Clive Morris
There's no rule book of what to do, and something about me, I like doing things where there is no rule book.
John Simboli
That's the voice of Clive Morris, CEO of Inivata, headquartered in Cambridge, UK. Listen in now to hear my conversation with Clive, his thoughts about leadership in biotech, and advances in non-invasive liquid biopsy to unlock genomic information and guide personalized cancer treatment.
John Simboli
I'm John Simboli. You're listening to BioBoss.
John Simboli
Today I'm speaking with Clive Morris, CEO of Inivata, headquartered in Cambridge, UK with facilities in Research Triangle Park, North Carolina, Clive, welcome to BioBoss.
Clive Morris
Thank you, John. Pleasure to be here.
John Simboli
Clive, how did you find yourself as CEO at Inivata?
Clive Morris
I've actually been with Inivata now for just over four years and actually initially joined as chief medical officer. I'm a clinician by training and held various different roles. And I was intrigued by the potential for circulating tumor DNA and Inivata, specifically, for a great company to join. So I joined, as I say, about four years ago. And then about two years ago, I took on the CEO role,
John Simboli
When you joined, was it at that point in your career when you were sifting 100 different opportunities and thinking, this looks like the right one or was it more a case of, huh, this presents itself rather clearly?
Clive Morris
Probably a combination of both of those things is the honest answer. So I'm always looking around in terms of very exciting areas and technologies and companies. I've spent a long time, a large part of my career in large companies, in large biopharma. So I had a lot of great experiences there. But I was clear at the time I joined Inivata, I was really looking for a small company role, small, dynamic, something really innovative, and something quite frankly, challenging. So something that not only that I hadn't done before, but quite frankly, nobody had done before would be great.
Clive Morris
So there's no rule book of what to do. And something about me, I like doing things where there is no rule book. So when I came across Inivata, I was aware of circulating tumor DNA from my time in large pharma and liquid biopsies, but at the time were very much breaking science not really established. And I liked the area, as I looked at it as both a clinician and a drug developer. I thought, if there's an area that's going to explode, the potential for helping patients, this is a huge bit of a departure for me. I'd spent most of my time in therapeutics developments. So to work on the diagnostic side of things was a challenge and the fact that there weren't any ctDNA products out on the market at that point, and they were still very early on, and just saw a great opportunity to shape something here that could really help patients. And met the teams and great people, some fantastic scientists and the early team at the time. And yeah, I was employee number 11. I think when I joined the company, so fairly early on, and yeah, the hunch proved correct. And we've now got our first product on the market in the U.S. fully reimbursed and helping patients with lung cancer, which is fantastic.
John Simboli
My understanding is that you are a physician by training and that I imagine that the opportunity to get a little closer to the lives of patients must have been appealing as well.
Clive Morris
I trained, general medical training, and then I was a surgeon by training and did GI surgery, and then a bit of time in oncology. And then I joined the biopharma industry—longer than I'd like to admit now, so quite a while, but about two decades ago. And actually, I've had a great time working across Europe and both in the US in groups and in Asia at times as well. So most of that time in oncology, but a little bit of time elsewhere, but in everything from what we now call translational science through to commercial stage projects and everything in between, Investor Relations.
Clive Morris
And it's one of the wonderful things about working in a large company is there's many different places that you can really develop your skill sets and whether you want to be very technical and deep or broad, there's a lot of good aspects of working in the company. So I spent the best part of 15 years in the large pharma industries, learned an awful lot. But I was hankering after the small company experience of something that was a little more dynamic, something that, actually not being a specialist and being more of a generalist I enjoy when every day is different. While there is a calendar, generally at the end of the day, the day has looked very different from what it looked like at the beginning of the day, because there's always things cropping up and I just liked that variety and ability to either be helpful or I'll stick my nose in, depending on who you ask, to in a whole host of different areas.
John Simboli
I've talked to a couple of CEOs who said, they were ready to make that move from big pharma to running a smaller company. And yet, in a very positive way, similar to what you just said, I remember a couple of CEOs remarked something like, I did get training in leadership which turned out to actually be very helpful once I got underway having to run the show. Is that your experience as well?
