Elisabet de los Pinos, founder and CEO of Aura Biosciences, shares her thoughts with BioBoss host John Simboli about leadership in biopharma and how Aura is working to envision new ways to treat cancer.
John Simboli 0:00
Today I'm speaking with Elizabet de los Pinos, founder and CEO of Aura Biosciences, headquartered in Cambridge, Massachusetts. Welcome to BioBoss, Elizabet.
Elisabet de los Pinos 0:09
Hello, John. It's a pleasure to be here with you today.
John Simboli 0:13
What led you to your role as founder and CEO of Aura Biosciences?
Elisabet de los Pinos 0:18
I have been driven by science all my life, throughout my career. I wanted to learn more about the molecular biology of cancer. The second driver was patients. And that was very much related to my father, who was a doctor. And he was very inspirational to tell me that I should work to help others and that I should really work hard to make sure that my work would help cancer patients. So science and patients, that's the mix.
John Simboli 0:51
And how did you make the big step from that passion and that interest to saying, I want to lead a biopharma company, I want to found one?
Elisabet de los Pinos 1:00
I think that you are an entrepreneur because you have that sense of purpose and lack of fear. I wanted to do something big. And I knew that by working at any of the pharma companies that were accessible to me, I wouldn't be able to do it. And because I'm brave and passionate, and I have a sense of purpose, I decided to do it myself,
John Simboli 1:29
When you looked at the options for how you could take that passion about science and patients and create something new, in this case, Aura Biosciences, how did you go through the process of fixing and focusing on what particular part of the science you would take forward?
Elisabet de los Pinos 1:46
The initial scientific driver was an enthusiasm for the biology of viruses because viruses are uniquely related to cancer. And I thought that that relationship would allow us to develop a better class of drugs. That initial concept, I went on and asked a number of top-tier virologists for their opinion. And they said, Yes, I think this is a good scientific basis for you to try this approach. That's the initiation or the early steps of putting the science to work.
John Simboli 2:30
Can you recall, was there a moment as an undergraduate, as a graduate, as a postdoc, anywhere along the academic cycle—was there ever a time that you recall saying, this idea about viruses, this has really intrigued me? I don't know why, or how, but this really has grabbed a hold of me. Do you remember anything like that?
Elisabet de los Pinos 2:48
Yes. It was so strong that I couldn't sleep. And I was all day long, looking at patents and publications to see if anyone else had done anything similar to what I was thinking I could do. And I couldn't, and the more I couldn't find it, the more excited and driven I became. So, you know, it's a combination of, again, the intellectual knowledge, but then the imagination.
John Simboli 3:21
What was it you were hoping to achieve by founding Aura Biosciences that you could not achieve someplace else or in a different way?
Elisabet de los Pinos 3:29
I wanted a transformational drug. I didn't want to follow the steps of anyone else. I wanted the moonshot, the absolute breakthrough. And I was willing to take the risk.
John Simboli 3:43
Did you find yourself second-guessing, as most of us do, when we step out and expose ourselves? Or did you, once your head was down, it was down?
Elisabet de los Pinos 3:50
I always say you start and once you start, there's only future.
John Simboli 3:56
One of the things I've noticed about my conversations with founders and CEOs over the last couple of years is that many of us have, of course, our meetings, at times, from a home office, and every now and then a cat will step into the frame, a child will appear. And it has brought up in conversation in BioBoss, this idea that sometimes family members will come to the CEO or founder afterward and say something along the lines of I didn't know that's what you did, Mom. I didn't know that's what you did, Dad. I didn't know that's what you did, spouse. Do you just talk all day? People evidently have a different picture of what goes on, maybe in the lab or maybe in a big conference room or something. But the question I'm trying to get at is what does a biopharma CEO do all day, all night? I know it never stops. But what is the work?
Elisabet de los Pinos 4:45
When the pandemic hit, we were all forced, all my family, were forced to work together. It was the greatest gift. My little one sat at the table with me. And we were both working. He was doing remote school and I was doing my remote job. He was fascinated because he saw firsthand what was the job of a biopharma CEO. One of the key things that he said is, you talk to so many different people. That's true. And usually, technical jobs are silos. You're very good at analytical, you talk about analytical development all day, you are a banker, and you talk about capital raising all day. A biopharma CEO is like the director of an orchestra, you have to play the violins first. But you have to silence the drums. And then when you want the music to play, you welcome the cello. So that's how you have to talk to a variety of personalities, a variety of people, and at the end of the day, make them work together so that we can have a concert.
