:29):
Incredible.
Okay, we've dropped it a coupleof times.
Now it's time to really open itup and explore it.
Biotech.
We have said this word a coupleof times now.
Number one, what is that?
What does that mean?
And where um where can we findourselves as as clinicians in
this biotech universe?
Dr. Satya (Nanu) Das (17:47):
Yeah, absolutely.
So biotech is is such a broadterm, but really it corresponds
to the biopharma orbiopharmaceutical industry.
And uh the discipline ofbiotechnology, it's usually
split.
This is a very simple way tolook at it, but the way I think
about it is that there is largebiopharma, and then you have
smaller biopharma.
(18:07):
So large biopharma, oftentimesuh public companies, the
companies that you see that yousee many of the commercials for
it, the Mercs, the Pfizers, theAstraZeneca's, uh, biotech and
are typically smaller biopharmaor private companies.
So companies that have aconcept, uh uh a drug or two
that they're working on, butthey haven't gone public.
(18:28):
And so they are still remainingon a on a smaller scale.
And so biotech actuallyconstitutes that entire spectrum
of both large biopharma andalso small biopharma.
And each of them, and I I wouldsay I've had an opportunity to
work in both, and I've kind ofsettled on the small biopharma
side, but there are pluses andminuses to each, and it really
depends on what aspect ofmedicine you prefer.
(18:51):
Is it truly discovery and kindof first in human signal
seeking, which may be smallerbiopharma?
Or is it more taking a drugthat's already picked up
momentum and developing it intoa commercial drug that can
ultimately get approval, whichmay be more of the path in
larger biopharma?
So that is a little bit aboutkind of the biotech industry.
(19:12):
So when I started as anacademic, gastrointestinal
cancer doc, um, I didn't knowhow much I'd fallen in love with
clinical trials.
But, you know, as I told you,the reason I went into medicine
was to work on new drugs, right?
And I think I quickly began torealize that all of the new
drugs, um, and I'm not sayingthis is good or bad, but so much
of drug development is nowindustry-facing, um, all of the
(19:36):
innovation in terms of theresources, the ability to pursue
new targets and to actuallycome up with new therapies are
coming from the biotechnologyside.
And so what I quickly realizedwas, you know, even three or
four years in, into my facultyposition, if I really wanted to
pull the strings and develop anddesign the trials that I wanted
(19:56):
that could change practice, Iwould probably have to do it.
On the biotech side.
And so at that time, I had alsohad a few mentors who had
transitioned for cliniciansgoing into biotech.
And under I was always underthe notion that listen, you have
to wait, gotta do 10, 15 yearsin this life, and then go,
(20:19):
right?
But all my mentors who had goneand said, if this is what you
really want, and clearly you'resomebody who is driven by the
passion to develop a drug, andyou write your own studies and
that that uh that motivationthat you have to truly help
patients come now, learn biotechbiotech industry from the
ground up, rise, and then youcan influence it in so many
(20:42):
different ways.
So that was kind of when thelight bulb clicked for me that
okay, it's not something onethat you can just you take on as
a later career path.
It's not just something that,you know, you do your time in
academia, you becomeestablished, and then you go.
There's no such prescribedpath.
I think if you have thecuriosity and the and the
courage to leave behind anestablished path, you can really
(21:04):
go anytime.
Now, I I would always recommendindividuals thinking about the
transition, though, to do someclinical time because you have
to spend time with patients, youhave to understand what are the
gaps, right, in currenttreatments and also what are the
needs, right?
And you always have to bringthat patient-centric lens in.
So I think having a few yearsof patient experience is always
(21:26):
important.
But then I think considering umtransitions is definitely
there.
Um, and then as far as whatyour role is in biotech, it's
it's a little bit of choosingyour own adventure, honestly.
It's um because you come inwith such a unique skill set as
a clinician that as long asyou're willing to learn, you can
fit in in any path.
(21:47):
So typically in biotech, thereare kind of, I would say, uh two
major paths that cliniciansusually fall under.
Um, one is clinicaldevelopment.
So that actually pertains todevelopment of drugs, writing
trials, um, and actuallypursuing the drug from phase one
to phase two to phase three.
And that's that's what I'minvolved in because um that's
(22:09):
really what makes me tick.
The the other piece of it ismedical affairs, which is
actually circulating theknowledge that your trials have
gleaned.
Or let's say you have a drugthat got approved, then you
actually engage with thecommunity at large.
How's this drug going to fitin?
Uh, you actually engage with uhinsurance payers to talk about
(22:29):
why your drug is meaningful andshould it be covered.
So medical affairs is kind of,I would say, the dissemination
of knowledge, and I would sayclinical development is the
creation of knowledge.
And that's kind of the way thatI look at them.
Ashley Love (22:41):
I literally did not know any of that.
That is so cool.
Like you could probably tell bymy face.
I'm thrilled by thisinformation.
Um, and that's primarily thoseare clinicians.
The clinical development andthe medical affairs are really
is that all MDs?
Or do you see other um othermembers of the healthcare team
doing this too?
Dr. Satya (Nanu) Da (22:59):
Absolutely.
So I think that's the also oneof the coolest things about um
the biotech industry that Iloved is how democratic it is,
right?
And and and you know, as youknow, coming up in medicine,
there's a bit of a hierarchy,right?
And sometimes positional.
Um, and and even when sometimesI remember in the hospital
setting, um, whatever you say isa doctor goes, right?
(23:20):
Because people aren't, but inbut in biotech, that's not the
case.
Everyone has a voice.
So your CEO could be a farm D,they could be um a PA, they
could be an RN, they could besomebody who has a bachelor's
and just did an MBA and came toit.
It's all about your experienceand your lens.
So I think that's the greatthing is um so many of my former
(23:41):
colleagues who are farm Ds havehad incredibly successful
careers transitioning over tokind of the medical affairs side
because that's what they do.
They talk about drugs and howit impacts patients, and and
they can do that.
And then I've also had people,um, PhDs, um, RNs who are
amazing clinical developers.
Um, and and some of my bosseshave been people from all
(24:05):
disciplines.
So it's been really cool to seethat it doesn't really matter
what path you come from, as longas you're grounded in clinical
medicine, uh, you bring thatskill set into this arena.
And then you have to learn drugdevelopment as well, which is
uh, you know, its own, its owndiscipline.
Ashley Love (24:21):
I think there's something very much, something
huge to be learned by this rightnow, the fact that everyone has
a voice, and yet this field isexploding with advancements and
is from what it sounds like avery well-oiled machine.
And perhaps hierarchy isinhibitory.
And we will not dive into thisbecause we will be here for five
(24:43):
hours if we have thisconversation.
But you know, it's somethingthat is worth, it's something
that's worth a look, and itgives me a lot of hope for this
field to hear how, like yousaid, how democratic it is, how
much respect is is being reallybeing shared.
So so cool.
Thank you for describing all ofthat.
You mentioned courage.
It was just it was squeezedright into the middle of one of
(25:05):
those sentences when you'redescribing your transition.
Um tell me a little bit aboutthat.
Break that down for me.
This does seem like it would bequite a scary transition for
somebody who maybe iscomfortable in clinic or
comfortable in in research, butfeels drawn to something more.
Dr. Satya (Nanu) Da (25:21):
Absolutely.
I think that, you know, Ialways tell, and even I'm
unfortunate to now work withsome mentees at different
stages, and and I always tellthem don't settle.
You have to follow what youlove, right?
We live this life once, right?
To the best of our knowledge,right?
And I think it's a shame and adisservice to not pursue that.
And sometimes that requiresbeing comfortable, being
(25:43):
uncomfortable, right?
And making taking a leap.
Um, I can say from my ownpersonal experience, you know, a
lot of people, yeah, evenmentors and friends and and
well-wishers, you know, lookedat me a little bit side-eyed
when I talked about this.
They were like, you're about totake off in your career.
You know, I was at a pointwhere I was fortunate to have
(26:04):
built a research program, uh,really creating a niche.
Uh, and they're like, Youreally, you're gonna go now?