Clive Morris
So there's a lot of good things with biopharma, not just the type of opportunities or the types of roles, but, yes, leadership development. So, I was fortunate to have gone through various talent development programs, did a range of courses, and a Harvard senior leadership course as part of that, amongst other things, I did an MBA along the way, as well. So I got a lot of very good training, which I like to think I benefited from at the time, from those things clearly. But I think also, along with the experience of managing groups of different sizes and interacting internationally and different cultures, from working with scientists through to people in sales and marketing, they have different cultures in the different groups, but also different geographies and fantastic learning environment for that both the formal and the informal training.
John Simboli
How did you decide you wanted to lead a biopharma company and I think the key word there is lead?
Clive Morris
I've always liked to be able to get things done and I love to take on challenges and I think naturally gravitate towards those leadership roles, rather than cookie cutter, follow up process type roles. So I'd like to do that. I like to be able to make an impact and actually see something that at the end of the day, make a difference. And what we've done at Inivata here now that the fact that there are patients with advanced lung cancer, who've had our liquid biopsy technologies, who have been spared invasive tissue biopsies and other things. So they get the results that get to the required therapies. And that saves the side effects, from the discomfort of those, but it's very tangible in terms of helping patients. It's not quite the same as sitting across the desk or across the bed in the physician sense but what you lose in that sense, I gained by just the potential breadth of the numbers of patients who can be helped by the technology. So I just think about it as helping patients in a different way.
John Simboli
What were you hoping to achieve at Inivata that you felt you couldn't achieve someplace else? What was the specific draw?
Clive Morris
I think it was a mix. I think it was looking for a role, exciting dynamic, small company environments, in terms of having a broad role across many different areas, I think is appealing. And I think the transformational nature of the technology and the platform that we were developing. And,I think the ability to be able to bring that out to patients, but also to have felt that having made a big impact in that of not being a little cog in a very big wheel.
Clive Morris
Actually I think in a small company, successes and failures are magnified. You get to share in the highs, but the lows also come with that if you're not successful. And I think that opportunity to make that impact and particularly to do it in the field that, hadn't been done before. So I think that's a particularly challenging thing to do. But knowing at the end of the day that there's the goal there about getting this technology to patients. And the other part I found fascinating, as well, coming from the pharma industry where the life cycles tend to be very long from finding the discoveries through to ultimately getting the innovation through to patients at the back end. It's much quicker, of course, in diagnostics and technology. So the company was only founded five years ago, yet our first product is now reimbursed on the market. It's actually much immediate in that effect. And I think that's useful as well.
John Simboli
So as people say, Clive, what do you do for a living?
Clive Morris
I start with the vision. We have as a company that we put in place to transform the lives of patients with cancer through the power of liquid biopsy. So I like to think of it quite simply as we help cancer patients get better. So that's the high-level question. Of course, that doesn't really answer the, well how do you do that? And without getting too technical, because I've got to admit, I do have a research doctorate and medical degree, but the science behind some of what goes on in the labs is astounding, and so trying to simplify that of just explaining how we can detect these minute, new tiny little bits of cancer DNA in a blood test and from that, we can start to tell exactly the type of the cancer and how to treat it. And look at the presence of cancer indeed, whether it's getting better or worse, just from a simple blood draw. When you talk through those terms with people, typically people have some knowledge of the space and know a little bit around medicine. And I think just, their eyes tend to wide open and go, You can really do that? And it sounds a little bit science-fiction, but there's these tiny little bits of DNA that are floating around in the blood, but the technology is fantastic and being able to find them—not just find them every now and again—repeatedly with very high sensitivity and specificity—really good quality, high-quality tests, which of course you need, because these are cancer patients whose lives depend on these.
John Simboli
If you're talking maybe with a kid, and they say, Well, Mr. Morris, but what do you do each day when you go into your office? What do you do?
