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Hi, everyone from New York Magazine and the Vox Media Podcast Network. This is On with Kara Swisher and I'm Kara Swisher. My guest today is Reid Jobs, founder and investor of Yosemite, a venture capital fund focused on cancer research.
He's also the son of Lorraine Powell Jobs and Steve Jobs, both of whom I've interviewed many times over the years. Steve, of course, was the iconic co-founder and CEO of Apple Computer, who died in 2011. And Powell Jobs runs Emerson Collective, which does both philanthropy and investments in immigration, education, climate, media, and more.
Yosemite is actually a spinoff from Reed's work as managing director of health at Emerson Collective. Its mission is to, quote, make cancer non-lethal in our lifetimes. It's both a lofty and very personal goal since his own father died of pancreatic cancer and the stakes are high. The American Cancer Society projects that this year we'll see 2 million new cases of cancer in the U.S., a new grim milestone.
Our question this week comes from former Wall Street Journal tech columnist Walt Mossberg, who knew his father very well up until his death. That's coming up after a quick break. And.
Hi, Reed. Thanks for being here. It's really, really great to see you. So I'm excited to talk to you about your new venture firm, Yosemite. Let's start with your mission. The only thing on the website right now is a sentence. Yosemite aims to make cancer non-lethal within our lifetime. Lots of organizations talk about finding a cure. You say non-lethal. Explain the difference. A lot of people have used the word cure and abused it a lot.
in the oncology space. So our first reaction was we have to be honest about where we view the science to be. And to have human cells, you always are going to have the risk of some mutation happening, a bad cell division, and cancer arising. In fact, all of us have
in us right now. Now, it's almost always taken up by our immune system or your cells are able to move against it and protect themselves. But that risk is not going away. So instead of thinking about this like, you know, an infectious disease that you could vaccinate and then your immune system is primed and you're going to be immune to it,
With cancer, a more realistic pathway is to figure out how you're going to eliminate mortality systematically across many different types of early and later stage cancers. That's going to likely in our view be a combination of next generation early detection therapies and really, really precise patient-based therapies.
So it's a little like this idea of we're going to cure cancer. Is what, a canard? Or that it's more like AIDS? We're going to live, living with AIDS has become the way they talk about AIDS now. More than anything, it's a little like cardiovascular disease. So if you think about
Cardiovascular disease 50 years ago, it was an end stage disease. You went to the hospital because you were having a stroke or a heart attack. It was at the very, very final stages of that disease manifestation. And the results showed that. It was horrible mortality. Today, it's a disease of monitoring early intervention and targeted therapy.
You know, you can monitor things like your genetic risk factors, your cholesterol. You can take interventions like statins, or you could have a valve replaced or, you know, a ton of other different things. And you monitor this with good diagnostics, whether that's a calcium score or just a blood test throughout your entire life. It's really an area under the curve disease. You want to like eliminate the amount of time you have at risk.
In some ways, cancer is going to be very similar in that you're going to see cancer probably arising quite a lot earlier in 10 years than you do today. And the therapies you're going to have for it are going to be significantly more targeted, both to the mutation specifically, but in our view, much more actually about harnessing your own body's natural anti-cancer powers against it. And that's really the basis of immunotherapy. So the idea is...
I don't want to say living with cancer, in that detecting it earlier, one, so that you can do something about it, because that's usually the case. And two, figuring out ways to cope with it in some fashion that's not lethal, doesn't kill you. I would say treat it
early on and not treat it when it's a late stage disease as unfortunately far too much is. Which is why the finding the cure idea. Is that just something that people do to keep going? Because I had dinner with Katie Couric last night. Obviously, she's raised $700 million, $800 million for different cancers. Is that the, I don't want to say the wrong way to do it, but when you think about how we've thought about it,
Does that have to shift? Because so much of it is around the cure for cancer. No, I think cure is a very hopeful mind space to be. I think it's very accurate in some cases. It's just not going to be for every single case. And for folks like me, we really just want to view what is going to be the most tractable thing scientifically and how do we get those things to the clinic. So we do things that aren't necessarily just therapeutics. We also do quite a lot of digital health work and quite a lot of diagnostic work.
