Jesús Martin-Garcia: CEO of GeNeuro

September 18, 2022 Jesús Martin-Garcia Season 4 Episode 51
Jesús Martin-Garcia: CEO of GeNeuro
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Jesús Martin-Garcia: CEO of GeNeuro
Sep 18, 2022 Season 4 Episode 51
Jesús Martin-Garcia

Jesús Martin-Garcia, CEO of GeNeuro, shares his thoughts with BioBoss host John Simboli about leadership in biopharma and how Geneuro is working to develop treatments against neurological disorders and autoimmune diseases by neutralizing causal factors encoded by Human Endogenous Retroviruses.

Show Notes Transcript

Jesús Martin-Garcia, CEO of GeNeuro, shares his thoughts with BioBoss host John Simboli about leadership in biopharma and how Geneuro is working to develop treatments against neurological disorders and autoimmune diseases by neutralizing causal factors encoded by Human Endogenous Retroviruses.

John Simboli  0:00  
Today I'm speaking with Jesús Martin-Garcia, founder and CEO of GeNeuro, headquartered in Geneva. Welcome to BioBoss. 

Jesus Martin-Garcia  0:09  
Thank you, John. Thank you for having me. 

John Simboli  0:12  
What led you to your role as founder and CEO at GeNeuro?

Jesus Martin-Garcia  0:16  
In my entire career, I've always been working on the edge of technology and how to use technology to improve the life of people. And I did that in the 90s, in the internet. I left McKinsey at a time when intrepreneurs didn't exist yet; they called they call you a fool if you were leaving a nice position in a successful and large company to get on to yourself. I was able to really run that wave and dive into that opportunity, creating Switzerland's number one e-commerce company that was later sold to Migros. Also getting involved in a company that was a large fixed line and internet provider and other companies like that. It was absolutely clear that this was an area where technology could incredibly change the life of people. It was also very clear to me that we're at a time where the tools that we use in the biotechnology field are evolving so fast that it's opening up a tremendous amount of new opportunities to treat patients and hopefully find cures for many of the diseases that have been plaguing mankind for millennia. So I turned to this and, at first, created an incubator—with the help of the city of Geneva, industrial partners, and some investors—where we incubated a number of companies. And one of the companies we incubated was GeNeuro, which was a technology which originated from Institut Mérieux in France, with the discovery of human endogenous retroviruses. I'll explain what that is later. But it's basically eight percent of our DNA, which is made of the traces of the viruses that infected our ancestors, and how they could be important to immune and neurodegenerative diseases. So we decided to give it a go and with Christophe Mérieux, at the time, and Hervé Perron, as scientists, we decided to put together a very small company to follow that science and see where it will lead us. And I joined the company full-time at the end of 2015, when we were making a partnership with a firm called Servier, in France, and also ready to launch a major phase two trial in multiple sclerosis. So I joined the company to try to give it some impetus, some new power. Before that, I was just a chairman of the board. And I've been there ever since through highs and lows because our industry is not only made of highs, but also a lot of lows.

John Simboli  3:30  
It was early enough, as you point, out early enough in how people were thinking about biotech and biopharma that—I loved your phrase "they thought it wasn't an intrapreneur, it was a fool." So how did you overcome what must have been a question in your own mind about am I doing the right thing? Was it very clear to you?

Jesus Martin-Garcia  3:51  
I decided I wanted to be in there, to be operational, and as much as I love McKinsey, I must say that I learned so much, incredibly bright people, and had a fantastic time there. I really wanted to be more operational and build something with my little hands, doing things.

John Simboli  4:07  
When you made this decision to move into a new area, had you considered taking your ideas about a different approach towards technology and taking it to an established company and trying to develop them there, as opposed to building something from scratch?