Um, you're gonna try to maybestart over, right?
But I think what I would say isthat there's no, there's never
starting over.
You take the experience of whatyou have and you bring that
with you to the table.
And making this jump and thecourage to make that jump was
(26:28):
was the best thing.
You have to bet on yourself,right?
Ashley Love (26:30):
Now, Dr.
Doss and I did not get a chanceto discuss a quality question,
which is an interview questionthat can help you prepare for
your own interview.
But something that he saidwould make a fantastic interview
question.
And it's this describe a timethat you bet on yourself even
when the outcome wasn'tguaranteed.
This question is not aboutconfidence, it's about courage.
(26:52):
When interviewers ask this,they're listening for how you
tolerate uncertainty, how youmake decisions without perfect
information, whether you takeownership of your own path, and
how you grow when the resultsare unclear.
Strong answers are not aboutwinning.
They're about choosing yourselfwith intention.
Keep in mind that there's moreinterview prep, such as mock
(27:15):
interviews and personalstatement review, over on
ShadowmeNext.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Satya (Nanu) Das (27:25):
I think in medicine, regardless of what
avenue we come from, we're alllifelong learners and we have
demonstrated already.
I think sometimes what I wouldsay is we have a nearsighted
view.
We're like, oh, we can't makethis transition because we don't
know what's next.
But if we actually look back atthe path we've travailed to get
to where we have, we've alreadycrossed much bigger gaps and
(27:49):
much more uncertainty already.
So sometimes it's rememberingthe journey that we've already
made that can give us thecourage to pursue that further.
So to me, it was the courage tomake the jump.
But then also I did biofar uhlarge biopharma for a year.
Again, very successful company.
I made a jump because I feltthat I wasn't being as creative
(28:10):
as I could, right?
And again, people are like, youreally want to lose this place?
There's like, um, yeah, I said,you know, what makes me tick is
I want to be molding.
I want to have an imprint onthis, right?
And and I can tell you, the themove beyond the move, that's
the right one.
As long as you keep chasingwhat makes you tick, um, given
the skill set that clinicianshave from their past lives,
(28:33):
you'll never be out of demand,certainly in biopharma.
I think honestly, biopharma isgoing to get better as we get
more clinicians in thisdiscipline.
We want people like us in theboardrooms, because when there
are decisions being made, wewant there to be a
patient-centric lens.
We want there to be somethingthat we know from the clinic is
going to be palatable or notpalatable when you write it into
(28:55):
a study.
We want that to beincorporated.
And I feel like um it's beensuch a gift because I feel like
all of my fire past is now sortof aligning with my present.
And so uh I think the courageto take that jump, what lies on
the other side is is sometimesgreat promise.
Um, and again, you're never,you're never losing your
(29:16):
clinical expertise.
So let's say you do make a jumpand it turns out to be
something it's not for you.
That's fine.
People transition back and dogreat, right?
You're never closing one doorby exploring this one.
And so I think that's what Iwould say is that that's kind of
one theme that um I've tried toembody.
And I think now I've kind ofbeen been forced to with recent
(29:36):
transitions is just that don'tbe afraid to have the courage of
your conviction to follow whatmakes you tick, um, because
there is promise there.
Ashley Love (29:44):
It is courageous, especially at the height of your
career.
You know, that's when peopleare are really getting to you
know buckle in and settle downand say, let's let's keep this
going.
But for you, it was that big,that big pivot that obviously
just gave you so much life.
And I'm so glad to hear that.
So for the person who'slistening who says, Wow, well, I
have courage, and this isinteresting to me.
I think I might want to dothis.
(30:04):
What maybe describe one or twoof the challenges and successes
that you saw working in clinicand research compared to the
challenges and successes thatyou're finding now in biotech?
Are they are they similar?
Are they vastly different?
What could that person belooking forward to if this is
(30:26):
something they ended upchoosing?
Dr. Satya (Nanu) Das (30:28):
Yeah, it's a fantastic question.
I I would say in the clinic,the the beauty of clinic and the
success of the clinic is theinstant gratification.
Um, as you know, Ashley,there's no better feeling than
taking care of someone in a timeof need, right?
And that satisfaction and thatjoy is instantaneous.
So you will get that, right?
(30:49):
And that's what clinical careis.
I think if you're drawn topeople and motivated by taking
care of people, there's nosweeter satisfaction than that
immediate gratification.
I would say the challenge is,and and maybe this is to your
point from a little earlier,maybe this is where our robots
and our AI can help us is in theadministrative burden, right?
(31:10):
Which is documentation, whichis making patient flow or
organizing our clinic schedulesso that we don't have to, or
that we're not spending half ourtime being administrators in
addition to clinicians, right?
Um, so some of that isdefinitely there.
I think we're fighting thesystem a bit on the clinic side.
I think one of the challengesis that that I always felt, even
(31:33):
though I was fortunate, um, youknow, I was at a referral
center, I wasn't seeing like inprivate practice, um, a cancer
doc sees 35, 40 patients a day.
Each patient's a story, right?
How do you synthesize uh evenjust a return visit?
It's just 15 minutes.
That's impossible, right?
So I think the challenge isyou're always fighting the
clock.
Um, and that's one thing.
(31:54):
Um, I think as you getseasoned, you you figure out
ways, but um one of thechallenges is is that it does
eat into some of your time.
You you can't color between thelines if you're going to be a
passionate clinician, becausepatient care doesn't have the
same boundaries that even youknow a clinical eight to five
does, right?
(32:15):
Like you're gonna be staying alittle later.
There is there are gonna bepatients that you're where
you're gonna be running late,right?
Because you had to care forsomeone or they had a
progression and you needed tospend five extra minutes holding
their hand to reassure them,right?
So that that's definitely, Iwould say, the challenge on that
side.
In biotech, I would say thechallenges are a little
(32:35):
different.
The challenges are uh patience,because and I'd say patience
here that waiting, because youdon't get the same instant
gratification, right?
Even if your drug's workingamazingly, you're hearing about
it through a telephone or youknow, through a third-person
communication.
You're not seeing that patientin front of you that's you know
went from feeling like uh, youknow, feeling like crap to
(32:58):
feeling amazing or doingsomething with their family.
You don't get to see that.
Um, and and you have to waitlonger, right?
Because you you don't get thereadouts uh in a clinical day.
You have to wait a few months,right, to actually see if your
drug is working or not.
So the challenge is thepatients, and I think the
challenge is a bit of thatinherent uncertainty, right?
Because no matter how well youdevelop the trial, how well you
(33:21):
write it, you're ultimatelybeholden to your drug, right?
And and I think um the data isnow changing, but the truth is
that even the drugs that make itto clinic, and I'll tell you,
there's a whole swath ofcompounds that are incredibly
promising that never even get tothe clinic because they never
get out of the lab, becausethey're either too toxic or you
(33:41):
can't formulate them into adrug.
So I'm even talking of thewinners, only 10% make it,
right?
Now we're hoping to change thatnumber, but you have to be
willing to embrace failure inbiotech.
And I think that's a challenge.
So if that you can doeverything right, and the drug
(34:02):
may still not be able to benefitpatients.
And and that's okay.
You have to pivot, you moveforward, um, you keep pushing,
but you have to be willing toaccept that that side of things.
Um, as far as the successes go,I would say the creativity um
is absolutely incredible.
Here, you actually take aconcept, you write the study,
you talk about the populationsyou want to benefit, you open
(34:25):
sites, you get to talk with PIs.
So you're really straddlingboth sides of the aisle.
You know, I get to work withformer colleagues and and
collaborators, but now as asponsor, right?
Where um I have the credibilityof having walked in their
shoes, but they also know that,you know, we're we're coming
with a drug that really has somepotential.
And this trial has beendesigned in the in the right way
(34:45):
to show something that couldpotentially impact patients.
And so that creativity, uh, andI would say that excitement of
when you actually get the dataand no one else in the world has
seen it, and you're seeing thatgraph pop up, the waterfall
plot showing the tumor shrinkageor how long patients are
living, there's nothing likethat feeling.
