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Erik van den Berg: CEO of Memo Therapeutics · BioBoss

• 0:00
  John Simboli: Erik, what led to your role as CEO at Memo Therapeutics?
• 0:03
  Erik van den Berg: I joined about two years ago, and what attracted me about Memo Therapeutics were, I guess, a couple of things. So first of all, it's a clinical asset in a field that has a great medical need, and it was already an ongoing trial, just starting up phase two. And that's attractive, for me, because I like to be able to be involved there to see how you can shape how you prepare for your next regulatory interactions, to really make this a phase three-ready asset, and with that, of course, a viable option to get to the market. So that was attractive. The unmet medical needs, and also the stage of development, I had connectivity with the investor base that provides, then, of course, some transparency and trust already, I think both ways. So that's helpful. And then when I met the team, I really had a good connection with them. So they seemed to be super, you know, and they were honest and involved and, you know, passionate about what they were doing. And they had come through a pretty difficult time as a company, like many biotechs, right? It's difficult to refinance, and sometimes you get to the end of your cash before you do it. But they pulled through that and were successful at that and I think is a good test of a team pulling together and delivering. So there's a plus for me as well.
• 1:14
  Erik van den Berg: And then what I also started with the thought that I could add value as well, based on my experience translating companies from earlier states to late stage clinical development. So that was sort of the key reasons for me to decide the job Memo,
• 1:30
  John Simboli: Your background as a co-founder and as an executive chairman, and having been doing this for a while, would make me think that process could have taken some time because you had so many options, so much, so broad a view of what you might want to take on next. Was that the case? Or did it happen quickly?
• 1:50
  Erik van den Berg: I think it happened quickly in the end. So I decided to, in my previous company, AM-Pharma, been there 15 years. I decided it was time to do succession planning and to work towards a handover to the Chief Operating Officer. And this was a process that we aligned on with the board and more or less prepared for a year where we had restructured the organization, refocused the clinical trials, refinanced the organization, and then I joined the board so I can still help and add value there. But also it was a decision to finish that, and then I start looking around.
• 2:22
  Erik van den Berg: So I did not have this opportunity, or any other lined up, to have a concrete, seamless transition. So it took about three months for me to evaluate multiple options, and it was hard work in between two jobs, there's lots that you can evaluate. You want to make the right choice. And then this one seems, at least, for me personally, the best fit based on the previous criteria that I just provided. And I have not been disappointed on any of these criteria. So it has been a blessing to work with the team and to be able to build on the bases and expand it significantly and also augment the investor base and work together closely with the board and the investors to deliver on the clinical trial results and becoming more and more closely involved with the patient community, as well, along the way. So this is a field in which I have, of course, a pretty active vested interest from the patient perspective. It's in transplantation. It's a well connected field. Patient organizations organize, for example, you know, on an annual basis, get together in the US, as an example, where they do sports together, as like Olympic Games for transplants to their patients. So it has been very much a joy to be working in this field and contributing, indeed, to providing a solution for patients that have a BK virus infection after transplantation.
• 3:41
  John Simboli: In that sifting, those three months that you described, is it more like eventually finding the right fit, or is it anything like falling in love, like as one falls in love with an idea as a student and in life? I mean, what's that like?
• 3:57
  Erik van den Berg: Your mind starts to work in a certain way, right? You're only looking for, I guess, affirmatory stuff, confirmatory stuff, at a certain moment in time that you think, okay, yeah, no, no, this is, this is the best opportunity because of these reasons. And you spend more and more time on that, you dig into the subject more and more, you read more articles, you speak with more people, and then it becomes a little bit of a self-fulfilling prophecy, I think, in the end.
• 4:19
  Erik van den Berg: So maybe that's called falling in love, but, yeah, it's, it's how it works, right? So apparently, that's where the heart goes, that's where your time goes. Then you feel comfortable with the choice that you're making. But there's so much fun things to do, I think, in biotech, right? So it's also a little bit being a kid in a candy shop, and would love to do multiple things in parallel, but that's not how it works, right?
• 4:40
  Erik van den Berg: If you are Chief Executive Officer, you have to focus, indeed, on one thing that you can lead at the same time, especially when it's in later stage clinical development.
• 4:49
  Erik van den Berg: There's so many choices to be made. There's so many nuances to be understood, and that's where you have to add your value by putting on your, you know, your boots and being in the mud together with the team and then making it happen.