Clive Morris
I think I failed miserably to be able to explain it to my own two kids who still don't know what I do and actually say, Well, that sounds really boring because you just sit on the phone and you go to meetings and you meet people. Don't you do anything? But really a part of the leadership role is it's not necessarily the things I do hands-on, it's actually the teams that we have and how do you orientate the team, so whether it's setting a direction or helping to get rid of problems, blockers, enable with resources, keep the train on the tracks. So, my daughter's pretty musical. So we have the concept of a conductor and the orchestra. It’s worked a little bit with her in terms of it's not playing any of the individual instruments, but it's making sure that they all work together. So is probably the closest that I've been able to get to.
John Simboli
What have you learned over the years about what management style fits you, is you, is just a natural thing for you?
Clive Morris
I think I'm still learning, to be honest. I didn't think a day goes by I don't learn something around this and every interaction you have. That's the core of it, I think it's having extensive direction of where you want to go, hire good people, and then spend the time either keeping out of their way or removing their blockers is probably the underlying thread of this. And that can mean different things to different people. Because, of course, every individual leader or person on the team is different. They all have their own skills and their own weaknesses, as do I. And that's another part of it, of knowing where my weaknesses are, and therefore, for building out a team, where are the areas that I need help in terms of making sure that we are rounded as a team?
Clive Morris
So I think there's an element of how do we make sure that as a group, we've got all the bases covered, rather than any one person having to do all of those. So I think I'm still learning I'm still adapting and learning how to do this the best. Having good people, people you trust, and actually knowing as I say, nobody's perfect and that's fine. But knowing where people's weaknesses are and making sure that, back to the orchestra and the conductor analogy, of knowing where you're strong and where you're not and adapting the team accordingly. I think I can be direct when I need to be. And sometimes you have to be direct, but sometimes consensus works. So it's flexing across those things, but making sure that, at the end of the day we make progress. And we can do that, if there's consensus, that's great, if not somebody has to make a decision. And,we keep things moving. And I like things to move at pace.
John Simboli
Many of the founders and CEOs I've spoken to in the US, when I asked them what their self-image was, when they were young kids, they say things like, I remember saying, like, I want to be a baseball player. But interestingly, several of the UK people I've spoken with have said, well, there were these TV shows on that we used to see all the time about medicine and about doctors and scientists, and I thought, that's what I want to be. So. can you remember when you were that age, what you thought you wanted to be when you grew up?
Clive Morris
I certainly remember not quite the doctor stuff. I grew up through the 1980s and I remember Top Gun was a big movie. So I certainly had a phase of wanting to be a fighter pilot; sounded very glamorous and I actually have a pilot's license and things very early on. I worked through that. I like learning, I like learning new things, and I like making an impact, and I like new challenges and as we solve the challenge of moving forward, and when I feel I've given as much as I can to something, and I've given my best to something, and there may be a time for a new challenge at some point. Now, I don't necessarily measure that in there's an end goal per se or a certain amount of time to spend in it, if it's fulfilling and I'm enjoying it and making an impact, doing good, then that's fulfilling.
John Simboli
What do you say, when people ask who is Inivata?
Clive Morris
It depends a little on who the audience is and degree of knowledge there, but it really comes back to a company trying to help patients with cancer, so to be better, diagnosed, better managed, and so to help that cancer journey. If there's a decent level of some knowledge around the space, we can describe it more what we do, but really then into how we have this suite of non-invasive products that means we can avoid lengthy, costly, invasive discomforts, from biopsies and other things. And by just taking a simple blood draw, and we can rapidly get results based on the cancer DNA. And so there's some great technology, we are, at heart, we came out of a technology company, we are, and but really around to the purpose of trying to do good,
John Simboli
What's new at Inivata?
Clive Morris
So we're really excited about having had our first product now to the point of commercialization. So in the US market, and we've recently announced a commercial collaboration with another large company, a company called the NeoGenomics who we will be working with and collaborating and partnering with to bring the technology to patients. And so that is a key part for us. Technology is just technology if it sits on the shelf, but it has to get to the patient ultimately. And I think there's a piece here around, it's fairly rare that as a company, you can do everything yourself. So actually looking about partnerships, I've always had a strong ethos around collaboration and partnerships. So it's a natural, thinking for me in terms of how do we think about good partners that can help to accelerate our journey. So I think that's going to be really exciting for us and seeing that rollout.