But to be fair, you know, Iwill say one point is that you
(35:07):
can also still find ways to,even if you transition to um
industry.
Uh, I know colleagues that havemaintained uh, you know, a half
day of clinic at a nearbyinstitution.
I personally didn't justbecause I wanted to kind of
delve in fully into this side,but I still do um some patient
consults through platforms,second opinions, um, family
friends.
(35:27):
And so I've found ways to keepthat patient focused or
patient-facing interface stillstill alive on this side.
Um, so you're not closing thatdoor, and I think that's also
important to remember.
Ashley Love (35:42):
Incredible.
And you know, it's something uhsomething that you mentioned,
and it was something I wanted toask as well.
Because you go from asituation, as you previously
described in clinic, that was socollaborative.
You worked with otherclinicians, you worked with
patients, you worked withresidents, you worked with nice
the list went on, right?
To um to biotech, which in Ithink maybe stereotypically, I'm
(36:03):
thinking of you sitting alonein a room with a bunch of papers
and textbooks and computers.
But you mentioned a PI, whichis a principal investigator,
right?
Which it reminded me that thisprobably isn't a very isolated
job.
I would imagine there's a teamof people.
Is that true?
Is it still very collaborative?
Dr. Satya (Nanu) Da (36:20):
Absolutely.
I would say, like, you know,here in in smaller biopharma, I
mean, we're say under 50 people.
Um, you know, we're poppinginto offices all the time.
My CEO is right there, my CSOis right there.
So we're having hallwayconversations, drawn on
whiteboards, having strategymeetings, taking all our large
calls together as a group.
(36:40):
We have team meetings two tothree times a week with our
entire core from our scientiststo our um our data individuals
to our safety andpharmacovigilance.
So it's actually very much ateam game.
And and I would actually say,interestingly enough, this I
would say industry is I wouldsay inherently even more
(37:02):
collaborative than the academicside.
Because sure, in clinic, yes,you're with tons of people and
I'll say RNs, PAs, uh, PharmDs,incredibly instrumental people
as well as part of the clinicalteam.
But then actually, when you'regoing into your office and so
forth, it is a little bit morelonely to speak of.
Here, by definition, I can't doanything.
(37:25):
I mean, I there's roles, but Ireally can't do anything in
terms of the decision alone.
So I have to bring in people.
And I think that's the reallycool part is it's all collective
decision making.
And it's about um, it's notjust about you have to prove
your points, which I love.
Uh, you know, you're tellingsomeone something, back it up,
(37:45):
right?
And I think that's what Ireally love.
Um, as part of thiscollaboration, is there is, um,
we were talking about earlier,this democratic feedback, and
and people push back.
And I think it's important tochallenge one another, um,
obviously respectfully, but Ithink that exchange is so, so
important.
And I and I see that so much onthe industry side.
And I think that was veryeye-opening to me.
(38:06):
I didn't know how much of thedecision making was
collaborative and how much, Iwould say almost the purest form
of debate that I've encounteredhappens on this side of the
aisle.
Ashley Love (38:18):
I was just gonna say that.
It reminds me very much ofdebate, which I think we have
turned into such a nasty wordthese days, but it is just, it
just it lights me up.
I mean, I hate debating.
I I I hate disagreeing withpeople.
But how else are you going tosharpen someone's idea?
And how else are you going toinvestigate and get deeper?
And, you know, we say playdevil's advocate, but is that
(38:40):
really what we're doing?
Or are we playing that person'sadvocate and helping them to
kind of explore and identifyeven deeper concepts to their
even deeper concepts of theiridea that they even realized was
their um, oh, I wish we didthat more in medicine.
Dr. Satya (Nanu) Das (38:54):
I agree and pressure testing, right?
And I think what I love is somuch of medicine, you know, we
have this notion that isevidence-based, but so much of
medicine is stilleminence-based, right?
Someone notable said something,and it takes a decade, right,
to disprove that.
Um, there's so many examples,you know, of that.
And what I love here is it's itreally is evidence-based.
(39:16):
Um, and and uh, and as yousaid, yeah, you have to um
pressure test everything becausesomeone even questioning your
own assumptions, you become amore thoughtful person, you
become a more creative thinkerand a more mature thinker.
So I think I've grown quite abit, and now it's been three
years on the industry side, butI I feel like, yeah, I've grown
(39:36):
a lot even in that period oftime.
Ashley Love (39:39):
I uh I've started reframing um those conversations
as challenges, but not anegative challenge, a positive
challenge, right?
Um and I think that thatreframing has really helped the
way I approach thoseconversations, not as you know,
a response to being attacked,but as an invitation to explain.
(39:59):
Explain even further, right?
Which is um exactly very it'sso very cool.
Okay, last question.
And this is this might be a bitof a big question.
So feel free to you know parseit down if you need to.
But of course, to wrap it up,what role does healthcare policy
play in drug development?
And because I think this isimportant to speak to, how can
(40:21):
patient stories influence thisprocess?
Dr. Satya (Nanu) Das (40:25):
Yeah, it's a fantastic question.
So um healthcare policy isinstrumental in setting the
framework for how drugdevelopment works, right?
And I think, you know, whatwe've seen, irrespective of what
side of the aisle we're on, Ithink turnover is not great,
right?
And I think unfortunately wesee so much turnover in the FDA.
And I think what worries us asdrug developers is is that going
(40:48):
to introduce inconsistency inhow drugs are assessed?
Because the last thing you wantto introduce for drug
developers, right?
I already talked about how muchinherent uncertainty there is.
If you change the goalposts oryou're moving the standards,
right, we have to be consistentin what is a meaningful benefit
for a class of drug and let'sstick to it, right?
Let's have our interactions,um, let's have the same bars,
(41:12):
the same metrics, so that we canall be judged equally and let
the best drugs win, right?
Because at the end of the day,the patients will win, and
that's what we all want.
But when we have so muchturnover in regulatory agencies,
it just creates inherentuncertainty because we don't
actually know how decisions arebeing made.
Why was it that one drug thathad very similar data or a
(41:33):
development path got rejected,whereas another didn't, right?
And I think that's so I thinkhealthcare policy trickles into
all of our lives.
And obviously, as clinicianstoo, you know, we can, again,
probably talk for five hours ofhow healthcare policy is
influencing not just academiccenters, but the practice of
medicine at large.
(41:54):
But it is so important to notlose sight of the main thing,
which is the patient.
So I think we can use patientstories as a very powerful lens.
So almost every, let's say,investor talk that I'm talking
at, or even with a PI or with anadvisory board, I start with
the patient anecdote becausethat's how that's how I was I
(42:15):
learned medicine, right?
We talk about the patient'sstories to frame our narrative.
And I think that is the mostimportant piece because lost in
the shuffle of policy andsometimes just disagreement for
the sake of disagreement, isthat the patients are the ones
that suffer because eithermeaningful or promising drugs
(42:36):
are delayed or a drug that couldhave been a real game changer
falls through the cracks, right?
And that's kind of the worstaspect.
So I think it's we're um ashealthcare providers, whether
it's in um biopharma clinicians,um, we have a deep
responsibility to continue totell our patient stories at
every avenue we get and beinvolved in policy discussion.
(43:01):
So if there are opportunitiesto go to Washington um to
advocate on behalf of ourrespective disciplines, it's
super important to do that.
But use the patient story um asour tool because I think um
that distills so manycomplicated things to a very
simple thing, right?
Is how do we do right by thepatient?
(43:23):
We think of we, you know, Ithought about that in clinic
every day.
That's what you're thinkingabout.
And I still think about thatevery day uh as a developer.
And I think we need ourpolicymakers to think about how
we do right by patients everyday as well.
Ashley Love (43:37):
The perspective is so important.
And I think as clinicians inthis role in biotech, it is our
greatest gift, really, is to beable to offer that perspective.
Nanu, it has been such apleasure speaking with you
today.
Thank you so much for being sowilling to um not just define
some of these topics first, butactually really describe them
(43:58):
and infuse humanity into thesesituations that I think people
really think are just automatednowadays and they're not.
