What we are in the midst of right now is

the United States massively losing to

China. China has built an industrialized

version of clinical trial infrastructure

for first- inhuman trials that is so

efficient and massively quick that

they're just able to go faster and

cheaper into the thing that matters

most, which is first in human trials.

What started as a place for American

companies to come run clinical trials to

get data and then take it to the FDA and

then do larger trials in the United

States has now created a flywheel

structure within China where now just

Chinese companies run their clinical

trials faster than the American

companies and then bring their Chinese

discovered drugs to the United States.

And what happens is the capital flow the

risk capital then says ah these

companies are more efficient I will fund

these sorts of aspects.

>> What does Strand do? So, Strand designs

what we call next generation genetic

medicines. You have DNA inside of your

cells. The DNA makes RNA copies of

itself and then that RNA makes proteins.

And actually, life is all proteins,

right? Your skin, your hair, your

organs, every cell is basically just

proteins stacked together. That is

everything that we are, right? You don't

really see the DNA and the RNA. It's

very small. The protein is what we think

of as like our being. And so the way to

actually intervene in disease, the way

to get to its core is to create the

correct proteins. Right? If if you have

a deficiency, everything from an enzyme

problem to a rare disease to cystic

fibrosis, it's usually a problem with a

protein that is being incorrectly made

by a cell. And so what we have figured

out over decades and decades is what's

gone wrong with that protein and what

would need to go right to fix that

protein or how you would replace that

protein correctly. What we have not

figured out is how to make the cells do

that. And that's because it's this very

complicated problem to tell certain

cells in the body to to do various

different things.

>> And so what we are really focused on

building,

>> we know what proteins need to be made.

we know where they need to be made. What

we need to do is get the message of what

type of protein to the place in your

body where they need to be made and we

need to do that effectively and safely.

And so what we have essentially figured

out a way to do is take that message

which is in the form of an a molecule

called RNA. A lot of people are familiar

with it from the co vaccines but those

are very small examples of what RNA

could actually be utilized to do. And

then we have found a way to send those

messages into the body into diseased

areas where they can access the cells

and essentially return the cells to a

state of homeostasis which either

corrects the problem or in the case of

cancer removes the problem any of those

pieces. And so that's the base case of

what we're trying to accomplish.

>> Mhm. So let me back up and give people a

little bit of context. So the first time

we met was in Boston at a dinner. Yeah.

Do you want to describe I don't think

they'll mind who else was there? Who

else was at the dinner?

>> Another biotech CEO, Phil Strandwitz,

and a

>> I don't know how to classify Jaime's

job. He's a leading professor at the MIT

>> bit of a polymath

>> polymath MIT media lab professor,

healthcare entrepreneur, advisor to

anyone who wants to know fancy things

sort of guy. And then me.

>> Yeah. Right. and you I'm already an

investor in Whole Biome, Phil's company.

Love what Jaime's up to and very

interested in what he's building as

well. We can put that in the show notes.

We'll put all that in the show notes.

And then we met and part of the reason I

became very interested in Strand. There

were a lot of reasons. So, one is the

technology, the results, the photograph

or I should say images that you showed

me, which we'll get to in a second. The

second is founder builder who is

technical but for whom also this company

this is going to be a strongly worded

statement but is like existential.

>> Yeah.

>> You're not a hired gun CEO who has been

brought in. This is very much entwined

with your identity and personal mission

which I find very attractive

and quite interrelated with that is the

fact that I found you to be a very good

communicator over that dinner. Right. I

learned a lot. You recommended a number

of books to me at the dinner and then

afterwards.

I'd say chief among which was the the

Janentech

>> fantastic book

>> origin story which is one of the best I

would say business books I've ever read

just unbelievably good because it it

also and I can't believe it made it past

all the Genentech sensors but like

actual contracts I mean screenshots of

contracts negotiations mistakes

all of the

serendipitous lucky moments and unforced

errors by universities and so on that

had to coales for Genentech to even

survive survive. It's just an incredible

story. And

I

also, just again, this is more for

people listening than for you, but I'll

continue to fluff a little longer, which

is

>> also that you seem to me to be very

aggressive without being haphazard.

Right. So you you were just furious at

this dinner when I started trying to get

an idea of the general biotech scene in

Boston and asking questions about

various startups and figures and

companies at how conservative and

dogmatic maybe would be a very generous

way to put it. You view a lot of folks,

not all but the default, right? The

status quo. And in contrast, you're

taking big swings, right? like you were

taking big swings. So all of those

things were attractive. When it comes to

strand, let's talk about the image for a

second. What was the image that you

showed me or images?

>> I happened to show you a photo of one of

our patients, one of the very first

patients that entered our trial. The way

that these early stage trials work in

oncology with a patient with stage 4

melanoma. In early stage trials, you end

up with patients who have been through

every exhausted every option by the time

they end up in your trial and they often

have pretty progressed disease. And so

>> you hope you can offer something to

these patients. They had melanoma. So

that's a skin cancer. But they had not

only aggressive what we call cutaneous

metastasis, which is across their

surface of their body in the skin, but

they had what's called visceral

metastasis, which that's actually what

kills you in melanoma is the metastasis

to the organs of your body. And it was

in their lungs. It was in other sorts of

areas. I think muscle deposits and bone

deposits. And in addition to that, this

patient had had multiple other therapies

that historically actually melanoma

responds very well to. What's

unfortunate about the current state of

affairs in melanoma and in some cancers

is we have these imunotherapy drugs.

What the biggest blockbuster of the last

few years is a drug called Kitruda from

Merc. Incredible miracle drug. Won a

Nobel Prize a few years ago. In

melanoma, if you respond to that drug, a

lot of patients do, that's great. If you

don't, the likelihood of survival begins

to diminish very quickly. And this

patient had had kitruda. They had had a

whole number of other drugs through many

what they call lines of therapy. You get

a drug,

>> your cancer responds or it doesn't. you

you know if it doesn't respond you go to

the next and the doctor the oncologist

cycles you through a number of drugs and

this patient was at a fairly advanced

hospital that not only had given them

the what they call the standard of care

and then the second line standard of

care they had given them actually a

number of other just like maybe this

will work maybe this will work you know

trying to help the patient stay alive

and the picture that we have and this is

in you know someone if you Google our

Asco poster which is a Clinical Oncology

Conference.

>> How do you spell ASCO?

>> ASCO. It's an abbreviation for the

American Society of Clinical Oncology.

It's a meeting every summer in Chicago

that sort of is the big breakthroughs in

clinical medicine for oncology. It's the

top of the top in a lot of ways for

people, you know, big results, small

results. We had presented this photo

there and I had met you a little bit

afterwards to show I mean the the photo

itself is quite striking and it's in

that poster.

>> It's basically a body riddled with

cancers. I mean they're everywhere.

>> I like to say you don't have to be an

oncologist to look at that scan and

understand the extent of which this

patient responded. Just riddled and then

no more. And one of the things as a

scientist Tim you mentioned something

earlier which was that this is more than

a company for me and actually a company

is only about one third to one half of

the time that I've spent on this like

mission to make genetic medicine work

correctly for patients.

