Tune in to this episode with Dr. Neil Sankar as he tells us about his journey as a physician leader in the pharmaceutical industry, his tips for those wanting to get into pharmaceuticals and how he finds time to relax. If you are thinking about getting into the pharmaceutical industry, you will find this episode extremely helpful!
“You know, after the drug gets approved, it’s a feather in your cap. You have been part of an NDA, that’s great. Your value goes up. But after that, what do you do?” -Neil Sankar MD, MPH
In this episode, DocWorking Founder and CEO, Dr. Jen Barna welcomes Dr. Neil Sankar. Dr. Sankar is President and Chief Medical Officer of SwanBio, LLC, a business development consultancy firm that facilitates the translation of scientific discoveries into cancer therapeutics. Dr. Sankar has over 16 years of experience in life sciences clinical development, pipeline strategy, clinical safety, and pharmacovigilance. Dr. Sankar shares his wealth of experience in the pharmaceutical industry with the DocWorking audience. He tells us about his journey, his tips for those wanting to get into pharmaceuticals and how he finds time to relax. If you are thinking about getting into the pharmaceutical industry, you will find this episode extremely helpful!
Neil Sankar received his MD degree from Bangalore University and internal medicine residency from University of West indies, Kingston, Jamaica and trained in the UK and the Caribbeans. He holds a postgraduate degree in public health from Queensland University in Australia.
Dr. Sankar got his training in clinical research and tumor biology from NCI Bethesda Maryland and since has held Clinical Development positions within leading Biotech/Pharma including Genentech, Medimmune, Pharmacyclics, FiveprimeTherapeutics, Portola, Loxo Oncology, Otsuka Pharmaceuticals, Elevar Therapeutics, Boston Biomedical, Effector Therapeutics and Rhizen Pharmaceuticals to name a few.
Dr. Sankar is President and Chief Medical Officer of SwanBio, LLC, a business development consultancy firm that facilitates the translation of scientific discoveries into cancer therapeutics. Dr. Sankar has over 16 years of experience in life sciences clinical development, pipeline strategy, clinical safety, and pharmacovigilance. He has extensive experience in the application of US Food and Drug Administration regulations and the Good Clinical Practice guidelines set forth by the International Council on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use. He has acted as Medical lead in numerous phase I, II and III clinical trials in the therapeutic area of oncology ranging from solid tumors, connective tissue tumors to hematological malignancies including, CLL/SLL, B cell lymphomas, T cell Lymphomas, Acute Myeloid Leukemia and Hodgkins Lymphoma. He is an expert in providing global clinical development and regulatory strategies for therapeutic drugs and was instrumental in filing the New Drug Applications for the antibody-drug conjugate in Metastatic Breast cancer and the Bruton tyrosine kinase inhibitor in Mantle cell Lymphoma. Dr. Sankar has extensive experience in designing and deploying data capture tools that evaluate the efficacy and safety of clinical trials. He also has extensive experience as a member of drug safety committees and advisory boards of few companies including Leukemia Therapeutics and iNDX Technology. Dr Sankar has led or has been part of FDA/Regulatory Authority discussions for various companies pursuing IND and NDA applications including Pre-IND and Pre-NDA F2F meetings.
Dr. Sankar is an active member of the American Society of Clinical Oncology (ASCO), the American Society of Hematology (ASH), the European Hematology Association (EHA , Drug information Association (DIA) , European Society of Clinical Oncology (ESMO), American Association for Cancer Research (AACR), Enterprising Pharmaceutical Professionals from the Indian Sub-Continent (EPPIC GLOBAL), Connective Tissue Oncology Society (CTOS), IACA and TiE Silicon Valley.
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Please enjoy the full transcript below
Dr. Neil: You know, after the drug gets approved, it’s a feather in your cap. You have been part of an NDA, that’s great. Your value goes up, but after that, what do you do?
Jen: Welcome to DocWorking: The Whole Physician Podcast. I’m Dr. Jen Barna and today, I have a terrific guest Dr. Neil Sankar, a leading physician in the pharmaceutical industry, who has held clinical development positions within numerous pharmaceutical companies. Dr. Sankar is President and Chief Medical Officer of SwanBio, LLC, a business development consultancy firm that facilitates the translation of scientific discoveries into cancer therapeutics. Dr. Sankar, welcome to DocWorking: The Whole Physician Podcast.