Those are indirect ways to eliminate mortality, but it's still really, really important areas for us to focus on. So this, we say, is a spinoff from your work at the Emerson Collective. I want to explain what Emerson is and how Yosemite is developed.
connected to it. This is something started by your mom, Lorraine Powell Jobs. Explain what Emerson is and then how it was connected and spun off so people understand. Absolutely. So Emerson is my family's family office. It's located here in Northern California. The structure of it is that of an LLC. It's not a foundation. Many family offices take the form of a
With our structure, we're able to do a lot more foreign nonprofit investing very seamlessly. And subsequent large family offices have followed a similar path. Chan Zuckerberg, for instance, has the same structure. What this meant for me and the health team, and it was, by the way, marvelous to start this with her. My entire family cares about cancer as much as I do. So the alignment there has always been incredibly strong. And
We began doing grants actually to a bunch of researchers in the cancer space, mostly starting here at Stanford just because it was right next door. And I became quite displeased with this because it was all a black box. You would give money away to a researcher, which is a laudable and positive thing. And maybe they'd give you like an email back a year later saying what happened. But it was completely unconnected to a new therapy and it was even further away from patients. So while I was at Emerson,
I quickly decided that I care about changing things for people. And we view universities as the wellsprings of all new innovation for healthcare. It's a very, very different ecosystem than it is in tech. And we can talk more about that later. But by partnering with super early stage researchers, we were able to see what are their most ambitious ideas. We were able to leverage a lot of blind spots that other funders have. For instance,
And surprisingly, a lot of people's most ambitious ideas, they're not able to get funded because people want to see more incremental progress as opposed to swinging for the fences. I like the opposite. I like people who are really going for it. So by using philanthropy to actually de-risk a lot of these early stage scientific assets, we were then right there when they wanted to take the next step into starting a company. And to get to people, the way the ecosystem works –
It really goes through academic labs to biotech companies to pharmaceutical companies. Most of that's just driven by how risky this all is by the...
very, very high, insanely high capital constraints. You know, a phase three clinical trial costs a billion dollars and only one out of three is going to succeed. Very few people can underwrite that. Although when they succeed, it's enormous, but go ahead. Although when they succeed, it's enormous, but there's a lot of sunk costs to be recouped as part of this whole ecosystem. So, and very few private companies are able to really assume that kind of risk. So by playing in the biotech space, what we're really able to do is
identify the best areas in academic labs, partner with the academics and build the absolute best, cleanest, sharpest companies we possibly can to get early clinical data to either then become, you know, companies in their own right that are going to go through clinical trials or partner with pharmaceuticals to do that themselves. So we just care about getting things to people as quickly as possible. And this was the most efficient way to do so.
The dual mission is investing arm and nonprofit. You have a donor advised fund. Yes. So you would start off with this fund and then move on to the investment itself.
We actually have done them both simultaneously. So the thing that we do a bit differently is some funds have a philanthropic component, but it's usually associated with the carry. Well, they'll take some of the money that they make and then put it in your market for a nonprofit, which is great. But from our perspective, we need to actually be using this –
to seed research quite early on that ideally we can actually translate in the lifetime of the funds. We're doing this both at the same time, both at the beginning. Now, this is quite unusual for a lot of other firms. One of the main reasons why this works really well in the life sciences is
In tech, you've got the stereotypical founder CEO who's crusading to move mountains. My dad was a lot like this. And if you look at most top CEOs in the Valley right now, they're founder CEOs.
Unfortunately, it's different in the life sciences because your founders are academics who usually have tenure and rarely want to leave their academic posts. They're more than happy to take a project so far and then hand it off to other people. Moreover, if they are going to join –
You actually don't usually want them to be the CEO because they're the very best at a super specific part of science, whether that's gene editing or immunotherapy. And why would you want to burden them with the administrative and fundraising needs of
A startup. Right. Exactly. So more often than not, if they're able to join, they're a great chief medical officer, chief scientific officer. They're on the scientific advisory board kind of pushing that forward. But the management is very, very different and disaggregated from the scientific work. So it's just a different model that we're dealing with.