• 5:01
  John Simboli: When you're building your team around you, I'm guessing that, the question comes up, well, how secure is this? So how does someone who understands that and has been doing it for a while, how do you address that? How do you explain that to people?
• 5:16
  Erik van den Berg: I don't think I've ever hired a senior from pharma without having some level of experience in a smaller outfit or an entrepreneurial role, and it doesn't need to be a biotech company. But I think, I like people to then have shown next to, of course, all the knowledge and capabilities that will come with the exposure that you had in a large company. I would like to see that people know what they're getting into.
• 5:41
  Erik van den Berg: And if you haven't been exposed to being in the dirt, as we are in a biotech company, but it can be also in an entrepreneurial role, then it's hardly a recipe for success. So typically, you deselect all people that had 20-25 years of experience solely in one or two single large pharmas. It's difficult to be happy, that such a person will be happy in the environment that we're operating. I've worked at larger pharma, as well, but before I worked in biotech, before I joined larger pharma, and I've worked in consulting, so I know that I like to work in the smaller company settings. So that's for me, something that works. I want to be involved, which typically means, if you are in the CEO role, then you're, of course, super involved, right? You're not on the sideline, and you can oversee all aspects and help direct where we're going on all these avenues. So for me, that is very satisfactorily to be involved with that. But it hasn't been a super, say,
• 6:42
  conscious process: I want to become a CEO of a biotech company. That's not where, when I finished my secondary school, thought that's where I got to end up. I didn't even know what biotech was. In the end, of course, saw the complexity, it came on my path relatively early in my career, when I was a consultant at Arthur D. Little, we consulted lots of pharma and chemical companies, and eventually also biotech companies, to develop their strategy and where to focus your R&D efforts. And that's basically the moment that I started to fall in love with the biotech sector, because it's so much about innovation, and you work on a global scale, it's super complex, and of course, there's that doing good element of it, as well. You're, at least in most of the biotech companies, we're focusing on unmet medical needs or really trying to solve real problems with, you know, cool science.
• 7:36
  conscious process: Well, what can be better than that?
• 7:38
  John Simboli: As you can remember, when you were younger, and you were in those formative years, and you had this idea of what, someday, your life would be like. Did it have anything to do with what this life turned out to be?
• 7:49
  Erik van den Berg: On a higher level, I guess, yes. So when I was young, what I can remember, at least, is that I wanted to become a vet. That was the original thought. I think that vaporized somewhere later on, so never returned to that original idea. But I was fascinated by biology, by nature. And I guess I've watched the entire sequels of David Attenborough when I was very young. At the same time, maybe a little bit older, I spelled out the economic section of a newspaper because I wanted to understand how the world works, right? And I guess the world of money dictates a lot what happens in the world. How are decisions made? You know, how do power balances work out?
• 8:30
  Erik van den Berg: So on that higher level you think about, where I'm now from, everywhere that was interested in as a kid. You know, it's still a combination of fascination with biology and making sure that the financing works as well, right? It is an enterprise. In the end, we need to make sure it has a business model. Somebody wants to put money in it. So we have to believe in the vision that is there for a company, and that there is a product at the end of the pipeline where you go through the development steps.
• 8:58
  Erik van den Berg: So it's kind of that connection of the two basic interests that I already experienced relatively early in life.
• 9:08
  John Simboli: From my vantage point, being on the branding side, I observe that scientists work in an area of life where facts matter, and I also see that when dealing with, that those facts change quickly, and so there's an inherent kind of chaotic aspect to working in biopharma. And I also see that people who have a background economics can see things in a broader, longer timeline, and they can try and make sense out of them. So how does one have an orderly mind as a scientist and also deal with the disorder of things changing all the time?
• 9:44
  Erik van den Berg: Yes, but there are signs in disorder or complexity as well. It's about, then seeing, more or less the general rules that apply, that you can create at least some order in that chaos. It's not very easy to done, of course, all sorts of details. At least, what works for me is keeping in mind what the bigger picture is, so that you have a very clear vision of where we're going to.
• 10:09
  Erik van den Berg: In my mind, that's not a single point, right? There's optionalities of what might be but what might need to happen in between. Of course, our end goal is clear. I want to get this drug approved and then being able to help patients. And okay, then you break it down on what the steps are in between. But the road to these steps can be different, right? So you work on optionality, you work on potential scenarios that might happen, and then you're kind of in this stream that is a river of, we don't change the river, but we can change the course of where we're, you know, in our boat on that river. And that's, I think, where you have to focus on. So what are the things that you can change in an organization? It's very helpful if there's a right culture in place, which makes, then, life much easier for everybody. If we're kind of speaking the same language, which means that at the moment, there is structure so we know what we're going to discuss at what points in times, right? On a meeting structure or company meeting sharing information, if everybody knows, hopefully they will get their information, ability to input and, you know, discuss things.