Clive Morris
And we've got some great products coming through in the pipeline as well, not just in advanced cancer, but actually into early-stage cancer. I'm looking at how we can really detect whether potentially patients are cured or not cured by their surgery, for example, and need other treatments, again, from a simple blood draw, and also how we can monitor patients to see are they still free of disease? Or is there evidence of their cancers recurring, again, from a simple blood draw that can be done out in the community so it's really building up as a pipeline for an exciting time for us with the first commercial product but also really pushing forward that research and development side.
Clive Morris
So in terms of the way the technology works and how we use it with patients, the patient undergoes a simple blood draw just the same as any other blood draw that you would, so simple, usually in the arm veins, standard needles and then we have some special tubes that preserve the DNA and preserve the sample. Two tubes of blood are taken, they're sent through to us by courier. So usually overnight courier through to our laboratories in Research Triangle Park, North Carolina. And when we get those, having, of course, cataloged them and requisitioned them properly, we basically extract the DNA from those blood samples. So and it's specifically the DNA that's floating around in the blood and the little pieces of DNA.
Clive Morris
And then we have sequencing technologies that basically reads that DNA. And then our series of what we call our analytics basically interprets that data and actually compares back with known databases of DNA and enables us to say exactly what type of DNA are we seeing which genomic alterations are present in those and therefore when you couple that information with knowledge on the patient, so for example, the patients have lung cancer. And then we have the DNA, you can put those two pieces together to potentially say this is how you should be treating those patients because we can identify certain drivers of cancer, that means they are sensitive to different therapeutics, different drugs.
Clive Morris
So we take that information, we actually then match it back up again with the list of approved drugs and also for clinical trials that are ongoing at any one point and we compile them back into a report, which we send back to the physician who can then use that to then best decide how to treat the patient be it a standard of care, or maybe a clinical trial depending on what they have available.
John Simboli
And then looking at it from a patient's point of view. What does that process you just described mean for them compared to a traditional biopsy process?
Clive Morris
So the lead product we have which is for advanced lung cancer, so traditionally the patients would come in and have their diagnostic workup to be diagnosed with advanced cancer. Part of that would involve having what's known as an invasive tissue biopsy where potentially a needle is passed through the chest wall. So, generally, the patients have to be sedated and they're under a CT scanner or other imaging. And then a rather large needle is passed through the chest into hopefully hitting the tumor, and then a little bit of a tumor is pulled out. And so it's removed. And that is then sent off to the laboratories to be checked out and to be identified, to hopefully give them the answer.
Clive Morris
There's something that's invasive and doesn't often succeed, and sometimes patients will have to have a repeated procedure. Sometimes there is enough sample from there to say that the patient does indeed have cancer, but not to do all the myriad of tests that we need to be able to tell how well, which drug do you treat this patient with? So patients may have to have either an empiric therapy where it's not guided by the science of what's in there, their cancer, or maybe even a repeat biopsy so they have to go through the procedure again, to have another go at this to try and get the tissue.
Clive Morris
What we do is they do simply have a blood drawn, which can be done as a standard blood draw by any healthcare provider, the blood sample is sent to us, and within seven days, they have the results back. So that's all there is for the patient. So it's all an outpatient procedure, no sedation. And whereas the standard, scheduling a biopsy and getting the results back takes up to three to four weeks in total, we get the results back from seven days from taking the blood draw. Not only on average, are they more likely to get the answer because we don't have the same failure rate as the tissue biopsies, but they get the answer more rapidly. So these are patients who have advanced cancer and need their treatments. And we hopefully get them to their therapies more rapidly. And that's the power of the liquid biopsy in this setting.
John Simboli
And my understanding is that it is a snapshot, but some series of snapshots in time and as cancers may evolve and tumors metastasize that your process allows the physician and the patient to have a better understanding over time what's going on in their body. Is that correct?