I mean, there's so much,there's so much thought that
goes into this, and um, andyou've described it beautifully.
Thank you so much.
Dr. Satya (Nanu) Das (44:10):
Thank you so much, actually.
It's such a pleasure.
Ashley Love (44:12):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
Shadow Me Next.
Hello, and welcome to Shadow Me Next, a podcast
where I take you into and behindthe scenes of the medical world
to provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
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Whether you're a pre-healthstudent or simply curious about
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(00:43):
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(01:03):
What happens when you discoveryour passion for medicine
expands beyond the exam room?
In this episode, I sit downwith Dr.
Sasia Doss, a former medicaloncologist who made a courageous
pivot into drug development.
We talk about carrying patientswith you long after clinic
ends, the tension betweenindividual loss and collective
(01:24):
progress, and what it means tofollow curiosity even when the
path forward is unclear.
He defines the biotech industryand he explains how courage,
creativity, and apatient-centered focus is still
possible, even when you stepoutside traditional clinical
roles.
Please keep in mind that thecontent of this podcast is
(01:45):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer, or company.
This is Shadow Me Next with Dr.
(02:07):
Satya Doss.
Thank you so much for joiningus today on Shadow Me Next.
I am thrilled to have thisconversation with you, primarily
because it is something that Iknow very, very little about.
So you are a former academicmedical oncologist, turned drug
developer.
And really, before we dive intowhat both of those roles mean,
(02:31):
think back a number of years.
Is this something you wouldhave predicted?
This shift, something that youwould have predicted when you
first entered medicine?
Dr. Satya (Nanu) Das (02:40):
You know, the funny thing is, um no, but
yes.
And what I mean by that is Ithink what led me to medicine
was I was always fascinated bythe mechanism of drugs.
I think, you know, I distinctlyremember as a young kid, um I
had a grandfather who passedaway from myelodysplasia.
Um, and this was 2530, 35 yearsago or so.
(03:01):
And so at that time, therereally weren't many treatments
outside of uh erythropoietin anduh blood transfusion.
So he'd constantly be gettingpoked and prodded.
And uh I remember almost like amap-like bruise, you know, on
his arm or extremity.
And I think even as a kid, Iwas like, I'm gonna come up with
a medicine that could maybetake care of that map because I
(03:22):
knew it was associated withdiscomfort.
So there's kind of breadcrumbsthroughout my career of what's
led me down that path, butcertainly not a linear one by
any stretch.
Ashley Love (03:33):
You know, it's it's a really interesting story and
it's a it's a fun thing toreflect on.
I think as children, um we seethese things.
Children are very aware.
And I like, for example, Iremember seeing Vidaligo for the
very first time when I was achild and thinking, as a kid,
wow, what a what a beautifulpattern on her skin, right?
Of course, it's very artisticto me.
(03:54):
Um, and then not reallyrealizing that there was quote
unquote people thought there wassomething wrong with her skin.
To me, it was just it wasbeautiful.
And and in your case, youassociated the pattern on your
grandfather's skin with painbecause, like you said, it was
due to numerous sticks and pokesand things that kids really um
are averse to.
So it's so interesting, youknow, the way we're exposed to
(04:16):
medicine as children and andwhat becomes of that ultimately.
Let's talk about your career asa medical oncologist.
Um, I believe your specialtywas gastroenterology, is that
correct?
Dr. Satya (Nanu) Das (04:25):
That's right.
Yeah, gastrointestinal cancer.
Yeah.
Ashley Love (04:28):
Really difficult things that you had to um to
walk patients through.
Describe what that looked like.
What was the day in your lifeas uh as a medical oncologist?
Dr. Satya (Nanu) Das (04:36):
Yeah, absolutely.
So I was fortunate to be um, Iwas at Van Devil when I was uh
in clinical medicine.
And so it's a big researchinstitution.
And so that was one of thethings that led me to medicine
was that I could be part of umboth the bedside experience, but
also be part of the experienceof trying to bring new new
treatments to patients.
Um, as you know, GI cancers,particularly pancreatic cancer,
(05:00):
stomach cancer, bile ductcancer, these were some of the
cancers that I focused on.
Still, we haven't made muchprogress.
And so uh unfortunately,there's a dire need.
And so for me, it kind of fitum like a hand in glove because
naturally doing GI cancer meantthat I would have to be involved
in experimental treatments.
And so for me, my I would saymaybe my week was split between
(05:24):
um clinical care and clinicalresearch.
And so I would do about twodays of full clinic with
patients.
Um I'd see maybe 20 to 25patients on those two days.
Um, these are patients that arenew patients coming in that
were referrals.
Um, sometimes as you build up areputation, people actually
come from all over, which iswhich is so humbling for people
(05:46):
to truly make an odyssey to comesee you to get advice.
Um, and then also some of myreturning patients who were
diagnosed in the area, and I wasfortunate to encounter them
early on in their journey.
Um, and then the other threedays was actually spending on
clinical research.
So I was um early phasetrialist, so I was writing early
phase trials.
Um, I worked with the NationalCancer Institute quite a bit.
(06:09):
And um the National CancerInstitute still to this day is
kind of this amazing place wherepharma companies can also
deposit new drugs and you cankind of create new combinations
through the National CancerInstitute.
Um, and that is the bug uh thatgot me actually in fellowship
to stay in academia during mymedical oncology career.
(06:29):
So those other three days, I'dbe either working on trial work
um or doing other types ofresearch.
And I think that's maybe alsoan important point to raise is
that research doesn't come inone flavor, right?
I think um everybody, at leastin medicine, wants to do trials.
Um and that's don't get mewrong, that's uh probably the
highest level of evidence, andthat's a very uh admirable goal
(06:51):
to do.
But there's also so manydifferent types of research that
you can do with things thathave been published.
So what I found myself doingtoo was taking literature that
already had been published andanswering important questions,
doing systematic reviews ofdrugs that had already been
approved in the last three tofive years to see that, hey, are
they really making a differencein the field?
So um, in that research time, Ialso taught.
(07:13):
Um, I worked with fellows, Iworked with med students, I
worked with residents.
Um, and so it wasn't as muchclassroom teaching, but they
would shadow me actually in theclinic or have uh come to me as
a research advisor and we'd havesome projects.
So um that was a little bit ofan overview of what I did in
that past life.
Ashley Love (07:32):
Oh, what an incredible overview.
Thank you so much fordescribing that.
There's a couple of things thatI want to circle back to.
Um the first thing you saidthat just by nature, GI cancer
means you'd be involved inexperimental treatments, right?
Are there other areas?
So let's say somebody hearsthis and they think, oh my gosh,
that that sounds sointeresting.
Um, I'm not sure.
GI is right for me.
(07:53):
Are there other areas ofmedicine that that are similar
where if you are involved inthis medicine, you can almost
guarantee that you're going tohave to be looking at some type
of experimental drugs orexperimental um uh treatment
modalities?
Dr. Satya (Nanu) Da (08:06):
Absolutely.
I'll say this.
I mean, I'll say this with alittle bit of bias because as an
oncologist, oncology bydefinition is experimental,
right?
I think I think this is such anamazing time to go into the
field because I really thinkwe're at the cusp of a number of
breakthroughs that are reallygonna change the paradigm and
maybe actually change qualityand quantity of life for
patients.
But I think oncology, just bydefinition, is inherently all
(08:28):
trial-based because ourstandards of care, to be very
frank, have been very modest andmeager.
And so we're always trying topitch the envelope.
So oncology is one, but I willsay there are so many other
disciplines too, um, inespecially as drug development.
I think oncology, and I wouldsay cardiology have kind of
bidden the poster child's.
Um, you know, certainlycardiology with a lot of the um
(08:50):
diabetes and obesitymedications, there's been a
renaissance in drug developmentthere.
But I see that there are otherdisciplines too, like
psychiatry, for example, wherethere hadn't been new drugs
invented in the last 30 or 40years that efforts are going
into.
So I think you can actuallypursue drug development in any
path of medicine.
But I will say that certaindisciplines, perhaps like
(09:11):
oncology and cardiology, are alittle bit more inherent.