>> One of the greatest accomplishments in

that, you know, career that I've had

thus far is being able to like say that

you did help a person. If that was just

one person, one patient, I'd say, "Wow,

what a career." We dream of more. We

have big ambitions here at Strand. I

have ambitions for how many people in

the scale at which we're going to be

able to help people. However, like that

was the first time that I really felt

like our science went out into the world

and it took, you know, someone's

grandmother and not only kept them

alive, but we're a year and a half in

and they still have no detectable like

lesions.

>> Yeah. It's wild. in the investor deck,

right? The pitch deck that I initially

read and had I apologize for that, but

like a million and 500,000

questions about for the non-technical

folks, right? The muggles, they can look

things up and are curious. What are

things that stuck for them like

particular slides or phrases?

certainly the images, but is there

anything else that comes to mind that

really resonated with people from that

deck?

>> There's one other bigger, you know,

generalist investor who who had come

into the round personally. And I had I'd

been having a conversation with them

about something in oncology that we call

the Kaplan Meyer curve.

>> Kaplan Meyer curve, if you're looking at

oncology results, is sort of a survival

graph.

>> Yeah. So, you know, you maybe look at

like two years and you look at from 100%

where you start the study and then it

looks like a step ladder going down. The

standard of care line has some amount of

people like steps down and you want to

have your drug be significantly above

that. either having more people alive

longer or you know you have like a what

they call the long tail where like

everything goes to zero in standard of

care at a certain time point but you

have an amount of patients that just

like look cured they continue on for

many years.

>> Mhm.

>> And in drug development we get very used

to looking at those graphs and sort of

making very statistical calls and saying

oh this doesn't look like it's active or

this drug's it or isn't that great. But

I think one of the things that I've

spoken to some generalists, some of our

larger investors who maybe aren't from

the biotech world, and I've I've tried

to zero in on some of those survival

graphs with is to say, you know, when we

look at these steps, these are lives,

the lines that go down on this, the

vertical part of the step is someone's

loved one dying. But the ones that go

horizontal and every time you see

something go further along that is

someone who got to exper even if it's

just three months you have no idea what

that means within that person's life.

And

when we take that that Kaplan Meyer

curve and those steps and we zero in on

each patient, we start to look at them

and we start to say like this is a

patient that didn't think they would see

Christmas in 2024 and they just

celebrated the new year of 2026.

>> That I think is meaningful in what we're

doing now. Whether or not that will be a

good product, right? There's a

difference between a good drug and a

good product. I'd say the good drug is

can someone take this and it does

something like injecting a therapy into

someone in a way that is very hard to

replicate but did a great thing for that

individual person is a good drug

fundamentally. It is a good drug. It

helped that person, right? Mhm.

>> And a good product is much more this is

where the idea of how we get medicines

to people come into come into play. I'll

give you a different example. There's

something else that we're working on

called invivo cell therapy. Essentially,

there's an entire type of science that

we have discovered how to take the

immune cells out of a patient, take

their immune cells out, reprogram them

so that they learn how to attack

cancerous blood cells and then put them

back into a patient.

>> Mhm.

>> They are phenomenal drugs. There are

people who are about to die of like

myoma and then they get this drug. But

the drug costs, not making money, the

drug costs $750,000 to make just to

manufacture. It costs three months of

time to manufacture.

It's very hard to see a world in which

that drug has a large impact on the

patient population because of the the

fundamental cost, the cogs, the cost of

goods sold,

>> not biotech, just straight business. The

cost of doing it and the time it takes

to get it to people, that's a bad

product. Y

>> and so if you could say instead of

taking the cells out of the body, if you

could reprogram them while they're still

in the patient, now you have a good

product because you know if you can make

the cells recognize the cancer, the

immune cells program to activate against

the cancer in the same way, but make it

an outpatient procedure where a patient

just gets hooked up to an IV bag for 2

hours and then goes home.

>> Mhm.

>> That is a phenomenal product. I have to

look at this from the perspective of a

non specialist because that's what I am.

Yes.

>> But like if you were giving a TED talk

on this and had to kind of get across

>> at least part of what you're doing, I

feel like what you just said sort of

hits the nail on the head. Yeah. Right.

Within the first few minutes, you'd have

to talk about the central dogma, so to

speak, of like DNA as master copy, so to

speak, mRNA, and then protein. But just

like in brief, could you describe

the treatment, what the treatment

actually looked like for the patient in

those photographs, the before and after?

Like dots everywhere representing tumors

and then holy [ __ ] right? I think

everyone, whether they're technical or

not, that looks at that deck probably

had the same response, right, to those

images.

>> So in cancer, you have you have

chemotherapy, I think people are fairly

familiar with. You also have

amunotherapy which is the ability to

activate the immune system to attack the

cancer directly and that's what some of

the biggest blockbuster drugs of all

time are currently Merks Kitruda Bristol

Meyer Squibs Updo and then there's a

number of other types of amunotherapies

which are classified as checkpoint

blockades. Mhm.

>> So what that is is your cells

essentially have a way to tell the

immune system that they are your cells.

>> Mhm.

>> So you don't want your immune system to

attack your own body obviously. And so

one of the mechanisms that you have is

this IMU signal that your cells can send

to the immune system. Cancers hijack

that mechanism to protect themselves

from being attacked by the immune

system. And what we figured out was a

way to block those signals. And that's

the entire field of amunotherapy. Not

the entire field, but I would say a vast

majority of the field of amunotherapy

and the successes of the last decade of

treating cancer and also commercial

success for a lot of these companies has

been based on further refining better

checkpoints.

The problem with that is that they're

all very similar mechanistically. And so

if one doesn't work, if you have cancer

and I give you kituda and it doesn't

work, the chances that the next types of

therapies will work since all of them

are very similar mechanistically.

the chances diminish quite drastically

and there's some nuance here and I'm

sure if there's you know oncologists

listening to me they're like no but you

don't know in double negative this

cancer if you combine with these it

doesn't matter right in general these

mechanisms become degenerative and we

don't have good additional options to

excite the immune system

>> a second theory for going back to the

'9s was if instead of just you know sort

of

blocking the cancer's ability to hide

from the immune system. If that's not

enough, what we actually need to do is

we need to activate the immune system

directly. And it would be best if you

could send that activation signal from

the tumor itself. So now you have a

tumor instead of just blocking the

tumor's ability to hide. You actually

have a tumor that's sort of screaming

like, I am a foreign object. Please come

and eat me.

>> That's kind of how immune systems kill

things. like like eat the other cells.

>> Yep.

>> And so the issue, this is not new. This

is basic science from like immunology

from the '90s. The problem is we haven't

had a good way to get the tumors to send

those signals. We've tried to make the

signals in the lab and then inject them

into the tumors. And the problem is the

signal just like goes away immediately

and then it's circulating in the body

and the immune system doesn't know

what's sending the signal. We've tried

everything we can to like make this

signal artificial and get it into the

tumors. And every single time we do it,

it's either not enough in terms of no

efficacy or it activates the immune

system in all sorts of places we don't

want it and it causes all sorts of

toxicities. And so what we are doing

with our medicine is

delivering the instructions into the

cancer cells

>> in a way that causes the cancer to

basically send its own signal out. So

it's artificial in that we have made it

in a lab, but instead of making the

signal, we're making a message that

tricks the cancer into sending the

signal. And so that is drastically

different. It makes a huge difference in

both safety and efficacy because now you

are recapitulating

how the signal works naturally.