• 11:14
  Erik van den Berg: And at the same time, we have these rules, which is our culture, which provides also certainty, I think, on how we interact with each other and what we are aiming to be. And that can also provide order or certainty or solid ground in a world that is super changeable, especially in biotech, right there's lots of events that happen, either outside of the company or in your programs.
• 11:44
  Erik van den Berg: It's early science that you cannot predict, and then, yes, you have to step back, reflect and make decisions.
• 11:52
  John Simboli: What are the elements of culture at Memo that help you to make that happen?
• 11:57
  Erik van den Berg: Well, one thing I think is important is that we we embrace, say, the collaborative mindset. I have not experienced here that people will say, Well, you know, that's not in my wheelhouse. It's somebody else that needs to do it. And I think that's because the overall objective is clear, the goal. So that's really a helpful part of our culture. We really embrace quality our output, because it's just professionally, it is fairly satisfactory, right, if you can do it in the appropriate way.
• 12:28
  Erik van den Berg: And then, just as another example, there are more cultural traits that we that we have, but the desire to make impact. And so we want to focus on the things that can really have a big change, right? So, and the BK program that we're working on in transplantation is, of course, a clear example of that, where we're the furthest along, at the farthest in development.
• 12:53
  Erik van den Berg: We've done a pretty large study for being mid clinical stage, and there's nothing out there on the market, right? And if you have a BK virus infection, then the outlook is that you double your risk of losing your graft earlier on, or even an increased mortality rate. The current standard of care is not yet good enough. We want to change that.
• 13:17
  John Simboli: There must be a great temptation to be the smartest guy in the room when you're the CEO or a leader. How does, in terms of culture, how do you deal with that?
• 13:29
  Erik van den Berg: I do like to ask a lot of questions, and sometimes that style can come across, of course, as criticism, which it's not. It's either genuinely being interested or not understanding it and wanting to understand it, or if I don't understand it, maybe somebody else, externally doesn't then understand it either, and then I start to have a lot of questions, which hopefully is then helpful for people to clarify their thoughts or direct future analytical work to come up to a better answer. Yes, it's maybe it's also inviting others to be critical so that, and then, of course, you have to show that you can accept criticism or feedback, which, otherwise the loop doesn't work.
• 14:16
  John Simboli: When people ask, who is Memo Therapeutics? How do where you like to answer?
• 14:19
  Erik van den Berg: Well, the short answer is that we're in the business of identifying highly potent antibodies derived from human immune responses and then translate them in unique medicines. And the other answer to that question is, our lead program is in, just finished phase two, in BK viral infections. And then we have an antibody that was derived from a patient that addressed his own viral infections very effectively. And then when we examined the antibody of all of resections at Memo where indeed we would the patients, we were able to identify the single antibody that had a highly potent response or binding and neutralization to the BK virus, the most potent antibody ever seen here. What I like about our concept is that you really, you know you're being inspired by nature, and you're building on that. You have a mature antibody in a human being. So it's a pretty safe starting position.
• 15:09
  Erik van den Berg: So we're giving a fully human antibody to patients, and one patient, in the end, helps, hopefully a lot of other patients then. So I think that's the beauty of that concept. The platform's name that we have at Memo Therapeutics is Dropzylla, as we call it. So it's a microfluidic platform where, based on these very small droplets, we're able to extract the genetic information out of each B cell that we obtain from a sample to see well, what antibody is that B cell producing? And then we can bank those antibodies by transferring DNA into RNA and then into a producer cell bank to evaluate indeed and Okay, let's screen that antibody of a specific patient or a combination of libraries that we have obtained for multiple patients, and then screen it against the target. Or what we are now also doing is use the antibody to discover novel targets, because then at one go, you have a novel target and a novel antibody. We identified, indeed, this antibody was working with blood from healthy individuals, but also from kidney transplantation patients that had a BK virus infection, and hence a relatively recent immune response to the BK virus, and then sample their B cells, find out what antibodies are there, and then identify very potently binding and neutralizing antibodies to the virus. And because this technology is kind of a copy machine, it can copy the entire antibody on, it increases the chance of finding a unique antibody also, if like a factor over the existing technologies, that's why we were able to find this unique antibody. And in our other programs, we're also finding, indeed, unique antibodies.