John Simboli 5:55
A conductor has to study the score; a conductor has to be well-studied in music theory; a conductor needs to have an understanding of the individual players in the orchestra that he or she is melding. How does the conductor, or in your case the biopharma CEO, how do you decide what to do at a given time, given that there's not enough time to do probably most of what you're trying to do?
Elisabet de los Pinos 6:17
A company is a living thing. Sometimes you have to give more attention to a particular area of the company and others, you have to give more attention to the capital raising, and it's never the same. And you know it because there's like a breathing organism, you have to have a certain amount of information to be able to credibly convince an investor to give you more money, but at the same time, you have to have the vision of what you're going to do from there on. I always think that you're always five years ahead of everyone else. But you're five minutes behind everyone else, too. So that's kind of like how . . . it's a difficult answer. But I guess it's also a little bit of a gut feeling on how you, you build it, you envision it.
John Simboli 7:08
What have you learned over the years about which management approach works best for you?
Elisabet de los Pinos 7:13
I am very simplistic sometimes. And so I use the three C's to my management approach. The first one is care. And not usually you see people caring as management, because I am a mother and I'm a woman, the first thing that I characterize myself is caring for people, caring for patients. So care. The second C is consensus. I hate to impose, I try to reach consensus across my executive team, across the people that we work with, across the board meeting, so that we have easy-going management versus aggressive or conflict-filled management. So that's the second C. The third C, I would say, you should guess, but it's courage. Because of course, we're doing things that are unprecedented; we're the first ones; we're setting the precedent for others to follow.
John Simboli 8:07
Can you remember when you were eight or nine or 10, or whatever is the appropriate age, and you probably had an image of what you wanted to be when you were a grown-up? That was likely the kind of thing that you thought your parents would want you to do, if you're like me, and most people. Can you remember that? And what was that image you had at that time?
Elisabet de los Pinos 8:26
You're going laugh at this one, I wanted to be Madame Curie. And even my grandmother called me Madame Curie sometimes. And it was kind of like the passion for science at the time. And I wanted to discover, I was driven by my enthusiasm of molecular medicine. My dad was a doctor, and he was telling me, you know, there's so much coded in the DNA that we don't know. And I was like, oh, I want to discover it. I want to create new medicines based on this new code and this new knowledge of molecular medicine. And so, that's what I thought I was going to be, I guess, a discovery scientist. It turned out that I ended up doing it as a company.
John Simboli 9:16
Did you have an image of yourself as a leader early on? I guess Madame Curie, you would think of as a leader, in addition to being a scientist?
Elisabet de los Pinos 9:23
I've always been not a leader, but I'd say a little different than anyone else surrounding me. So I did not fit into the, I would say definition of professions that were in early Spain in Barcelona. When they said what do you want to do? And I said, I want to discover drugs and they said, ah, so you want to sell aspirin? And I said like, no, no, no, not sell them. I want to discover the new modern aspirin. Being different, not really being a leader, maybe being different and being okay with being different.
John Simboli 9:59
Eli, when people say to you, who is our Aura Biosciences, it will depend on the audience, of course, but how do you like to answer?
Elisabet de los Pinos 10:06
It's a company that's developing complete new drugs to treat cancer patients. It's new, drugs and cancer. Those are the three unique words that define us.
John Simboli 10:19
And for people who are somewhat conversant with our field, they may launch right into, Oh, it sounds like . . . And then sometimes there's a process of weaning people away from that. Saying, well, it's actually not this. It's this. What is that process like?
Elisabet de los Pinos 10:35
Yes. And then, Oh, are you like Pfizer? And I would say, well, we're not because we're doing a class of drugs that's never been done before, using viruses. And secondly, we're doing it initially for patients that have had no drugs approved for 50 years, which are patients that have cancers in their eyes. And so not only we're trying to prevent them from dying, we're trying to prevent them from being blind. So usually, when they hear the word virus, they either associate you with a vaccine, right? Oh, are you using a virus like a vaccine,? Or they associate you with gene therapy because viruses are the key tool for gene therapy. When I'm trying to differentiate what we do, we say we are not a gene therapy because we're not trying to correct a gene with a virus, we're trying to kill a cancer cell. So we're certainly a therapeutic. We may be using a virus shell, but not to correct the gene. So that's how we differentiate from gene therapy. When they try to say, are you a vaccine, then I said, no, because we're treating cancer and we're not preventing infectious disease. But we're also learning from all of the vaccine development so that we can manufacture our drug. So we kind of bridge disciplines, in molecular biology and modern medicine. That's what you do. Right? So but you clearly are creating a very novel class of drugs.
