Paul Romness

This transcript was edited for readability: Henry Harrison Podcast — Entrepreneurs, Business & Finance Guest: Paul Romness Henry Harrison Well, good afternoon, Paul. Welcome to Entrepreneurs, Business and Finance. Paul Romness Hey, Henry. Henry Harrison Paul is one of my very good friends. Even though we live in separate cities now, we grew up together in Arlington, Virginia. Paul is still in Arlington, and when I go up to visit, which I like to do fairly often, I’ll often stay at his house because he’s a very generous person. I was thinking before this call about all the things we’ve shared over the years. We were at each other’s weddings. Our parents were friends. We’ve been to funerals together, unfortunately. We’ve spent a lot of time together over the years. Our brothers are both doctors and both trained at the Mayo Clinic, as did your father. I used to go see your father if I had various orthopedic injuries. I played golf with your dad. And of course, the story still goes on, so I’m very glad to have you here. Although I know some of the story, I also know it’s an extraordinary one. We played a lot of golf together, and I actually had the best shot of my life playing with you down in Dallas one day. Paul Romness That’s right. I remember that very well. Henry Harrison I wanted to have you on because this story is exciting, and your daughter is part of it too. You had a long career in the biopharmaceutical industry, but in the last number of years you took a big chance — one that I think is going to pay off for you and for a lot of other people — and became a full-fledged entrepreneur. How did that get started, in your own words? Paul Romness As I often say, doing startups is no country for old men. But I remind myself that the founders of Home Depot, Bernie Marcus and Ken Langone, didn’t start Home Depot until they were about 55 years old. So we’re not too old to do this, Henry. That said, I’d still recommend entrepreneurship to people a lot younger than us. We started the company because this disease found us. I had been in the biopharmaceutical world my entire career — Johnson & Johnson, Amgen, Boehringer Ingelheim — but it wasn’t until my daughter’s best friend, and the daughter of some of our best friends, was diagnosed with this very deadly bone cancer called osteosarcoma in February of 2017 that everything changed. I’m looking out the window from my house as we talk, and I can literally see their house from here. I know I’m ruining the suspense, but I’ll tell the end of the story first: Olivia is doing great. She has now been cancer-free for six years, and she sits on the board of OS Therapies. But when she got sick, there weren’t many options. About half the kids who get this disease end up dying from it. We wanted to make sure we changed the odds for Olivia, and in the long run we realized we might be able to change the odds not only for kids with osteosarcoma, but maybe for other solid tumors too. Quite frankly, it would be my life’s work just to improve survival for one rare disease. But if we can eventually help with other solid tumors as well, that would be extraordinary. The biopharmaceutical industry has done a really good job with many blood cancers, but solid tumors have remained especially challenging. With osteosarcoma, as with breast cancer and many other solid tumors, the disease often presents as a solid tumor that can be removed. The patient gets blasted with chemo and radiation. If the disease doesn’t come back, they’re fine and they go on to live their lives, though sometimes with side effects. But in about half the kids with osteosarcoma, it comes back. And when a solid tumor comes back, it usually doesn’t come back where it started. These little micrometastases are looking for two things: oxygen and soft tissue. So they often end up in places like the lungs or the brain. And once that happens, survival rates drop dramatically. So what we wanted to do was find a way to prevent those little Darwinian survivors — the ones that make it through chemotherapy and radiation — from landing in the lungs and brain. We first started a nonprofit. My daughters were involved in that, and Olivia’s father helped start it as well. We’ve raised around $3 million for osteosarcoma research. Then about a week before we had a group of doctors coming into town to teach about the importance of genetic testing, I read in one of our industry trade magazines about a technology that was being abandoned. I understood why it was being given up, because osteosarcoma is a rare disease, but I also realized there might be an opportunity there. That led us to build OS Therapies around osteosarcoma, and eventually around the broader potential of treating other solid tumors too. Henry Harrison I remember that part of the story very clearly. And I remember too that at one point you were looking not just at one cancer, but at how the same platform or scientific insight might apply to several, and then from there perhaps to even more. So