We sort of instantiated at Emerson. We worked there for years and we honed this model quite well. We then frankly saw the pace of companies coming out of our academic portfolio really growing at a pace that we needed to bring external funding on to sort of match. I'll also just be honest with you, Cara.
I wanted my own firm. My whole family always – each generation, we'll start our own company. So at a certain level, it was a very natural, organic thing for us to transition over. Now, the relation with Emerson is still very close, but it's more of a GPLP one. They're amazing. They give us amazing support. We are extremely close, of course, on a personal level.
But they're alongside our other LPs on our LPAC, and it's been a clean break. So talk about the companies you've focused on. Where have you put your money so far? Some of the areas we're really excited about are the next generation of immunotherapy. It's been likened quite a bit to software, which is not a perfect but not a terrible comparison. So right now today, the notion of
leveraging your body's immune system to attack cancer specifically has been a really attractive idea for scientists for years. It took Jim Allison's work to really get this to have legs. He was a researcher here at Berkeley. He's originally from Texas. And he identified not only the T-cell receptor and how your immune system looks at things. We don't even know how it sort of worked before. He really cracked that out.
He also then figured out how you would block these receptors that get lied to by the cancer. Cancer is unbelievably wily. It will sort of use your own body's immune cloaking devices against itself.
And Jim is a hero of mine. He was the first person to win a Nobel Prize, not only for the discovery of something, but for developing the drug against it, which is just so wicked cool. He also plays Harmonica with Willie Nelson as a character. But since then, that was really the first generation of technologies there. Subsequently, we've actually taken this to the point where we can take out your immune system and actually –
to what the cancer is and have it attack that more specifically. Now, the amazing part of all this is it works incredibly well in a minority of cancers, yet it doesn't work for everybody. We have a lot of ideas about what drives that difference, but
optimizing this so that it's not just 20% of people that this is efficacious for, but 80% is likely going to take the next couple of decades, but it's really where we're putting a lot of our bets. So there's quite a lot in that, whether it's figuring out these next generation cells as therapies or changing the microenvironment around the tumor to make it more amenable to this. Those are all areas that we're really, really deep into because we see them as critical to the next generation of immunotherapy. Yeah.
And when you're dealing with this, unlike software, this is a lot more issues around privacy and in terms of treating patients, correct? You're doing a lot of digital health. We do a lot of digital health. In digital health, what we're really looking at is actually remote care delivery and really putting data into the decision-making ecosystem. So right now, we're
Physicians don't really treat people based on any outcomes data. They do it based on their training and what they kind of grew up knowing. And about three years ago, the amount of scientific literature being published every day physically eclipsed the ability for people to read it in that given time. So it's unfortunately impossible to actually be up to date as a physician. And there's no data in the loop here at all.
This drives really bad outcomes for patients and frankly doesn't help physicians at all either. So figuring out companies that are really engaging with that in clever ways are huge areas that we're focused in. The other one I just mentioned was remote care delivery. So for the longest time, if you were going to be in a clinical trial, you needed to live near an academic medical center that was hosting it. And there was a law passed about 30 years ago, which –
came from a good place. It said you can't pay people to be in your clinical trial, which is a good thing, by the way. That could be abused a lot. However, the downside of that was you couldn't reimburse people for things like transportation, for food, for housing, you know, if you need to stay by there. And
Generally, that added up to really prohibitive economic costs for most people who participate in clinical trials. It's one of the reasons why, you know, if you look at who's participating, it skews wealthy, very Caucasian, very disproportionate to the rest of the population. As always. Something that was a silver lining for COVID was all these clinical trials couldn't really
exist in hospitals anymore during COVID at the height of the pandemic because they were overrun with COVID patients, of course. So what happened was pharmaceutical companies had to work through local physician offices. And they set up a lot of infrastructure to be able to do this, which continues to exist because it's a lot cheaper to recruit patients where they are as opposed to where you want them to be. And the accessibility and the quality of data that's come out since then has been enormously better.
figuring out how we optimize that and actually take that to the next generation is another big area that we're focused on. Which are broken parts of the system. I just did an interview with Tom Skoka, who did a great story in New York Magazine, and he got all kinds of things happening to him. And he went to specialist after specialist, but it wasn't until he was able to get himself in a hospital that they were able to address it because of the broken system. He didn't have money.