• 18:12
  Erik van den Berg: like to see how we can get new targets, and with that, new antibodies identified at the same time to be developed in cancer, tumor cancer indications.
• 18:24
  John Simboli: When you explain to savvy investors, let's say institutional investors, prospective investors, what distinguishes Memo, and some will understand it and value it.
• 18:35
  John Simboli: Some will understand it and say, That's not for me. Some will say, Oh, I think I have it. And then you may realize, I'm guessing here, that they have understood it in a way that you did not intend them to understand it. So the question is, when there is a misperception, a miscategorization, what's that tend to be? And then how do you
• 18:56
  Erik van den Berg: I don't think we ever have misunderstandings about the mode of action, in the sense, right? Because it's, everybody knows antibodies.
• 19:02
  Erik van den Berg: Okay, you neutralize a virus. We know that your immune response can be is that the way, how your immune response is to deal with like foreign entities, so and then to deal with the disease. I think everybody also gets the unmet medical need, in the sense that there's nothing on the market currently, and that projections for these patients are not ideal. What might be maybe not misunderstood is too strong, but not fully appreciated, is that, so the current standard of care to treat BK virus infections is to lower immunosuppression.
• 19:35
  Erik van den Berg: Patients, if they get an organ transplant, in our case, kidney transplants, they are offered pretty heavy immunosuppression because you don't want to reject the graft. Clearly, of course, that is easier than for viruses and other infectious agents to be upregulated or infect the patient. In our case, 90% of the population has the BK virus.
• 20:01
  Erik van den Berg: It's dormant in the kidney, so it's transplanted with the kidney. We have strong immunosuppression. It's upregulated in a severe form in 20 to 30% of transplant patients. And then, you know, immunosuppression is lowered to be able to get the immune system, you know, elevated again, to be able to address the virus. But the background of
• 20:21
  that is two-fold: One is that's the standard of care, and we know the outcomes. So after 10 years, if you do not have a BK virus infection, 60% of the patients stay alive with a functioning graft. If you have a serious BK virus infection, it's 36% and that's with this current set of care. So sometimes people will feel, well, the current set of care is good enough, right?
• 20:45
  that is two-fold: We can address this, you know, little flare of virus increase by lowering immune suppression.
• 20:49
  that is two-fold: But then if you look at the consequence of that on the long term, it's not satisfactory at all. And then the other part is the patient perspective there.
• 20:59
  that is two-fold: So patients are told, you know, pretty severely, that they have to take their medicine, right?
• 21:04
  that is two-fold: It's important to take your medicine. As you can imagine, if you would forget to take your medicines, or infrequently take it, maybe within a couple of weeks after your transplantation, you will be at the ICU, right, because your organ is being rejected. So it's really, you know, important to take your medicines. And then all of a sudden you get a BK virus infection, at least some patients. And then the message is, well, don't worry, we'll lower your immunosuppression, right? So it's counterintuitive to do it, because it feels you're risking your graft. And to some extent that's true, of course, so it increases the risk for acute rejections episodes, which can be treated again by increasing immune suppression.
• 21:45
  that is two-fold: But the guardrails where physicians and patients have to operate in, where the immunosuppression is, like the Goldilocks scenario, it's just right, it's not too much because then you get a lot of opportunistic infections. It's not too low, because then you're rejecting your graft. The guardrails are relatively narrow, certainly in some patients. So being able to provide much more flexibility and freedom if you can add an antibody to your standard of care, that you don't need to lower immuno-suppression, or you don't need to lower that much, makes a lot of sense. And I think that concept sometimes, of course, takes a while to realize that immuno-suppression lowering is the only thing we have currently. It comes, of course, with some risks, and it's definitely not ideal.
• 22:33
  John Simboli: Finding that balance within the guardrail, is that, in a way that you just described, is that differentiating for Memo? Are others approaching it in the same way, similar way?
• 22:43
  Erik van den Berg: Well, there are not that many others. I think that's the first thing. An antibody makes sense in this setting, because a typical small molecule approach is not very likely to work with DNA, small envelope virus, non envelope virus and other things. So of course, you can think about antisense as an approach, which a company is doing, but in the end, we'll just work with what nature already has provided us, which is, you know, a neutralizing antibody, which we all have, right? We all have neutralizing antibodies because we all have the virus, and that's how we keep it in check.
