This is Impactful Breakthroughs, the podcast where we highlight top leaders driving breakthroughs in clinical research and life sciences.
Each episode features candid and inspiring conversations with the people who have dedicated their lives to shaping the future of healthcare. You'll hear stories from the physicians who've run hundreds of clinical trials, biotech founders chasing the next cure, surgeons pioneering new techniques, and patient advocates who turned their own diagnoses into a mission to help others.
Hosted by Zach Gobst, who has spent his career working alongside clinical trial teams and patient communities, be sure to subscribe on Apple Podcasts, Spotify, or wherever else you listen.
I always say that you're only as good as your team is, so you need to really spend a lot of time thinking about the execution of my team and what the dynamics are and really play to the strength of the people that work with you. We had to overcome some beliefs. Some people would think like, oh, this is never going to work. But the patients are at the center of everything that we do, right? This is a big, strong value that we have at Candel, and every one of these requests, there is a story of a patient and a family around it that I want to be able to help.
Francesca Barone:And so that's why I do this job, because at the end of the day, I'm a medical doctor. I decided to do this because I had something inside me that really drove me to do that, and I wanna give it to all the patients that I need.
Producer:Welcome to Impactful Breakthroughs, the podcast dedicated to the incredible individuals who are shaping the future of medicine. You just heard a snippet from today's guest, Francesca Barone, the Chief Scientific Officer at Candel Therapeutics, the clinical stage biopharma company developing multimodal biological immunotherapies to help patients fight cancer. Francesca has always held a fascination with the immune system and all of its complexities, which she followed from research to implementation, making the leap from her long career in academia to where she is today in biotech. In today's conversation, you'll hear about why Francesca purposefully seeks out opportunities that challenge her, the novel approach her team at Candel is taking to fight cancer, and how she incorporates every part of the patient experience into her work. And now, your host, Zach Gobst, founder and CEO of Leapcure.
Zach Gobst:Francesca, welcome to the show. Thanks for being on. Wanted to ask, first, start at the top. How did you get into this space? Like, what prompted you to get into science and clinical trial research?
Francesca Barone:First of all, thank you for MMA. I'm an MD. I'm a medical doctor. I graduated in Italy. I did my PhD in London at King's College.
Francesca Barone:And then I started to sort of get this double interest in clinical aspects and research. And so I did a postdoc that was like a proper basic science postdoc. And then I started this career as a physician scientist in England, like following the academic past. And I got very interested at certain stage in clinical trials, but in particular in the implementation of biological measure of outcomes in clinical trials. So I sort of split my lab.
Francesca Barone:There was a classical research lab in two parts. One was doing basic science research and the other one was really trying to understand how we could implement measurements like histological measurements, changes in biopsies in tissue as a readout of clinical efficacy or surrogate markers of clinical efficacy. And that's how I really got starting to work with pharmaceutical companies and biotechs in Europe working on this space. And that's what then brought my interest to explore how could I broaden this up, right, and do more not just from the research point of view or from the laboratory point of view, but see more of this space. And that's why I moved to biotech.
Francesca Barone:And then ultimately, I landed to Candel six years ago where I've really been able to do this work and to really work across the biomarker space and the clinical trial design and how to merge those and how to learn from mechanism of action to clinical outcomes and back and forth from research and clinical application.
Zach Gobst:Very cool. Yeah. Curious what you think drives you to kind of broaden. You probably could have had a fantastic career just being a physician and treating patients, but for you to kind of layer on top and work your way to where you at with Candel, where do you think that comes from that you decide, I'm going to keep doing more and more?
Francesca Barone:It comes from the backpack story. I've got a backpack tiering that every few years you should put the backpack back on your shoulders and travel somewhere like traveling another towards another challenge, learn something new. So the backpack is like the knowledge that you have built up over a period of time. You put it inside, but then you need to go in a new path somewhere you haven't been before. So for me, it was moving from academic research that was quite comfortable.
Francesca Barone:It was a very comfortable space. By training, I'm a rheumatologist. And so I've done a lot of autoimmunity and I feel I was very comfortable in my space. I knew what I wanted to know. I was known in my field.