You know, they couldn't figure it out. None of the data was available to the other doctors. And it was fascinating, like, how ridiculous the answer was at the end.
It's preposterous. No, hopefully you don't have to, but to enter a hospital is a little like a time machine. You're sort of going back to about 1989. And I can't tell you how many patients have come up to me because they have gotten their medical records either in paper form. And in one case, I remember it was a floppy disk. And this was in like 2019, which is just so preposterous that it would be funny if it weren't for the severity of the stakes involved.
Absolutely. But the main thing you're aiming at is cancer. So is there any type of cancer that you have more or less hope about or something that's under-innovated, underfunded? So we work across all cancers. You know, I have a personal history with pancreatic cancer. Most people who work in biotech on cancer do it for, you know, personal reasons. And
I would say we see a lot of segmentation in terms of different cancers for sure. Unfortunately, pancreatic is likely going to be one of the final ones to see a lot of efficacy. There's two main reasons for that. It has very few mutations. It's just like the wrong ones, but it's only a small handful. And it gets basically scar tissue around it. Your body thinks it's a wound and tries to heal it.
This has the unfortunate unintended consequence of sort of cocooning the cancer and actually protecting it.
So it doesn't really become symptomatic until it's metastatic and then the game's over. So unfortunately, pancreatic, brain, ovarian, these are going to be ones that are going to take a long time to really get traction for. The good news is cancers that are far more common, so colon, breast, lung, prostate, these are seeing incredible advances.
especially in colon cancer and lung cancer, which are the two highest incidence ones along with breast. So in the last five years, there's been new therapies and actually new early diagnostics for all of these that have been incredibly specific and the populations you're dealing with are just enormous. So we anticipate a lot more mortality reduction in those areas. I would say if you look kind of the last 10 years,
Some of the most interesting things that have happened have been in really actually highly mutated cancers. So ironically, going back to the immunotherapy conversation, when you reveal cancer to the immune system, the more mutated it is, the more different from you it looks. So actually the easier time your body has eliminating it.
So things like melanoma that have the most mutations because it's from UV radiation and it's just off the charts actually is the most highly treatable by immunotherapy. You might have heard of Jimmy Carter having metastatic melanoma. He actually had mets in his brain. And one immunotherapy treatment eliminated all of this, all of it. He's totally cancer-free. It's unbelievable. He's pretty incredible in his own right.
But it shows that actually the more highly mutated cancers, which about 10 years ago were the very, very worst, have had the most traction. The killers. The killers. Because I...
I've had several people who have died very quickly, many years ago of exactly that, which was amazing. Now they're not at all worried about it. Yes. So you highly mutate in cancers. That's really interesting. So you started, we'll get to pancreatic cancer in a minute. Your dad died of pancreatic cancer for people who don't know. But you started with $200 million plus in funding from a group of limited partners. You mentioned Emerson Collective, but John Doerr is also on the top of the list. Yeah.
He has long been interested in cancer. He has family history, not himself. But talk about how you raise the money. Is that enough money? It seems like a small amount of money, actually, when I'm thinking of – but right now I'm dealing with artificial generative intelligence companies, so they're in the trillion-dollar fundraising game.
I mean, yeah, we take it, but it's absolutely been an incredible start for Yosemite. So, you know, for us and just for me, candidly, coming out of a family office, it really mattered a lot that we had backing from more institutional investors. I have a whole team that I built at Emerson that came with me. So it was much more of a sort of later stage fund than a first time fund.
I'm really proud that we were able to get endowments from a lot of universities on the East Coast to deal with us now. You have MIT, Rockefeller University, Memorial, Sloan Kettering Cancer Center. Yes, those are the announced ones so far. And, you know, for those, it was very just important for us to get those long-term institutions who have exactly the same timeframes and sort of scientific focuses that we do behind us as well. Speaking for myself, you know,
If it was solely comprised of people from Silicon Valley, that would not really be the type of momentum we were hoping for. Why is it important to have the MITs, the Rockefellers, the Sloan Kettering? Why is that important in this area?