Dr. Neil: Thanks for having me, Jen. Good morning. Good afternoon viewers, wherever you are.
Jen: I’m so interested in hearing about your journey, because you’ve had tremendous success, you’ve had a career where you’ve made such a difference in numerous therapeutics to treat various forms of cancer, and I’d love to hear when you decided to go into the pharmaceutical side, and do you practice clinically as well or–?
Dr. Neil: No, no, not for the last 20 odd years.
Jen: If you would, tell me a little bit from the beginning. How did you decide to get into pharmaceuticals? I think a lot of our listeners are curious about that. It’s not something that most of us know much about.
Dr. Neil: Absolutely, Jen. I think you nailed it. I stumbled upon it even though I was not aware of it. I’m originally from the southern part of India, a state province called Kerala. That’s where I’m originally from. Moved to the US, I think, at the end of 1998. I did my USMLE Step 1, and I came into the US to do my Step 2, and then pursue my career as a clinician. At that time, interestingly, I got an opportunity to work in the National Cancer Institute, which is under the federal government health and human services. I got my medical oncology training there. I’m primarily an internist, but evolved into a medical oncology, primarily due to my training and work environment there. Interestingly, NCA was looking for foreign clinicians to support their Phase 1, Phase 2 programs, which are funded by their own– which is [unintelligible [00:02:34]. That’s where I stumbled up on this.
Clinical research was very new to me. I had heard about it, but it’s like a story. It’s not something– Then, I went on continuing that for almost four years at the National Cancer Institute. I had the privilege of working with some very big names in the lymphoma field there and then started getting more interest pursuing that career path. After four years of my involvement in NCA, I moved into the industry, and then, kept on moving with different companies. Now, I have my own startup. SwanBio is a medical consulting firm. I’m the only one there primarily doing as you nicely pointed out. Translational science to getting these therapeutics approved, whether it’s biologics, small molecules, you name it, that’s where my role comes from and that’s what I’ve been doing since 2014. I’ve been consulting from this company SwanBio, been consulting with a few clients and now I’m also part of the executive management of a few startups. I don’t know if I can reveal that, but one of them is going IPO very soon this year. Again, touchwood. We don’t know how the market is going to go, but looking forward to the journey, too.
Jen: So, just out of curiosity, is the startup that you’re involved in that’s going public, is that a pharmaceutical–?
Dr. Neil: Yes, it is. Absolutely, it’s a therapeutic pharmaceutical company and we have assets primarily in oncology and inflammatory space.
Jen: Okay, great. There’s a lot here that we can talk about. For starters, I would just love to know for someone who’s thinking about perhaps a career in pharmaceuticals, would you say that it is something that really should be a decision made very early in a career?
Dr. Neil: It depends. That’s a very good question, Jen, because a lot of the people keep trying to move back to the industry being in academia, for example, or clinical care at the hospital setting or tertiary care center, you name it. The problem though is I tell people, a lot of them reach out to me, I work with clinicians primarily. Pharmaceutical companies, biotech companies are my client’s, but then I also interact primarily with all the KOL’s, Key Opinion Leaders in cancer and principal investigators. These are all leading clinicians. People all the way range from starting academia to a very senior level [unintelligible [00:05:18] so forth.
One thing I would like to let them know is, you can do that from the start, because when I started my career, I wouldn’t say there were a lot of options available in that sense. I don’t remember at least seeing courses primarily. There are some certification courses, but they were all very low key, but now, you have very specific courses, whether it’s in biometrics, data management, and also in clinical research, clinical development. There are a lot of very tailored and expansive courses now. People have to go through that, see what their interest is, because even in pharmaceuticals there are different avenues. You can be in the preclinical lab setting because there are a lot of clinicians who have their own lab, even if they are working in the academia where they do research. There is also inpatient care. There are a lot of clinicians who move into safety management within pharmaceuticals, and then they go into medical affairs, for example, medical affairs and commercial, which is like after the drug gets a regulatory approval, for example, FDA. Then, they go into commercial medical affairs. That obviously involves a lot of traveling, 60% to 70% of travel. They have to figure out where they want to be.
