00;00;05;04 

MAPS 

Oh. Welcome to this episode of the Medical Affairs Professional Society podcast “Elevate”. The views expressed in this recording are those of the individuals, and do not necessarily reflect on the opinions of MAPS or the companies with which they are affiliated. This presentation is for informational purposes only and is not intended as legal or regulatory advice. And now for today’s “Elevate” episode. 

00;00;33;22 

Michael Kahn 

Hello and welcome to the latest episode of the Map’s Elevate podcast. I’m your host for today, Michael Kahn. I am Deputy Domain Leader of the Business Acumen and Business Knowledge Domain for MAPS. And we’re here today, with two leaders from Xilio Therapeutics, Ruth du Moulin and Rene Russo. I will have them introduce themselves. Ruth du Moulin is Senior Vice President, Medical Affairs, and Rene Russo is the President and Chief Executive Officer to both of you. Welcome. 

00;01;07;04 

Rene Russo 

Thank you, Michael. We appreciate you having us here today. 

00;01;10;19 

Ruth du Moulin 

Yes, indeed. Thank you. Michael. 

00;01;12;16 

Michael Kahn 

Absolutely. Ruth, would you introduce yourself? 

00;01;16;06 

Ruth du Moulin 

Thank you very much. My name is Ruth du Moulin. I am originally from Ireland and moved to the United States about fifteen years ago. I have a PhD in Biochemistry, and I have been in the industry for about twenty years. I started off in clinical development and moved into Medical Affairs when I was in a small biotech, where I got the opportunity to see a company go from early stage right through to launch. I found my home in Medical Affairs, and I have been in this field ever since, mostly in oncology and mostly in the Boston and Cambridge area in Massachusetts. 

00;01;59;28 

Michael Kahn 

Wonderful. And, Rene. 

00;02;02;10 

Rene Russo 

Yes, thank you. Hi everyone, I am Rene Russo. I am President and CEO of Xilio Therapeutics. We are a biotech company focused in immunotherapies out of the Boston area. My background, probably like many of you listening, started out in clinical pharmacy, as I am a PharmD. I began in academic medicine and then took my first industry role in large pharma twenty-four or twenty-five years ago now. I then moved into large-cap biotech and, along the way, transitioned into smaller and earlier-stage biotech in a number of roles that continued to expand until I eventually took on a CEO role. This is my second public company as a CEO, and I have also had roles as chair or executive chair of private and public companies. 

00;02;59;19 

Michael Kahn 

That’s fantastic. And I can’t think of a better pairing to talk about the importance of business acumen for Medical Affairs professionals and how, working with and absorbing business acumen can help people become more effective, more strategic leaders, and rise within the organizations. So, Rene, I’d like to start with you, as someone who rose through the ranks of, the science functions of a company, to rise to the CEO position. Can you go into a little more detail about what your career path was like? And specifically what led you to your interest in the business side of pharma? 

00;03;39;20 

Rene Russo 

As many career paths are, mine was winding and certainly was not planned to lead to a CEO role from where I began. One of the consistent themes throughout my career is that I always dove fully into every role. I have loved every role I have had, and I have always found a way to solve problems in those positions. Over time, each role has led me to take on more responsibilities, and I have always said yes to every opportunity that has come my way. I very much leaned into the science, initially looking into therapeutic areas where I felt I could see an immediate impact for patients. I really focused on areas like infectious diseases, emergency medicine, critical care, trauma, and oncology. These are all fields where you have very objective measures of success regarding what your therapeutic is doing, and that is what has always driven me. 