Um, because one, in oncology,we need to improve the standards
of care.
And in cardiology, uh,cardiovascular disease touches
such a broad swath of patientsthat you can conduct these
massive studies to try toimprove long-term outcomes.
Ashley Love (09:29):
Oh, it's so interesting to me.
Thank you for breaking thatdown.
You know, it's it's like youmentioned, um, research doesn't
just come in one flavor.
Well, obviously, there are somany different flavors of
medicine as well.
And within each of thosespecialties, too, you can really
diversify it pretty strongly.
Another thing you mentionedthat I love so much is this dual
relationship that you had inpractice with clinic and with
(09:52):
research, right?
Which I counsel students onthis a lot when it comes to
choosing their specialty.
But I'm speaking of it moreclinic and surgery, um, because
that's my background, is is uhmy background is clinic and then
um most micrographicdermatology surgery.
And um, and I love it, youknow, I love it because I can
form these relationships with mypatients and speaking with them
(10:15):
and evaluating them, but then Ican also really address the
bottom line, and that's removingskin cancer with my supervising
physician and doing things withmy hands, which is just a whole
nother um way to providepatient care.
I would love to break down thisrelationship that you have,
which is just a little differentwith clinic and with research.
And I think I want to start itwith how does how did your
(10:39):
relationships with yourpatients, which I think is
something you feel very stronglyabout, um, how did that inform
your research?
Dr. Satya (Nanu) Das (10:48):
Yeah, I think the it raises the urgency,
right?
I think you're constantlyconfronted by uh, you know, I
think as all physicians, butparticularly oncologists, um, we
carry a lot of ghosts with usof people, um, of loved ones
that we've encountered.
Uh, these are patients thatbecome family right over time
because you see them week in andweek out over the course of
(11:10):
their journeys.
And you're always confronted bythe fact that um most likely at
some point you're gonna have tobreak bad news to this person,
even in the midst of joy andthem doing well.
And so I think the urgency forme was every day I was in
clinic, I was confronted by thatbecause I would encounter a
situation that either didn'tfall within the existing
(11:32):
therapy.
So there's a lot of gray.
I think um it's fascinatingwhen you go through medicine and
you're in medical school, youthink everything is black and
white.
Yet actually, as you become aseasoned physician or uh more
seasoned in in life in anyhealthcare profession, it's all
gray, right?
And I think I began to realizeas I saw more and more patients
that how many patients fell intothe gray, that they didn't fall
(11:54):
cleanly into this setting orthat.
And, you know, maybe there's adrug for pancreatic cancer,
maybe there's a drug for coloncancer, but the small bowel,
which kind of sits in betweenthem, no one studied that,
right?
And but I've had numbers ofpatients with small bowel
cancer.
So that kind of raised thelight bulb that, you know what,
we need to also look at raretumors and understudied diseases
(12:17):
and perhaps look atcommonalities.
Maybe it's not so much, andthis is certainly something that
we are approaching in drugdevelopment today.
Maybe it's not so much aboutthe cancer as it is about the
target, right?
Because if you have a targetthat's expressed across multiple
cancers, then you can get themby targeting that particular
receptor.
And you don't have to worryabout, hey, shoot, um, this this
(12:40):
patient didn't have a cancertype that didn't quite fit in
the trial.
They have a target which wouldthereby make them eligible.
So that was one piece.
Um, I think the other thing wasjust the fact that uh what I
was constantly confronted by waseven these so-called wins and
FDA-proof therapies that we had,um, not that patients didn't
benefit, but it's always tooshort, right?
(13:01):
I think, you know, when we'relooking at these Kaplan Meyer
plots of survival and we say,wow, you know, five year
survival has been extended to30% from 5%, right?
That's that's great, but that'snot enough time, right?
And I think when you're on thepatient side, you're always
confronted by the other side.
Um, and and in fact, you know,one of the pieces um that that
(13:23):
it is is that I had worked onwas a small piece called The
Other Side of the Waterfall,right?
And it was actuallyhighlighting a case of a patient
who's actually on a verypromising treatment, a treatment
that was actually ended upbeing approved, was considered a
game changer, but they didn'tbenefit from the treatment,
right?
And so how do you reconcileindividual disappointment with
(13:49):
collective success, right?
And so these were questionsthat I think constantly fueled
my research efforts because thatkind of created the bug for me
to continue to push to thinkthat you know we have to do
better, we have to look morebroadly at cancer as a whole
rather than individual diseases,um, and a lot of led a little
(14:11):
bit to my pivot down the road.
Ashley Love (14:13):
How do you reconcile individual
disappointment with collectivesuccess?
I mean, it it's it's the weightof being in your role, and it's
a really miserable burden tobear, I would imagine, at some
point.
But but how motivating.
And, you know, thank you fordescribing the fact that as
clinicians, first of all, butalso as a researcher, you do
(14:37):
carry the weight of thesepatients and their diagnoses and
their deaths deeply, you know,and I think that uh it is one of
the gifts that we have beinghuman in medicine is the fact
that we do feel those things.
And that is what is going tomake us irreplaceable um by
robots in the future.
Dr. Satya (Nanu) Das (14:55):
Definitely empathy, empathy.
Um, but I think it's also howdo we protect ourselves too,
right?
From our humanity, and how dowe not lose that humanity?
Or, you know, I'm sure you canattest to this, those cases that
stick with you that you'rebringing home.
And um, and for me, it was itwas a it was a toll, and and you
know, in many ways, this pathallows me to be invested, but
(15:16):
maybe one step removed as well.
So um, because you're right,it's uh you can't just turn on
and off, and and nor should you,right?
That's that's kind of part ofthe burden that that you carry.
Um and I would just say oneother thing too about patients
participating in trials.
I mean, at least I can speak tooncology experience, is that um
patients are so altruistic anduh truly heroic, right?
(15:39):
I mean, so many of my patients,because I did phase one,
meaning first in human, ourearly phase.
Ashley Love (15:45):
Wow.
Speaker 1 (15:46):
And so many times I remember the resonance of a
patient saying, um, doc, I Iknow this may not help me,
right?
But I hope it helps someoneelse, right?
But boy, would it be nice tohave a patient benefit from an
early phase study, right?
And I think that's why oncologyis pivoting so beautifully, is
that we're now not long nolonger phase one, which is phase
(16:09):
one is traditionally justlooking at safety of a drug.
Phase two is where you look ateffectiveness, and phase three
traditionally had been where youcompare against the standard of
care to get it approved.
But the paradigms are gettingblurred in oncology.
Now we know that with thediagnoses that patients carry,
it's not enough just to look atsafety in phase one.
You got to start looking forsignals.
(16:29):
And so now phase one and twoare being blended together.
So um, with some of these newerapproaches, um, they the goal
is to benefit patients.
The goal is always to benefitpatients, but now I think we can
say that a little bit moredefinitively with the way trials
are going and with the way someof these new treatments are
going too.
Ashley Love (16:46):
And that's got to be really comforting for you as
the clinician or or perhaps thethe person who's conducting this
trial to be able to look at thepatient and say, thank you for
your altruism, thank you foryour selflessness and your
heroics.
But you know what?
Let's help you too.
Dr. Satya (Nanu) Das (17:00):
Yes.
Ashley Love (17:00):
That's got to be so nice.
Dr. Satya (Nanu) Das (17:02):
Because I've never, I've never had a
patient um ever say no when I'veproposed a study to them
because of the therapy.
So it's a it's a you have anobligation, right?
You have an obligation as aclinician, and then now in
biotech or in industry, we havean obligation to put the best
trials forward so that when thatpatient who is going to be
saying yes, that you know, thisis something that can really um
(17:26):
has a shot to to help them in ain a deep way.
Ashley Love (17:29):
Incredible.
Okay, we've dropped it a coupleof times.
Now it's time to really open itup and explore it.
Biotech.
We have said this word a coupleof times now.
Number one, what is that?
What does that mean?
And where um where can we findourselves as as clinicians in
this biotech universe?
