Peter Attia MD346 - Scaling biotech and improving global health: lessons from an extraordinary career in medicine
At a glance
WHAT IT’S REALLY ABOUT
Susan Desmond-Hellmann's Path From AIDS Wards to Genentech, UCSF, Gates, OpenAI
- Desmond-Hellmann describes training at UCSF during the early AIDS epidemic and working in Uganda from 1989 to 1991, where she triaged Kaposi sarcoma patients with limited chemotherapy.
- She recounts how serendipity moved her from private oncology practice in Kentucky to Bristol Myers Squibb, where she led Taxol, and then to Genentech, where she worked on Herceptin, Rituxan and Avastin.
- The conversation walks through drug development from preclinical work and IND filing through phases I to III, plus the pricing controversy over Avastin's cost versus its modest survival benefit.
- She discusses leading UCSF as chancellor through the 2009 recession via philanthropy, then running the Gates Foundation, where she applied portfolio management and defined culture as bringing out the best in people.
- She and Attia discuss lost public trust after COVID, ivermectin misinformation, and AI's promise in clinical trials, healthcare burden and biomarkers, along with her skepticism about liquid biopsies.
IDEAS WORTH REMEMBERING
5 ideasSerendipity shaped her career
Her husband's insistence that Bristol Myers Squibb find a role for her led to a consulting job on Taxol safety, and she later became its project team leader; she calls herself a poster child for serendipity.
Antibodies changed oncology
She explains that Herceptin and Rituxan worked as naked antibodies against skeptics who thought solid tumors needed more powerful agents, and that antibodies can be re-given after relapse unlike chemotherapy such as Taxol.
Hitting cancer smart beat hitting it hard
At ASCO, Herceptin's success was announced as bone marrow transplant for breast cancer was debunked, and she says the lesson was that hard treatment wasn't the point.
Diagnostics must be developed in parallel
FDA refused to approve Herceptin until an approved HER2 test existed, and she says Genentech's failure to develop one alongside the drug was an inexperience-driven mistake.
High prices created access concerns
A Wall Street Journal headline asking whether breast cancer patients could afford Avastin was the first time she saw a Genentech drug framed as unaffordable, prompting more executive discussion of pricing despite patient support programs.
WORDS WORTH SAVING
5 quotesPeople felt like you just needed to hit the cancer hard. You just needed to hit the cancer smart. Hard wasn't the point.
— Susan Desmond-Hellmann
I define culture in a really specific way, that when you come to work, you feel like the atmosphere, the surround sound brings out the best in you. And that you have some ownership of tweaking it if it doesn't.
— Susan Desmond-Hellmann
The sense of how bad HIV was before antiretrovirals, it's impossible to overstate it. Just impossible.
— Susan Desmond-Hellmann
Work never fills in for home, ever. It never makes up for bad home.
— Susan Desmond-Hellmann
I think using AI more and more on pieces of the clinical trials process so that if something takes time, it's because it's benefiting a human, not because we just couldn't do it fast enough.
— Susan Desmond-Hellmann
High quality AI-generated summary created from speaker-labeled transcript.