Clive Morris
Yeah, that's correct. So you can use the liquid biopsy in different ways. So you can use it as the one-off snapshot to say, how do we treat, as you say that cancers continue to mutate, and you can develop resistance mutations or other things that will confer resistance or sensitivity to other drugs, so you can repeat the testing. So it's a simple blood draw, you can repeat them. And part of the beauty of circulating tumor DNA is it's removed from the blood very, very quickly. That sounds somewhat counterintuitive, but what it means is you're getting a real time snapshot of what is happening in the patient. So if you do a sample now, and then you did a sample in three month’s time, when the patient may have had some therapy and develop resistance, you can find the resistance mutations. So the old DNA is gone. And what you're seeing is the new DNA. So it's very dynamic in that sense. So yes, absolutely.
Clive Morris
And you can also, and people are now starting to use these, rather than trying to look at the genetic makeup of cancer, but just looking at the presence of cancer. So for example, if patients who have early stage cancer have undergone surgery, for example, to try and cure the cancer, if you take a blood sample a few weeks after the surgery when the patient's healed, if you can detect the circulating tumor DNA, then the patient hasn't been cured. They need some more treatments to be able to cure them, even if you can't see it on any CT scan or anything else, the concept of residual disease detection. So it's something that we're now starting to see coming through.
Clive Morris
And also you can use those same modalities to really track whether the cancer comes back in patients. So today, of course, patients will go and see their oncologist or other health care provider potentially for up to five years after their surgery. They may have imaging CT scans, other things, to try and look for any evidence of recurrence. And only after three to five years of being cleared, people get the all clear that they're cured. Potentially we can do something very similar with blood samples in the future. So a simple blood sample, done out in the community, if it's clear from the CT DNA, then come back and have another blood sample and, in another six months or so. And the data is now starting to accumulate to show that you can detect recurrences earlier using CT circulating tumor DNA than you can with standard of care imaging. So potentially, you can pick these recurrences up sooner, and of course, potentially prevent imaging and hospital visits and other things in patients who are otherwise well who don't need to be going in and inconveniencing the patient and also tying up healthcare resources.
Clive Morris
So quite a change to a much more minimally invasive way of managing patients. And then, perhaps it's not surprising, but as a science-led company in the early days and still to this point, but early on, it was there was a lot of scientific focus as we were developing the first assay, , we're thinking about how is this differentiated? How is this going to work in the market? And a lot of the answers were quite technical around the sensitivity, the ability to detect DNA and a water level and such things and that has remained, and it's absolutely part of it. But it was very interesting as we got into the commercial part in terms of really starting to roll this out very early on, what we were getting a lot of feedback was the turnaround time of the test. Being able to get these results in seven days was fantastic. Now, we really thought it was going to be important, but we didn't realize quite how important but it was one of those. And again, that was a little bit of one of those. It's a bit of an “aha” moment. But it's so obvious when you think about it, and you stand back and you go, well, why wouldn't you want the results back quickly? Where these are patients who are dying of cancer, who want to get on to the right therapy? Why wouldn't you want that quickly? So I don't know why we didn't think about it earlier. But anyway, it's one of those things that when the feedback starts coming through, and you start hearing, and you hear it repeatedly, and it comes back and it comes back again, and somebody else says it, you think there's probably something around this and it's a good example, our differential and our positioning has come that it's not just the performance of a test, but it's also now the turnaround times is a key part of that.
John Simboli
Is there a way to talk about how the pipeline is a differentiator for the company? As a whole, the nature of the things that you're pursuing?
Clive Morris
The technology platform the company was founded on was designed to be the most sensitive, the most specific way of detecting cancer DNA in the blood. So the scientific founders did a great job tackling the scientific problems there to create a platform that is indeed, extraordinary. What we've then done at Inivata is turn that into products. So there's a mixture there of the technology platform, but also how is it being developed. It's a standard test that everybody with lung cancer can have. And it looks for a standard set of markers that have been associated with certain drugs that are approved by the FDA and other regulatory authorities.