John Simboli 12:13
When you get that nod of, oh, I now understand, how do you go about describing that your work is intended to kill the cancer but also to activate the immune system? It's got this dual thing going. How do you go about that?
Elisabet de los Pinos 12:29
Yes, and I love our approach because of that. Usually, for cancer treatment, we've been thinking about giving a very toxic drug to kill the cancer cell. What we do is deliver the toxic drug with a virus and then the virus activates the immune system, it signals the body that you have an infection like an infectious disease at the tumor site, and your immune system will attack it. It's like a double punch. We've learned that the immune system is so critical, and it can help so much with cancer treatment. But we've also learned that without the power of very toxic drugs to kill the cancer, the immune system alone is not enough. So combining both, it's ideal within the same treatment. And that's why I think this is potentially going to transform the treatment of cancer.
John Simboli 13:26
How does the Aura Biosciences pipeline express your vision for the company?
Elisabet de los Pinos 13:30
Initially, it expresses my vision because we're very focused on the ocular oncology franchise, where not only there's ocular melanoma, our first indication, but many other eye cancers or cancers that start in the eye that have had no innovation. So that focus, initially, of our pipeline, is the absolute determination of my vision where if we were successful, we would make a difference for patients that have nothing available. The second vision is now cancer is not just ocular oncology, our technology can help many more patients, so let's expand that. And the remainder of the pipeline is broader oncology indications like bladder cancer, for example. And so that's how I'm envisioning the growth of the company, owning ocular oncology as a landmark of innovation and bringing science to patients and then growing into oncology to leverage that potential across.
John Simboli 14:37
In that two-stage realization of the vision, do you find the word platform helpful or not helpful when you talk about these multiple stages?
Elisabet de los Pinos 14:48
Platform, because when you define a new class of drugs, it's not just one. You learn from that initial approach and you improve it, you adjust it, you grow the pipeline with that new concept. So by default, it's a platform. Because by default, it's a drug or a class of drugs that have never been tested before. Some people like platform, some others don't. I think that for us, it's by default a platform.
John Simboli 15:19
How would you describe the mechanism of action of your lead candidate?
Elisabet de los Pinos 15:23
Our lead candidate has a dual mechanism of action. The first step is the virus-like particle delivers a cytotoxic payload that directly is getting into the cancer cell. It doesn't bind any other cell, normal cell, in the eye. Once it's binding to the cancer cell, you activate the drug with infrared light. So that's another key part of the mechanism of action, our drug is non-toxic unless you activate it, which makes it extremely safe because you only activate it at the tumor. Then that leads to direct necrosis and direct cytotoxicity of the cancer cell and the cell dies in a way that's highly pro-immunogenic. What that means is that instead of dying slowly, it dies fast. And a fast death that's driven by damage usually is a sign to the immune system that something wrong has happened. The second alarm to the immune system is the virus, because we're delivering this drug with a virus, the immune system is like, Oh, something is wrong, something is dying in a way that I'm not used to. And there is a virus there. And so we have all of these signals that usually turn what's considered a cold tumor, that's hidden from the immune system—tumors are very smart, they hide from the immune system—to a hot tumor. So now there is necrosis, there is a virus, we're creating that microenvironment to really use the tools of our immune system to fight cancer. The potential benefit long term is that not only we are using the immune system to kill the cancer, we're educating the immune system to recognize whenever new cancer comes back so that we have those warriors ready to go if the cancer should recur or metastasize. And so for us, as a therapy for an early-stage cancer, it's ideal because we have a lot of safety, we preserve vision, you can kill the cancer in the eye, and then you have this opportunity to prevent metastatic disease.
John Simboli 17:36
If you're speaking to someone from outside the biopharma discipline, and they hear the word virus, do they ever say, oh, that sounds scary?
Elisabet de los Pinos 17:46
Yes, and I usually say it's not really a virus. It's a virus-like particle, it's like a synthetic virus. And I usually say it cannot replicate, it cannot infect, it cannot deliver nucleic acids, or their own nucleic acids into your cells. So it's very, very safe.
Elisabet de los Pinos 17:46
What kind of partners are a good fit for Aura Biosciences?
Elisabet de los Pinos 17:53
The key one I want to highlight because it's been extraordinary for us is our academic collaboration with the NIH. The scientific founder of our company is Dr. John Schiller at the NIH. And he had a translational science n his mindset. He had been involved and was one of the initial inventors of the HPV vaccine. He knew the impact that his science and discovery could have on public health. And so that, together with our drive, and our willingness to make something happen, was the success of our company. A lot of times I've seen biotech companies fail because the translation of the science or the relationship with the academic center, it's not that good or cannot be sustained throughout the years. For us, it's been one of our greatest assets. So that's the one that I would say it's a privilege. And it's been fantastic.