Jesus Martin-Garcia  4:24  
You know, it's always difficult to convince large companies of the waves that are coming. I can give you an example in an area which I was involved in early, which was digital photography. Some friends of mine here in Switzerland had created one of the first precursor companies in the field of digital photography, basically being able to take a digital picture and able to send it to a Quadri-chromic printing system, whether the flashing that was used in photography at the time or printers. And I remember some discussions with the leaders at that time in that area, which by the way, have all disappeared, and going to them and telling them, guys, this is a huge wave, it's coming for you. And we have a solution. And this is the way you could adapt. And it was way too difficult because when you're sent in ways of doing things, it's extremely difficult for them to change course and to be able to see something, which, in fact, would become fatal for those companies.

John Simboli  5:24  
When people ask you, what do you do for a living, they may picture you in a lab, for instance, because you work in biopharma. What is the reality? What does a CEO and founder of a company like yours do each day?

Jesus Martin-Garcia  5:38  
It's really bringing things together and forward. Not in a lab, I'm not even a scientist, by training. I'm a lawyer and Harvard MBA, so you know, nothing further from the lab. But really, my goal is to harness all the resources together that are needed to push the company forward and to make sure that we're all pulling or pushing in the same direction, which is the success of the products that we're trying to develop. And ultimately, it has to be to bring really new value to the patients. Really, the role of the CEO is not to do the clinical trial, or to do the preclinical research or to be in the lab, it's really making sure that, one, you harness all the necessary resources to be able to do that. And then to make sure that everybody is pulling and pushing in the same direction.

John Simboli  6:27  
What have you learned as the CEO, that is your management approach, your style, your way of communicating that works for you and defines who you are?

Jesus Martin-Garcia  6:36  
it's really about listening, it's really about making sure that you are able to listen to problems to make sure that people are able to talk to you about their problems, and to be able to help them solve it. If your help is required, to be there and need to help them solve it by yourself or by pulling in resources. Remember that when I left McKinsey, I left it to be an entrepreneur. So I have experience in creating companies from scratch. You know, when we created LeShop, which became Switzerland's number one e-commerce company, it was putting down the service, together, and managing a team of coders, developers, that were basically putting together a very innovative software, for the time, to do e-commerce in a novel way, again, at the time. When you're doing biotech, it's not very different. Biotech is an incredibly cross-functional industry in which you need an incredibly diverse amount of know-how. And it is really important that those are brought together and work in unison. It's like an orchestra, everybody's got to be playing the same tune, otherwise, it becomes cacophony extremely fast. And it's making sure that we have the pianos that we need, and that we have the basses that we need, and the violins are there when you need to have a violin. And you can change that for preclinical pharmacology, regulatory CMC, clinical trial, medical direction, etc, etc. But it's really about putting all that together in a way that is harmonious and advances the project.

John Simboli  8:17  
Jesús, can you remember, when you were eight or nine or 10, whatever is the appropriate age, and you were thinking about, well, what do I want to do when I get to be a grown-up? And you're probably like most of us thinking, Well, what do my parents want me to do? But in any case, can you remember that image you had? And can you see any connection to what you're doing now, professionally?

Jesus Martin-Garcia  8:36  
I was coming from a family of bankers. So, you know, I pictured myself, very naturally, as a banker in Switzerland. I actually tried it. And frankly, this is something that didn't attract me too much. So I diverged, I went into economics, law, Harvard, and McKinsey. And that was it. That was the start of my career. I spent some time, which was very fundamental for me, which was the World Economic Forum. Because Professor Klaus Schwab was one of my professors at University of Geneva. And he basically took me with him to the WEF, where I spent a year and a half, which was tremendously formative for me, in terms of seeing how people thought at the higher levels, and also to get completely disinhibited about important people or non-important people and seeing that we're all the same and think, more or less, the same, except the burden of our shoulders is always relative to what you're doing with this. There's no more stress for one or for the other. So that was also transformative for me.

John Simboli  9:46  
What do you say when people ask who is GeNeuro?