while the company starts with osteosarcoma, the path forward potentially opens into much larger areas. Is that a fair way for a layman like me to understand it? Paul Romness Yes, that’s fair, and there are really a couple of pieces to it. When we first started, we started with the nonprofit. That nonprofit — along with seven or eight other nonprofits — has invested in the company, because their mission is to advance research. So we currently have a clinical trial going right now, and that trial is being funded through those investments. It’s advancing research, and it’s going well. We have 41 kids enrolled across 21 different facilities — children’s hospitals around the country — and they are receiving our therapy, which stimulates the body’s immune system to go out and fight those micrometastases. Now, even if that trial ultimately failed — and I don’t think it will, because it appears to be going well — the nonprofit mission would still have been fulfilled, because the money would have advanced research. But if it succeeds, then we’ve done more than advance research. We’ve actually helped bring a new treatment to market. There’s a very good precedent for that. Vertex, for example, was financially supported years ago by the Cystic Fibrosis Foundation. Eventually, the Cystic Fibrosis Foundation sold the royalty stream from that investment for billions of dollars. That allowed them not only to keep funding treatments, but also to work toward cures and prevention. That’s really the ultimate mission of disease-focused nonprofits: treat, cure, prevent. Now, to your second point: when we first started as a company, we were basically a one-hit wonder. We had one technology focused on osteosarcoma. As a business model, that’s challenging. If that one program fails, you’re done. So we wanted to broaden our platform in a way that still made scientific sense. Our first technology is really aimed at preventing those micrometastases from landing and growing. But we also brought on another technology that’s very hot in biotech right now: antibody-drug conjugates, or ADCs. I often describe ADCs as a kind of cruise missile with payloads attached. There’s a targeting ligand that directs the whole system to where the cancer is located, and then these little linkers — in our case, silicone-based, pH-sensitive linkers that are part of our intellectual property — are broken down in the tumor environment, which releases multiple payloads into and around that cancer environment. The idea is to debulk large solid tumors. So our original platform is about preventing those micrometastases from taking hold, and the newer ADC platform is about directly attacking larger solid tumors. Those two technologies complement each other very well. Henry Harrison From a business standpoint, one thing I admire is your perseverance. I know this takes a lot of stick-to-itiveness. And I also know — because you’ve been public about it — that you’ve put your own retirement money into this. So it’s not as though you were sitting there with an extra pile of money and no pressure. You really committed. Paul Romness Yes. There was an article in Arlington Magazine, our local community magazine, that told the story of why we started the company. There was only one real misquote in the entire piece. It said that I had told the reporter that I cashed in my retirement to fund the company. I never actually said that to her. My chief medical officer told her that. But yes — it’s true. My daughters’ college funds are in this. My retirement funds are in this. The boat has pushed off the dock. Henry Harrison That’s also the story of a lot of entrepreneurs I’ve known. Whatever people think of Elon Musk, I’m reading his biography right now, and he has essentially risked everything several different times over in his life. But I know for you, this really is about saving lives and making a contribution. Paul Romness Absolutely. And I learned this at Johnson & Johnson: every decision we make starts with the patient first. You ask what is in the best interest of the patient. Then you think about caregivers, the community, and ultimately the shareholders. But if you do the first three right, the shareholders generally do just fine. This is what I call a do-good, do-well investment. To be part of a mission that helps bring treatments to kids with a rare disease like osteosarcoma — it’s hard to describe how meaningful that is. And again, if we can extend that into other solid tumors, then the impact becomes even larger. Henry Harrison That really is inspiring. And it sounds like, scientifically and clinically, the company is taking the right steps and making progress. You have to have steps along the way. So congratulations on those first important steps, and I believe there are going to be many more successful ones to come. Thank you for sharing this from the heart, because I know you, and I know it really is patients first for you. Thanks again. Paul Romness Absolutely. Thanks, Henry. Talk to you soon.