Clive Morris
Our follow up product for early stage cancer takes exactly the same platforms for the same strengths, but now we create individual assays to the patient's cancer. So we take the patient's cancer at the time of surgery, we profile it to find the exact mutations that that patients cancer has. And we build a patient-specific test that looks for that signature. And when we combine the strengths of our platform with that personalized approach, we can get incredibly sensitive assays. And that's really why we can go into the earliest stages of cancer where there is even less DNA in the blood, this potentially tiny, tiny amounts of DNA. So you need very, very sensitive assays. And that approach enables us to do it. So it's quite a meld there of fantastic science, but also just the operations required to be able to do that to be able to create these individual assays at scale. And then of course, to be able to then deliver those to the patient. So I think it's a mix of the technology, but then also the operations and other things and a dedication to quality. So, in terms of getting the quality assays, very rapid turnaround times, easy to read reports, these are all part of the what is the experience for the clinician in terms of making that easy. So we make the complex science simple.
John Simboli
When you lay out that vision as you're starting to do with me here, I know often, all too often those opportunities are very compressed. It may even be a 15-minute investor presentation and afterward you draw breath you think I said it clearly. And then afterward someone comes up to you and you realize they didn't hear it the way I intended them to hear it. Some did, some didn't. Those who don't hear it clearly those who bring a filter to it or are misunderstanding, what do they typically misunderstand about Inivata? And then how do you help them to get an understanding of what your vision is?
Clive Morris
Some of the concepts that we have actually can get quite complicated very, very quickly. So I think one of the dangers is that people just get a little bit drowned in the science that we have to keep it simple enough for people so it's judging when do people, what's the right level of conversation and a lot of people who are in and around the industry have a certain level of knowledge but we're also learning, even of those who are steeped in this day in out there, there's an awful lot that we don't know. So the people who are a little bit further removed, know a little bit, but know even less and think they know things. So that's one of the challenges I think of, there's so many things that we don't know. And because it's a new technology in the field out in clinical practice, again, people haven't used these, they're not as if these technologies have been around for 20 years, and everyone has experiences.
Clive Morris
So people get very colored by their initial experience, and they have a good experience, they have a bad experience. There's, how does one test vary from a different one, these are things that are very difficult to talk about in the abstract. And when you're very early on in the adoption of technology, when people ask some of those questions, it's very difficult to give clear answers, because medicine is practiced on evidence. So there's a lot of a lack of evidence in many of these places. So that's the challenge as well of how do we get the right level of scientific depth but also recognize that there's so much we don't know when trials need to be done and data needs to be provided. So there's an awful lot of work still to do. We think we know a lot now but I suspect In 10 years when we look back little realized how little we knew,
John Simboli
What kinds of partners are good partners for Inivata?
Clive Morris
I like to think of things where there are complementary skill sets or resources. So, I referred earlier on to a commercial partnership where we developed assays and got them through early stages towards commercialization, but then the whole process of commercialization is, then, a different one, so, we can choose to build that, or we can choose to partner for that. So, in this particular case, we chose to partner and we both, I think you have to make very clear that you have alignment of goals that ultimately what makes both parties successful, there's an alignment there and also that both parties have to put some resources into this. So both parties need skin in the game, part of the risk they share, but also there's a shared view of the goals that why you're doing something, and I think that just helps to make partnerships successful.
Clive Morris
But then as they come in many guises, we do a lot of academic collaborations where we work with different academic groups to study different areas. And of course, there we bring the technologies and the assays and some of the operations there, but of course the clinicians bring some of those areas around the science and the medicine and of course, access to patients, which again, is an obvious partnership when you think about it, but one that I think, ultimately, we're trying to get to the right answers and further the science, but neither group can do it on their own. So, they work very well.
Clive Morris
So many and varied, as I say, from other diagnostic companies, academia, and the other one is with biopharma partners as well. So clearly, this type of technology can be really useful for biopharmaceutical companies in terms of thinking, how do they develop their drugs? How do they track the genetic makeup of cancers over time in their trials, how do they select patients into trials? How do you have the diagnostics that accompany their therapeutics to be able to guide their appropriate use, so there's a natural bedfellow there as well in terms of how the biopharma and the diagnostics industry comes together. So my sense is that, in fact, I don't think you could ever plan to do something like this and be successful if you were trying to do it on your own. I just don't see any way it could happen, by its nature. Science is generally a collaborative effort. And therefore thinking, where are those strong partnerships? Where is there good alignment on mission and other things that we want to be successful?
