In the biopharmaceutical world, where innovation and breakthroughs often dominate headlines, a fundamental question is frequently overlooked: are we truly listening to patients? For Paul Peter Tak CEO of Candel Therapeutics Inc (NASDAQ:CADL), the answer has shaped a career rooted in both scientific discovery and personal resilience.
As Candel prepares to unveil pivotal data from its prostate cancer clinical trials, Dr Tak reflects on the crucial role of embedding patient voices in the heart of medical innovation. Drawing from his own battle with a debilitating condition, he underscores the transformative potential of prioritizing patients—not just as subjects but as partners in the quest to redefine outcomes and improve lives.
The opportunity to transform patients’ lives is huge – so why aren’t we listening to them?
Everyone who knows me will attest that I am perpetually curious. Not just about science but about people, their cultures, belief systems and stories. That insatiable hunger for learning beyond pure data is a pre-requisite for our work as scientists.
And that learning takes time. In a few weeks, we’ll be at the culmination of a decade of learning when we at Candel reveal data read-outs of two large randomized clinical trials. Ten years of learning, researching, testing, measuring, understanding, pivoting and finessing our localized prostate cancer treatments.
For me, that work has been driven by learning as much as I can about the patient. It sounds obvious but, too often in this industry, learning directly from the patient is an afterthought rather than at the heart of all we do. It’s especially important in prostate cancer because prevalence of the disease is growing. In the US alone, the American Cancer Society says there have been almost 300,000 new cases and more than 35,000 deaths just in 2024.
Just as Candel has innovated to push at the boundaries of science, so we have been hugely innovative in getting closer to those patients, to embed their voices at the heart of our entire approach. Uncovering insights that, until now, have lain hidden.
That closeness ought to bring us new perspectives, innovating through the patient’s voice, eyes and experience. But, if we are honest with ourselves, are we really using new technologies in conjunction with patients or merely alongside them? Do established processes enable us to focus on the right end points or cause us to miss them?
For instance, in prostate cancer we always talk about long-term survival rates but less-so quality of life, including the debilitating side effects of existing treatments. Not only pain and exhaustion but depression, incapacity, incontinence and sexual dysfunction. Peers in the field sometimes talk about these realities as if they don’t matter in the pursuit of long-term survival. But listen to the patient. They do.
Evidence suggests that almost three quarters of prostate cancer patients say it’s what most concerns them. Overall survival is vital but so is quality of life. Such as halting the disease’s progression with a relatively simple therapeutic intervention, if possible, especially in early stage, localized prostate cancer. The more choice that patients have, the greater our ability to respond directly to their diverse needs with tailored treatments at the optimum moment. We believe that developing new therapies that help the patient’s immune system to fight cancer more effectively may improve outcomes and give people greater control over their disease. The patient – as much as the science – has shown us that patients want to avoid tumor progression and the need to undergo future treatments associated with a negative impact on the quality of their life.
Or take this example from Candel’s patient research. People who have never practiced medicine think that injecting a medicine into the prostate is a highly complex operation. As any urologist will tell you, it’s an out-patient procedure that takes around 15 minutes, simpler than a standard diagnostic biopsy. Our data shows that patients experience the intratumoral injection as the same or better tolerated than prostate biopsy. Also, the procedure is performed only twice or three times with the goal of getting durable anti-tumor immunity. If we can reframe the conversation so it’s more attuned to their experience – rather than simply promoting our belief systems - we can have more success in helping them.
Listen and learn. That’s been a theme throughout my career but, personally, it’s more than that. I know the patient matters because I learned as one.
Many years ago, I suffered from a rare and debilitating condition known as cluster headache. The pain – typically on one side of the head and behind the eye - can be so unbearable that neurologists know it by another, terrible name. Suicide headache. With no curative treatment, those who suffer from it particularly acutely must either endure or succumb. I battled through it for many years and can vouch for the fact that it is one of the most intense pains you can possibly feel.
I surprised myself by my own resilience and am lucky that I have not had an attack in decades. But those years have influenced every professional decision I’ve taken because they brought me closer to the patient experience. I truly listen to their stories, want to understand their symptoms, what they need, how they cope, how we as medics help and hinder, what we’re missing and what we need to be better at. So that they feel listened to and we can focus on the real unmet needs.
Too often, people see patient involvement as a tick-box exercise, simply to show that you’re doing the correct thing or to boost enrolment in clinical trials. But the patient voices give credence to the kind of innovative medicine we do here at Candel. By bringing real-life experience into our work, we become more meaningful to the people whose lives we are trying to transform. By staying connected to them, our decisions become more empowering because we’re focused not just on the problem that we as scientists feel is most important, but what the patient does.
If you work in a commercially-driven consumer company, all you think about is how can our product satisfy people’s needs, how can we innovate to make ourselves more meaningful to them and their environments.
What a difference we could make if all of us in the biopharmaceutical industry adopt that same philosophy.
Paul Peter Tak, MD, PhD, FMedSci, is the President, CEO, and Board Director at Candel Therapeutics, bringing decades of leadership experience in immunology and biopharmaceutical innovation. Previously, he served as Senior Vice President, Chief Immunology Officer, and Global Development Leader at GSK.