These are all really large endowments that are run as institutional capital. And they're very active, frankly, backing early stage managers because they're such long-term capital providers and because they have the luxury of having endowment that's going to be around for the next 100 years. They can look at that timescale. So that alignment was something that we were really, really searching for because
A lot of people don't have that kind of patience and don't have that sort of mandate. So that composition was really much more how we look at things because yes, we're a venture fund, but more than anything, we have just...
hardcore fidelity to the science. And we don't, again, one of the reasons why we eschew the word cure, we want to be really honest about what is the very, very best state of the art and how can we improve it? How can we take ambitious but logical bets here? And that kind of thinking is exactly the framework that most universities have. Something I am excited to announce is
On Friday, Yosemite announced a partnership with the American Cancer Society on our first inaugural tranche of Yosemite grants. So this is the first time since really launching this program that we're really beginning our first round of grant funding. It's in the areas of tumor microenvironment, several AI topics.
And, you know, one more in early detection. And all of these are areas that we've, you know, spent quite a lot of time as the investment team thinking about, you know, how we want to see progress forward. And partnering with such an amazing philanthropic institution has been a big has been a change for us. And one that we were really, really excited to announce. And this is to pump the
pump the system, I guess, right? There's no strings attached. So we don't have any IP rights or any ownership to any of these. It's really just to promote the very, very best ideas out there. So then later you can be aware of them or put them in the direction you want them to go in, correct? Because there's been attempts in Silicon Valley to do this. Well, it depends though, Cara. We're not looking necessarily to shoehorn companies. We obviously care about that as an outcome, but
We've been funding, for instance, things in the microbiome space for years. All the bacteria that live in your gut, they find their way into tumors. It's really interesting how it works. There's a lot of connections between your neurological and immune systems. And we've never actually invested in a company in that space. Certainly, it's not because we don't find the technology or the area interesting. We just don't believe it's mature enough.
And that's fine. We continue to look at applications today. So I would just say it shouldn't just be looked at as a purely incubation model. We want to meet the science where it is and just progress it along in the right way. Can I ask you, when you think about, you mentioned Silicon Valley, I've been in so many dinners of like going to cure cancer kind of stuff. There's a bunch of awards they're trying to do. I know Yuri Milner was trying to do it and various people. How
How does it differ from the Silicon Valley version of this? Because there's been a lot of attempts, and there certainly are a bunch. How are you different from the venture capitalists in biotech right now? So our engagement with universities with the no-strings-attached basis is quite unusual in biotech. There's a few people that do this with a few universities. We cast a much wider net, and we are –
really one of the largest funds focused on a single disease area. You're seeing a little bit more of this in the neurological space. And a few funds have done this as a sleeve of one of many funds. But no one else has really, as far as we know, been as focused at this scale. So already, that's incredibly differentiated from a lot of the other firms out there. And
Our focus on really early stage cancer work is something that people, other people do. You know, we collaborate and, you know, we syndicate with people all the time. But that, you know, bullseye is something that other firms don't really have. We'll be back in a minute. I want to talk about the future of cancer research in a second and biotech field in general. But every week we get a question from an expert, from someone you might know, I think. I'm not sure if you do, but let's listen to it.
Hi, Reid. This is Walt Mossberg, former technology columnist at The Wall Street Journal and co-producer of the D conferences. I knew your father well, and I think I even may have met you once briefly when you were a kid at your parents' home. I have a two-part question. First, what qualities of your father's do you think you have adopted in your career?
And secondly, were you allowed full use of screens and digital gadgets and games and other software when you were a kid? Or did your parents have limits on that? Oh, Walt. Anyway, that's a good question. Answer the last one first. I'm just curious. I am curious. Oh, sure. We did have restricted access. Restricted is the key word there.