>> If the cancers weren't cancerous, if

they were just deregulated and you know

cells were starting to grow out of

control, your cell would naturally send

the signal and be like, "Oh no,

something's wrong." And your body would

take care of it. You actually generate

cancer like all the time in your body in

terms of disregulated cells. your immune

system just comes in and takes care of

it before it becomes like a, you know,

when it becomes a real problem. That's

when you get tumors. That's when you get

the disease we call cancer.

>> And so what we're doing is we're sort of

resetting that system. We're having the

tumors resend the signal out. And so

what we created in that first drug was a

very simple administration procedure.

You take our genetic medicine and you

inject it into the tumor directly. And

what that does is the immune system

comes into the tumor and it kills it.

But then it gets activated by that

killing process and it learns what the

tumors look like and it can better

identify the other tumors that have been

hiding throughout the body.

>> So that's the point that I was hoping to

get to. It's basically like in this in

the case of this patient, not to belabor

this point, but it's like you injected,

if I'm remembering correctly, into

cutaneous, meaning like at the just

under the skin.

Not sure what the right term is.

Nodules, like instances of cancer. Yeah.

Right. So, my follow-up question was

going to be like, well, then how do you

suddenly get to the visceral instances?

Right.

>> Yeah.

>> And I think that's what you're

describing. And within the world of

oncology, is that a novel observation?

Is that something that is new in terms

of being able to do that? It's something

called the abscopal response or the

abscopal effect which means that one

tumor is sort of what you've put the

activating drug into and that's where

the immune system will attack first but

now the immune system is activated and

educated to go and kill the other

tumors. It's not new in the fact that

like I didn't come up with that name.

>> Yeah. It has been observed in limited

other settings

of a few other drugs that people have

have gone out with. I guess the problem

has been that it's been very very

limited in terms of the abscopal

response that other people have seen. So

>> for instance, you would have a patient

with a tumor maybe melanoma patient. So

they'd have a a cutaneous lesion, a skin

lesion on their chest, and then they'd

have another one on their shoulder, and

you would inject the one on the chest,

and the shoulder one would also kind of

shrink. They're in the same region,

right? The immune system is sort of like

fighting the cancer in the same region,

but you wouldn't necessarily see that

happen in like the lungs. And so one of

the big push backs on a drug like the

one that we took to the clinic two years

ago was,

you know, you don't die from having

tumors all over your skin. You die from

when they metastasize into your lungs

and into your liver and, you know,

impact the organ functioning. That's how

patients die of melanoma.

So if you are only able to address the

tumors that you can either inject or

that are near the injected tumors, you

you won't have an effective drug if if a

patient already is like further along.

>> Mhm.

>> We are to my knowledge one of the first

companies, if not the first company to

demonstrate a direct injectable drug

into the tumor

that in a large number of patients,

>> this isn't a one-off. There wasn't one

miracle patient that had that. That is a

beautiful photo of that patient. I'm so

happy that they're still on the trial

and still doing great and it's amazing.

But, you know, this is about being

broadly applicable because that's how

you actually impact population level

lives.

>> And so, we are the first company that

I'm aware of to show this sort of like

extent of abscopal response in visceral

deep organ metastases in a you multitude

of patients. And really right off the

bat, I mean this is from the very first

patients we put on this trial at the

very beginning of it

>> began responding.

>> Yeah,

>> that is very uncommon. It's very

uncommon to have patients on a phase one

trial on the drug 6 months later. And of

our first three patients that ever

entered this trial in the summer of

2024, two of those three are still on

the trial 18 months later. M

>> that is something that I think is fairly

shocking.

>> Yeah.

>> And if we were a traditional biotech

company, we'd be really happy with all

of this data and we'd say, "Wow, let's

take this forward." However, you I think

the real message of Strand and what we

can accomplish in genetic medicine is we

don't have to stop it just injecting

into the tumors. There are a number of

concerns with injecting tumors from a

product perspective, not a drug

perspective, but a product perspective.

Right? The difference between, you know,

a drug is all about does this work and a

product is about how will these patients

get these drugs and injecting directly

into a tumor is doable and most

oncologists can handle it, especially

for skin cancer patients. But as you go

to rural health communities, it gets

harder and harder to have doctors that

have that training. And as you get to

other sorts of tumors beyond skin cancer

patients, some of their skin lesions

have been removed by a surgeon. And then

you go beyond skin cancer. How are you

going to inject a patient with nonswall

cell lung cancer? Like you start to get

this idea of there's a limited amount of

patients you can access, right? And so

you have a product may be limitation

>> in cancer. The way that we actually

treat cancer patients is that there's an

infusion clinic. You go to the infusion

clinic. the oncologists and the nurse

practitioners and everyone technicians

hook you up to some sort of an infusion

and then the oncologist can monitor

multiple patients at a time. And that's

what our infrastructure looks like right

now of how we treat patients. And if you

want to have the largest impact in

medicine, you need to make medicines

that plug into existing infrastructure.

As much as you want to like tell

everyone, hey, change everything about

how you think about treating patients,

the way to like have a near-term impact

is to build drug solutions that can plug

into existing infrastructures. You know,

if we become a giant biotechnology

company that has all sorts of resources,

maybe we can talk about changing how

everyone gives drugs, but for right now,

if we want to be able to help the most

amount of patients in the near term, we

need to plug into that infrastructure.

We need to find ways that we can access

organs. I'd say in addition the

bloodstream is also a really good way to

get around the body believe it or not

like I mean the bloodstream carries

oxygen to everywhere in your body and so

if your drugs can travel through the

bloodstream and get where they're going

very effective

in genetic medicine I would call it the

holy grail for the last 30 years has

been thinking about how do we IV

administer intravenous which means into

the bloodstream

>> administer

genetic medicines that can get to places

throughout the body. We've been trapped

in one organ for the past 30 years and

that's the liver. The liver naturally

filters your blood and thus it picks up

a lot of these genetic medicines that we

put into the bloodstream. Y

>> and so what we've done for the last 30

years is figure out how we can treat

diseases in the liver with this like

it's this old internet meme which is

like step one blank step two question

mark step three profit right I remember

like the old days of Reddit people used

to use that structure right step one do

this step two question mark step three

profit in biotech in genetic medicine

the joke is like step one prove it works

in the liver step two question mark step

three we'll treat all these diseases and

after 30 years we've really nailed step

one.

>> Mhm.

>> And step two has remained this like big

question mark. And so when we started

Strand, our number one goal actually was

not even to get to this first drug. As

amazing as it's been for these patients

and as happy as I am that we have been

able to help those people in their lives

and as impressive as it is, our main

goal was to solve this step two question

mark that's been sitting there in plain

sight. Mhm.

>> And I guess the big piece here is that

like, you know, everyone who thinks they

know what they're talking about in

genetic medicine will say, "Well, the

issue is delivery." And it's like, "You

need to be able to deliver." And I'm

like,

>> "That's a very handwavy."

>> Again, it's just a cheap answer, which

is like not wrong, but it is incomplete.

And I believe that it's actually three

problems at once. It's three children in

their father's trench coat pretending to

be an adult. It's like we're delivery.

