From Cardiff to Cleveland and back: Developing a cancer biopharma ecosystem for Wales

Born in Cardiff, I spent my formative years in Cathays rolling alleys on the street for entertainment before, following a fortunate incident, moving to “The Burbs” and Dinas Powys. At age 11, I returned to Cardiff on the daily Thomas of Barry bus to attend Ysgol Gyfun Gymraeg Glantaf, where under the tutelage of Mrs. Elizabeth Williams and Mr. Berian John in the Biology Department and Mrs. Mary Thomas in Chemistry I decided medicine may be an interesting career to follow. As the family’s first “potential” university graduate I knew little of the subject, but it sounded fun. 

Return visit to the now much expanded Glantaf in 2023

I defaulted to my “local” University of Wales College of Medicine (UWCM) and was interviewed by the then Provost Sir Herbert Duthie, whose opening line was “With a name like Stiff I presume you want to be a pathologist”. Later in the interview he asked, “So why do you want to be a doctor” to which I naïvely responded, “Well it appears that as long as I behave myself, I will have a job for life”. He rested back in his chair, laughed and said, “Well that’s the first honest answer I heard today”.

My time at medical school was wonderful. The first two years at Cardiff University were spent studying basic science then up to the Heath Hospital (now Cardiff and Vale University Health Board) for the clinical years. My first two clinical attachments were medical and then came my first surgical block with Mr. David Crosby – I was sold! 

Thereafter, I switched all attachments I could, attended operating lists instead of lectures, and started research with the junior doctors obtaining my first authorship as a third-year student. The same year I wrote an essay on the “Current Status of Liver Transplantation”. Research included trawling through Index Medicus to identify papers of interest and then handwriting requests (these were the days before computers), driving to Birmingham to identify cases, find out there was a donor about to go ahead, attend the operation, fly the liver in a helicopter to Addenbrooke’s in Cambridge and watch the recipient operation. All this was with my college buddy Mike Nelson, now a surgeon on the IOW. 

Equally as memorable was the drive back from Birmingham, exhausted, in his red Ford Fiesta, windows fully wound down singing along to Marillion and trying to stay awake. I mention this cross-border experience as this defined my career and interest in the liver and, subsequently, pancreatic surgery (the two being intrinsically linked). 

At the end of the fourth year we undertook an elective at a location of our choice. I chose to spend two months with Dr. Thomas Starzl, the godfather of liver transplantation, at the University of Pittsburgh Medical Center. At the time the group was undertaking over 700 liver transplants per year in addition to operations for liver, pancreas, and bile duct cancer (HPB). He was also pioneering multivisceral transplantation and there were many 24-hour operations during which we took pizza breaks. I hardly slept for 2-months but left enthused and with lifelong friends many of whom subsequently circled back into my life.

University of Wales College of Medicine – graduation day June 1992 with members of the Cardiff Young Surgeons Drinking Society

I completed my studies, graduated medical school and commenced surgical training in Wales. Again, a thoroughly rewarding experience and numerous wonderful acquaintances. In addition to training in Cardiff, I spent time in Birmingham and at the end of my program I also spent time in Leeds supplementing my Wales-gained knowledge with additional skills in HPB surgery. Despite there being no option for a former lecturer position, I researched extensively obtaining three additional degrees and was rewarded with several honours including the Moynhihan prize, and the Medawar and Tanner medals. However, the most important was a Hunterian Professorship of the Royal College of Surgeons of England which I received for an oration given at the Welsh Surgical Society in Gwbert-on-Sea. Sadly, as there were no “dead man’s shoes” to step into, plans to expand the Welsh HPB unit were scampered. 

Through a surgeon in Leeds, I was recommended for a senior Fellowship at the Cleveland Clinic in Cleveland, Ohio. Although the pathologies I was encountering were the same as the UK, the experience in the US healthcare system was very different to the NHS and there appeared to be a lot of support for academia (a well that long since dried up in the UK). I returned from the US, dealt with a few “personal” issues, sat the additional exams, applied for a visa and returned as a staff HPB surgeon in 2014. Over subsequent years my clinical practice grew exponentially but despite earning a laboratory in the Lerner College of medicine, Case Western Reserve University the promised seed money never arrived. 

In 2019 I realized that many of the patients I was subjecting to six-hour cancer operations were developing recurrent disease and dying within two years. Current adjuvant therapies were clearly not doing the job and surgery alone was not a cure for most patients. After much contemplation I took the decision to leave clinical practice and that my new raison d’etre was to find new options for patients.

At the time I had been advising one biopharma company who had a natural molecule to treat glioblastoma (brain cancer) and they were looking for a clinician with expertise in the management of pancreatic cancer to guide them. This role expanded over a year or so to Chief Medical Officer and I started learning the “ins and outs” of the biopharma space. The Chief Scientific Officer of this company then invited me to join a second and then become a co-founder of a third. Before I knew it, I had also formed two companies of my own Glantaf Biofarma in Cardiff with Professor Keith Morris of Cardiff Metropolitan University and InCym Biopharma in Cleveland, the name highlighting the Indian and Cymru origins of the founders. 

The former is developing a new molecule from two existing natural molecules and targets inflammation in cancer and starting with pancreatic carcinoma. The second took advantage of supercomputer design capabilities and artificial intelligence to develop a small molecule to target a critical pathway in hepatocellular carcinoma (primary liver cancer). There then followed consulting roles for a number of companies in the cancer space one of which led to restructuring the existing company to form DEspR8 Therapeutics and acquisition of an antibody targeting activated neutrophils. This subgroup of white cells prevents the action of iimmunotherapy and so this new approach could provide great opportunities to gain benefit where existing treatments have failed. More recently, I expanded into biotech and developed my first cancer-treating device and am currently evaluating a second device that uses electromagnetic radiation to target cancers – an idea first proposed by Tesla.

With my family all in Wales, I have maintained regular visits to my homeland, but the benefits of networking increased the interaction in 2023. At a Cardiff University Alumni meeting in New York City in April, I met Dr. Cameron Durrant a fellow UWCM graduate who graduated several years ahead of me. Following a glass, or two, of wine and a little reflection we decided to work together to determine a means of giving back to both our alma mater and Wales. After initially working as a GP, Cameron had transitioned to working in the pharmaceutical industry, and had extensive experience in many executive roles in both big pharma and biopharma companies and this complemented my more extensive clinical-academic experience and my more recent transition to industry. 

After many video and in-person meetings we came up with a formula to help academics in Wales with commercialisation of their oncology assets which we entitled Cymorth Cancr Cymru. We connected with the Welsh Government, regional bodies, university officials, academics, and clinicians and held a meeting at Cardiff University in October 2023. There was unanimous support for the project and so the next step is fundraising. We are looking to a multi-faced blended finance approach including both institutional and philanthropic support. In relation to institutional investors, as well as Welsh, UK and local government sources we are approaching pharma/biopharma companies with a view to partnering in return for first right of refusal of future assets, and also attempting to draw a contract research organisation to Cardiff as a partner in development now and into the future – as Wales does currently does not have such preclinical services. We are also proposing that we approach venture capital funds with our slightly unconventional proposal.

If this is something of interest, please get in touch with me via GlobalWelsh Connect