One thing I would always caution people though is it’s a very stressful place to be in generally, because when you’re coming from academia, you deal with the patient care, but you probably know how your day goes most of the time. Whereas in the pharmaceutical industry, things could change by the hour, especially if you’re working in a small company. If the data doesn’t look good, there’s a safety issue with the drug, you’re learning that, FDA shuts down that trial due to patient safety, you are gone. Next day, you don’t have work. It’s a very stressful place to be in, but every job has its own pros and cons. That’s how I would put it. But people have to be aware of that. Yes, there is money there. I think the industry pays you more than what you obviously make in an academic setting or anything. Definitely more, but it comes with its issues too.
Jen: When you started out, did you go the lab route or more administrative?
Dr. Neil: Oh, I’ve been into clinical development, more on the clinical side, I never touched the lab. My role starts from, let me put it this way, late translational, you finish testing in the lab, you finish testing on the animals, now, you are ready to enter the clinic, that’s when I start my role. From then on, I take the drug all the way up to regulatory approval.
Jen: When you were first starting at NCI, how did you see the opportunity to go into pharmaceuticals and what was your entry point?
Dr. Neil: Yeah, that’s a good question. When I started working on it, I always liked science, because I was always strong in biology in my school days. I always had that science niche and I liked it because I get to work with new therapeutics. When you are in the clinical setting, yes, you are saving patients’ lives, you’re treating the patient. But for me, I am working on getting those drugs into the market. To me, that’s more enticing because I get to see work with these drugs.
This particular job, I also have to be very involved. I also had to do a lot of training. It’s like you are a practicing clinician. You have GCP training, you have a lot of SOPs, you do it. There’s tons of training. Because this environment is a very regulated environment. Whatever you do, you have to document it. Because if you don’t document it based on the regulatory agencies’ thoughts, it’s not done. If it’s not jotted down, it has not happened. It’s a very, very regulated environment. So, that’s how I moved into that, so I was very intrigued by the science. That was the shift for me.
Jen: You came in on the regulation side?
Dr. Neil: No, no. No, I came on the clinical side, but what I meant by regulation is the whole industry is very regulated. It’s like everything, because the moment you take a drug to approval, regulatory agencies do audits. Whether they do a total audit of the company, they do an audit of the product. Everything is looked through the lens. It’s a very tedious year-long process. Once you submit the approval package, it takes almost a year for the FDA to review it, because there’s a whole set of reviewing processes happening at that time.
Jen: Yeah, and that’s a great point, which brings us really to what you’re doing now. Having worked for a pharmaceutical company startup way back before I went to graduate school and medical school, I know a little bit about the process of drug discovery and what a difficult road that can be for a small startup company. So, is what you’re doing assisting those companies to bring their product to the market?
Dr. Neil: Exactly. That’s exactly my role. I start from designing the clinical trial to designing the whole clinical strategy, how should we take it forward, what is the therapeutic, what is the cancer type you need to go in, should we take a combination strategy, should we combine our drug with something else and go or should we go take an independent route like just our drug? There’re a lot of things involved. Those decisions should be made based on what is out there for this particular cancer, how crowded is the market? Because a smaller company, you don’t want to be in a situation where you are catching up. You are never going to catch up with big pharma. You don’t have the financial muscle or the people, capital muscle or anything, headcount. Working with a few, maybe 10, 20 people and then we outsource it to a CRO. So, for us it’s very, very important. Clinical strategy is the most key thing. How do we take it to the market in the quickest way possible rather? Yeah.
Jen: Now, what is the earliest stage that you begin working with someone? Say someone is in academics, and they are doing research, and they have an idea for a potential product, at what point would they potentially reach out to you for help in terms of creating a startup? Would it be after they’ve already got the startup and then they’re looking to get to the next phase or would it be prior to starting?