And then you open it up and it's like

potency, specificity, and delivery are

all here inside. And no one wants to

hear that because people want simple

solution. They want like, oh, it's

delivery, so we'll just fix delivery.

And I mean, just 30 years in, no one has

a good idea about this piece. And I I'd

say that the thing at Strand when I

started the company that I just could

not understand why everyone didn't see

what I was trying to tell them and I was

very bad at pitching. You think I'm too

much of a scientist now perhaps or maybe

your audience does if they're listening

but like man you should have seen my

very technical zero market insight pitch

deck of 2018. That is complete dog [ __ ]

It is an awful I am can't believe

someone funded us. I'm a huge fan of

Elon Musk's like first principles based

thinking, right? I don't know if Elon is

the one who invented first principles

based thinking, but I think he's

probably the main evangelist and

popularizer of this like thinking

modality where, you know, if you take

SpaceX for example, his idea was what is

the thing preventing commercial space

flight? And it's dollars per kilogram,

right, of launch. Like it's just like

dollars per kilogram. That's it. Like

how do you get it down? And you start to

like, well, where's the cost centers in

a launch? And you go, okay, well, the

cost center in a launch is in like these

rockets,

>> trashing rockets,

>> these fuselages that were just trashing

80% of it. And you go, well, like, why

don't we just like reuse them? And

people are like, well, you know, they do

this, they do that. You know, they're

hard to retrieve. They're in the ocean,

they're floating, they can't. And he

goes, he goes, "What if they like land

themselves?" And it's like, that's an

insane person thing to say. What I want

the world to understand is that we are

standing right now on the precipice of a

revolution in genetic medicine. And

that's important for a number of

reasons. One, it's important because

there are near-term diseases that we're

going to be able to solve. We're going

to be able to get to a point in the not

too distant future where I think a lot

of types of cancers are at the very

least chronic diseases instead of death

sentences. You know, we all want to get

to cures. I want to get to cures, but we

are getting at least to a point where

it's a manageable disease, right? That's

I think a near-term

piece,

>> right?

>> There's sort of multiple lines of

technology that are coming together that

I think people are not fully

appreciating what what they're going to

mean for the future of medicine. And so

there's a lot of focus right now on AI

based drug discovery and people are

building proteins and antibodies and all

sorts of stuff with AI models that are

doing incredible things. We have decades

of work on designing exquisite proteins

that do all sorts of stuff from edit

genomes to cure whatever in some sort of

mouse model. What we don't have is the

infrastructure,

the medical biio medicine infrastructure

that gets any of these things, these

discoveries, whether they're made by a

human with Microsoft Word stitching

amino acids together, whether they're

made by an LLM that knows exactly all

the pieces that are going to make this,

whether it's made by high throughput

screen of 14 different robots in

concert, it doesn't matter. What matters

is how we're going to get those into

patients, how we're going to get them

into the places they need. And I think

about this as this infrastructure of

medicine comes forward and what this

will actually mean for the future of

healthcare. Anyone in any sort of a

place of power throughout the world I

think needs to understand where where in

the next 10 to 20 years we very well may

be headed with medicine which is smaller

indications, niche indications. We are

moving in a way where I think medicine

becomes maybe not completely bespoke but

much more refined. And the way that we

get there, we're going to get there

technologically and we're going to get

there from a design perspective much

quicker than we're going to have the

infrastructure to actually deliver those

medicines to people safely, effectively

at scale. And so our goal at Strand and

our challenge is building drugs today

that impact patients lives.

>> Yep.

>> We're not a research institute. Our goal

is not to do really cool research on

mice and join the ranks of people who

have cured mice of cancer. There's

millions of them. There could be a Nobel

Prize every five minutes for someone

who's cured a mouse of cancer. Our goal

is to cure human beings of human being

cancer. Our goal is to cure human beings

of human being diseases and do so in a

safe, effective, scalable way that

impacts a person's life as little as

possible.

>> And that is what we're building as a

commercial organization. We're building

drugs today, but what we're doing is

we're laying the groundwork for this

infrastructure to where when we're

successful in tumors with the new trial

that we're running this year, when we're

successful with being able to IV

deliver, you know, infuse a genetic

medicine that goes to the tumors, we

have an instruction manual, what we call

a payload, right? The protein that we're

tricking the cancer into making. We have

one that we've chosen. But success there

actually means that I could now in 6

weeks design a completely new protein to

be delivered to the tumors and I could

just go over and over and over again.

I'm only going to be gated by the

infrastructure I have to build like new

ones of those and the FDA's ability to

move quickly with us as we try to test

new and newer things. But we know the

general high level safety of this

>> that's coming right that's coming in a

lot of other areas of the body. We're

we're designing things to get into TE-C

cells so we can help, you know,

temporarily

influence the immune system so you could

take out things like autoimmune disease

and allow patients to revert back to

their pre-treated state without doing

any sort of genetic modification. We're

trying to get all sorts of these

therapies forward. And every time we

have a success, we lay the groundwork

for this infrastructure going forward. I

want people to understand it one because

we have large ambitions.

>> A lot of people have thought first they

thought that the first principalbased

approach we were taking was incorrect.

They're like it's a delivery problem.

You need to build a better delivery

vehicle. Why don't you focus on that?

And I'm like okay everyone's done that

right now. We've shown this complex

solution actually fixes this like

age-old problem and we're going to be

continuing to move that forward. I'd say

the biotechnology industry will be

dragged kicking and screaming into into

the future or it will, you know, be

built up in a new way from new players.

For us, I want to find the people

throughout the globe who want to partner

on these things. The innovators in

America and those are all sorts of

different sorts of folks. Those are

people in policy. Those are

>> Yeah.

>> You know, people.

>> So, let's dig into that just for a

second. Like for instance, with this

podcast, let's say I was like, "Well, I

got good news and I got bad news." The

bad news is

>> I can't put this out to my whole

audience. The good news is you get to

tell me which thousand people I send it

to and that gets handd delivered to a

thousand people, right? And I mean, a

similar way to look at it would be like,

"All right, you're giving a TED talk,

but it never gets shared online. It is

only for the thousand people in that

room, but you get to handpick them.

Who are those people? And it could just

be categories of person, but how would

you think about that? I think there are

people policy leaders not just in the

United States but you know across the

globe that need to think like critically

around

how we are going to both handle enable

and empower the future of medicine

because things you know incentives

things are going to look quite

differently 10 years from now than they

do today in terms of the scope and the

style in which we can build medicines

>> and the policy leaders are important.

Sorry to hop in, but because ultimately

they're going to determine the rules by

which healthcare is played. Is that one

way to put it?

>> Yeah. I mean, healthcare is very similar

to the space industry. Yeah.

>> In that policy leaders essentially have

two major pieces is that they are both

the arbiters of what is allowed to be

done and they are a major payer, not the

only payer, but they are a major payer

of the purchasing of that. And so as the

fundamentals of medical development

change,

>> yeah,

>> now I'm not making a drug that I hope to

give to, you know, 2 million people

worldwide.

>> I'm making a 100,000 variants of a drug

that I'm hoping to give to, you know,

10,000 people worldwide or 10,000

variants of a drug that I hope to give

to a 100,000 people worldwide. And I get

to more people, but there's more

variants. Both the regulatory and the

payment systems I think need to adapt

themselves to allow for that. It's on

us, the medical innovators and the

engineers and the entrepreneurs to build

systems that are still good products.