Francesca Barone:But then this drive of learning something new or putting myself into a position of uncomfortability, right, to discover something new, to to learn something, to to challenge myself. And so that's been the bad bacteria that brought me to this space. So now I'm a rheumatologist, the worst in oncology. I still apply a lot of the knowledge that I've learned by becoming a rheumatologist. I was a PhD in immunology, so a lot of what they do in the oncology space is immuno oncology.
Francesca Barone:So it's actually very relevant. But it's in a different space with different measure of outcomes, with different type of patients, different type of disease. So that's what brought me here, this idea of changing and challenging with something new.
Zach Gobst:I like that. Building on that, you know, curious about what has been most impactful at some of the stages you've had, you know, leading up to where you are now. You know, when you think about your backpack theory and you start to get uncomfortable, how do you decide what's next? What was impactful for you that that says this is the direction I want to go into more?
Francesca Barone:Well, a series of things. Right? Sometimes it's a personal experience, sometimes it's opportunities. I think I've been able to recognize an opportunity when it was coming. And sometimes it's also failures or settle back.
Francesca Barone:So I remember, for me, the biggest decision has been leaving academic work to move to biotech. And this has been a combination. It was a period in which I was working and building up something at the University of Birmingham in The UK where I was working, but there was like a sort of a closure of a cycle. Some people and colleagues had left and my position was becoming a little bit too comfortable, as I was telling you before. And an opportunity arise, and it was an opportunity I wasn't expecting at all.
Francesca Barone:And so I was offered the possibility of doing something completely new, go and do experimental medicine and become a clinical lead in a biotech where I've never done drug development before. And so I think recognizing this opportunity has been super important. More recently, I think the passion has been fostered also from personal experience. We work in the company where I work Candel Therapeutics works in the cancer space. And so it's very unfortunately, it's very easy and very common to get in contact with personal history of people that are battling cancer and be still battles that we don't win.
Francesca Barone:We don't win in large numbers. And so some of those had an impact and drove some motivation in doing this and doing it more and insisting and trying to understand and trying to develop new drugs or understanding better whether the drugs that we have work better for one population versus another and so on.
Zach Gobst:Yeah. That's fantastic. I'll kind of frame that as always being open to seeing opportunity and whether that's for yourself or to support others and then being open to going with it after. The academic path doesn't always lend itself to going outside of structure. And so for you to kind of do that is pretty remarkable.
Francesca Barone:Well, I don't know if it is remarkable. I mean, there are some great, great people that works in academia, and they really foster discoveries and foster new science, blue sky science. I think that is a little bit different from what the belief that this only happens in academia is not true, actually. There is some beautiful science, some very innovative research that happens in biotech and in big pharma. One aspect of the academic life that I think didn't suit me completely and I've abandoned and I'm happy to have abandoned is that it can be a little bit focused on a single person career.
Francesca Barone:So you really do a lot to foster your own career. So the publications become a currency, certain positions, certain academic position or position on boards of, you know, international institutions and things of the sort become more important. Sometimes they're really asking the hard questions. So I think that this is not the case in drug development, in biotech or in big pharma. At least I haven't really experienced it.
Francesca Barone:I've experienced much more this teamwork, this reality that you really are working for a cause that is the cause of your group and then your group is the company itself. And so you really have this purpose that you're not just a single person winning. It's not just a single name on a publication and things like that. So for me, this works extremely well for my character, and I really, really embrace that.
Zach Gobst:Yeah. I'm glad you showed that. That's fascinating. And, yeah, the more that I think about it with business, yeah, it is a bit more of a team sport in many ways where you can only go as far as where your team can help take you and the other way around as well.
Francesca Barone:Absolutely. I always say that you're only as good as your team is. So you need to really I really spend a lot of time thinking about the execution of my team and what the dynamics are and really play to the strength of the people that work with you is extremely important. So really creating designing as a football team, I think, is a great is actually the the example that our Candel CEO always uses. Like, we are a football team.
Francesca Barone:We really need to play our strength together in a concert. So that's very true.
