The man behind AstraZeneca’s ‘blockbuster’ cancer drugs
As far as life goals go, defeating cancer might be deemed one of the more fanciful.
But for Dave Fredrickson, head of oncology at AstraZeneca, it’s an entirely plausible prospect.
Fredrickson, who has been running AstraZeneca’s cancer business for six years, has overseen the deployment of Enhertu, a breakthrough breast-cancer drug which has been shown to extend life expectancy in the sickest patients by binding to tumour cells and delivering precision chemotherapy.
“We believe that Enhertu could be one of the biggest oncology medicines ever,” he says. “It’s quite clear we have a very special medicine on our hands.”
Some analysts suggest it is a “blockbuster” which, if it shows equal promise in earlier stages of breast cancer, could reach as much as $17bn in annual sales - almost half the AstraZeneca’s yearly revenue.
By contrast, sales of AstraZeneca’s current oncology stars - lung and ovarian cancer drugs Tagrisso and Lynparza - brought in just $7.3bn combined in 2021. Then, sales of the little known Enhertu totalled a mere $214m.
Fredrickson says oncology is medicine's fastest growing therapeutic area - and has been tipped to succeed current chief executive Pascal Soriot when he decides to step down.
Success for Enhertu would represent a deeply-felt triumph for Fredrickson, who started his career as a management consultant. His brisk demeanour is still laced with that formal training, but it is softened too by a little sun-soaked ethos from California, where he lives.
Fredrickson says today, for example, that he feels his work only “took on purpose” when a chance encounter led him to start working with a client bringing a new antibiotic to market. After that he exchanged executives for patients and healthcare providers and life took on new “meaning… overnight”.
If he speaks with hard focus and determination, that only reflects the monumental stakes he reckons he is playing for. In his mind, defeating cancer is a real prospect. “I’m lucky to have a chance to do the work that I do,” he says.
And there may be more where Enhertu came from. When Soriot took over a decade ago, AstraZeneca’s drug portfolio was, in Soriot’s own words, “quite frightening”.
Now Fredrickson raves about having launched eight new oncology medicines since 2014. This year hopes are pinned on the results of final trials of a new lung cancer drug which works in the same targeted way as Enhertu. “We’re hopeful that we can replace chemotherapy… in a very large group of patients,” Fredrickson says.
Both drugs are leading lights in AZ’s “cancer killer” portfolio. Directly targeting tumour cells in this way, says Fredrickson, is one of the company’s two principal strategies to fight the disease, the other being to harness the patient’s own immune system to shrivel tumours.
Together they form a rejuvenated cancer pipeline that has proved a boon for AstraZeneca, with cancer drugs sales rising by almost a quarter last year.
This has helped AstraZeneca’s share price surge 30pc in the past year, contributing to a quadrupling in the value of the company since Soriot took the helm a decade ago.
No wonder Fredrickson has been described as Soriot’s “blue-eyed boy”. The chief executive's family is based in Australia, far from AZ's headquarters in Cambridge, and he has previously been criticised for spending too much time there, though the company insists there is no impact on his effectiveness.
Fredrickson will not be drawn on whether he is keen to succeed, instead giving the question an almost suspiciously wide berth, and protesting his devotion to Soriot as a “tremendous leader”.
Fredrickson’s current seniority should still be enough to give British regulators pause, as he joins a chorus of complaints from pharma companies that a levy designed to reduce the NHS drugs bill will have a chilling effect on innovation in Britain.
The levy requires companies to pay a slice of revenues to the Government - 15pc in 2022 rising to 26.5pc this year - if the NHS drugs bill grows too fast. Fredrickson suggests it could discourage investment and drive innovation elsewhere.
“Countries where… the ability to capture value for innovations is part of their outlooks.. are the most important and attractive areas for the industry,” he says, bluntly.
He won’t confirm that AstraZeneca will pull UK investment unless the NHS levy is reconsidered, instead saying: “As we think about the places where it makes sense for us to invest, a supportive innovation climate is a key consideration.”
His words come just a week after Stefan Oelrich, head of the German conglomerate Bayer’s drugs business, said levies in Europe were “making [pharma company] lives miserable” and said it would deprioritise the UK and Europe to focus on China and the US.
Fredrickson insists that he was not warning Britain but instead offering “an encouragement” to see healthcare spending prioritised as an investment that sustains the rest of the economy, rather than a cost.
There are other wrinkles in AstraZeneca’s outlook too. For all Fredrickson’s enthusiasm about its oncology pipeline, he concedes that on one outstanding research prospect the company is lagging behind.
So called “cancer vaccines” - immunotherapies which can use a specific tumour’s genetic code to direct the body’s defences against it - are “compelling and… very, very interesting,” says Fredrickson. “But right now with cancer vaccines we are more nascent in the work that we've done. Strategy is about choice.”
If choosing not to pursue vaccines with vigour proves a strategic blunder though, it is one he says the company is prepared to remedy with its wallet.
“We've demonstrated consistently that as we see technologies emerging we feel we need to be a part of, then we make the moves in order to do that... Acquisition is absolutely a part of part of the strategy,” he says.
Enhertu was, after all, not developed in-house at AstraZeneca, but by Japan’s Daiichi Sankyo, with whom the company signed a $6.9bn deal in 2019 to develop and sell the drug.
It proved a canny move, driven through by the late oncologist José Baselga, who died of a rare brain condition in 2021 only two years after joining AstraZeneca and immediately insisting on the partnership with Daiichi.
Annual sales for the drug were then projected to peak at only $4.5bn. “We don't have a monopoly on all great ideas,” says Fredrickson, “and we do need to continually look for clinical partnerships, targeted M&A”.
Yet he insists that “our own, in-house capabilities” should remain the bedrock of AZ’s growth, noting that more than a fifth of total revenue is invested in research. He talks excitedly of “cell therapy” - in which new, healthy cells are inserted into the body to replace diseased or damaged ones - as a major avenue of research, with patients benefiting “in the latter half of this decade”.
“It is,” he says, “remarkable, really, truly exciting to see the explosion in science that's happening across the industry.” Cancer, he says, has shown itself to be beatable.
Suddenly, pioneering new therapies are emerging to fight a disease for which the standard menu of treatment - surgery, radio and chemotherapy - has barely changed in decades.
Pascal Soriot will go down in history as the man who went out on a limb to vaccinate the world against a terrible new disease.
Will his successor be a man who wants to protect humanity from a terrible old one? Or even cure mankind of it altogether.
“My clear objective, my ambition,” Fredrickson says, “is to eliminate cancer as a cause of death.”