You know, a lot of teens kind of rebel from their parents. You know, maybe they, you know, have a girlfriend they don't like or, you know, change their appearance. In my case, I carried a Razor flip phone with me for about three years in high school unnecessarily, you know, because...
When you're 15, you're pretty stupid. Yeah, this is a Motorola. I love that flip phone. Yeah, exactly. It's a good phone. So that was my form of rebellion at the time. But no, we of course did have plenty of access, but we all were –
frankly, such like hardcore like students. And we were all so nerdy that it wasn't really much of a distraction. And we never really played many games. We just weren't really ever a gaming family. So what qualities have you adopted? Not just your dad, but your dad and your mom? What do you how do you think of yourself?
Well, I would say I've learned so much from my mom, really just about judging people and the quality of the people you partner with. She has an amazing eye for talent, for potential. And that's something that I've really tried to cultivate in myself, which if you're leading a firm is actually one of the most important things. From my dad, it's the simplest thing, but I would just say, I get up and I love what I do every day. And it makes me so much better at it. And
Obviously, his story and his journey was a big part of why I'm here. And I actually love that I can still feel connected that way and that it's actually making a difference. Some of these things are working. The potential for what we're funding right now in a couple of years of development is off the charts cool. And
One of the really interesting things I love about medicine that is actually true in tech that he was great at is seeing how innovation comes from all these orthogonal places. And it's such a synthesis problem where you can read the very best data in the world, and actually it'll be a researcher studying something completely different that comes up with the breakthrough. And being super flexible, being open, and having beginner's eyes towards all this is actually –
to continue to be successful. Yeah, I thought orthogonal is an excellent word. Your dad did see orthogonally and it's very hard to do so, you know, and it also, it,
People resist that, right? They resist the ability to – everyone wants you to go the way you're supposed to go. And I imagine the pressure is enormous to do that among everybody around. And I think you're right, but especially in creation of new things, you have to go a totally different way, even if you displease people. Now, you were actually involved in biotech at an early age.
as a summer intern in oncology labs at Stanford in high school. One of the things your dad is quoted in a biography by Walter Isaacson was that your interest in biotech was a silver lining of his getting sick. What did you think when you read that? You don't have to comment on the book, but in general, do you think that was the case to get you here? Of course, absolutely. It is a silver lining. I don't think that's a bad way to put it at all. Mm-hmm.
Again, most people who work in cancer do it for very personal reasons. And the drive that that gives you is not what most people have in most jobs. It's not something that, you know, it's something you pay for very, very dearly, but it is valuable and it matters a lot. It matters a lot to me. I would just say the thing that stuck with me from his experience was
Not just getting incredibly passionate about this, but I was fortunate enough to join him in a lot of his tumor boards. And we would meet with some of the very best experts in the world. So from a very young age. Explain what that is. Explain what the tumor boards are. A tumor board is a meeting of top doctors.
oncologists, researchers from different areas to review a case. This happens for complex cases. It happens all the time. It's a very normal thing. And because of knowing Art Levinson and having worked in the space for a bit- This is the Genentech head who's on the board of Apple. Yeah. I learned about
gene sequencing about really the cutting edge of biotech quite a long time ago. And I've never really lost a lot of those connections and a lot of that exposure. So the foundation for what I'm doing now was established quite early, even if funnily enough, those particular innovations are a bit...
For people who don't know, Steve Jobs, he was one of the first 20 people in the world to have all his genes of his cancer tumor sequenced, which was amazing. It was an amazing thing. This was May of 2011. That's right. We were studying at Stanford, which was quite early. So even in his illness, he was trying to find something new in it, which I remember him talking to me about this. I thought this is not the last thing I would do.
But he, in fact, was very interested in it as a thing versus just his own personal struggle, which I thought was fascinating. It is. And since then, the cost has come down about a thousandfold. It used to cost – the first human genome was about $3 billion in 2003. Now it's less than a thousand. So even though there's limits to how useful –
Sure.
formed everything I ever did. Everything. There's nothing that is, that I don't do that I don't think of him mostly time, the time you have, which is something your dad talked about and everything else in terms of how you move through life and how you get things done. I think most people who have had that happen do have that urgency, I guess, urgency. I mean, so really that's what propelled me to start when I was 15 and cancer labs, we were sequencing colon cancer tumors and,
I really learned everything I could for these tumor boards. I tried to at least have a point of view on everything. And though he obviously didn't make it, I do believe that that generation is going to be one of the very last to have so few options. And I see it moving incredibly differently for people who are my generation and younger. Now, again, I think, to be honest, pancreas is going to be one of the very last ones to go.
