One company’s failed drug is this company’s ‘jewel’

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Many pharma execs find that a personal experience with a patient serves as a catalyst to enter the field. For Dr. Thomas Bock, CEO of the precision oncology medicine company Notable, that brush with a disease has hit especially close to home.

Notable CEO Dr. Thomas Book

Permission granted by Dr. Thomas Buck.

In fact, Bock says his entire life has been centered around advancing medical oncology. When Bock was young, his 6-year-old sister died from brain cancer. After seeing how she experienced the “toxicity [of her cancer treatment] without the benefit,” he embarked on a quest in medical school to develop better treatment options.

As his career in pharma later blossomed, Bock accrued a lengthy list of accomplishments that harkened back to those early life goals, including the development of six blockbuster medications while working for Celgene, Alexian, Novartis and others.

Then, about 10 years ago, Bock’s wife began her battle with breast cancer. As it would turn out, one of the treatments she was given was Femara — a blockbuster Bock had helped bring into existence. Talk about seeing the impact of your work up close.

“I’m particularly proud of Femara because my own wife was treated with this. And so that hits quite deeply,” Bock explains.

Bock’s wife survived her cancer diagnosis. And studying the difference in her experience versus his young sister made Bock an even stronger believer in the need to develop oncology drugs that are more effective with fewer toxic side effects.

Today, that sharp focus is guiding Bock’s leadership at Notable, which specializes in a “new class” of predictive precision drugs for various cancers. The company’s approach is to identify existing treatments that are less attractive to other drugmakers due to their lower efficacy, and then, using a proprietary platform, Notable “bio-simulates a patient’s cancer cells” to identify a patient population that is more likely to respond .

In other words, the company uses its platform to match oncology diamonds in the rough with the right patients.

Notable currently has two candidates in phase 2 trials for acute myeloid leukemia, and two in phase 1 for pediatric leukemia and solid tumors. According to Bock, early studies have shown that its platform is over 90% accurate at identifying clinical responders. The approach also helps patients and their doctors answer what Bock says is the important question in someone’s journey with a disease.

“In the end, it comes down to one thing I believe matters most to the patient: Will this drug work for me?” he says.

Here, Bock talks about his storied history in pharma, the business advantages of the company’s approach, and how notable has turned the pandemic into an opportunity to be more efficient and innovative than ever before.

This interview has been edited for length and clarity.

PharmaVoice: What attracted you to Notable?

Thomas Buck: When I got connected with Notable, its founders and its team, we had exactly the right passion because we had this personal experience, very high ambitions and a high bar. We said if we want to move forward to serve our family members and our patients, we have to do two things: We have to develop drugs with compelling medical benefits. But the second piece is we have to make sure that each treated patient also has that dramatic benefit, and it’s not just one out of three [patients who] get benefits.

We now develop treatments by combining tech and life sciences that work in more treated patients, and that’s huge. So that’s what attracted me immediately and what resonated.

In your career, you’ve played a hand in developing six blockbuster medications. Tell me about some of the highlights in that journey.

There are three that really changed the paradigm of how we treat patients. One was Gleevec, [which was developed] when I was the global medical head at Novartis Oncology. It was the first cancer precision medicine and a designed molecule for a genetic mutation of a biological pathway. With Gleevec, you treat the patient and find out whether she or he responds, and it was just game changing. You replace bone marrow transplantation in this field and 99% of the patients responded, and it extended the lifespan by many years.

The second one was Revlimid at Celgene. Everyone wanted to treat and kill cancer cells and treatments were very toxic and we said, ‘Let’s modulate the immune system and get cancer under control.’ And so, Revlimid was much more tolerable and again, extended life spans by five to seven years.

Then there was Soliris, from when I was global head of medical affairs at Alexion. It’s a company that really intrigued me because they said, ‘No patient should be left behind. Even the smallest populations, (which we defined as 5,000 patients or less worldwide), deserve progress.’ It wasn’t the business model at the time and people thought you couldn’t create that, but we delivered. If you create momentum for innovation and drug development on these patient populations, and if you create that life-transforming impact, you can also create a business model around it that’s viable and sustainable. That’s been my experience.

Tell me more about the medication you helped develop that your wife used to treat her cancer. What was it like to see a medication you helped create being used by a patient in your own home?

It made me very humble, honestly. And you can see that even great therapies sometimes have side effects because you’re now so close to the patient, and it makes you doubly cautious and diligent when you set the bar for any new drug that you develop.

How did those experiences impact your approach to developing medications at Notable?

When I met the founder and the team of the company for the first time, they had developed this predictive platform mostly for diagnostic purposes. We give it to a doctor and then they can predict which target they should give to a patient and whether they’ll respond or not. I saw this and thought, ‘Wow, that’s an amazing thing.’ But imagine if we could develop drugs where that is not even necessary because they’re only developed for clinical responders?

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