• 23:14
  Erik van den Berg: So keep it simple and safe.
• 23:14
  Erik van den Berg: Hopefully soon after phase three successful on efficacy.
• 23:21
  John Simboli: What makes a good partner for Memo Therapeutics?
• 23:24
  John Simboli: What kinds of partners might make a good match to Memo? What would you say?
• 23:29
  Erik van den Berg: We have, you know, I see our investors as partners. We have, of course, a CRO we work with, a lot of clinical sites. We've worked with patient organizations. We work with manufacturing outfits.
• 23:38
  Erik van den Berg: We think we probably sign, I don't know, five contracts a week or more. So we have a lot of external connectivity. We're a small core, where you have expertise on all different areas. We have our labs here, of course, in Zurich as well. Then you work with lots of externals that can provide the expertise or hands or facilities that we don't have, and then we work with them.And in the end, we'll likely work with pharma partners to leverage our asset to become available around the globe.
• 24:14
  John Simboli: How about academis partners? Partnerships? What sorts of connections do you have in place at this point? I know you're always looking.
• 24:21
  Erik van den Berg: We do have connections with, well, first of all, of course, in the clinical trials with the hospitals. But if you look at the science part of the organization, and also how, for example, we had discovered our antibody here, it was in collaboration with universities that worked together with us on this program. And we do the same in our oncology program. We work with a network of universities and other suppliers from the science side. We regularly have, you know, Swiss grants, so the local grant system granted to us, where we then collaborate with, you know, the University of Basel, for example, of the University of Zurich to bring innovation further.
• 24:58
  John Simboli: How significant a change do you envision if this works out in the way you hope it will?
• 25:03
  Erik van den Berg: I think it will be a significant change, yes. It's a real concern in transplantation that you have a BK virus infection, because if you don't get it under control, you know it will destroy your kidney cells. And with that kidney function, and with that, over time, you're graft, you will need to be re-transplanted, if possible. As an example, here in the US, you have, you know, 500,000 patients that have end stage renal disease and hence have dialysis. 100,000 are on the transplant list, and less than 30,000 are transplanted each year. So the average waiting time for a transplant is about five years in the US, pretty similar in Europe. It's even higher in Japan. With that shortage of donors, and, of course, a shorter graft life, if you have a BK viral infection, you know, on top of all the concerns that it has for for patients, whilst having this, you know, infection and having to deal with all sorts of changes in your immunosuppression, which is not ideal. Yes, I think if we can add then something to the mix, with an antibody that neutralizes the virus, can help, you know, get rid of the virus quicker, which is data that we see from our phase two study, where the BK virus infection both measured in blood as well as in the kidney, where it replicates, it has a profound effect on lowering the BK virus presence in the kidney and in blood. So I think it will have a tremendous impact and become part of the standard of care where we say, well, let's use the antibody and deal with the virus in that way. If you're an end stage renal disease patient, and you can, this how patients experience it, get the gift of getting a transplant, and with that, you're off dialysis, right? You'll get to a relatively normal life then quickly again, it has a profound impact on lives of people.
• 26:55
  John Simboli: Is there anything about working in the Zurich area that that is similar to or different from other places you've worked?
• 27:02
  Erik van den Berg: It's a pretty tightly knit, I think, ecosystem that you have here. So Zurich itself has a pretty large startup field, also outside of biotech, ETH is almost a guarantee for a lot of spin outs that is located here. So I think it's a very good ecosystem in Switzerland in general. And there's always things to improve, of course, but if I look at it as an outsider in, there's a willingness to create spin outs from universities. Our universities are very capable of doing that. And maybe in some countries, that's a longer process, and there are more academic resistance to it. So people are more pragmatic here.
• 27:37
  Erik van den Berg: If you want to get innovation to patients or to people, in the end, science needs to be translated into a product.
• 27:45
  Erik van den Berg: That's called innovation. And the best setting for that is, of course, in companies. And there's a pretty broad support also from the angel investor side, from individuals or family offices investing into also biotech which have, of course, typically, a long horizon. I experienced that as more in Switzerland than in other countries. So lots of biotech companies will have a wider shareholder base because of their early phases of life, they relied, indeed, on also angels investors to help the company get going.
• 28:22
  John Simboli: Eric, thanks for speaking with me today.
• 28:24
  Erik van den Berg: My pleasure.
• 28:24
  Erik van den Berg: Lovely, speaking with you as well.