I decided to move from clinical practice into the industry because there was an expanding role in a company focused on infectious diseases. It was an area of interest to me, and it was a very focused medical operations or Medical Affairs-type role at the time. I jumped right into a product launch and learned all of that. It was a great experience, but I quickly realized I did not understand early drug development. Doing the tail end without understanding the beginning was a disconnect, so I took a role in clinical discovery, what you would call clinical pharmacology today, sarting from first-in-human trials in that same massive pharma company. This caused quite a bit of upset because the human resources function in this 50,000-person company had never dealt with someone moving to a lower role. I actually took a step down in role to learn something new from the very beginning. I would definitely advise folks, especially early in your career, to not worry about constantly moving up. Go broad, learn everything you can, and take a step down to learn something new. That hands-on experience working on a global filing from first-in-human all the way through has been invaluable for me, and I use it every day in my role now as CEO. 

After that, I moved into a mid-size biotech company, also focusing on infectious diseases. As you get into smaller companies, you have to wear many hats. You get a lot closer to the strategy, the executive team, and the C-suite, and you can really lean in to help solve problems at the company strategy level. I highly recommend that experience if people want to get closer to the business. Ultimately, I was given an opportunity to take on a CEO role in a company where I was serving as Chief Development Officer, driving the clinical development. I got thrown into the deep end, but it turns out that a pharmacy and Medical Affairs background works really well for this type of role. Balancing science, clinical patient care, end-users, payers, and the systems in which these medications get used, while also understanding the business, is truly a sweet spot for folks with a Medical Affairs background. 

00;07;25;28 

Michael Kahn 

That’s an impressive career path. Thank you for sharing that. Ruth, I want to ask you a question. What motivated you to join Xilio? And more specifically, more information and context around the decision to bring Medical Affairs expertise into the company so early in its development and in the immuno oncology space. 

00;07;46;18 

Ruth du Moulin 

Thank you. Michael. Similar to Rene, my career path was winding as well, and I more or less fell into Medical Affairs. I have been lucky enough to work in big pharma and small biotech at different stages of development, and, much like Rene, I never said no. I always said yes to the opportunities that were put in front of me. However, my personal preference is working in a smaller biotech. The roles I have taken in larger companies were specifically to gain experience in areas like an oncology business unit and to work more closely with the commercial side, but I prefer the smaller biotech space where you are there at the very beginning. When you are involved in early clinical development and first-in-human trials, you are truly able to get your hands dirty. You understand the history of the company and the complete story of the molecules—the good, the bad, and the ugly. You get to speak with healthcare providers and patients very early in development and do what Medical Affairs does best, which is bring in the insights that can shape the development program or the overall strategy. 

One of the main reasons I joined Xilio was to work with Rene. She is an inspiration to me and a prime example of a Medical Affairs leader who has risen to the ranks of CEO. She was the one who wanted to bring Medical Affairs into this company early because she saw the value we provide. She recognized that Medical Affairs can really own the scientific story, not just for the medical audience, but for the entire company. Rene encourages me to take on the corporate communications role and shape our story for all of our molecules. I firmly believe that being involved early helps you understand what the company is doing, the scientific foundation, and the business strategy. Ultimately, this helps you perform better professionally while keeping both the company’s business and scientific interests at heart. 

00;10;10;01 

Michael Kahn 

Yeah. And I imagine that, because it’s a small company and because you’re at the top of the organization chart that, particular business skills probably are, more called on, for, for your role, very interested in hearing what business skills. You found it important to develop, throughout your career, to be able to contribute and develop a good partnership with Rene. And then Rene would love your take on this partnership as well. 

00;10;39;02 

Ruth du Moulin 

A lot of it comes down to relationship building. I see that as the absolute core of Medical Affairs, whether you are working with an external healthcare provider, patients, or internal teams. It is all about relationship building, finding common ground, and collaborating. That is a crucial business skill. 

Today, we are focusing on business acumen and understanding the business. Working in a small company naturally affords you more opportunities to speak directly with business leaders, but regardless of size, you must understand the business strategy and priorities. I am a firm believer in identifying the three priorities that matter most and running with those, rather than getting distracted by all the other things you could possibly be doing.  