You have to think about where you're

going and then build a system that can

still be a good product. If it costs

10,000 times as much, it's not going to

work. Like it just won't work at scale

and you won't access these patients. But

if if you can see a path forward and

think creatively, I'm not a politics

guy, but I am fascinated by policy and

how incentives shape the future of

highly regulated industries like biio

medicine, like space, like all these

things. And and that is regulation plus

payment. I think that there's incredible

work to be done. And the last big time I

think productive collaboration between

worldwide policy makers and and the

United States as a leader. But the last

big collaboration of that came in the

80s when biotech started to take off in

the '9s when it really ripped right when

we started to harness the power of

recominant proteins. The Genzyme book

you plugged it earlier. That's

phenomenal.

>> Oh Janentech.

>> Janentech. Sorry. Jenzyme's the

Janentech of Boston. I get the two of

them were like

>> Yeah. But the Genentech book really, you

know, studying the history of Genzyme.

Jenzyme actually had the leader Henry

Tmir who was the actual quarterback I'd

say of the policy innovation, you know,

worked with government officials to

figure out like what will this new class

of medicines look like that aren't just

small molecules that you can take home.

Now we have antibodies. We have all

these drugs that are amazing because of

it. We have the Orphan and Rare Disease

Act which led to people building these

rare disease drugs. I'd say we need to

have more productive collaborative

conversations around what the future

will look like because things are going

to change very fast. You know, I read

the AI report from the the White House

for instance and sort of how the state

of AI is. And I read through it and I

was like, you actually need one of these

for biotechnology as well because things

are changing as rapidly

>> and it's going to be further accelerated

by AI and if we don't have some

productive conversations, we're going to

be stuck in one of two places. One is

where only the ultra rich can get the

really disruptive drugs because they're

the ones who can who can pay for it

because we don't have a system set up to

like have these new radical changes

commercial quick enough or or dispersed

quick enough. Or the second is the

inability to pay, the inability to find

ways that like support an ecosystem

makes an uninvestable thesis for

investors. And so all of these like

great innovations that we have coming

out of the lab right now just die on the

vine

>> get cut off at their knees because just

like space space industry it's a long

time cycle to read these things out and

you need capital to get there

>> so a lot of what I try to do in my own

meandering way is kind of answer the

like thousand people in a room question

>> interesting

>> and then to figure out it's like okay

let's just say you're spending time in

DC you sit down somebody their staffer

convince them to sit down for 30 minutes

right like what do you lead with right

then that can inform form potentially,

right? Like the website or appearances

on podcasts and stuff. So just in case

it's helpful, I can obviously share this

afterwards too, but it's like a couple

things come to mind, right? And I think

in terms of like, okay, what does the

TED So once you identify the people in

the room, then it's like what does the

TED talk look like if you got 20 minutes

on stage? And I mean, you're good at

this stuff, but sometimes you're so

close to it that it's helpful to have a

muggle.

>> No, I I want to hear this, Tim, by the

way. It's a a free communication lesson

from someone much more versed in the

area.

>> Well, yeah, thank God because I can't do

science. So,

got to allocate responsibilities. Well,

I don't want me in charge of developing

amunotherapy. So, the Christmas story

and the photos, right? So, if you kind

of like started with that, I'm just like

walking through in my my madeup TED

talk, right?

>> Yeah. And then let's just say you went

from there like okay let me take a

sidebar for a minute and you talked

about SpaceX right and the reusable

rockets right and the analogy also of

like once you have this engineering

platform developed from first principles

now you have something that is payload

agnostic right once you've made it

economically feasible and you have this

platform whether you're launching you

know superconductors into space as an

alternative to propellants for a

satellite reorientation. Check out

there's a company called Zeno. I might

have to redact this, but they're in New

Zealand CNN O. They're pretty [ __ ]

amazing. But whether it's that, whether

it's something else is entirely up to

you in terms of deliverables because

you've done the hard work of developing

this engineering platform.

>> Yeah.

>> Then talking about like, okay, well,

what does that actually mean for

biotech? And you've got the holy grail,

right? How do you IV administer genetic

medicine? And then you could segue to

because there's there's a good drug.

>> Yeah.

>> And there are lots of good drugs that

die. Why do they die? Because they're

never going to actually make it into

production, so to speak, at scale in

healthcare. And I've seen a lot of

analogies with this, and I won't digress

too far, but with psychedelic medicine.

>> Yeah.

>> And it's just like, okay, you need like

an overnight nurse. This is going to be

an eight-hour experience or six-hour

experience.

And sure, you could argue that you might

have the rich people pay $10,000 out of

pocket and that subsidizes the it's sort

of like Uber Black subsidizing Uber X.

Like there is an application there, but

if it's fundamentally

incompatible with current healthcare,

you're trying to win a race with your

ankles tied together, right? It's

probably not going to happen. And then

you have people looking at like 5 DMT

instead of psilocybin and stuff. And I

have my own thoughts on that. But sure,

it's like you look at the failure just

real quick of like MDMMA assisted

psychotherapy when it got in front of

the FDA advisory committee. A lot of

reasons for that. But then you have

people coming out of the game, they're

like, "Oh, we tried to couple they tried

to couple psychotherapy with it. The FDA

does not regulate psychotherapy. It

became a huge quagmire of just like

confusion. And therefore, these other

people are like, well, let's do

methylone. It has a much shorter

halflife. You can actually fit it into

like an hour hypothetically, right? you

can decouple the therapy. We're just

looking at drug effects and lo and

behold, like it's making a ton more

progress, right? But the point of saying

all that is that you've got the kind of

SpaceX, you segue to like the holy grail

and then like what if you could

reprogram cells in the body, right? Like

what happens? So I do love the fired up

handwavy delivery thing, right? Because

you're like what they've missed is and

I'm again I'm ad libing here so it might

be [ __ ] It's like

>> No, no, I love it.

>> They're right and they're wrong. They're

wrong because of reasons X, Y, and Z,

right? And this is a lot of hand wavy

stuff. And like

>> we're still at a point where we're

defining triple negative breast cancer

by what it isn't. It's like if you have

trouble with your shoulder and you're

like, well, good news, it's not

elephantitis and it's not Parkinson's

disease. And you're like, how does that

help me? It doesn't really, right? But

then you say they are right about

delivery in the sense that like if you

cannot plug this into health care and

deliver it to end patients game over

like it doesn't matter how effective it

is in an N of one or an N of five or

whatever your small clinical is. And the

idea these are not necessarily in the

order but talking about like even though

it's not the end goal what if we could

turn cancer into a chronic disease it

can be managed right and it's like back

in fill in the blank 1980x

right HIV was a death sentence y

>> and no longer the case now you look at

on television and it's like you see ad

after ad related to some preventative

but also like maintenance drugs that

allow people to live with a chronic

So anyway, those are a few things that

kind of hop to mind. I would be curious,

I mean for policy makers, what are the

things that most catch their attention

whether from experience or

hypothetically, right? Like what is it

that actually gets their attention?