Dr. Neil: That’s a good question. The timeframe they would reach out to me is, we will be in early discussions in the sense where it’s going. But the time point when they want me hands on would be when they are ready to enter the clinic. That’s how I would put it. That means when they are ready to start their Phase 1 early clinical trial program first time in human testing, that’s when ideally– I start working earlier, but that would be the ideal timeframe, I will start coming into the play.
Jen: Perfect. Good to know. Now, I would like to shift gears and ask you a little bit about your journey delving a little bit further, because what you did if I understand what you’re saying, you came to the US, you were already a physician, and you began working at NCI, and you saw this opportunity to go into the pharmaceutical industry, but you took it so much further than just that, and we’ll publish in the show notes a list of all the different pharmaceutical companies where you’ve worked and clinical trials, Phases 1. 2, and 3, and the body of work that you’ve accomplished is impressive and extensive. I would love to know, if something might come to mind for you of a time that you saw some struggles in this achievement, what was the journey like? Was it just a simple straight path to success all the way? How would you describe it?
Dr. Neil: That’s again a very good question. Not easy, but at least for me it didn’t come easy. The way I did it was I timed it well, but I also used to network quite a bit during my early phases of the career. I would like to encourage my viewers to professional networking. That’s what I meant. It is very, very important, because especially the biotech pharma industry is a small world. If you work 15 to 20 years in the industry you will pretty much know a lot of people. Let me put it that way. You may have worked with them directly or indirectly, but they know you, you know them. It’s like that. “Yeah, I have heard about him through so and so. Yeah, I have worked with him.”
The way I would put it is, it didn’t come easy for me and I moved along. Within the industry, one thing you would notice is, within clinical development, the clinicians within that space, I would say at least 60% to 70% of them move out of the company. Normally, a journey of a drug is probably five to seven years. What happens is, for example, somebody is joining a company in the middle part of the lifecycle and then he or she takes it to approval, after the drug gets approved, it’s a feather in your cap. You have been part of an NDA, that’s great. Your value goes up. But after that, what do you do? The drug is approved, there is kind of– Do you want to stay here, go, see, they have another drug or another team you could move into, because that’s where a lot of people do leave. They probably go to a startup or they go to a different company, because at the end of the day, you need to keep yourself motivated. You can’t just stay. So, that’s what I did.
I moved out two to three years ago and that helped me out. Then, I moved into the Bay Area, maybe 11 years back, and then moved to Genentech, got a great job, and a great company at that time. Even now, they’re great. That’s when a lot of things started changing for me. I started networking more and then, I moved on to Pharmacyclics, which was another great company I was involved with. I was involved with NDA there for one of the cancer, hematological malignancy. So, I got two NDAs and then I decided to start my consulting firm, moved on, met some great mentors, things like that during my journey.
Jen: How much would you say mentorship has affected your journey?
Dr. Neil: When I say mentors, there are two types of mentors. One is like when you’re in the lab, when you are doing research, there is mentorship. Then, at work there could be mentors, your boss or somebody you are working with, think about this. When you’re working on a project, they may be more senior than you, they may give you some touch points which you can cling on to. That has helped me. That has helped me boost my confidence and things like that. One of the people I would like to say is Dr. Robert Sikorski, he is a great– He was the CMO when I was in Five Prime Therapeutics. Great guy. Even now we work on projects together, a great clinician. He has played a role. Dr. Sunil Sharma, he is now a teacher in Arizona. So, these are some names. I like to give a shout out to them.
Jen: Terrific. You mentioned the very grueling nature of this type of work. How would you say that you managed to balance work and life outside of work as you were pursuing your career aspirations?
Dr. Neil: All the questions are great. You guessed it right. 80% of my time was devoted to professional work, because especially when you’re going up the ladder, you take more responsibilities. Now, I’m a small business owner if I may say. There are a lot of sacrifices you have to give, that is one thing. I think this question leads into another point, which is very important. When people think of moving– I get a lot of calls. Even a couple of weeks back, a medical oncologist called me from Mayo Clinic and they wanted to pursue a career from academia to industry, and they were talking to me and things like that. This is what I told them. It’s not easy. There has to be some sacrifices you have to make, because it’s not like you’re in an academic setting. Academic setting is as busy as cities, but this is much more, much, much more. So, I sacrificed quite a bit to develop my professional life.