Relationship building, being laser-focused on the key priorities, and understanding the business strategy ultimately help you with insight capture. We are out there gathering insights to bring back into the company, and when you truly understand the business strategy, you can filter for the insights that really matter and that will actively shape strategy. If you put your business hat on, you can accomplish this effectively in both small and large companies. 

00;12;05;27 

Rene Russo 

Thank you, Ruth. In terms of business acumen generally, it is very important, but I also think it is fairly intuitive to people in Medical Affairs roles. You are constantly thinking about the realities of delivering that medication to patients at the end of the day, which involves understanding different components of the healthcare business. You simply are not successful without navigating all of that. We are all uniquely positioned to have that broader, balanced view between the data and the science, as well as the commercial aspect of how we will actually deliver this treatment and whether it is going to make a difference. That really is the core business question we must look at while developing medicines. 

For those interested in moving into executive-type roles over time, I definitely recommend investing in some type of business training. I went through a phenomenal program at Harvard Business School called the Program for Leadership Development. I learned all aspects of business strategy, including finance, accounting, manufacturing, business development, and negotiation. There was also a massive focus on building your own authentic leadership style. So much of my role relies on relationships, connecting with people, listening, understanding their goals, and being authentically myself. Leadership is truly about finding the best way to authentically be you while guiding an organization or strategy. Some of these programs are incredible for exposing you to all of these concepts, and sometimes the right executive coach can be helpful too. You do not necessarily need to get an MBA, but getting exposure to financial documents like a profit and loss statement or a balance sheet is critical. You should actively stay up to date on your company’s public SEC filings, such as your 10-K and 10-Qs, and learn how to read them to understand what is driving the business. You need to know what investors are interested in and read the reports from analysts covering your company. While many Medical Affairs professionals in larger companies might not spend time looking at these documents, I definitely encourage you to do so if you want to move into executive roles. 

00;15;14;23 

Michael Kahn 

Rene. I’m really glad you brought up, the importance of understanding financial statements, because I view those as the sort of report card of the organization, and the metrics of the organization, in the success of the organization, at least as far as the business goes. Then that raises another question, which is, how do you, as CEO, and, Ruth, how do you, as a head of Medical Affairs, balance those business specific objectives with medical and scientific objectives, when when they’re not the same and one’s reported out, you know, typically on a quarterly basis and one, might not be. 

00;15;53;17 

Rene Russo 

Balancing these objectives is very tough in a public company. We are reporting quarterly earnings and tracking progress quarter to quarter, yet we work in an industry with a very long time horizon. It is generally an eight-year cycle from when you have a development candidate or a target to when you gather meaningful data. Along the way, you learn more about your molecule—both good and bad—and the entire treatment landscape shifts as lines of therapy evolve. You are managing this long-term evolution while simultaneously needing to communicate quarterly progress. 

To me, it comes down to a very simple point: in this business, we are here to help patients. Period. Full stop. End of story. That is why we wake up every day; it is in our DNA. But we will only be able to help people if we have a successful business model that can actually deliver that medication to the patients who need it and reinvest back into the science. You have to have a successful business model to continuously bring new innovations to patients, so the two are completely intertwined. When I was in Medical Affairs, my role was to understand what clinicians and patients needed and ensure we were focusing on the right data generation and indications. Now, as CEO, my role is to ensure we have the resources needed to bring these medicines all the way forward and reinvest. 

What is good for patients is good for business. Sometimes your data do not show what you hoped, but the sooner you act on it, own it, and change course, the better that is for the business. You must be transparent and sometimes make tough decisions, like cutting a pipeline product that did not deliver and moving those resources into something that addresses a true patient need. If you are not generating something valuable for patients, you need to rethink your approach and ensure your resources are focused where they matter. 

