Andrew S. Plump, MD, PhD, President of Research & Development at Takeda Pharmaceutical Company Limited, spoke with Cure about changes needed in the way we approach science to achieve cures. This conversation has been edited for length and clarity.
Cure: You're a physician-scientist. How do we get to cures from where we are today?
Andy Plump: As someone who has grown up curious about science and who has cared for patients, I've seen so many patients die of diseases that we should be able to treat. I think this idea of shooting for a cure is what we should all aspire to. As science evolves, our understanding of human disease evolves, and our access to a diverse array of modalities has expanded. We absolutely have the potential to achieve more cures. I think the only thing that stands in our way is ourselves.
Cure: We are hearing a lot of hype about digital technology sciences, artificial intelligence and machine learning. Where does that come into play in finding cures?
Plump: Digital technology is and will continue to be an increasingly fundamental part of everything we do. Unfortunately, we won’t be able to go into a computer, click a button and have a molecule delivered. That's not going to happen — certainly not in my lifetime — but the applications of digital technology will continue to be profound across our whole value chain.
Look at tools like AlphaFold, which came almost out of the blue and has revolutionized how we look at the structures of molecules and how therapies bind to molecules. Tools like that immensely enable our ability to make decisions and move more quickly.
Cure: One of the biggest challenges today is finding patients for clinical trials. Can you address some of these challenges and how we need to approach them?
Plump: Rather than going to a clinical trial site and looking for patients, we need to go out into the world, find patients, and then identify the sites near them. We also need to improve the diversity of patients enrolling in clinical trials of new medicines and expand access to these studies. We've done ourselves and patients a disservice because there are a lot of people in marginalized populations who could enroll in clinical trials. We need to gain their trust and communicate with them in ways everybody can understand.
We also need to think about decentralizing clinical trials, which means moving the studies away from clinical trial sites that patients often don't have access to and bringing them right into patients' homes. The technology to do this is already available. We have to be able to implement that type of change management.
Cure: Are there ways we can accelerate the process of drug development?
Plump: We've been very old school. It's like a big barge. It's very hard to turn, and there are parts of what we do that you cannot accelerate. For example, if you're going to do a toxicology study in an animal model to understand the safety profile of a new molecule, that needs to be a nine-month period. You can't accelerate that. But there may be things we can do, such as using digital twins, to test new hypotheses — perhaps in smaller sample sizes. There are many opportunities for acceleration.
Cure: Let's talk about change management. How do you, as a leader, manage the complexity and change it takes to transform both the culture and outcomes of a large organization?
Plump: As scientists, our training is very technical. We rely so often on our intellectual prowess and lead with that. But in reality, as leaders, we have to think about how we enable and elevate the people in our organization. There have been many books written on this topic. and they make it sound quite easy, but it's not. It requires a lot of attention and focus. If there's one thing I've learned, it's you always have to remember you're dealing with people. You need to be fair to people. You need to respect people. You need to be inclusive, listen and bring people along. When you have a difficult message to share, you need to be transparent, fair and honest.
Cure: What do we need to solve as a society to get us from here to cures?
Plump: Science is a challenge, but we can overcome that challenge with the tools we have. To accelerate what we are trying to do, we need to implement new tools more rapidly while working within the highly politicized regulatory system that governs how we work. A lot of what we do is influenced by the political dynamics of the world in which we live. There are provisions in the Inflation Reduction Act that will limit innovation and impede our ability to go after cures. We have to work better together to ensure we are moving toward the same common goal, which is to treat and ultimately cure disease. A scientist's biggest reward seeing a breakthrough actually reach as many people as possible and cure them.