>> I was in DC yesterday, right? And my

overarching message is sort of like

there are two things we need to to do

better. We have to build regulations

that I think are common sense that still

allow us to like more more cheaply test

drugs right now for a lot of reasons. We

have sort of vestigual over many years

reasons as to why it takes us a lot of

money and a lot of time to just get to a

simple answer on a medicine, right? And

that is creating a world in which the

biotechnology industry is incentivized

to do very small steps forward because

the cost of failure is so high that

you're trying to reduce your risk in a

way that is let's make a drug that's 10%

better right because you know taking a

truly innovative risk would be very

difficult to underwrite for for certain

investors. I'd say at the other side,

you know, the thing that catches folks

attention is to talk about how medicine

is fundamentally changing and we all can

see that AI is changing, how business is

done, how people build things, how

people read things, how people parse

through information. It's making highly

motivated people 10x better if not more.

And it's not just AI and biio medicine.

It's sort of multiple threads coming

together of novel technologies of how we

build medicines, genetic medicines and

their sort of advancements. Things like

what we're bringing forward, our ability

to diagnose diseases and subcategorize

diseases and change the way in which we

interpret, you know, how this disease

is, the sequencing technologies which

allow us to do that and other sorts of

computation and AI that plugs into those

pieces. All of that's going to

fundamentally change medicine.

>> Yeah. Because if I can't just make a

decision around the drug that every

breast cancer patient gets and then I

agree on the cost that that drug is and

I pay for it a number of years and then

the drug goes to generic and someone

brings the next drug forward that's 25%

better and blah blah blah and we just

continue along that that's the

non-inovative way in which we've been

developing medicines for for the past

number of years and every once in a

while we have a breakthrough. I'd say

policy makers tend to like that because

well it comes down to like numbers and

medicine is a very interesting piece in

policy.

>> What do they like? Could you just say

that again? They like the idea of

breakthrough versus incremental.

>> They like trying to learn about it. Like

when you start to talk about medicine,

it's very interesting because you think

about paying for medicine like the

government or health insurer, but the

government paying for medicine is a

near-term cost center that that should

long-term reduce a larger cost center,

right? So brandame medicines are 8% of

US health care spending,

>> but hospitals are 26% something like

that in the high 20s I believe. And so

you imagine that like for eight% of your

dollar in health care spending, you are

pulling down the amount of people that

are now hospitalized. You are increasing

people's life. You're keeping people in

the workforce. You're keeping people in

their homes. You're keeping people out

of a system that, you know, no one wants

to go to the hospital and and the

government that pays for a lot of

people's hospitalization in the form of

Medicare and Medicaid doesn't want to

pay for people to go to the hospital.

And so you begin to talk about that

system and you say preventative

healthcare, but all medicine to a

certain extent can be thought of as

preventative. If it's able to save off,

you know, hospitalization, it's at least

at the very least hopefully preventing

you from being in the hospital. And so

policy makers like those conversations.

I'm going to try to keep this from like

sounding too conspiracy theory, but what

what I'd love to know is what's in it

for policy makers to help you. And that

might sound strange, right? Because I'm

not saying these are bad people and we

could talk about the kind of industrial

regulatory exchange programs another

time, but that's a thing. So I guess

what I'm wondering is how do you how do

you align incentives with policy makers

so that they feel compelled and

interested in being helpful? So let's

just say there are thousand policy

makers listening right now or if you're

in the room but like what is your ask if

they're like hey look again good news

bad news bad news is I can't meet again

I'm just too busy. Good news is if you

have a reasonable ask I can green light

it right now right? Yeah,

>> but you need to do it. What is the ask?

>> My first ask right now is we need to

streamline how we test new medicines in

humans in clinical trials. In fact,

maybe if this ever sees the light at

day, hopefully the op-ed that I wrote on

accelerating first in human trials and

becoming a more innovative powerhouse as

a country.

>> Oh, where is that?

>> I just wrote it a couple weeks ago.

Okay, got it.

>> And submitted it to a handful of of

places in the last couple of days. I

think that it's the single greatest

advancement in biio medicine that we're

going to be able to make. And it of

course it opens a lot of doors for us as

strand because we have way more ideas

than we have the resources, time, and

money to take forward at $50 million a

try.

>> But if you start to make it more simple

and a lot of these things are common

sense regulations. We're we're spending

way too much time and way too much money

doing things that I think are

>> quite antiquated and vestigial in our

regulatory process. And so if you can

reduce that time and reduce the amount

of money, then you can change the

economics and the incentives around

building new drugs and you can begin to

generate more diverse data that allows

you to train things like AI models on,

you know, what actually makes a

difference in a drug and a human. We

just don't have enough data. We don't

have enough diversity of data to be able

to train them nearly to the level that

we want right now. And a lot of it just

at the end of the day, it comes down to

like does this do something in a human?

You can do all you want in the lab. You

can do all you want in mice. You can do

all you want in primate studies.

Whatever it is that you do, it just

doesn't matter to nearly the same level

until you do it with a human. And when

Janentech and Genzyme were coming up in

the 80s and 90s, it was a comically

fraction of the cost and time that it

takes to bring new medicines forward

today. This isn't a impossible thing.

we've just created a lot of weird

barriers and we need to get back to a

first principles way of thinking within

government as well. I'm not the only

person preaching that and I'm certainly

not the only one in policy that that

thinks about it. I'd say in America we

want to be the headquarters of

innovation, but a lot of other countries

want to be innovative too, right? In

Asia and in the Middle East, there are

countries that are like, we can do this.

We have the technology. We can make

investments into the space. we can make

investments into companies earlier that

we think have a high leverage point in

the future health

>> and we want to you know go in those

directions. The United States is is able

to do it too but that's it right?

>> If you did an 8020 analysis on the

impediments and someone's like okay we

want to streamline but if there are 10

items on your wish list let's pick two

or three. What are those two or three?

One I think is that we should remove the

FDA from a direct permissionbased

oversight organization on the beginning

of first in human trials. So let me just

explain this for like a different sort

of of audience, right? Right now in

order to do a clinical trial of what we

call a first in human, the first time

you give a drug to a human, a new drug,

right? So a phase one, in order to do

that in the United States right now, you

need to write an IND, which is called an

initial new drug application to the FDA.

It's very long. I think ours for our

first trial was 22,000 pages long.

>> It costs just to write it. You have to

have professional writers,

professionalized system, all sorts of

very expensive things just to write it.

It's millions of dollars.

>> Wow.

>> The studies that need to go into it are

millions of dollars. The manufacturing

of your drug and the associated

analytics of your drug in order to be

correct in the document cost millions of

dollars. And this tax up and up and up

and up and up and all of a sudden this

application cost you $25 million and it

takes 18 months to put together. Mhm.

>> Now, in China and in Australia, two of

the countries that do much faster first

in human trials than the United States,

they have a system where you go to

something to the hospitals called the

IRB, the investigational review board.

In Australia, they have a lot of

professional centralized IRBs that, you

know, manage multiple hospitals and they

they work in like a for-profit system to

help companies figure out whether or not

they're going to be a fit for the

hospital. And you still have to do that

in the United States. After you get the

IND approved by the FDA, you then have

to go to the IRBs.

And so right now since it costs so much

money and takes so much time to get an

IND from the FDA, if you have decided to

do that instead of go to Australia and

go directly to the IRBs in Australia or

go to China, your board wants you to

essentially go to the top hospitals.