Jesus Martin-Garcia  9:50  
GeNeuro. is a company that is really dedicated to bringing novel treatments for neurodegenerative and autoimmune diseases, which is a huge area of medical need. We do so by leveraging the biology, the normal biology of the viruses within our DNA, which we believe are incredible levers to change the course of these diseases.

John Simboli  10:10  
And can you tell me a little bit about why it is that, I think it's sometimes referred to as the fossil aspect of this is important?

Jesus Martin-Garcia  10:20  
Fossil viruses, it's actually, it's a good image you're using, John. They're called fossil viruses because they have been integrated into our DNA by viruses that contaminated our ancestors. Viruses can't replicate, they don't have the machinery, so they need to use our cells. And by using our cells, they leave traces within our own DNA, which they u. And if that's a germline cell, it will be passed on to other descendants, the same trace will be passed on to all descendants. And this has happened for millions and millions of years with all animals that are subject to viruses, and obviously also the last 100,000 years in the human species. And today, we have human endogenous retroviruses, which are fossil viruses in our DNA. And they represent eight percent of our total DNA,. There are about 30 families that represent eight percent of our total DNA. If you compare that with classical gene-producing, protein-producing genes, we're talking about two percent of our DNA. So this is something that is three to four times larger, of what we see in normal-producing genes. That is very important. You know, it's human arrogance, which you can see over history all the time. Well, we don't understand we call junk, or, you know, unimportant. And for a very, very long time, everybody was focusing on this two to three percent of genes that are producing proteins, very clearly in trans exons. And the rest was unimportant. And today, we're realizing, more and more, because we have the tools to do that, that the rest of the DNA is, in fact, extremely important in health and in disease. And our company was based on discoveries that we made at Institut Mérieux almost four years ago, published for the first time in the Lancet in 1991, about viral proteins that looked like viruses, but weren't really viruses because they could not replicate like a virus. And everybody was wondering, what, what does that come from, and it took the sequencing of the human genome back in 2002, to actually realize that a big part of our DNA was made of viral genes and that they were there. And normally, they're very well controlled. That's the good news; if that eight percent of our DNA was producing proteins all the time, we will simply not be alive. But problem is that when a virus from the environment, you know, the viruses will know about the EBV, SARS COV2, etc. When they interact with a cell, they take away, one of the things they want to do is to use the cell for replication. So one of the things they do is it takes away the brakes against viral replication. And what happens is that some of the cousins within our own DNA, those fossil viruses, can then be expressed. And in some cases, that will lead to the production of pathogenic proteins, which are still active as viral proteins, considered as self, because produced by the cell, so it's not recognized by the body as a foreign threat, it is something which is produced by a cell, but it can initiate an immune reaction. Thus, an autoimmune type of reaction is something that comes from the self that will trigger the innate immune system. And we'll be working in MS, which is our main area, and again, we're a very small company, so we focus on very few areas of activity. But the potential of this technology of this application of trying to block these proteins from our fossil biologies is absolutely tremendous.

Jesus Martin-Garcia  11:08  
Do you find that, in addition to your current focus on MS and ALS,  do you find that people's greater understanding of viruses, because of COVID, obviously, has helped the general understanding of the work that you're doing?

Jesus Martin-Garcia  14:28  
Yes, I think that several factors will play for us in the medium term. The first one has been, obviously, the amount of great work that has been done with SARS COV2, and COVID, because we have been threatened by this bug that nobody knew about. And the best minds on the planet have been trying to understand what it does. And one of the things it does is de-repress some of our fossil cousins within our DNA. And the data that we've seen that has been published so far shows that this may be the most important trigger in post-COVID or long COVID. You know these neurological symptoms that people have long term, they last, three, six, twelve months after the disease. People are having major cognition problems, brain fog, fatigue, anxiety, and depression, and these fossil viral particles within our DNA may be one of the clearest explanations of what is happening. And this is why we're starting a clinical trial, actually, very soon. I mean, we have the okay from the authorities a few weeks ago. And we're now preparing for the launch of a trial against the neuro-psychiatric syndromes post-COVID. And that was fantastic, I would say collective effort from academia. And believe me, when people told me there was a link between COVID and fossil viruses, my first reaction was, you know, let's stay away from this. But when I saw the amount of data that was generated, and the fact that those people have a very nasty protein that comes from viral genes that are circulating, and that it is known for its pathogenicity on neural system cells, that would explain many of those neuropsychiatric symptoms, we had to go ahead, and we are now on track with that. 