Zach Gobst:I probably overuse sports analogies with my team as well. Well, may maybe it's not overusing. It can be really helpful to get people to play total football and switch positions and help each other from different perspectives. I think there's a lot to take from sports. I also wanna kinda touch on a little bit of you.
Zach Gobst:You spoke about kind of the level of innovation in academia that you're taking to industry, and I know with Candel, there's a very novel approach that you're kind of taking to market in terms of, like, approaching tumors in an entirely different way than how most are. That's pretty bold. I don't know, you know, for you to be kind of taking a different approach than how everyone else is kind of moving. Curious what that's like for you to take things in a new direction. I know you mentioned that some of these things might have overlap with rheumatology, but interested in what it's like day to day for you, really taking a different approach to oncology.
Francesca Barone:Yeah. So I think it depends on the angle that you explore this thing. So from the discovery and research point of view is extremely fascinating. So when I was offered the possibility to come and work at Candel, they had already two clinical assets. One was just really newborn.
Francesca Barone:The other one was fairly advanced, was already in phase three. And ESA Glatimogen is our lead clinical asset. But there was also the possibility of build up a complete new R and D still using viral vectors. So what we do is that we design and develop the viral vectors that are delivered directly at the level of the tumor. So with intratumoral delivery, and then the lead asset is given in combination with the prodrug and the other the second asset is a classical oncolytic virus.
Francesca Barone:So it replicates and kills tumor cells directly. It doesn't have its prodrug. And then we had the possibility to create this new plethora of vectors that would deliver in the tumor microenvironment specific payloads that would modify the tumor microenvironment. For me, was like getting to a candy shop. I had so many possibilities.
Francesca Barone:And so I saw like endless combination. This is viruses that have their own properties that then you could leverage, modify, tune, and then obviously the possibility of delivering payloads. There could be different payloads. There could be immunostimulatory, anti immunosuppressive and so on and so forth. So it was an incredible so from the discovery point of view, it's really great.
Francesca Barone:Even with the clinical assets, we could build up new knowledge. And, you know, people think the discovery stops really at the time in which you do the experiment in mice and then you go into the first clinical trial. By then, you know everything about your asset. Actually, that's a very limited view because there is so much that you can learn from your asset in the clinical studies. If you do good biomarker research, you really learn enormous amount of things.
Francesca Barone:I'll give you an example. Our clinical accela, Gratinogen, when it was put into non human cell lung cancer patients in a Phase II trial, we've done very extensive biomarker research and we've discovered an enormous amount of things about our drug, how to use it better, refining the population, where do we need to inject, which type of tumour, which location, how do we see that inject one tumour and you have a biological and then clinical effect on a non injected lesion. So this has been incredible. But it's also challenging when you are the first one to do this in a large scale like we did it like a big phase three trial of intratumoral delivery of replication defective adenovirus in the prostate cancer. We had to overcome some beliefs.
Francesca Barone:Some people will think like, oh, this is never going to work. How is it possible that you deliver something in one tumor and then you're going to see a strong biological effect in the peripheral blood without that much toxicity because this is the beauty of these locally delivered vectors. So it's extremely well tolerated by patients. Also, the endpoints that we use for our phase three trial is an innovative endpoint in agreement with the FDA, but still innovative endpoint. So people were skeptical.
Francesca Barone:Now this is changing. Even investors were skeptical. So we had some challenging years. But then with the right support, we believed in the drug. At the end of the day, you were asking like, how does he feel?
Francesca Barone:It feels great because we could see the clinical effect. We could see it in the open label trials. We could see in the small trials. We could see even in indications that we're not following through because we had so much to do and you need to do some portfolio prioritization. But when we started to see the first phase three trial that is blinded and completely randomized to placebo and standard of care and you see a separation of the curves, then you start having really a strong validation.
Francesca Barone:This is really working. And so that is the rewarding part. So that point, there is always going to be a fast person. There is always going to be somebody that will have to do the hard work, and then others will come. And this is happening in the field of viral immunotherapy, like even big pharma like J and J has got now an intratumoral delivery program, a big unit that is working on something similar to what we have in the lung cancer space.