It was, you know, just very unlucky. He had a rare form of cancer, and those are extremely difficult to treat. The good news is there's many that are far more common that are having much more traction. That are lethal, that shouldn't be necessarily. So when you think about that, when you're – I'm just curious, you didn't become a doctor or a scientist, correct? You're doing venture firm. Yeah. Why that choice?
Because you certainly could have become a doctor easily. My brother's a doctor, to follow my dad, who died. Well, that's beautiful. Yeah. My decision...
I, you know, like a lot of kids, I was thinking of, you know, going very far away for college, but he was getting pretty sick, so I stuck around it. And I went to Stanford, which turned out to be amazing. It's not bad. I've heard it's a good school. It was a good fit, but it's quite close to my, you know where I grew up. It's pretty close to home. The local college. Yes, I'm teasing. I'm teasing.
I didn't take time off after he passed away because it was really important for him that I finished college. Even though he dropped out, actually, he cared a lot about finishing college. And just to be frank, it was personally really hard for a couple of years. I was pre-med at the time. I was taking all the organic chemistry and all the kind of prerequisite classes. And
I had about two years where I really was a bit allergic to cancer. I just couldn't really deal with it. Honestly, I'm a little ashamed of that. I wish that that hadn't been my reaction, but it is what it is, and that was what I went through. So
I ended up, you know, changing majors because if I didn't want to do cancer, I had to do something else. So I always have loved history. And I did a program actually studying nuclear weapons in Stanford's International Security Program. Wow. Which is, you know, a little more cheerful. Yeah.
Yeah. Ah, cancer, nuclear weapons. Yeah, exactly. But it was honestly incredible. And I actually even got a master's studying some of that. I was contemplating, you know, I could do academics. I'd like, you know, worked kind of all around actually where you live now in Washington. But I decided, and this was when I was 24, one of the biggest decisions of my life, I really knew that it wasn't the battle I really cared about. And I didn't think that
It was the kind of impact I wanted to have. Like I, I'm sure I could have done a good job at a think tank or something, but you're still just out of think tank. So I took a, you know, about a month of introspection and I just realized that ultimately cancer was the thing I'd always cared the most about. And it was really, it was unfinished. So that was right around the time that I had was finishing up my graduate work. And that's when I, uh,
figured out what Emerson was doing. And I asked if I could take a lead there and the rest is history.
Interestingly, something your father did say was that one of the biggest innovations of the 21st century will be the intersection of biology and technology. I think this too. I think it's really important. And also climate change is the other one I think is probably going to be the big area too. But there are currently only four cancer vaccines that have been approved by the FDA to prevent cancer. Do you think we're going to see more and for what types of cancer? I want you to sort of, you don't have to predict everything, but where are we right now in that regard?
Cancer vaccines have been this really tantalizing idea for a long time. It is. You know, if cancer is a different thing, can you prime your immune system for it? That way it'll identify it and boom, there you go. Yeah. Kill it. How awesome would that be? It,
It has never really worked. The vaccines you're talking about are for virally mediated cancers, for HPV, for hepatitis, for those kinds of things. That is not most cancers. Most cancers are not turned on by viruses. They might be impacted by them a bit, but it's not the driving factor. What you're talking about is a prophylactic vaccine, is something you take preventively, which is totally the dream. Now, that hasn't ever worked really just because...
You need to be incredibly precise with what you're going after. Because remember how I said, you know, all of us have kind of proto-cancer in us. Well, most of that is not actually going to really matter that much. Most of it will get cleared out. Right, because it doesn't activate. It doesn't activate. And...