Jesus Martin-Garcia  16:34  
The second thing that will also help us, medium term, is that we're starting now to have the tools for deep sequencing. Because when people say, in the in the general literature, and the general press, DNA has been sequenced, in fact, what you're sequencing is only two percent of the human DNA, which is the easy part. Because we know it very well, it's very well mapped, and you basically cut it into little pieces, and you have software that will put it back together. But when we're talking about the rest of our DNA, it's much more complex. And for example, with human endogenous retroviruses, it's 30 families representing eight percent of our DNA, so it's hundreds of 1000s of copies, which are spread all over the DNA. And in addition to it, we all have the same gene that codes for the color of our eyes on the same chromosome. In HERVs, human endogenous retroviruses, it's all around the place. It's fixed copies on fixed copies, you'll find more of this kind of copies on Caucasians, more of this on East Africans more of this on Inuits. It depends really on who was infected by what. And the differences between human groups and individuals are tremendous. So imagine the difficulty with the tools we had, which was to break it down into little pieces. And to put it back together with software, you cannot deal with that complexity. So it's been only a few groups that have those kinds of technology, like the University of Utah and Cornell, that have been looking at human endogenous retroviruses in the past, but now with the deep sequencing becoming cheaper and more affordable, and, if you allow me the word, which is not the right word, smarter, we're going to be able to really start tracking a lot more and understanding a lot more of which of these fossil viral genes are doing what in what diseases.

John Simboli  18:34  
When people hear the story about GeNeuro, what do they misunderstand? What category would they like to place you in, which you're not really in? And then how do you help get back on track?

Jesus Martin-Garcia  18:46  
I think the biology is better and better understood. Although if you had told me when we started the company, this was really not classic biology, and those are the kinds of things you can get easily burned with. If you're not in the canonic space, you're talking about proteins coming from junk DNA, people have sometimes a bit of a, you know, this is not classical. No, thank you. I think it's really a mix. I think now, more and more people are interested in this area, in this field. I even saw that one of the major US funds, Flagship, has started a company looking at proteins from what they call the rest of the DNA. So, the interest is coming. I think another area which is which is hard to convince investors with is neuro-degeneration because it is a really hard area in the sense that we like the animal models and it's very human-specific, and those are slow processes. So anything you do in clinical trials, and we have never done a clinical trial for under a year. This is not oncology or cardio where you can have biomarkers. This is really about how people neuro-generate, and we don't do it all at the same rate, because we have different brain plasticity and different cognitive reserve from each other. I say those are the two major breaks. But on the other hand, I insist on the fact that whoever cracks the neuro-degeneration nut, you know, is in, first of all, to bring a dramatic improvement to the life of millions of patients. So every effort you can do in this area is really worth it. And second of all, if you are able to do that, then you will also be rewarded by tremendous financial success. But this is an area of huge need, yes, it is a difficult area. But if you have good solutions and good demonstration, then you can crack this nut. And this is something that you have a decent, a very good shot at actually bringing solutions, then it's really worth it for the patients, millions of them suffering and also, that success with patients will also mean a tremendous financial windfall.

John Simboli  21:06  
When people do misunderstand and categorize, and pigeonhole, and say, Oh, you're a x company or a y company, what are those categories they try to place you into, that you are not?

Jesus Martin-Garcia  21:18  
It's really the difference between viruses and human endogenous retroviruses because they're called the same. And people don't understand that we're trying to tackle not infectious diseases, but chronic diseases, where viral fossil proteins are key, are central, to the process.