Francesca Barone:They're a little bit in an early phase, but it's a big statement that, you know, intratumoral delivery is not something absurd and but something that actually works. Patients like it because it's, you know, two administration or three administration as compared to chronic treatment with some of these drugs that have got lots of side effects. And ultimately, you have a clinical benefit like we're starting to see histological response. Then in the our open label trial in cancer, saw this prolonged survival. So it's been rewarding, but we actively live for a period of time, and it's been a bit of a solitary space for a while.
Francesca Barone:Now it's getting much, much more support around.
Zach Gobst:What I'm hearing is just you have this understanding or you kind of see the opportunity and you kind of keep your persistence even in the face of people who are used to doing it in different ways. But over time, you kind of find your footing. You find your momentum. You continue to kind of, you know, make sure you're building off of the validation as you see the opportunities that you kind of trailblaze where we're now seeing, you know, others in the industry jump into is fantastic. So glad to get your perspective.
Zach Gobst:But I think it aligns with what you were saying earlier around, you know, your backpack theory too in terms of the way that you're kind of, you know, building and seeing opportunity. I I think that's what's kind of going on in in the way that you're approaching the space, and and it's leading to change in the space, which I think is fantastic. You spoke a little bit about the human impact side of it. You know, what have you learned? Cause I think now you've seen, you know, multiple sides to care, but in terms of impact on patients, you know, leading biotech in a portfolio, you know, curious what is impactful to you on a patient level from your current seat.
Francesca Barone:The patients are at the center of everything that we do, right? This is a big, strong value that we have at Candel, and it starts from our CEO and then it comes through all the leadership. Just today, I'm coming from our town hall where we had the presentation from our patient and partner leader and how she's shaping with the rest of the leadership, all the activities. Patients are key. They're much better at designing trials than we are.
Francesca Barone:I mean, if you really embed them in your path to drug development, you will avoid to make a lot of mistakes. And so for us, it's been super important to have that part. And now obviously, we want to engage with them because patients will tell you what is really important for them sometimes. And I'm a physician, so I am guilty of that. We think that we know better what patients want and what patient needs.
Francesca Barone:And it's not always the case. I mean, even in my rheumatologic career, I found that, you know, I treat patients with rheumatoid arthritis and I thought, oh, they want to ultimately be cured. And then in some cases, there were patients that would say, no, I just want the pain to go away. Right. Or vice versa.
Francesca Barone:The patients were very capable of tolerating pain, but they wanted to know that at the end of the day there was going to be a cure for them. And sometimes this doesn't happen. Right. It's not the case. But so that is definitely patients are really at the center of the career.
Francesca Barone:When you develop the drug in biotech, sometimes you can be very detached from the patients, especially if you are in the discovery space. You get obsessed with this little drug. And this is where it's been what I would say has been a great superpower of being a physician that I never forget the patients down the line in my discovery process and thinking. I always think like what this medicine will look like, who would benefit from this medicine and that has guided wrong or right, some of my decisions, what this dose will look like. Is this something that is acceptable for a patient or not?
Francesca Barone:So it's something that I always refer to that aspect. In terms of impact, just to tell you that is the most rewarding part of our job. So we have patients come in to speak to our company. And one of these patients, she has an interview actually that is also available online for people. This is a patient with a recurrent glioblastoma.
Francesca Barone:This is a deadly disease. This is a really awful disease. She dealt fast with the first line diagnosis, so she had a glioblastoma, that she had a recurrent disease. And at the time of recurrent disease, people didn't want it to the physician that she spoke to didn't want it to treat her, didn't want it to go to to resect that tumor. So she came to Breham here in Boston, and she met Nino Kyoka, that is the principal investigator of our trial in linoserpaturab, that is the oncolytic virus that I mentioned before.
Francesca Barone:And he said that rather than resecting that, he would have injected with this drug if she wanted to be part of this clinical trial. And this patient is now almost six years alive after that injection. And this was a patient that using the words of the investigator, you say like he didn't think that she had much to leave at the time in which she had the recurrence of the disease. She had lost her memory. She couldn't recognize her family, and it was in a very terrible space.