Hey, if we're spending 25 million on an

IND, I want you to go to MDA Anderson. I

want you to go to Sloan Kettering. I

don't want you to go to, you know,

random pick a random great but random

hospital in the Midwest. Right? So now

we have a lot of hospitals in the United

States not running first in human

clinical trials, which means we have a

lot of Americans who exhaust their

standard of care and can't get, you

know, the access to drugs maybe before

they are fully approved and they're just

out of options unless they want to fly

to Houston or New York or Philly or

something like that. And a lot of people

don't if they're, you know, facing the

end of life or for all sorts of reasons,

people don't want to do that. And so you

have Americans not having access to

drugs. You have companies shoved into

clinical trial sites that are already

overburdened. You have IRBs at those

hospitals which are difficult to deal

with and also overburdened and like

trying to process all the people who are

trying to come through their sites

doors. And all of this is taking place

after you've spent way too much money

and way too much time submitting a

safety document to the FDA in order for

them to approve it when the FDA actually

has a lot better things to do as well.

>> Mhm.

>> And so all of that reeks of an

inefficient system.

>> So if they said got it, problem sounds

terrible like you can author the

solution. What is the alternative? So

the alternative is to allow the

hospitals and their IRBs to make the

they already make the decision on

whether or not to run a trial and

they're assessing the safety of you know

the data that you have on your safety as

well as your efficacy and the sort of

patients you want to go after. The IRB

is going to assess that and make a call

after you get the IND done. I think the

the transition system to transition to

is what Australia calls it as a CTN.

It's a clinical trial notification

system. you notify the regulators, hey,

we're going to run a trial. It's not a

pass system. There are exceptions.

Certain types of drugs still need to go

through them for like formal approval,

but for the most part, you can notify

them, go to the IRB, the IRB can say,

"Yep, we think this is safe enough." And

the reason that is still a very safe

option because patient safety from a

drug company perspective, from

everyone's perspective, is number one.

There is nothing that will kill your

company faster. There is nothing that

will you know just make me never be able

to sleep again. It would be harming

patients especially harming patients

because you are being sloppy. And the

group that cares obviously cares just as

much if not more than everyone else is

the hospital's review board because the

hospital does not want patients harmed

or dying god forbid in their trials.

Right? The FDA isn't magical in their

oversight of safety, but you distribute

this workload across the IRBs that exist

throughout the United States. And they

get certified with the FDA to be able to

approve this. You can centralize the IRB

so that you know individual hospitals

don't have to have their own IRB. You

can have all of these systems. And now

all of a sudden, you have hospitals that

have the ability to attract

biotechnology companies for for drug

trials.

>> Yeah. It takes infrastructure to run

clinical trials. And so the free market

sort of picks up there and builds a

system that I think can accelerate

clinical trial management. And you free

the FDA to focus on the things that

matter, which is approving drugs based

on efficacy and safety. That's how drugs

get approved.

>> Mhm. I know you got to run a bit, but

>> we can chat again, too. This is fun. We

don't talk enough.

>> Yeah. This is a juicy piece, so I want

to chew on it a little bit more.

>> Yeah. So I've funded a bunch of science

in

mostly New Zealand but also in a few

other countries simply because the speed

of cutting through red tape and the

sheer amount of red tape is much less.

So that's why I would choose like a New

Zealand and some of these very credible

universities over like doing research.

No offense to Jamaica, but it's like

there's psychedelic stuff going on in

Jamaica, but it's like nobody in the US

gives a [ __ ] right? They're not going

to listen. It's not going to hold

anyone's attention. Yeah.

>> And I guess what I'm wondering is

simultaneously I can look at a New

Zealand and say, "Okay, it's mostly

sheep. Yeah, you have some people, but

it's a lot easier to run New Zealand

than it is to run the United States." So

I can't just say this works in New

Zealand, copy and paste into the United

States. Australia is is substantially

larger, right? So I guess two questions.

The first is like 0 to 10 confidence.

What is your confidence level that if

policymakers got behind it that

something could be done along those

lines? Not necessarily even at the

federal level, maybe at a state level. I

mean, there's all sorts of complexity

there, but what's your confidence level

that something like that could be

implemented in the US within the I don't

know what the time frame would be, the

next 5 years, let's just say 5 to 10

years if policy makers got behind it.

And then the the correlary to that is is

there any competition for scientific

innovation that is attractive to a

company like Strand much like companies

are moving from say California to Texas,

right? because there are certain

incentives.

>> Is there a competition for talent

globally through which if the UAE wants

to greenlight something incredibly

quickly and fund it that Strand would be

interested or is it live or die, ride or

die in the United States for any host of

different reasons, right? I know some

companies who have tried to tackle the

FDA first because they're like, "Hey,

once we have this data, we can kind of

copy and paste a lot of it into the EMA

in Europe, which is the sort of

equivalent."

I know that's a lot that I just threw

out there, but what are your thoughts?

>> So, to answer the first question,

there's a global competition for running

clinical trials like this, and actually

what we are in the midst of right now is

the United States massively losing to

China. China has built a an

industrialized

version of clinical trial infrastructure

for first in human trials that is so

efficient and massively quick that

they're just able to go faster and

cheaper into the thing that matters most

which is first in human trials. And so

the United States is actually in the

process of very rapidly as a country

falling behind China because what

started as a place for American

companies to come run clinical trials to

get data and then take it to the FDA and

then do larger trials in the United

States has now created a flywheel

structure within China where now just

Chinese companies run their clinical

trials faster than the American

companies and then bring their Chinese

discovered drugs to the United States.

And what happens is the capital flow the

risk capital then says ah these

companies are more efficient I will fund

these sorts of of aspects and so there's

always state by state we want to have

biotechnology here every state's always

tried to have it I'd say just like AI

tech like the best technologies remain

in like Boston and San Francisco just

tech companies might have left for Miami

and Texas but like where's open AI right

it's in San Francisco

>> yeah right

>> you know all due respect to Austin and

Miami I love those cities But you know,

San Francisco, it's hard to replicate

those pieces. And biotechnology,

Boston's really dominated a lot of it

for the past 30 years. Though in this

new age of medicine, I'd say San

Francisco is really rivaling Boston

because the risk capital and the

openness to like radical new ideas is

much higher. I think that also attracts

a healthy amount of like hype no

substance companies and hype no

substance founders and technologies. But

I think that's a low price to pay to

like take some big swings at like what

could be transformational technologies.

Even though I run a company in Boston, I

love Massachusetts. I personally

identify with that ethos a little bit

more of like if some [ __ ] hype

filters into this, it's worth it in

order to take the correct swings at the

truly big ideas because one out of 10

transformations is better than seven out

of 10 logical steps forward. So CTN in

the US like some version of that. Yeah.

As you described in Australia, if you

were a betting man, right? If you were

like, "Okay, I'm going to go on poly

market and I'm going to put half my net

worth on a bet." I guess I'm asking you,

how possible or impossible is the task

of retrofitting the FDA and approval

processes.