John Simboli 19:21
What kind of people do you find make the best fit and just are the most helpful to you when you go to hire?
Elisabet de los Pinos 19:30
Living here in Boston and Cambridge, it's the greatest human resource capital that you could find in the entire world. We live in a biotech cluster, we really do. And so it's a competition for talent, you're convincing them to join the company versus a scarcity of talent. There's an abundance. Our criteria usually with the first pass being the technical background and experience, assuming that that's an A plus, usually is we want humble people that can really be team players that they don't think that they know everything, or they have to teach everything they know to all of us, but rather learn from others. So humility is a key asset that we look for. And then, you know, the passion for science for doing something new that they're not afraid of doing something that they haven't done before, they feel comfortable that whatever their knowledge is they can apply it to something new. And then always, always is the sense of purpose, to help patients and to help others because that defines our culture and it's the biggest retention. I found that throughout the years in the highs and in the lows, I can retain people if they have a sense of purpose, if they think that what they're doing is important, if it's not just the paycheck,
John Simboli 21:01
When you try to work on the day-to-day process of figuring out the scientific puzzle and making the company run efficiently, and then also keeping in mind why you're doing it— to help patients—Is that latter part about helping patients, is that something you can keep in mind as you go? Or is that something you get to once you achieve the success of having something that's farther down the line?
Elisabet de los Pinos 21:24
That's a really good question. In the first part of building Aura, we had the patient in mind, but it was kind of like a cloud. Yes, it's our sense of purpose. It's our goal, but we're dealing with tox studies, and pharmacokinetics and animal, and then a lot of hard science that sometimes makes you a little bit forget about the patient. The day we dosed our first patient, it radically changed. The patient is the first thing you wake up in the morning, and the first thing you think about when you go to bed. There's nothing more important. There's nothing more relevant. And it's the absolute center of the life of the company. It's so interesting. I told you from the beginning that I was fearless. I've told you that one of the key things in my management is courage. The day we dosed our first patient, I was afraid, because there's so much responsibility when you're dealing with a human, with a person, with a mother or a father. And that doesn't go away. So it is the core. And it depends on where the company is. We'll never lose that.
John Simboli 22:44
What aspects of the industry, the science that fascinates you, whatever it is, at this time, what is it that is pulling you forward and saying, Oh, I can't wait to find out more, I can't wait to learn more or become a voice in this?
Elisabet de los Pinos 22:57
Actually, the one thing that I'm really excited about that I see in the future that I don't have now at the company, but I do want to have, is the knowledge provided with artificial intelligence. We humans are limited. When we have our clinicians evaluate patients, we have a limited amount of information, and we take our decision based on that. But especially in the eye, we have so much imaging content. And if we can use some of these tools that are provided by data collection, evaluating images and providing them as guidance for us as drug developers, but also for early diagnosis of cancer. In the eye, as an example, it's one of the key diseases because the eye is so available, we wear glasses, we, you know, we go to the ophthalmologist, we could diagnose these cancers so early. We should not allow late-stage cancer to be diagnosed with these tools. So I envision a future where most cancers we can diagnose early, and we can treat early. I don't want to be looking at drug development in terms of months of survival. I wouldn't be looking at early development in terms of years, decades that we've changed the lives of patients. And that only happens with early early early. I'm very, very excited. I think we can do it. It's becoming more available. It's just the interface of disciplines that needs to happen now,
John Simboli 24:34
What would help to make that process you just described happen, what would tend to get in the way of it happening?
Elisabet de los Pinos 24:42
I think that we just need to make some of these technologies less difficult to work with. That usually happens with tech, and biotech. There are silos and we need to make them easy. We need to help them integrate into our iPhones so that I can scan my retina. And I can send the image of my retina to a database. And then you know, there's going to be an algorithm, they're going to say, that image starts looking like an early melanoma or, you know, a stage-zero melanoma. It's that knowledge that should be easy. That's the barrier. When it's very complex or very expensive, it becomes an academic exercise. So it's the integration to make it simple. That's the key that needs to happen. And obviously, to make it simple, and to make it available, broadly, is because we're looking at the collection of data. The more data, the more powerful, but that means that a lot of people need to use it
John Simboli 25:52
Is working in Cambridge, similar to or any different from other biopharma centers, where you've, in your career, where you've worked?