Francesca Barone:And now she has regained her function. This is a delightful lady. And so it's beautiful story. It's one story, right? I want to have the possibility of developing these drugs for all the patients.
Francesca Barone:For me, one thing that breaks my heart is when we receive, for example, compassionate use requests and we cannot sometimes say you cannot have all the patient taking a drug because the drug has not gone through all the process and is correct that the drug needs to go through the process because the FDA, the EMA, they need to check that these drugs, they need to see all the data, they need to check that these drugs are safe for the patient. But behind every one of these requests, there is a story of a patient and a family around it that I want to be able to help. And so that's why I do this job because at the end of the day, I'm a medical doctor, I decided to do this because I had something inside me that that really drove me to do that, and I want to give it to all the patients that I need.
Zach Gobst:Yeah. I had a similar kind of thought journey. When I started my company, it was about bringing advocacy to clinical trials and helping for some of the reasons you brought up, patients are the best at kind of understanding their needs, how to design trials, and for me it was to bridge participation. Over time, what's become most important to me is the patients that come to us Yeah. Helping advocate for them and leaving them all better off if we can, whether they join a study or not.
Zach Gobst:Yes. Understanding, like, what you described with patients coming in for compassionate use. These are all people that have, you know, a journey and a story and a family, and they're coming to us because current care, what's available to them, isn't the quality of life that they're looking for, and that's kind of a general statement. But we've kind of done our best to kind of make sure that every patient we interact with, they're getting access to the resources we know about. They know how to look for clinical trials as well as we do if this isn't a fit.
Zach Gobst:They can find advocacy groups. They can find community and peer groups. And like, the business side is kind of just, like, what keeps the lights on now, and and our purpose is more on, like, well, how do we have impactful conversations with patients as much as we can? Because in theory, like, yeah, we're doing work that can can impact so many people, and that's really special. But I think when you really dive down, that's what ends up driving me at least.
Zach Gobst:And glad to hear something in your story too even from your seat because my job can be a little bit more simple than the scientific things that you're dealing with, vectors and, you know, portfolio management and investors, things like that. So wanted to next go to pieces of advice you've received or mentors you've had in this space. Curious about any people or kind of pieces of advice that have driven you over the years.
Francesca Barone:Pieces of advice. I think more than just advices were examples of great leaderships, right? I think there were three men in three different stages of my career that have really impacted my thought process and impacted the way in which I've shaped the person that I wanted to be in my career. One was my first professor of rheumatology when I was in Rome, and he's a great human being. And he really taught me the lead by example.
Francesca Barone:And it's a super charismatic figure that was extremely humble. This was a great immunologist that ended up having a rheumatology chair. And when he got this rheumatology chair, he got into a rheumatology department where he was the boss, but he probably knew least the list of the rheumatology space. Right? And he approached this with such a grace and such a humble attitude of learning.
Francesca Barone:And I think that probably the backpack theory comes from that, really put yourself in an open position to learn and learn from others, to collaborate, and this enormous work ethic. And I remember that he would ask people to do things for him and people would just do it 100%, 300% because he would give you everything back. But even more, he would do it before you. Right? So it was always the first one working.
Francesca Barone:And he was an amazing physician. So I thought, like, I want to become like this complete and this great. And this was Professor with the Valisini in Rome. The second person was the my mentor at the University of Birmingham was the person that brought me from London to Birmingham. And it's Chris Buckley, and it's a fantastic clinician scientist.
Francesca Barone:He he really is curiosity. His passion was just contagious. And so he gave everything in terms of the scientific drive, everything. He gave me a lot freedom to develop my thinking, but a lot also of clinical thinking, a lot of questions. And so the conversation with him are are has been, like, the the best part of the ten years that I spent in Birmingham.
Francesca Barone:And the last one is actually my current CEO that is the person that also took me from academia and brought me to the industry space. And he's a fantastic leader, so he's taught me everything. It's very funny because professor Butler told me at some stage, I know that I'm gonna lose you for because he can teach you things that they cannot teach you. And so they are very different, come from very different angles. But has been an incredible mentor from the point of view of leadership skills.
