We can"t make an impact if we do not understand how to commercialise research findings. Today, there is no medical pharmaceutical product or instrument at a hospital that has not been through a commercialisation process. It spans everything from the curtains to the instruments doctors use to operate". says Nils Brünner. Photo: Kasper Løftgaard

Oncology Research Is Done in Vain If It’s Not Transferred to Patients

Armed with a wealth of research and teaching experience in oncology, Nils Brünner is now taking his third company to the Stockholm Stock Exchange. In this article, he describes the challenges Denmark faces when it comes to creating the next big life science company, including the tendency to sell life science competencies and knowledge to large international companies and how a new network will help solve those challenges.

In 2015, the Danish company EpiTherapeutics was sold and merged with the United States biotech, Gilead. Prior to its acquisition by the American giant, the company emerged from the University of Copenhagen and researched epigenetics. Their research was lauded for contributing to the treatment of a variety of diseases, especially cancer. But with the merger, the research and findings fell into American hands. And that’s a shame, ­according to Nils Brünner – a former professor at Copenhagen University, current CEO of the biotech company Scandion Oncology, and previously doctor at both Bispebjerg Hospital, Rigshospitalet and Herlev Hospital:

“It happens almost every time we see a promising oncology company built on solid research; they are bought by international mastodons. And, most often, the companies close down the Danish operations because the new owners want total control over what they have just bought. This happens in ninety per cent of cases”.

Taking a proactive approach, in 2017 Brünner and his Swedish colleague at Lund University, Carl Borrebeck (professor in the Department of Immunotechnology), formalised an oncology network to tighten the relationships across Øresund to exchange knowledge between Denmark and Sweden.

Every day, forty-three Danes die from ­cancer. If we are to change that, it must come from start-ups and the knowledge they generate
Nils Brünner

In Brünner’s words: “In Denmark alone, we do not have the capacity and competencies to build the next large oncology company at the size of the largest Danish life science companies. That is why we must bring the Swedes along. But we will never succeed if the most promising companies are sold as soon as they achieve good results. Therefore, the network must spread the knowledge of Danish oncology research throughout Sweden and vice versa”.

Given that smaller biotech companies usually lack funding, merging competencies in Denmark and southern Sweden can create larger companies with more stable funding and research foundations. This has the added advantage of enabling companies to stand firmer when foreigners want to buy them out and transport them abroad, Brünner explains.

Losing the largest source of income

In Denmark, the four largest life science companies are Novo Nordisk, LEO Pharma, Lundbeck, and Ferring. Relationships must be strengthened between life science disciplines and their operations to enable the fifth major Danish company to focus on oncology. The reality is that there is a clear need for a highly specialised workforce in this domain, and to have the capacity to commercialise new research.

As Brünner sees it, “If a smaller company is capable of producing and researching pharmaceuticals, joining a company that makes biomarkers, and then teaming up with a third company that can conduct clinical trials, then the company suddenly consists of three functions and three-times as many employees instead of a small company between five to ten employees with only one main competence”.

It is also worth pointing out the high tax contributors. According to Brünner:

“In Sweden they lost the two big tax contributors in Astra and Pharmacia. They simply disappeared to the United States when they were acquired. In Denmark we have to remember that Novo Nordisk is our biggest contributor to the tax system, and that the whole life science ecosystem is the biggest source of tax contributions to the ­Danish state – by far. And they lost it in Sweden”.

Failing to realise potential

Denmark and southern Sweden differ in several areas of the oncology sector. In Denmark there are advantages for conducting clinical studies, since there are more patients who have diverse needs and greater access to hospitals that have the necessary facilities. A further advantage is that it is illegal to have a private practice in oncology, meaning all cancer patients who show up at the hospital will be registered.

Photo: Kasper Løftgaard

Brünner points out: “The Danish cancer registry is the oldest in the world, and we also have the oldest prescription registry in the world. It means a lot to our research that we can extract and analyse the right numbers. In the near future, when new technologies make it easier and more efficient to work with large volumes of data, we will see big leaps in data processing and the speed at which we can create new solutions and research results”.

He also hopes that machine learning and artificial intelligence will help commercialise lab results and advance treatments for patients with cancer. This may be overly optimistic, however considering the major medical challenges the field of oncology confronts in Denmark. Healthcare research cuts deeply into the public purse, and the largest share goes towards cancer treatments.