Dr. Satya (Nanu) Das (17:47):
Yeah, absolutely.
So biotech is is such a broadterm, but really it corresponds
to the biopharma orbiopharmaceutical industry.
And uh the discipline ofbiotechnology, it's usually
split.
This is a very simple way tolook at it, but the way I think
about it is that there is largebiopharma, and then you have
smaller biopharma.
(18:07):
So large biopharma, oftentimesuh public companies, the
companies that you see that yousee many of the commercials for
it, the Mercs, the Pfizers, theAstraZeneca's, uh, biotech and
are typically smaller biopharmaor private companies.
So companies that have aconcept, uh uh a drug or two
that they're working on, butthey haven't gone public.
(18:28):
And so they are still remainingon a on a smaller scale.
And so biotech actuallyconstitutes that entire spectrum
of both large biopharma andalso small biopharma.
And each of them, and I I wouldsay I've had an opportunity to
work in both, and I've kind ofsettled on the small biopharma
side, but there are pluses andminuses to each, and it really
depends on what aspect ofmedicine you prefer.
(18:51):
Is it truly discovery and kindof first in human signal
seeking, which may be smallerbiopharma?
Or is it more taking a drugthat's already picked up
momentum and developing it intoa commercial drug that can
ultimately get approval, whichmay be more of the path in
larger biopharma?
So that is a little bit aboutkind of the biotech industry.
(19:12):
So when I started as anacademic, gastrointestinal
cancer doc, um, I didn't knowhow much I'd fallen in love with
clinical trials.
But, you know, as I told you,the reason I went into medicine
was to work on new drugs, right?
And I think I quickly began torealize that all of the new
drugs, um, and I'm not sayingthis is good or bad, but so much
of drug development is nowindustry-facing, um, all of the
(19:36):
innovation in terms of theresources, the ability to pursue
new targets and to actuallycome up with new therapies are
coming from the biotechnologyside.
And so what I quickly realizedwas, you know, even three or
four years in, into my facultyposition, if I really wanted to
pull the strings and develop anddesign the trials that I wanted
(19:56):
that could change practice, Iwould probably have to do it.
On the biotech side.
And so at that time, I had alsohad a few mentors who had
transitioned for cliniciansgoing into biotech.
And under I was always underthe notion that listen, you have
to wait, gotta do 10, 15 yearsin this life, and then go,
(20:19):
right?
But all my mentors who had goneand said, if this is what you
really want, and clearly you'resomebody who is driven by the
passion to develop a drug, andyou write your own studies and
that that uh that motivationthat you have to truly help
patients come now, learn biotechbiotech industry from the
ground up, rise, and then youcan influence it in so many
(20:42):
different ways.
So that was kind of when thelight bulb clicked for me that
okay, it's not something onethat you can just you take on as
a later career path.
It's not just something that,you know, you do your time in
academia, you becomeestablished, and then you go.
There's no such prescribedpath.
I think if you have thecuriosity and the and the
courage to leave behind anestablished path, you can really
(21:04):
go anytime.
Now, I I would always recommendindividuals thinking about the
transition, though, to do someclinical time because you have
to spend time with patients, youhave to understand what are the
gaps, right, in currenttreatments and also what are the
needs, right?
And you always have to bringthat patient-centric lens in.
So I think having a few yearsof patient experience is always
(21:26):
important.
But then I think considering umtransitions is definitely
there.
Um, and then as far as whatyour role is in biotech, it's
it's a little bit of choosingyour own adventure, honestly.
It's um because you come inwith such a unique skill set as
a clinician that as long asyou're willing to learn, you can
fit in in any path.
(21:47):
So typically in biotech, thereare kind of, I would say, uh two
major paths that cliniciansusually fall under.
Um, one is clinicaldevelopment.
So that actually pertains todevelopment of drugs, writing
trials, um, and actuallypursuing the drug from phase one
to phase two to phase three.
And that's that's what I'minvolved in because um that's
(22:09):
really what makes me tick.
The the other piece of it ismedical affairs, which is
actually circulating theknowledge that your trials have
gleaned.
Or let's say you have a drugthat got approved, then you
actually engage with thecommunity at large.
How's this drug going to fitin?
Uh, you actually engage with uhinsurance payers to talk about
(22:29):
why your drug is meaningful andshould it be covered.
So medical affairs is kind of,I would say, the dissemination
of knowledge, and I would sayclinical development is the
creation of knowledge.
And that's kind of the way thatI look at them.
Ashley Love (22:41):
I literally did not know any of that.
That is so cool.
Like you could probably tell bymy face.
I'm thrilled by thisinformation.
Um, and that's primarily thoseare clinicians.
The clinical development andthe medical affairs are really
is that all MDs?
Or do you see other um othermembers of the healthcare team
doing this too?
Dr. Satya (Nanu) Da (22:59):
Absolutely.
So I think that's the also oneof the coolest things about um
the biotech industry that Iloved is how democratic it is,
right?
And and and you know, as youknow, coming up in medicine,
there's a bit of a hierarchy,right?
And sometimes positional.
Um, and and even when sometimesI remember in the hospital
setting, um, whatever you say isa doctor goes, right?
(23:20):
Because people aren't, but inbut in biotech, that's not the
case.
Everyone has a voice.
So your CEO could be a farm D,they could be um a PA, they
could be an RN, they could besomebody who has a bachelor's
and just did an MBA and came toit.
It's all about your experienceand your lens.
So I think that's the greatthing is um so many of my former
(23:41):
colleagues who are farm Ds havehad incredibly successful
careers transitioning over tokind of the medical affairs side
because that's what they do.
They talk about drugs and howit impacts patients, and and
they can do that.
And then I've also had people,um, PhDs, um, RNs who are
amazing clinical developers.
Um, and and some of my bosseshave been people from all
(24:05):
disciplines.
So it's been really cool to seethat it doesn't really matter
what path you come from, as longas you're grounded in clinical
medicine, uh, you bring thatskill set into this arena.
And then you have to learn drugdevelopment as well, which is
uh, you know, its own, its owndiscipline.
Ashley Love (24:21):
I think there's something very much, something
huge to be learned by this rightnow, the fact that everyone has
a voice, and yet this field isexploding with advancements and
is from what it sounds like avery well-oiled machine.
And perhaps hierarchy isinhibitory.
And we will not dive into thisbecause we will be here for five
(24:43):
hours if we have thisconversation.
But you know, it's somethingthat is worth, it's something
that's worth a look, and itgives me a lot of hope for this
field to hear how, like yousaid, how democratic it is, how
much respect is is being reallybeing shared.
So so cool.
Thank you for describing all ofthat.
You mentioned courage.
It was just it was squeezedright into the middle of one of
(25:05):
those sentences when you'redescribing your transition.
Um tell me a little bit aboutthat.
Break that down for me.
This does seem like it would bequite a scary transition for
somebody who maybe iscomfortable in clinic or
comfortable in in research, butfeels drawn to something more.
Dr. Satya (Nanu) Da (25:21):
Absolutely.
I think that, you know, Ialways tell, and even I'm
unfortunate to now work withsome mentees at different
stages, and and I always tellthem don't settle.
You have to follow what youlove, right?
We live this life once, right?
To the best of our knowledge,right?
And I think it's a shame and adisservice to not pursue that.
And sometimes that requiresbeing comfortable, being
(25:43):
uncomfortable, right?
And making taking a leap.
Um, I can say from my ownpersonal experience, you know, a
lot of people, yeah, evenmentors and friends and and
well-wishers, you know, lookedat me a little bit side-eyed
when I talked about this.
They were like, you're about totake off in your career.
You know, I was at a pointwhere I was fortunate to have
(26:04):
built a research program, uh,really creating a niche.
Uh, and they're like, Youreally, you're gonna go now?
Um, you're gonna try to maybestart over, right?
But I think what I would say isthat there's no, there's never
starting over.
You take the experience of whatyou have and you bring that
with you to the table.
And making this jump and thecourage to make that jump was
(26:28):
was the best thing.
You have to bet on yourself,right?