Francesca Barone:He's extremely thoughtful in the way in which he builds up his teams. He's really has got this calm and steady leadership you were talking about before. Like, sometimes you get in storms or situations where, you know, people didn't believe very much our modalities and everything. I think he's been the the light where that really guided us as a team. And I'm Italian.
Francesca Barone:I tend to be more passionate. I tend to have like more up and downs or I used to. But I think with this example, I've tried to channel much more an interior calm, and I've seen that it's been extremely helpful both in my job for myself, but also for my team and trying to provide that same level of of steady leadership that that he gave me. So three very different learning, extremely intelligent man, extremely capable at their job, extremely creative in their thinking, but then provided these three different angles that they really are trying to bring and apply to my my leadership and my work every day.
Zach Gobst:Yeah. That's wonderful. Thing we haven't talked about a lot is, like, along your journey, and you kind of alluded to it, you know, you have an Italian background, then you go to Birmingham, England now to The US. Yeah. There's very different cultures that you're jumping into with each of these jumps as well.
Zach Gobst:And you probably having to find ways to acclimate as you go. And so you've done that at the same time, speaking probably a different language than your native language. I've come away, yeah, very inspired by everything you've kind of taken on in your journey. I know you continue to see these opportunities. That's going be something I take away, so I'm glad you were able to share that.
Francesca Barone:There are some funny stories about the language. So I'm Italian and I did classical studies in Italy. And so English was not really one of my focus. So I did some extra studies here and there. My mom was actually very supportive of making me do extra English classes, but my English wasn't great.
Francesca Barone:And so when I started my PhD, it was an Italian professor that hired me and offered me the PhD. But then it was at King's College London. Right? So there is like these beautiful English speakers that were like super, super, super, super fast. And I remembered I dreaded the coffee breaks because I would go into these rooms and people will just talk over my head.
Francesca Barone:And I was terrified that they were gonna ask me questions. So they all thought that was extremely timid and reserved that I'm not. But it's because I would never speak, and I would just stay there and smile. And it was horrendous. So it took a little bit of time, and it took like a community of Italian mixed with English mixed with people from France.
Francesca Barone:So we were all learning the language with each other. That was a barrier at the very beginning, but I had to I had to survive and and learn and go with that. But it is true. Is that it's a cultural shock from Rome to London, then it was a cultural shock from London to Birmingham. And the last one was a soft landing.
Francesca Barone:So from Birmingham to Boston was a very, very soft landing.
Zach Gobst:Yeah, I bet. Great to see that you're kind of on the other end and able to kind of reflect. That's funny. Anything else that you'd like to share before we end the conversation?
Francesca Barone:We did discuss the patients and what do we want to do for the patients. I think that that is our motivation and that's why I want to impact, right? Ultimately, want to make that job that I had as a medical doctor as broad as possible. And so seeing one of the drugs I've worked in in patients and see how that would impact their lives in terms of survival or in terms of better quality of life or improvement of function, no need of taking toxic medications, things like that is something that that for me is super important that the drives and, you know, keeps me together with the curiosity. So I'm very privileged to do this job.
Francesca Barone:I still don't believe that, you know, they pay me to do it. I probably will deny that they say that, but I'm very fortunate to do something that they love, and hopefully, it's gonna be impactful for many people.
Zach Gobst:Yeah. That's great. Grateful for who you are and how you approach this. Your openness to, you know, understanding what's happening to patients in the way that you see opportunities for everyone. No surprise to me, the momentum you've had up to this point and I'm excited to kind of follow the momentum you have here.
Zach Gobst:So, Francesca, thanks for being on the show and looking forward to staying in touch.
Francesca Barone:Thank you.
Producer:That's a wrap on this episode of Impactful Breakthroughs. A heartfelt thank you to Francesca Barone for inspiring us to put on our backpacks and always seek the next mountain in our lives and careers. Francesca's story is a reminder to us all the patient experience must stay central to what we do every day, especially for those whose roles may feel far removed from patients themselves. If today's conversation sparks something in you, be sure to subscribe, share, and connect with us for future episodes. Until next time, stay informed, stay engaged, and keep pushing for better health outcomes for all.