00;19;02;22 

Ruth du Moulin 

I completely agree. The patient is at the center of everything we do, and that is what gets us up in the morning. One of the reasons I love working at Xilio in immuno-oncology is that we get to work across many different tumor types. When we bring a program into Phase 1, it is a small company, so many people—including Medical Affairs—sit at the table. We look at the scientific data, the different tumor types, and the business rationale to make decisions on which path to take. I really love that collaborative process. Medical Affairs brings insights from advisory boards and focus groups, and all of that medical data combines beautifully with the commercial considerations. You have the business need alongside the patient at the center, and you use all that information to decide on a first-in-human trial. Sometimes in Phase 1, you look at many tumor types and must decide which single one to advance to Phase 2. At the end of the day, in every company I have worked for, the science drives your decision-making. You obviously need a commercially viable business model to move forward, but if you keep the patient at the center—and rely on core company values regarding patient urgency or centricity—it becomes much easier to balance all of these factors. 

00;21;04;15 

Michael Kahn 

Yeah. I think those are great points. And, you both alluded to, you know, your experience, coming up through different organizations of different sizes. And so in this role, I’m really curious to hear, have you, both of you, throughout your careers, has your concept of how Medical Affairs delivers value to the broader organization? Has that changed over time as it developed at all? 

00;21;29;26 

Ruth du Moulin 

Absolutely, the concept of how Medical Affairs delivers value has changed for me. As you move up through the ranks and become a more improved version of yourself and a better leader, you start to see the bigger picture. When you are starting out as an individual contributor, you might have a bit of tunnel vision. But as you lead teams and larger departments, your perspective widens. Take insight capture, for example. As a Medical Affairs leader, it is all well and good to send your Medical Science Liaison (MSL) teams out to gather general insights on a program. However, unless you are very specific about what those questions are, they will bring back a lot of insights that are very difficult to distill. I have found a lot of success by being extremely clear and focusing on the three priorities that matter. I determine exactly what three things we need to know, and that is what the MSLs go out to gather insights on. Being highly strategic, clear, and focused is how you bring back the best value. Otherwise, you just gather a lot of noise that does not help the company with strategy or business decisions. 

00;23;10;09 

Rene Russo 

Yeah, I totally agree with that, Ruth. I have always pushed the boundaries of the Medical Affairs role in all of my time in various functions. To me, the insights, understanding, and connections that Medical Affairs professionals possess represent the complete picture. They understand what the patient needs, what the obstacles are, and how to solve those problems. They see the big picture of how a medicine fits into a health system for prescribers and payers, which is an incredibly unique perspective to pair with a deep understanding of the clinical data. 

In a mid-size commercial stage company, I pushed Medical Affairs to own post-marketing research, registry work, and post-marketing commitments. In the infectious disease space, we built a bridge making clinical microbiology part of Medical Affairs, because that is a massive part of how we communicate with hospital systems. Additionally, once Government Affairs functions recognize what a Medical Affairs professional can bring to policy conversations on Capitol Hill, they will call you non-stop. Medical Affairs expertise is also incredibly useful for business development diligence, where you can assess opportunities by capturing data from key opinion leaders before entering a new landscape. 

In a very early-stage company like Xilio, bringing in someone with Ruth’s expertise was a phenomenal opportunity. We are pushing her to run corporate communications, shape investor relations, and put the scientific story together for board meetings and strategic off-sites. Medical Affairs can be heavily involved in telling the story of our science and technology across the entire continuum of an early-stage public company. 

00;26;41;15 

Michael Kahn 

That’s really fascinating. And thinking about pushing the boundaries, then, is it fair to say that your vision of a Medical Affairs function of the future could encompass many different functions and could look very, very different from company to company, depending on, you know, intrinsic factors like size, product maturity. Those are some really interesting areas of, of Medical Affairs involvement and even ownership. What could what could the Medical Affairs department, function of the future look like for you? 