While the most effective treatment is surgery, in cases where the damaged cells cannot be removed, doctors often turn to chemotherapy. According to the Danish Cancer Society, only one in every four Danes responds to chemotherapy. This nods to the need for precision medicine and companion diagnostics, as there is much to gain in this field.

Adding to this narrative, Brünner claims: “We are still losing around fifty per cent of the patients who are diagnosed with cancer and this is primarily due to resistance. We are not strong enough in this field and effective enough when it comes to treating the right patient at the right time with the right medicine”.

Even so, Brünner acknowledges that Denmark”s treatment approaches and outcomes are on par with other developed countries. In fact, as soon as treatments and drugs are approved in other parts of Europe, Danish patients will benefit from them as well. Contributing to the field, Brünner has his sights set on biomarkers, precision medicine, and immuno-oncology:

“Perhaps we are a bit more restrictive than other countries. And for good reason. We have to be careful, but we also have to commercialise products for the market, and if new technology can accelerate that process, then we need to embrace it. Solid research is being undertaken in vain if we don”t know how to make it beneficial to patients”.

The art of commercialisation

Although Brünner no longer teaches at the University of Copenhagen, commercialising public research remains close to his heart:

“At the university, we must show that we are both capable of educating talented people, and that we can create an impact on the world around us. That’s ultimately what we get paid for. We can”t make an impact if we do not understand how to commercialise research findings. Today, there is no medical pharmaceutical product or instrument at a hospital that has not been through a commercialisation process. It spans everything from the curtains to the instruments doctors use to operate”.

Brünner is careful to point out that it is not only the universities that need to focus on commercialising research. From 2013 to 2018, he was head of a division of the Danish Cancer Society.

Despite the fact that the association had existed for 100 years, as of 2013 not a single product from the institution had reached patients.

“When I joined in 2013, my primary task was to improve this. The researchers spent most of their time in the laboratories and many were concerned as to whether their inventions would work when tested on cancer patients. We did manage to send some research to market, but it took a lot of convincing researchers that their findings were sufficient”, Brünner explains.

Photo: Kasper Løftgaard

In general, he calls for more engagement from public stakeholders who have expertise in innovation. Their advice and coaching would also benefit new companies. Brünner’s insights are based not only on his experiences as a professor, but as a seasoned entrepreneur who is readying to take his third company to the Stockholm Stock Exchange:

“We mostly never hear anything from them. No one has offered us a service and we have to go out and search for them while they are not looking for us. They should host seminars and be present in the ecosystem, because that’s where the small businesses that need their skills are located. Most often people at the universities do not have the knowledge to commercialise their product. So many start-ups and small companies could benefit from their knowledge of business development and commercialisation”.

Friends become enemies

From Brünner’s standpoint, if we are to see a change in oncology and research in Denmark, it must come from enthusiasts who want to create new businesses and jobs from ground-breaking research:

“Every day, forty-three Danes die from cancer. If we are to change that, it must come from start-ups and the knowledge they generate. This is reinforced by the many large companies we are seeing close their research departments to exploit the findings of start-ups. Over the past 15 years, new pharmaceuticals that have been commercialised from start-up mergers have increased significantly. That’s why the big companies cut costs on their own R&D and instead scout start-ups around Europe”.

In Denmark alone, we do not have the ­capacity and competencies to build the next large oncology company at the size of the largest Danish life science companies
Nils Brünner

As an accomplished researcher and CEO of the biotech company, Scandion Oncology Brünner has sat on both sides of the table at the university’s Tech Transfer office – linking universities with businesses that can work with their results. While this office is nice in theory, in Brünner”s experience the funds are drowned in administrative red tape: “The Tech Transfer system needs to be redesigned. Instead of requiring collaboration between universities and businesses, they shut down the funding resources. The Danish tech trans offices that I know of are usually rigid systems where there is a fundamental lack of understanding of the needs of researchers and the interests of companies.”

Photo: Kasper Løftgaard

In Denmark, universities own their researcher”s inventions, whereas in Sweden the inventor owns them. This means that a Danish university researcher who has made an invention is entirely subject to the universities’ tech-trans offices, while a Swedish university researcher can decide how the invention is to be commercialised. This is compounded by the fact that the Danish ecosystem lacks capital and financial incentives for private investors, as the shares in Danish start-up companies are taxed unfavourably for investors.

Concluding, Brünner remarks: “It goes without saying that it is very motivating even to stand at the helm of one’s own inventions. Perhaps in Denmark one could find a model that better meets the needs of public researchers to set the course for developing their own inventions”.

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