John Simboli
What's the connection between your work at headquarters and your work when you're speaking with your colleagues at Research, Triangle Park?
Clive Morris
It's no different. So it's exactly the same. We have groups that are spread across both sides, we work flexibly across both sides. So it's no different. It's exactly the same. And some areas of the business are more concentrated in one side or the other. Some are spread equally across both and our leadership team is spread across both sides we have so it's not a hierarchical relationship between the sites at all. It just happens to be two geographies where there's great talent and resources and skills that, together, we're all Inivata. And we're not too big, we're only about 75 people today. So it's not too big that it's still personal enough that whether it's on different sides, different groups, through different management layers that people know each other and then interact. So, like to think we're very, very flat in that sense.
Clive Morris
Having a laboratory in the US is a key part of that. So it was always the intent that as we spun out from Cambridge as a handful of people. But as we grew and came for the commercialization, the US was always going to be important. And we looked around and as the Research Triangle Park is a fantastic area for not just a biomedical innovation, but there's a lot of information science and others there's a lot of IT, IS companies in around the space as well. So, there's a really interesting mix of the biomedical with some of these other skill sets and plus of the more general skill sets that I mentioned them tapping into talent there and the number of great universities in around the triangle there, of course.
Clive Morris
So you look at it together and it seems like a good place to be and looking on the financial side is not as expensive to operate in as perhaps as some of the other places in the US from, the Bay Area and Boston. So that, overall, it's a good mix for us. And the other one related to this is the path through that we've had to reimbursement for the area; there is a group that conduct these assessments. The Palmetto and Medicare can conduct such assessments, and we sit in their backyard so we naturally fall into that reassessment process, which has also helped us in terms of being able to get the product through reimbursements and to commercialization. So, overall, a really good a good place for us to be.
John Simboli
I know you're in the thick of it. Now, day to day you're working on all the details that are required to make the next stage of the company successful. You've also talked about how you hope to help patients. Do you still have the time, at this point in your directing the company? Do you have the time still to sit back to think, boy, if this works out the way I hope it does, I'm really going to, through this company, be able to do some good in the world? Or is that something you think about later on?
Clive Morris
It's part of the reason why we get out of bed in the morning. It’s very easy to get dragged down on the day to day of whatever issues happened to be so whether it's fundraising, technical, R&D projects, commercialization, there's always something that you can be dragged into those details, but at the end of the day,yes, solving those challenges is fulfilling, but actually, it's that greater good that makes sense. So, I'm not sure I sit back at the weekend and think about it, but I think a constant reminder that's there. And we have our mission statements around transforming the lives of patients with cancer. So we have this up through the office and posters and things like this. So there's those reminders that are there. And of course,I mentioned, we do a lot of collaborations with academia and working with clinicians. So of course, you get that ready feedback. And you need to have that ongoing touchpoint into the day to day lives of patients and clinicians.
Clive Morris
And then every now and again, you get little extra little appointment reminders. I remember, a couple of years back, we were at a big lung cancer conference, and we had a little exhibition booth, very modest, and compared to some of the large firms that are around but as I came around one of my colleagues was there, there's a lady crying on her shoulder. She'd had been cured of her early-stage lung cancer, but she'd had an invasive tissue biopsy and she'd had a collapsed lung and had some quite nasty complications and nearly died. And she was there in tears. This goes back five or six years ago, these technologies weren't available, but she was saying, look, had she had this at the time how much different her life could have been. So those things that are a good reminder as to how do we do those and we periodically bring in external key opinion leaders or even patients we've brought in to do almost like staff sessions in terms of questions and answers and other things. So just maintain that connection, between what we do day to day and the patients.
John Simboli
What kind of people thrive at Inivata?
Clive Morris
We have a lot of different skill sets. For a small company, we've got very technical, we run assay development, cutting-edge science through to our operational labs, the focus on quality and being able to deliver the tests at scale through clinical trials and all our regulatory and into the more commercial parts of the business. And then, of course, we have the usual finance, HR, all these other things. So, we have lots and lots of backgrounds and the workload can be pretty high—it's because we're a small company and it does mean that we tend not have 10 people in the same function. So where there is a peak if there isn't a natural buffer of things there. So I think people who like some of those challenges, they're people who like to actually make a difference.