00;27;16;09 

Rene Russo 

I think the Medical Affairs function of the future can really flex depending on what the organization needs. As Ruth said, it depends on identifying the three most important things the company is doing right now. Medical Affairs experts can play a major role no matter what those priorities are. I see value in building functions with subset capabilities. For instance, you might have a few people focused entirely on supporting Government Affairs because policy work is critical at that moment, or you might have folks dedicated to supporting Business Development by doing deep diligence on potential assets to acquire. You can build a flexible support system that provides this unique view to many different functions within the company. Whenever someone gets access to that Medical Affairs input, they always keep going back for it because it is incredibly highly valued. Additionally, companies will continue building Medical Affairs strategy groups focused on evolving the landscape of specific therapeutic areas, alongside the more traditional core functions like MSL roles and medical information. 

00;29;00;04 

Michael Kahn 

Fantastic. Ruth, what has, working, to, effectively own the company’s story across more traditional corporate communications and investor relations? How how has that developed your skill set? Your career, your take on what Medical Affairs should be in a high functioning organization. 

00;29;22;18 

Ruth du Moulin 

Thank you. I love this aspect of the role. I have spent a lot of time in medical communications throughout my career, and coming to a company where I am stretched to own the scientific story across all corporate and external communications is like a dream come true. However, as Rene mentioned, the stakes are very high. The messaging must be on point, crystal clear, and scientifically rigorous. You cannot lose the science, but you must be diligent and clear in what you are saying to different audiences without constantly deviating. 

In larger companies, I used to own massive, traditional scientific platforms for every product, which required a lot of time, numerous slides, and a multitude of messages and sub messages. I have actually moved away from that approach. Instead of a massive platform, I now focus on identifying the core messages that matter. I determine how to tell those core messages most simply and ensure we communicate them consistently through all of our collateral without changing our words all the time. You can flesh the messages out depending on whether it is a publication or a press release, but remaining true to three or four core messages is critical. We stick to our clear, one-page core message and deploy it effectively to all audiences without getting distracted by adding twenty-five different sub-bullets. 

00;31;56;26 

Michael Kahn 

Yeah, I love that one. Wanted to wrap up with one final question. Rene, it’s for you. What final words of advice would you have for Medical Affairs professionals, really, at any level? But who really wants to develop their leadership, who are interested in, leading a company and getting to the C-suite? What advice would you have for them? 

00;32;16;17 

Rene Russo 

Medical Affairs professionals have the perfect background for biotech, pharma, and drug development, and are well-positioned to lead in these areas. If getting to the C-suite sounds exciting, my first piece of advice is to go broad early in your career. Do not worry about constantly moving up vertically. If you move up too quickly in a single function, you miss the breadth of the entire drug development continuum that you need to put yourself on an executive path. It is much easier to move laterally at the entry level to learn clinical development and pharmacology than it is when you are a senior executive. It takes time, but it is entirely worth it, and you will use that broad experience every single day. 

Second, find out the biggest problems facing your company or department. Identify the biggest challenges for your leadership team and lean into being the person who helps solve them. I love cross-functional projects; if you get an opportunity to work on one, do it. Make connections and understand how other functions operate. 

Third, invest in building your own business acumen. Read the financial statements and track exactly what strategy your CEO is formally communicating to investors. 

Finally, do not limit yourself. Many of us come from a background of serving patients, and because Medical Affairs is often viewed as a support function, it is easy to take a backseat. The background you all have is incredibly valuable to so many functions across the company. Push the boundaries, reach in, and jump into roles you have never tried before. Chances are you will be highly valued, you will learn something new, and you will love it 

. 

00;35;09;06  

Michael Kahn 

So go abroad, solve problems for leaders, being authentic leader and lead Cross-functionally I’ve heard that right. 

00;35;16;10 

Rene Russo 

Yes, yes. 

00;35;17;06 

Michael Kahn 

Outstanding. 

00;35;18;10 

00;35;22;26  

Michael Kahn 

For sure. For sure. Well, that about wraps it up for today. Want to thank both of our guests, Ruth du Moulin and Rene Russo of Xilio Therapeutics. Thank you so much. 

00;35;33;26  

Rene Russo 

Thank you Michael. We appreciate your time. 

00;35;36;19 

Michael Kahn 

My pleasure. Thank you all for listening.