John Simboli  21:39  
What makes a good partner for GeNeuro?

Jesus Martin-Garcia  21:42  
A good partner is somebody you can share the vision and the objectives with. It's somebody with whom you're you're pulling in the same direction, and you really sharing the objectives and the goals. And we, for example, are very blessed to have a fantastic number of great academic partners. In the U.S., we worked a lot with a NINDS, the National Institute of Neurological Disorders and Stroke, which is a fantastic group of people. We're working with them in ALS and also a little bit in long COVID. We've been blessed also by all those groups that came with the data about SARS COV2 and the human endogenous retroviruses, HERVs, and the demonstration that they could be central to the neuropsychiatric symptoms, that a lot of people are experiencing post-COVID. It's actually millions of people. So it's really about these views of trying to bring really novel solutions to patients and, who says novel solutions. There are many ways of bringing novel, you can bring novel because you have novel ways of approaching the problem, like gene and cell therapies, which are very much the flavor of today's biopharma world. But if you look at that, it's just new ways of delivering, old, you know, those are tools, not necessarily cures. And what we're trying to do is good old-fashioned innovation in biology, which is, you know, there's a biology in there, which is provoking something and you can neutralize it by applying your pharmaco solution.

John Simboli  23:23  
What are the qualities that suggest people will thrive at GeNeuro? What you're looking for when you're looking to bring people in-house?

Jesus Martin-Garcia  23:31  
I think a lot of it has to do with dedication and passion to this idea of bringing real novel treatments to patients. It's also, obviously, competence. This is something which you can't replace, you cannot put a trumpetist behind the violin, otherwise, you'll have a problem real soon. So especially when you're not the Philharmonic Orchestra of Vienna, with hundreds of violins and dozens of pianos, where you know, unless you have a very, very good ear, a piano can go a little bit south, you won't notice. When you have a small orchestra, you need all the instruments to be able to play really well. And that's critical for a small company, if you can't get that, then outsource it. But you can have people being able to contribute to the common goal really fast and people that also like to ask questions, curious people, people that are not afraid of bringing up problems or making questions. Those are critical. If questions are not asked internally, then you will always find out too late.

John Simboli  24:51  
In what ways is the pipeline at GeNeuro an expression of your vision for what you're trying to achieve for the company? 

Jesus Martin-Garcia  24:57  
It is the tip of the arrow of what we're trying to achieve. It's the tip of the arrow that is trying to penetrate the goal and the target. That's how we call it, the tip of the arrow. Today's multiple sclerosis will have our phase 2 data showing that we can have a strong impact on the key markers of neurodegeneration. The same product actually could be extremely useful in post-COVID neuro-psychiatry, so we're applying it there. And we have another arrow today against ALS, in partnership with the National Institute of Neurological Disorders and Stroke. But I will consider a pipeline today as the tip of the arrow. Again, the number of possible applications of this vision that these fossil viruses within our DNA, are critical in health and disease, and therefore can be used and leveraged to block proteins or to stimulate processes in autoimmune and neurodegenerative diseases is huge. For me, it's really a question of when you're a small company, and you're constrained by resources, you really need to find that tip of an arrow and try to penetrate as fast as possible towards the target. If you try to make it too large or too wide, then you know, you could very rapidly lose focus and actually not be successful where you could have been.

John Simboli  26:27  
If GeNeuro succeeds the way you hope it will, what effect will have on patients? Will it be an incremental effect? Will it be a significant effect? What do you foresee?