Jen: Do you have any tips for ways that you found to actually balance the wellness and care of yourself as you move through those grueling work schedules?
Dr. Neil: Yes. What I normally do is, my work also used to involve a lot of traveling. I go to at least four or five conferences a year like ASCO, then AACR, ESMO, ASH, [unintelligible [00:19:28] some years. That is one set of travel. Then, on the second set of travels, I go to meet up with the KOL’s big academic centers. The clinicians who are part of our network in the sense who are doing the clinical trial, these are some of the people I get to work with very senior high-profile investigators, because they also like to put their name to work with new innovative drugs. You get a chance to publish things. You get to work with these novel therapeutics. So, I have to fly to meet them, talk to them about the project. They are a part of your key advisory team, so I have to always keep them informed and things like that.
What I do is, travel is some time where I wind down. As long as you figure a way out to– For example, I’m traveling coast to coast, I tried to sleep in the plane and catch up, because at that time I know I cannot work. In the sense, there are some slides or something I’m doing I can. But I take a quick nap if I can for three, four hours, and then, also plan my day, and make that time just for myself, not very focused on work and things like that. What I would say is try to space it out and see if you can have some time to take it for yourself, however. I do it when I’m traveling.
Jen: Do you have hobbies that you pursue outside of work?
Dr. Neil: Absolutely. I used to go hiking, all those outdoor activities. I like driving and hanging out with friends. I have friends all over. Primarily, they are clinicians. I also have friends who are not clinicians, but most of them obviously are. I hang out with them, spend time with them or family time. We all get together and things like that. That’s what I do. Because when I get a chance, I run for a quick run, quick jog and come back. I have hurt my knees recently. So, I’m trying to slow down a bit. But otherwise, that’s what I do.
Jen: When you travel, because I’m sure you do have connections all over the world, probably. Are you able to incorporate some time out visiting the friends that you have that may be not related to this specific trip, but friends, perhaps from other connections.
Dr. Neil: Yes, for example, when I go to ASCO, I have my cousins there. ASCO always happens in Chicago. I think it starts at the end of May or the very first week of June, five, six days. I have my cousin there. I make it a point to visit them every year when I go there. Not the last two years, because of COVID. The meetings were virtual, but other ways I make it a point to go and visit them however busy I am.
Jen: If there’s one piece of advice that you could give to someone, who is early to mid-career, who’s considering going into the pharmaceutical industry, a physician or other healthcare provider, what would your advice be?
Dr. Neil: Make sure that’s what you want to do, because if you have a family or especially if you’re starting a family and things like that, you have to be open to these long hours. Travel also comes. You also have to travel, because especially if you are in clinical development, you have to go to these meetings [unintelligible [00:23:03] and also you have to go to academic centers, meet with these clinicians and things like that. There is travel involved. Also, if you have a family, raising a small child, and things like that, just be cautious. Cautious in the sense, be open to it. That’s what I tell people. I’m not scaring anyone out, but be open to it. Don’t think it’s very easy to work in the industry. I can tell you it’s a very monitored industry. Everything is monitored. Bottom line, you have to be very detailed in whatever you do. You have to be very attentive and detailed. You cannot mess up.
Jen: How can people reach you if they’re interested in learning more about what you do with your consulting business?
Dr. Neil: Yeah, absolutely. They can reach out to me, Jen, through my email. Email is always available in the sense I’m connected. So, Neil Shankar, N-E-I-L, my last name with the H. So, S-H-A-N-K-A-R, my name doesn’t have the H, but the email has, [email protected]. My LinkedIn also is a good way. I have made my profile public. I have around 31,000 followers. They can reach out to me. But one thing I would also caution them is, I would like the communication to be focused more on a professional side, but absolutely if they want to talk about the career path they want to choose, I always will set aside time for that.
Jen: Thank you. This is a really valuable conversation. Dr. Neil Sankar, thank you for joining me today on DocWorking: The Whole Physician Podcast.
Dr. Neil: Thank you, Jen for having me. It was great chatting with you.
Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you so much for listening. Please don’t forget to like and subscribe and head over to docworking.com to see all we have to offer.