Ashley Love (26:30):
Now, Dr.
Doss and I did not get a chanceto discuss a quality question,
which is an interview questionthat can help you prepare for
your own interview.
But something that he saidwould make a fantastic interview
question.
And it's this describe a timethat you bet on yourself even
when the outcome wasn'tguaranteed.
This question is not aboutconfidence, it's about courage.
(26:52):
When interviewers ask this,they're listening for how you
tolerate uncertainty, how youmake decisions without perfect
information, whether you takeownership of your own path, and
how you grow when the resultsare unclear.
Strong answers are not aboutwinning.
They're about choosing yourselfwith intention.
Keep in mind that there's moreinterview prep, such as mock
(27:15):
interviews and personalstatement review, over on
ShadowmeNext.com.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Satya (Nanu) Das (27:25):
I think in medicine, regardless of what
avenue we come from, we're alllifelong learners and we have
demonstrated already.
I think sometimes what I wouldsay is we have a nearsighted
view.
We're like, oh, we can't makethis transition because we don't
know what's next.
But if we actually look back atthe path we've travailed to get
to where we have, we've alreadycrossed much bigger gaps and
(27:49):
much more uncertainty already.
So sometimes it's rememberingthe journey that we've already
made that can give us thecourage to pursue that further.
So to me, it was the courage tomake the jump.
But then also I did biofar uhlarge biopharma for a year.
Again, very successful company.
I made a jump because I feltthat I wasn't being as creative
(28:10):
as I could, right?
And again, people are like, youreally want to lose this place?
There's like, um, yeah, I said,you know, what makes me tick is
I want to be molding.
I want to have an imprint onthis, right?
And and I can tell you, the themove beyond the move, that's
the right one.
As long as you keep chasingwhat makes you tick, um, given
the skill set that clinicianshave from their past lives,
(28:33):
you'll never be out of demand,certainly in biopharma.
I think honestly, biopharma isgoing to get better as we get
more clinicians in thisdiscipline.
We want people like us in theboardrooms, because when there
are decisions being made, wewant there to be a
patient-centric lens.
We want there to be somethingthat we know from the clinic is
going to be palatable or notpalatable when you write it into
(28:55):
a study.
We want that to beincorporated.
And I feel like um it's beensuch a gift because I feel like
all of my fire past is now sortof aligning with my present.
And so uh I think the courageto take that jump, what lies on
the other side is is sometimesgreat promise.
Um, and again, you're never,you're never losing your
(29:16):
clinical expertise.
So let's say you do make a jumpand it turns out to be
something it's not for you.
That's fine.
People transition back and dogreat, right?
You're never closing one doorby exploring this one.
And so I think that's what Iwould say is that that's kind of
one theme that um I've tried toembody.
And I think now I've kind ofbeen been forced to with recent
(29:36):
transitions is just that don'tbe afraid to have the courage of
your conviction to follow whatmakes you tick, um, because
there is promise there.
Ashley Love (29:44):
It is courageous, especially at the height of your
career.
You know, that's when peopleare are really getting to you
know buckle in and settle downand say, let's let's keep this
going.
But for you, it was that big,that big pivot that obviously
just gave you so much life.
And I'm so glad to hear that.
So for the person who'slistening who says, Wow, well, I
have courage, and this isinteresting to me.
I think I might want to dothis.
(30:04):
What maybe describe one or twoof the challenges and successes
that you saw working in clinicand research compared to the
challenges and successes thatyou're finding now in biotech?
Are they are they similar?
Are they vastly different?
What could that person belooking forward to if this is
(30:26):
something they ended upchoosing?
Dr. Satya (Nanu) Das (30:28):
Yeah, it's a fantastic question.
I I would say in the clinic,the the beauty of clinic and the
success of the clinic is theinstant gratification.
Um, as you know, Ashley,there's no better feeling than
taking care of someone in a timeof need, right?
And that satisfaction and thatjoy is instantaneous.
So you will get that, right?
(30:49):
And that's what clinical careis.
I think if you're drawn topeople and motivated by taking
care of people, there's nosweeter satisfaction than that
immediate gratification.
I would say the challenge is,and and maybe this is to your
point from a little earlier,maybe this is where our robots
and our AI can help us is in theadministrative burden, right?
(31:10):
Which is documentation, whichis making patient flow or
organizing our clinic schedulesso that we don't have to, or
that we're not spending half ourtime being administrators in
addition to clinicians, right?
Um, so some of that isdefinitely there.
I think we're fighting thesystem a bit on the clinic side.
I think one of the challengesis that that I always felt, even
(31:33):
though I was fortunate, um, youknow, I was at a referral
center, I wasn't seeing like inprivate practice, um, a cancer
doc sees 35, 40 patients a day.
Each patient's a story, right?
How do you synthesize uh evenjust a return visit?
It's just 15 minutes.
That's impossible, right?
So I think the challenge isyou're always fighting the
clock.
Um, and that's one thing.
(31:54):
Um, I think as you getseasoned, you you figure out
ways, but um one of thechallenges is is that it does
eat into some of your time.
You you can't color between thelines if you're going to be a
passionate clinician, becausepatient care doesn't have the
same boundaries that even youknow a clinical eight to five
does, right?
(32:15):
Like you're gonna be staying alittle later.
There is there are gonna bepatients that you're where
you're gonna be running late,right?
Because you had to care forsomeone or they had a
progression and you needed tospend five extra minutes holding
their hand to reassure them,right?
So that that's definitely, Iwould say, the challenge on that
side.
In biotech, I would say thechallenges are a little
(32:35):
different.
The challenges are uh patience,because and I'd say patience
here that waiting, because youdon't get the same instant
gratification, right?
Even if your drug's workingamazingly, you're hearing about
it through a telephone or youknow, through a third-person
communication.
You're not seeing that patientin front of you that's you know
went from feeling like uh, youknow, feeling like crap to
(32:58):
feeling amazing or doingsomething with their family.
You don't get to see that.
Um, and and you have to waitlonger, right?
Because you you don't get thereadouts uh in a clinical day.
You have to wait a few months,right, to actually see if your
drug is working or not.
So the challenge is thepatients, and I think the
challenge is a bit of thatinherent uncertainty, right?
Because no matter how well youdevelop the trial, how well you
(33:21):
write it, you're ultimatelybeholden to your drug, right?
And and I think um the data isnow changing, but the truth is
that even the drugs that make itto clinic, and I'll tell you,
there's a whole swath ofcompounds that are incredibly
promising that never even get tothe clinic because they never
get out of the lab, becausethey're either too toxic or you
(33:41):
can't formulate them into adrug.
So I'm even talking of thewinners, only 10% make it,
right?
Now we're hoping to change thatnumber, but you have to be
willing to embrace failure inbiotech.
And I think that's a challenge.
So if that you can doeverything right, and the drug
(34:02):
may still not be able to benefitpatients.
And and that's okay.
You have to pivot, you moveforward, um, you keep pushing,
but you have to be willing toaccept that that side of things.
Um, as far as the successes go,I would say the creativity um
is absolutely incredible.
Here, you actually take aconcept, you write the study,
you talk about the populationsyou want to benefit, you open
(34:25):
sites, you get to talk with PIs.
So you're really straddlingboth sides of the aisle.
You know, I get to work withformer colleagues and and
collaborators, but now as asponsor, right?
Where um I have the credibilityof having walked in their
shoes, but they also know that,you know, we're we're coming
with a drug that really has somepotential.
And this trial has beendesigned in the in the right way
(34:45):
to show something that couldpotentially impact patients.
And so that creativity, uh, andI would say that excitement of
when you actually get the dataand no one else in the world has
seen it, and you're seeing thatgraph pop up, the waterfall
plot showing the tumor shrinkageor how long patients are
living, there's nothing likethat feeling.
But to be fair, you know, Iwill say one point is that you
(35:07):
can also still find ways to,even if you transition to um
industry.
Uh, I know colleagues that havemaintained uh, you know, a half
day of clinic at a nearbyinstitution.