Jesus Martin-Garcia  26:37  
It's a huge impact. If you take MS today, we have 16 drugs that are available on the market and they're great drugs for cutting acute inflammation, which means making sure that the patients don't have relapses. But unfortunately, 85% of the patients, although they are treated properly against relapses and effectively against relapses, will have the disability progress over time, to the point where they, unfortunately, will be losing the ability of movement and independence and ability to work etc, etc. And that's 85% of patients. So I would say that the drugs today are absolutely fantastic, needed, and a great contribution of the industry to multiple sclerosis, but we still need drugs that can change the course of this disease, which none can. And what we're trying to do is bring a drug that can change the course of the disease. So that will be a phenomenal change. For people that are diagnosed with multiple sclerosis, which today can be offered a relatively good quality of life, initially, with the anti-inflammatory drugs, but beyond that, long term, there is very little to shield them against disability progression. When you look at ALS, I mean, the question is pretty obvious. This is, unfortunately, a disease that is killing people at an incredible rate. This is the oncology of neurology if you allow me to say those words, and with the NINDS, we have really looked at what seems to be a causal factor in sporadic ALS, which is this protein coming from the fossil viral genes that is actually able to destroy motor neurons. So same thing for PASC, Post-Acute Sequelae of COVID. Those are people like you and I that actually just had COVID, maybe not even in a very strong form. But today, they've lost major cognitive functions. And they are unable to live a normal life and go back to work. I think the last thing I saw was a million people that are completely out of work in the United States, because of long COVID. A million are completely out of work. I mean, those numbers are just gigantic. And if we can really show the protein that may be causing that neuropsychiatric damage, that could be a tremendous contribution for those people. We are really looking at none of the incremental improvements, we really are, our ambition at least is to provide major improvements in those areas. And the same for other autoimmune diseases. Obviously, there are not many autoimmune diseases where today, you have things that can really stop them. What we do, in most cases, stop the symptoms, is work on the symptoms, which is in the inflammation part, generally by suppressing it. And we really are looking at what are the mechanisms that lead to that autoimmunity and how can they be stopped?

John Simboli  29:37  
It sounds like there's a significant puzzle that you're working on here that not too many others are working on in terms of how you're looking at the biology. In trying to put that puzzle together, do you have time at this point, perhaps on a weekend, once a year, to step back a step and say, you know if this develops the way I hope it will, we really are going to change lives of people? Or, is it in the nature of an entrepreneur and someone who's starting something like this, that you have to just be completely focused on the scientific puzzle. And then those thoughts about the utility of it come later?

Jesus Martin-Garcia  30:16  
You know you don't have a lot of time to be to be thinking about the puzzle. Basically, what you do is, you decide you're trying to bring a solution, and you're trying to put everything together. The complexity of the biology cannot go on to the complexity of what you're doing. Biology is a field of creativity and creation, because there's so much we don't understand and where people need to come up with new ideas. Developing is very, is a very Germanic attitude, you know, very little creativity in drug development, You have to follow the path to tick all the boxes until the moment you have proven your efficacy. So I see the distinction between both and although I like the creativity part, most of my job is leading the Germanic path of everything that needs to be done and achieved to convince our partners, but most importantly, doctors, patients, regulators, to help us and, obviously, investors to conduct, fund, clinical trials and move forward.

John Simboli  31:33  
How would you talk about the mechanism of action of what the company is working on?

Jesus Martin-Garcia  31:40  
It's actually something which is not that complicated because, for a very, very long time, autoimmune diseases have been associated with infections. That goes back to Professor Scharko in the 19th century. Okay, so nothing new there. The virus is important in autoimmune diseases, it comes and goes because nobody really can get their hands around it. But recently, for example, this was this tremendous article that was basically saying that EBV causes a mass, you may have heard about it, it's done a tremendous amount of noise and brought back viruses to the first line or first light in autoimmune diseases and MS. That's really interesting, because if EBV really caused the mass, then 95% of the people in the world would have multiple sclerosis, which is thankfully not the case. So what you need is what is the mechanism by which EBV, which is obviously necessary, it's not EBV, actually, it's the entire herpes virus family can put in place a process that can lead to MS. And this is where our fossil DNA, viral DNA plays in. Because we've been showing for over 10 years that EBV and the herpes family of viruses that have a high tropism for the brain can actually trigger the expression of these proteins in the microglia, of who will become MS patients. And it's not everybody, it's only a few people. And do we know why? No, we don't. But I can give you another example that has been done by academia during SARS COV2, when you expose the blood cells of healthy volunteers, to SARS COV2, in 80 percent of the cases nothing happens. And then in about 20% of the cases, people start expressing, which is a very pathogenic protein. And once this protein is expressed, it is not going to stop expressing itself whether you have SARS COV2 or not. This is why when we learned that from the beginning was, uh oh, people are probably going to end up with severe neurological symptoms long term. And it happens to be true today. Today, we have evidence that that is actually happening. And that protein is present in a very large number of those people that have neuropsychiatric symptoms, heavy neuropsychiatric symptoms post COVID. And the good news is we have the antibody at least to try to stop it. This is where we're going to start in the next few weeks. So it's really this you know, what I have to explain our mode of action is really about this interaction between the viruses in our environment, and the viruses within our set of fossil viruses within ourselves, and that when combined together, they can lead to a number of autoimmune situations and a number of neurodegenerative situations, including MS, including long COVID, including ALS, including many others like that.

