It was estimated that in 2024, around 169,500 cases of cancer would be diagnosed in Australia, with approximately 52,700 deaths. Today, we have something a little different as we speak with Race Oncology Ltd CEO and managing director Daniel Tillett about cancer, chemotherapy, different treatments, and where Race fits into the treatment space.
Proactive: Daniel, it's good to see you.
Daniel Tillett: Good to see you too, Jonathan.
Attracted to minimising clinical risk
Proactive: Before we get into the details of chemotherapy and cancer treatments, can you tell us a little about yourself and what attracted you to this space?
Daniel Tillett: My background is in science. I’ve worked in the biotech sector, and I also have a private biotech company in the genomics space. I was a lecturer at La Trobe University in the School of Pharmacy, so I have some familiarity with this area. What drew me to this field was my awareness of clinical risk. Many exciting new treatments emerge that scientists and investors get enthusiastic about, but the reality is that in oncology, less than 3% of drugs make it from Phase 1 to full approval. The risks are significant.
One advantage of working with more traditional approaches is that it reduces that risk. From an investor perspective, it's preferable to invest in a company with a clinical program that has a 75-80% chance of success rather than one with a 1% chance. That’s why I found Race Oncology so interesting—it minimises clinical risk.
Chemotherapy side effects
Proactive: Before we discuss Race Oncology's treatment, let’s talk about chemotherapy. What are the most common short- and long-term side effects, and how do they impact a patient’s quality of life?
Daniel Tillett: Cancer treatment has traditionally relied on three approaches: surgery, radiation, and chemotherapy. Surgery is very effective when cancer is caught early. Radiation is also widely used, though it can be quite harsh. Chemotherapy, which involves using chemicals to kill cancer cells, has been a mainstay for the past 60-70 years.
The challenge with chemotherapy is that while it can be highly effective, it also causes significant damage to healthy cells, leading to severe side effects. While newer treatments like targeted therapies and immunotherapy exist, they only help a small percentage of patients—under 20%—because we don’t yet have drugs for most cancer types. So, chemotherapy remains essential, but there is a strong need to improve it and reduce its harmful effects.
Proactive: That must make things more difficult for healthcare professionals. They not only have to treat cancer but also manage the side effects and the mental health impact on patients.
Daniel Tillett: Exactly. Treating cancer is not just about eliminating the disease. Aggressive treatment can leave patients permanently damaged, and that’s not a good outcome. Chemotherapy, radiation, and surgery can all cause long-term harm. These treatments are extremely powerful—essentially poisons designed to target cancer cells, but they also harm the patient. Some people recover quickly, while others suffer long-term effects, and we don’t always know in advance who will react badly.
Proactive: How does that variation affect the severity and duration of chemotherapy side effects?
Daniel Tillett: A good example is anthracyclines, a class of chemotherapy drugs that are very effective but also highly toxic to the heart. Doctors often limit the dose to prevent heart damage, which means the cancer may be undertreated. Since heart tissue doesn’t regenerate, any damage is permanent, and this becomes an even greater concern as patients age.
Proactive: What advancements have been made to reduce chemotherapy side effects?
Daniel Tillett: Unfortunately, progress has been limited. Some supportive care drugs can help with issues like bone marrow suppression, but there hasn’t been much improvement in reducing chemotherapy’s long-term damage. Most of the industry has shifted its focus to targeted therapies and immunotherapy, which are exciting but only benefit a small group of patients.
Proactive: Are survival rates improving?
Daniel Tillett: Yes, but slowly. For some cancers, like melanoma and certain lung cancers, new treatments have led to dramatic improvements. However, for most patients, progress is incremental. Better screening has helped, as catching cancer early increases the chances of a cure.
Proactive: Let’s talk about Race Oncology. What is the company developing, and what stage is the treatment at?
Daniel Tillett: Race Oncology is unique because we took an old drug that was already approved for treating acute myeloid leukemia (AML) but was discontinued due to formulation issues. The drug was highly insoluble in blood, causing severe side effects. We developed a new formulation that solves this problem and also qualifies for new patents, giving us a 20-year protection window.
We also discovered that the drug could protect the heart from damage caused by anthracyclines while enhancing their cancer-fighting properties. This combination could significantly improve chemotherapy outcomes while reducing risks.
Watch the full interview below
Progressing clinical trials
Proactive: Can you update us on the progress of your clinical trials?
Daniel Tillett: We initially ran two Phase 2 trials in Israel for AML patients who had undergone multiple prior treatments. The drug showed a 40% complete response rate, which is promising. However, because the AML market is relatively small, we are focusing on the broader application of heart protection in chemotherapy. We are about to start a Phase 1 trial, which will test the drug’s safety and effectiveness in combination with anthracyclines.
Proactive: What is the market potential for your treatment?
Daniel Tillett: Anthracyclines are widely used, with over 20 million doses administered annually. Despite being generic drugs priced between $60-$100 per dose, they generate about $1.5 billion in sales each year. Our treatment would be an add-on, not a replacement, meaning oncologists can continue using anthracyclines while improving patient outcomes. Cancer drugs typically sell for $20,000-$50,000 per dose, so even a small market share could be highly valuable.
Proactive: What milestones should investors watch for in the short to medium term?
Daniel Tillett: Our Phase 1 trial will establish the safe dosage and determine how well the combination protects the heart and treats cancer. It’s an open-label study, meaning results will come in continuously rather than all at once. Investors can expect regular updates.
Investor attraction
Proactive: There’s clearly a lot of excitement in this space. What should investors look for when evaluating biotech companies?
Daniel Tillett: Minimising clinical risk is key. Many companies have great science but low chances of success. At Race Oncology, we work with a drug that has already been through clinical trials, reducing risk. Investors should look at management, funding, and intellectual property, as these are quantifiable risks.
Proactive: Finally, what’s your outlook on the future of cancer treatment?
Daniel Tillett: Advances in science have given us a much better understanding of how cancer works. While cancer remains extremely difficult to treat, we have moved from the impossible to the extremely hard. That’s real progress, and it gives us optimism for the future.
Proactive: Daniel, thanks for your time today.
Daniel Tillett: Thanks, Jonathan.