>> This is not a comment on politics and

this is also not a comment on like a lot

of different things that are happening

at the FDA right now. But I will say in

terms of the last 10 years of the FDA,

the time to which they would be open to

such a radical transformation and

radical in government bureaucracies

terms, right? The thing about government

bureaucracies is they very rarely seed

their oversight. They will take new

things to be oversight of, but like in

general regulatory anything takes a This

is the problem with nuclear energy in

America for the past 30 years. It's like

we just tack on one more thing and one

more thing and one more thing and one

more thing and these cottage industries

emerge to support the giant regulatory

machinery and we don't take a step back

to be like why are we doing this? At the

same time I'd say to look at the FDA

right now this is probably the most open

I've seen people to the idea of like we

want the FDA to be an exceptional

regulatory body. We want them to build

regulatory sciences that give us

ultimate confidence in like the drugs

that we build. But there are new

technologies that we've been slow to

implement. There have been markets that

haven't been able to be fully created

with technology for things like clinical

trial analysis because no one was sure

if the FDA would embrace them. And there

are things such as like early stage

safety which are already handled by

hospitals themselves where it will take

some time to make. But if I was a

betting man, I'd say I I give it a 50%

likelihood that in the next, you know,

two years we can get to this. I wouldn't

be spending my time talking to policy

makers about an idea

to like a senator. This is like I

believe that this is possible. I believe

that we can do this. I believe if we

don't do it, it is actually existential.

Like we will lose a lot of our ability

to develop drugs in America over the

next few years to China if we don't do

it because capital has no allegiance,

right?

>> Yeah. I also believe that there's other

countries and especially you know the

UAE for example are ones that are

watching it carefully and going hey like

we have great technology we have a great

landing place for western you know for a

lot of western values and western

companies we have great quality of life

here we could attract folks to come do

innovative work here

>> and so when I hear various different

leaders of countries in the Middle East

talk about it I certainly think it's

possible because they are countries at

least over the last 10 years where

you've seen be able to make aggressive

bets in certain directions in order to

attract innovation and you know so if

they were able to do that then yeah I

mean these sorts of things could

radically transform how people think

about developing medicines and at the

end of the day if we are able to develop

better medicines quicker faster cheaper

more ambitiously

everyone wins

>> yeah I've been so impressed with the

speed at which the department of health

in say Abu Dhabi or UAE even more

broadly speaking but it's incredible

>> how ambitious they are but in addition

to that how willing they are to take big

swings and accelerate things

unbelievably

>> that's the country we've spoken to the

least in the Middle East I will say

though I know that they have you know I

mean it's connections and it's spending

the time trying to decide like what

people want to do

>> y

>> I'm a believer in allied countries

coming together we run our trials in the

United States and Australia. I think

countries that share very similar values

on like the future of of the world need

to come together to build like

innovative solutions to the massive

problems facing us as like a human

species. It's not every country though.

>> No, it's not every country. Anything you

want to talk about just in the last

however many minutes we have?

>> I've actually taken a lot of way of I

don't know responding to how you're

responding to different pieces of the

story, right? I think I view it as

important to sort of tell the world

about this innovation and whether that

means finding the large sovereign

wealths of the world that are going to

help us like right now we are as a

company everything is working within our

technology stack. We sit here and look

at these problems of like gosh to use a

bad analogy it feels like Sophie's

choice sometimes around like how we're

going to prioritize what we're going to

work on. We can't work on everything.

The other overused analogy is robbing

Peter to pay Paul, right? It's like,

okay, this feels like I wish this wasn't

zero sum, but I have, you know, if we

look at what our technology can do

today, I look across and I'm like, okay,

we want to work on cancer, we want to

work on autoimmune disease, but also

like kidney is really interesting and oh

my god, we could do so much good if we

applied this in the crisper space and

all of these things. And so what I've

been trying to spend the last 6 months

and my time thinking about is like what

is the correct model for us to make sure

we are doing our diligence of advancing

medicine at the fastest rate we possibly

can.

>> There are so many different things that

we strand can work on. We need to find

various different partners. Sometimes

that's pharma partners that are like

we're interested in this disease area

and and it's very simple because the

biotech and pharma companies work

together all the time on partnerships.

But I'd say, you know, what's really

interesting is this opportunity, you

know, this global opportunity and this

broader opportunity to say like we could

do all of these different diseases.

We're we're fighting a resource

constraint at all times. So, how do we

find other people who want to

participate with us both intellectually

and capitalally with capital that can

help us build various different

solutions? Whether that's for diabetes,

whether that's for polycystic kidney

disease, whether that's for all sorts of

other indications throughout the world.

It'll take novel scientific models

because what we are doing is is

scientifically novel. So we'll need

different sorts of business models to

think about this. But you said something

earlier about my like frustration with

biotech's ambitions sometimes. And I

think it's just like God the Janentech

and Genzyme people used to do insane

things. Genzyme used to drive around

Boston collecting placentas from the

hospitals. They had a van called the

placenta mobile. They would pick up

placentas and then use them to purify a

protein that they were turning into a

drug for a rare disease. It was like the

ultimate founder mode of how do we stop

this disease? And somehow we're now

like, well, I don't know what would that

look like from a TPP and if FDA won't

think about a proven mechanism and it's

just [ __ ] exhausting. We got to just

get our entrepreneurial pants back on

and like try to fix disease. So, I've

just taken the few minutes you gave me

and diet trib

like more interesting conversations for

us to have on and off recording. Tim, I

love talking to you. You're just fun,

man. So,

>> yeah, we'll do more. We didn't even

really get into the platform aspect of

things. I I used the space X analogy of,

you know, the sort of

>> first principles

engineering payload agnostic platform,

right? We didn't even really get into

the platform. Are you leaning away or

leaning into the

>> kind of programming reprogrammable

>> language of around Strand? I'm leaning

away from the words programmable or

programming within there because

>> they get people confused about what a

what a platform is. Like in my new deck,

it ends actually with this piece of like

what Strand is, right? Strand is a

flywheel of various technologies, AI

models, manufacturing expertise like

talent that we have, you know, trade

secret, all these pieces that create a

flywheel of how we build platforms for

areas of the body that we want to

access. That's the platforms, right? So

tumor delivery is a platform. T- cell

delivery is a platform. We want to build

more of those platforms over time. We

build them as drugs like the ST00003

that's coming to the clinic this year 6

months ahead of schedule. That is a

drug, but it is a platform for tumors.

It's not a platform for everything you

want to do throughout the body. And

that's where people got lost. I think

that's where Madna got lost. They

thought your tumor platform also worked

for your liver worked for the kidney. We

could do everything with one platform.

It's just not true. And so what I've

been trying to do is help people

understand it. And it's the SpaceX

analogy kind of works well within this

because SpaceX over time built different

platforms for different use cases that

were more and more complex and took more

and more time and knowledge and they

used the learning. So Falcon 1 was able

to get single satellites up. It took

them a while to figure it out, but they

were able to perfect the landing and the

recovery and the reusability of a rocket

that was useful, but it wasn't super

useful. Then they had Falcon Heavy. They

were like, "Now we can take multiple

things up or we could take large

payloads up. We could take astronauts up

to the space station. We could do all of

these things." Then they have Starship,

right? Which is you can't start with

Starship. Even Elon 20 years ago being

one of the greatest fundraisers and

visionaries couldn't go, we're going to

build Starship. That's our first

product. You got to build the Tesla

Roadster to get to the Model 3. You got