John Simboli  34:46  
Which areas of thought leadership regarding the future of biopharma are currently the most engaging for you?

Jesus Martin-Garcia  34:52  
As a society, we have to deal with the increasing amount of health care costs. And we have an aging population. And the fact that people are aging is also making them more fragile to a lot of chronic and neurodegenerative diseases. And we're going to have to find ways to tackle that. And I think we all have to think about how to make the cost of development of drugs while keeping the gold standards, but making them lower. And also to try to make drugs, once approved, more accessible, but I think it goes together. There was this recent FDA decision about a drug that everybody knows about, Alzheimer's. And everybody started yelling and crying about, I have no opinion, I'm not an Alzheimer's person, I have no opinion whether it was the right thing to do or not right thing to do. But I thought it was pretty interesting to see that the FDA was going from wanting clinical endpoints, which are extremely hard to achieve, and almost impossible and a hurdle for any development in this area, which makes the cost of drugs in this era prohibitive, whoever cracks the nut. You know, biomarker-based decisions. And I think that we need a lot more of biomarker-based thinking in terms of developing drugs. Obviously, with gold standards of safety and gold standards, in terms of the association with biomarkers and ultimate response. Let me give you an example. We have a drug, temelimab, for multiple sclerosis, we've shown many, many times now today in three through different trials that you can cut in a very strong way about 50% the rate of atrophy of the cortex. That can only be good for patients, right? But how do you translate that into a clinical benefit is much more difficult. And it's going to be long, it's going to be expensive, it's going to be through clinical trials of actually designing with potential partners and regulators. But you can also see it in a way of saying, Okay, wait a minute, that if we are actually reducing the atrophy by 50%, and that can be confirmed in clinical trials of a substantial size, is this something that should be good for the patient and therefore provided to them? Without waiting another 10 years, or 10, I'm exaggerating, but three or four years, until this can be proven in a clinical trial that will cost several 100 millions of dollars. And those are the kind of questions that we have to ask ourselves as a society is about what is a way of developing drugs because if the cost of developing drugs continuous skyrocketing, then the price of drugs will continue skyrocketing, and it's going to be a society disaster. Because the number of diseases can only increase as we increase the lifespan. Cancer hasn't exploded tremendously over the last 50 years, it's just that the number of people that live over 60 has expanded dramatically. You know, same thing for Alzheimer's, same thing for many, many diseases. So we've got to think back and, and how we develop drugs is probably one of the biggest challenges we have going forward. Because if we keep increasing the requirements, sometimes for purposes which are not understandable, and therefore exponentially increasing the costs, then we're going to end up with drugs which are unfortunately not affordable by everybody. And I think that everybody that develops a drug, at least we would like to have his or her drug in the hands of as many patients as possible, all those that require it, is really the goal for all of us.

John Simboli  39:13  
Thanks for speaking with me today, 

Jesus Martin-Garcia  39:16  
Thank you for having me, John.