Elisabet de los Pinos 25:59
Cambridge is just unique. It really is unique. And some people have asked me but what is it that it makes it, why did you move? I had Europe available to me, I had Switzerland, I had London, and even Barcelona has a great talent pool. I think it's the combination of different disciplines, like we have the leading hospitals of the world in a very small area, with the leading academic centers where most of the innovation takes place. So there's a lot of relationships. And then there's just this desire of entrepreneurs that are driven by life sciences, or biopharmaceuticals to be here. Sometimes I say, in the 15th century that happened with art in Florence. You had Michelangelo and the schools of Raphael, and everyone wanted to go learn from them. That couldn't be replicated anywhere in the world. It just happened in Italy. It was at that time, and for a certain reason. It's what has happened in Cambridge, and Boston. And it's incredible that we have it. Will it happen in other places? For sure, yes, we can try to replicate it. But right now we have it here.
John Simboli 27:23
There are many different paths to success in biopharma. People who lead biopharma companies, that I've spoken with, some of them come from business backgrounds, some from a science background, some from a legal background, there are lots of different ways because all those are components, right, that have to be accounted for. So my question is, is there anything about being a founder, a scientist as a founder, that makes it either clearer how to get the job done? Or less clear? Is it possible to be unbiased?
Elisabet de los Pinos 27:53
You know, it's such an interesting question. One of my greatest leaders and mentors that I've met, that I had the privilege to meet was Henri Termeer. Henri Termeer was the founder of Genzyme, built the greatest biotech company, successful all around for patients, and for everyone that worked there. And Henri was not a scientist. And I thought, perhaps, if I didn't know, or I didn't worry so much about all of the aspects of the science that can go wrong, I would take better decisions because the decisions would be more gut-driven, versus evaluating every single aspect of a scientific hypothesis. I don't know the answer. I think that there are just extraordinary leaders that lead pharma companies that are economists, somehow they're extraordinary when they take the helm. I don't think there's a role. The variety of humanity is just wonderful.
John Simboli 28:53
How does one learn to trust one's gut instinct? If you're a rational, scientific, theoretical person? How do you learn to do that?
Elisabet de los Pinos 29:02
It is a combination of the knowledge you have with the circumstances that surround you. I'll give you an analogy, when they said, how did Einstein discover the theory of relativity? How could that happen? Maybe we need to evaluate Einstein's brain when he died. And one of the key things that he certainly said—Einstein was Einstein because his brain was surrounded by the life he lived, by the experiences he lived, by the circumstances. So I think that that is the answer. You know, the gut feeling is a combination of your knowledge, with the circumstances that you're surrounded by at the time. You've got to have the capacity to accept that you're going to take a decision with very limited information, and that, somehow, on average, most of the decisions are going to be alright.
John Simboli 29:59
Elisabet, how clear is it to people that there are eye cancers for which there are no approved drugs?
Elisabet de los Pinos 30:04
Ocular oncology is an unknown to many people. One of our key efforts is to raise awareness of this disease and to show that not only from a scientific perspective but also from a business perspective. As long as you develop a good drug for patients that really need it, there is an excellent business and there is a good return for investors. And most importantly, there is a life-changing impact to the patients who tried to serve. So yes, awareness, ocular cancers, they exist and they can be treated.
John Simboli 30:40
Currently, what are the choices for a patient diagnosed with cancer of the eye?
Elisabet de los Pinos 30:46
Unfortunately, it's radiotherapy or enucleation. Enucleation is the removal of the eye, they give you an artificial eye, which is horrible. Radiotherapy gives you radiation to kill the cancer. But unfortunately, the retina, which is this delicate layer that provides vision, is damaged irreversibly with radiotherapy. And throughout the years, you become blind. So that's the problem. We don't have anything. We diagnose this disease so early, we should be able to give something before we just bombard the eye with radiotherapy. And we now have the understanding, the tools, the molecular knowledge, to help patients and give them a first option to preserve vision, treat early, and hopefully preserve life.
John Simboli 31:36
What do you picture? Do you picture someone with a bit better life? A completely different life?
Elisabet de los Pinos 31:43
A transformed life. Because right now, if you're a patient with a cancer in your eye, you need to choose between blindness and life. I don't want anyone in the future to have to choose between being blinded or being alive. The fear of blindness is one of the greatest ones. Some people would rather die than be blind. I think that if we are successful, we're going to transform the lives of these patients. And not for one month, but for the rest of their lives. So it's one of those that when we go back we will say proudly, we made it.
John Simboli 32:22
Eli, thank you for speaking with me today.
Elisabet de los Pinos 32:23
Thank you, John. It was a pleasure. I really enjoyed the conversation. I look forward to meeting you in person soon.