I personally didn't justbecause I wanted to kind of
delve in fully into this side,but I still do um some patient
consults through platforms,second opinions, um, family
friends.
(35:27):
And so I've found ways to keepthat patient focused or
patient-facing interface stillstill alive on this side.
Um, so you're not closing thatdoor, and I think that's also
important to remember.
Ashley Love (35:42):
Incredible.
And you know, it's something uhsomething that you mentioned,
and it was something I wanted toask as well.
Because you go from asituation, as you previously
described in clinic, that was socollaborative.
You worked with otherclinicians, you worked with
patients, you worked withresidents, you worked with nice
the list went on, right?
To um to biotech, which in Ithink maybe stereotypically, I'm
(36:03):
thinking of you sitting alonein a room with a bunch of papers
and textbooks and computers.
But you mentioned a PI, whichis a principal investigator,
right?
Which it reminded me that thisprobably isn't a very isolated
job.
I would imagine there's a teamof people.
Is that true?
Is it still very collaborative?
Dr. Satya (Nanu) Da (36:20):
Absolutely.
I would say, like, you know,here in in smaller biopharma, I
mean, we're say under 50 people.
Um, you know, we're poppinginto offices all the time.
My CEO is right there, my CSOis right there.
So we're having hallwayconversations, drawn on
whiteboards, having strategymeetings, taking all our large
calls together as a group.
(36:40):
We have team meetings two tothree times a week with our
entire core from our scientiststo our um our data individuals
to our safety andpharmacovigilance.
So it's actually very much ateam game.
And and I would actually say,interestingly enough, this I
would say industry is I wouldsay inherently even more
(37:02):
collaborative than the academicside.
Because sure, in clinic, yes,you're with tons of people and
I'll say RNs, PAs, uh, PharmDs,incredibly instrumental people
as well as part of the clinicalteam.
But then actually, when you'regoing into your office and so
forth, it is a little bit morelonely to speak of.
Here, by definition, I can't doanything.
(37:25):
I mean, I there's roles, but Ireally can't do anything in
terms of the decision alone.
So I have to bring in people.
And I think that's the reallycool part is it's all collective
decision making.
And it's about um, it's notjust about you have to prove
your points, which I love.
Uh, you know, you're tellingsomeone something, back it up,
(37:45):
right?
And I think that's what Ireally love.
Um, as part of thiscollaboration, is there is, um,
we were talking about earlier,this democratic feedback, and
and people push back.
And I think it's important tochallenge one another, um,
obviously respectfully, but Ithink that exchange is so, so
important.
And I and I see that so much onthe industry side.
And I think that was veryeye-opening to me.
(38:06):
I didn't know how much of thedecision making was
collaborative and how much, Iwould say almost the purest form
of debate that I've encounteredhappens on this side of the
aisle.
Ashley Love (38:18):
I was just gonna say that.
It reminds me very much ofdebate, which I think we have
turned into such a nasty wordthese days, but it is just, it
just it lights me up.
I mean, I hate debating.
I I I hate disagreeing withpeople.
But how else are you going tosharpen someone's idea?
And how else are you going toinvestigate and get deeper?
And, you know, we say playdevil's advocate, but is that
(38:40):
really what we're doing?
Or are we playing that person'sadvocate and helping them to
kind of explore and identifyeven deeper concepts to their
even deeper concepts of theiridea that they even realized was
their um, oh, I wish we didthat more in medicine.
Dr. Satya (Nanu) Das (38:54):
I agree and pressure testing, right?
And I think what I love is somuch of medicine, you know, we
have this notion that isevidence-based, but so much of
medicine is stilleminence-based, right?
Someone notable said something,and it takes a decade, right,
to disprove that.
Um, there's so many examples,you know, of that.
And what I love here is it's itreally is evidence-based.
(39:16):
Um, and and uh, and as yousaid, yeah, you have to um
pressure test everything becausesomeone even questioning your
own assumptions, you become amore thoughtful person, you
become a more creative thinkerand a more mature thinker.
So I think I've grown quite abit, and now it's been three
years on the industry side, butI I feel like, yeah, I've grown
(39:36):
a lot even in that period oftime.
Ashley Love (39:39):
I uh I've started reframing um those conversations
as challenges, but not anegative challenge, a positive
challenge, right?
Um and I think that thatreframing has really helped the
way I approach thoseconversations, not as you know,
a response to being attacked,but as an invitation to explain.
(39:59):
Explain even further, right?
Which is um exactly very it'sso very cool.
Okay, last question.
And this is this might be a bitof a big question.
So feel free to you know parseit down if you need to.
But of course, to wrap it up,what role does healthcare policy
play in drug development?
And because I think this isimportant to speak to, how can
(40:21):
patient stories influence thisprocess?
Dr. Satya (Nanu) Das (40:25):
Yeah, it's a fantastic question.
So um healthcare policy isinstrumental in setting the
framework for how drugdevelopment works, right?
And I think, you know, whatwe've seen, irrespective of what
side of the aisle we're on, Ithink turnover is not great,
right?
And I think unfortunately wesee so much turnover in the FDA.
And I think what worries us asdrug developers is is that going
(40:48):
to introduce inconsistency inhow drugs are assessed?
Because the last thing you wantto introduce for drug
developers, right?
I already talked about how muchinherent uncertainty there is.
If you change the goalposts oryou're moving the standards,
right, we have to be consistentin what is a meaningful benefit
for a class of drug and let'sstick to it, right?
Let's have our interactions,um, let's have the same bars,
(41:12):
the same metrics, so that we canall be judged equally and let
the best drugs win, right?
Because at the end of the day,the patients will win, and
that's what we all want.
But when we have so muchturnover in regulatory agencies,
it just creates inherentuncertainty because we don't
actually know how decisions arebeing made.
Why was it that one drug thathad very similar data or a
(41:33):
development path got rejected,whereas another didn't, right?
And I think that's so I thinkhealthcare policy trickles into
all of our lives.
And obviously, as clinicianstoo, you know, we can, again,
probably talk for five hours ofhow healthcare policy is
influencing not just academiccenters, but the practice of
medicine at large.
(41:54):
But it is so important to notlose sight of the main thing,
which is the patient.
So I think we can use patientstories as a very powerful lens.
So almost every, let's say,investor talk that I'm talking
at, or even with a PI or with anadvisory board, I start with
the patient anecdote becausethat's how that's how I was I
(42:15):
learned medicine, right?
We talk about the patient'sstories to frame our narrative.
And I think that is the mostimportant piece because lost in
the shuffle of policy andsometimes just disagreement for
the sake of disagreement, isthat the patients are the ones
that suffer because eithermeaningful or promising drugs
(42:36):
are delayed or a drug that couldhave been a real game changer
falls through the cracks, right?
And that's kind of the worstaspect.
So I think it's we're um ashealthcare providers, whether
it's in um biopharma clinicians,um, we have a deep
responsibility to continue totell our patient stories at
every avenue we get and beinvolved in policy discussion.
(43:01):
So if there are opportunitiesto go to Washington um to
advocate on behalf of ourrespective disciplines, it's
super important to do that.
But use the patient story um asour tool because I think um
that distills so manycomplicated things to a very
simple thing, right?
Is how do we do right by thepatient?
(43:23):
We think of we, you know, Ithought about that in clinic
every day.
That's what you're thinkingabout.
And I still think about thatevery day uh as a developer.
And I think we need ourpolicymakers to think about how
we do right by patients everyday as well.
Ashley Love (43:37):
The perspective is so important.
And I think as clinicians inthis role in biotech, it is our
greatest gift, really, is to beable to offer that perspective.
Nanu, it has been such apleasure speaking with you
today.
Thank you so much for being sowilling to um not just define
some of these topics first, butactually really describe them
(43:58):
and infuse humanity into thesesituations that I think people
really think are just automatednowadays and they're not.
I mean, there's so much,there's so much thought that
goes into this, and um, andyou've described it beautifully.
Thank you so much.
Dr. Satya (Nanu) Das (44:10):
Thank you so much, actually.
It's such a pleasure.
Ashley Love (44:12):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
Shadow Me Next.
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