Clive Morris
And I like to think of people who are natural problem solvers, because what a lot of what we're doing are not things that we're copying from a rulebook, and it's not a cookie-cutter approach that people have to solve problems that they need to be innovative. And then I think that commitment to the patients and the quality and doing a good job, I think, is something that runs throughout as well. So I think all of those things, hopefully, we have some fun along the way. So people who are good colleagues. And, it's interesting, certainly the sites we have where people will congregate and everybody has lunch together and big communal tables and things like this of, it's not just work colleagues, but friends as well. So hopefully, it's a fun environment as well as intellectually and academically and professionally rewarding.
John Simboli
Many of the founders and CEOs I've spoken with have said that they have a high tolerance for ambiguity and some have even used the word chaos. Would you say it's a necessary or useful quality to be able to deal with a world of ambiguity if you're a biopharma executive?
Clive Morris
I don't know for sure, but I suspect it's probably true for an executive in any industry and let alone the biopharma one. And it's one of the benefits of as I look back, as I developed from junior physician in industry and have moved through different roles of increasing seniority, nobody tells you along the way is what you're dealing with varies and actually that the questions become more and more ambiguous. And again, it's one of those things make sense when you think about it, because simple answers get answered by somebody, the ones that are more difficult get shunted up to the next level, they answer then the next layer of them. The more difficult one will get shorter.
Clive Morris
So eventually you get to, if you're in the CEO role, everybody's answered all the questions that have an answer that you can possibly justify by science and everything else and you're left with the ambiguous ones to try and work through. And that's where it becomes down to judgments. I think that's where I think then the team of people you've got and knowing understanding their skills, both strengths and weaknesses, but also their judgment and how they work through and how do you take counsel from various different people? But yes, everything is pretty much ambiguous. So that, that we deal with, you have to be comfortable with that, I think, and you have to be able to make good decision in there and not be haunted by it, because then just recognize that some of them will be wrong. So you can't beat yourself up. If you make a good decision on the information you have in it turns out to be wrong. That's just life; you've got to learn from it, move on. If you make a mistake, learn from it. Don't make that mistake again.
Clive Morris
But I think it would be easy to be paralyzed by not being able to make a decision because there isn't an obvious answer, and I think that then just paralyzes the organization. So you've got to find a way to cut through that. But also do it in a way that I think then gives people confidence that it's not just a guess. There's actually some reason that people don't feel confident to get behind whatever that decision is. Particularly when you're leading teams of scientists who always want to probe, well, why, why this? Why that? And of course, that's where it gets more difficult with those ambiguous type of scenarios, but I think that's one of one of the skills of leadership, I think of being able to deal with ambiguity, make a reasonable decision, and not beat yourself too much up if you make a wrong one. Learn from it if you make a mistake, and keep learning.
John Simboli
Thanks for speaking with me today, Clive.
Clive Morris
Thanks, John, been a pleasure.
John Simboli
Right at the beginning of my conversation with Clive Morris, he told me there's no rule book of what to do. And something about me, I like doing things where there is no rulebook. When there's no rulebook to fall back on, it would be easy, as Clive said to be paralyzed by not being able to make a decision because there isn't an obvious answer. After all, Clive points out that simple questions get answered by somebody else. And as CEO, you're left with the ambiguous ones to try and work through. And that's where it comes down to judgment. Clive goes on to say, you have to be able to make good decisions and not be haunted by it. Just recognize that some of them will be wrong. If you make a decision on the information you have, and it turns out to be wrong, that's just life. You've got to learn from it. Move on. If you make a mistake, don't make the same mistake again.
John Simboli
This seems to be a recurring quality with many founders and CEOs who have been my guest on BioBoss—a combination of intellect and humility, that links to curiosity and innovation. As Clive said at the end of our conversation, we think we know a lot now but I suspect in 10 years, when we look back, we'll realize how little we knew.
John Simboli
I'm John Simboli. You're listening to BioBoss.