Unless you're going to be crazy precise about when is the right point for your museum to recognize that, it's really hard to be able to design something like this. My own instinct, and this is just my own view, is it's one of those things that doesn't work until it does. And then, oh my gosh. So it is something that we have research that we're supporting.
There was a paper from BioNTech that came out about six months ago, and actually in pancreatic cancer, it's a small phase one, but they had about a 50% response rate for a phase one trial. I wouldn't read a ton into that, but it shows that it's still a very active field. And especially as we've gotten better at vaccines, that also changes what we can work with.
So it's a super interesting idea, but it's super early. You've also worked with Jennifer Doudna, who won the Nobel Prize for a method for genome editing called CRISPR. What are the new developments you're seeing in this field for cancer? We do a lot of work on both the gene editing side and actually on something called the epigenetic editing side. And
Those two things are somewhat similar but have different applications. So with CRISPR, right now, one of the big things we're working on is the delivery issue. So basically, if you think about gene editing like a copy and a paste, CRISPR is sort of half of that. It's incredible at cutting out with single gene specificity things along the genome, which is incredible.
It's not really good at pasting things in. So you can't replace a bad gene with a good gene. But for instance, there's many diseases that are called monogenic diseases, one gene, where you have one mutated gene that's causing the whole disease. So you saw this recently with- You just take it out and that's that. Just take it out and that's that. This is like sickle cell anemia, Huntington's disease, which is awful.
And, you know, several other kind of neurodegenerative developmental diseases. Those are the areas you're going to start with that. However, right now, the issue for a lot of other applications is you can't deliver this with any kind of specificity. So like, let's say I had a problem with my kidney. You can't give me a gene therapy that just goes to my kidney as an organ. It'll go to every single cell in my body. And that's not acceptable from a safety perspective.
So figuring out the next generation delivery modalities that don't have that problem and have much more specificity is sort of where the field is right now. And long story short, there's a giant race happening. There's dozens of companies pursuing this. We're involved with some of them. It's a big deal. And it's really the next stage of where that technology is going, is cracking the delivery problem. You said something that just caught my ear, where you said that you don't know what the dangers are involved in.
I know when I interviewed Doudna, she was very concerned about that, not just clone, everything. She was concerned about everything she had done and the misuse of it. That's not something you are concerned about, or that's within your purview, correct? That is certainly not in my purview. I think...
It's an interesting kind of cocktail conversation. It's a long way away from being something that I would say is a serious concern just because this technology is so nascent. However, these are fields moving incredibly fast. So
Jennifer, everybody is right to keep this as a serious concern. I think, frankly, her leadership in that from a moral perspective has been amazing. And the last thing in the world we want is for this to be abused by people. Which brings me to AI, because that has a lot less safeguards already, or none at all. So AI.
Talk about the shift AI is making in cancer research. There's much ado about gene folding, and I've heard it called a quantum leap. Let's talk a little bit about how AI shifts this and what investments you might be making here or you think is important. I kind of break it down into three areas. Okay. AI really right now is affecting diagnostics, drug discovery, and then there's kind of the sandbox of what could you build, right?
In terms of diagnostics, this is happening a lot with radiology and pathology, where it's a very easy transition make because it's pattern recognition and image recognition. So already, some of the things you're seeing, which I think are amazing, are identifying like micrometastases or super early tumors that might be obscure to a radiologist's eye through AI. Right.
These are software plays. You could easily put these into imaging systems, whether that's a PET scan or an MRI, and
That transferability is happening very quickly. You're not going to be replacing radiologists, but you will be improving them better than the very best in the world. This is quite tractable. It's happening quite soon. So I would say that's one area that we're incredibly excited about. Frankly, it's not one that we're investing a lot in because it's already quite mature. So it is not the best fit for venture. So that's detection. That's detection. Early detection. Okay. Now with drug discovery,
The notion broadly is, you know, could you model proteins out to find basically druggable niches in them without having to do super expensive x-ray crystallography? And could your library of drugs that you have, maybe as a pharmaceutical company, maybe as an academic, be able to go in there and do what you want it to do? This is a super big deal because it's not really replacing people, but it's accelerating the pace of innovation by an order of magnitude. So,
already a lot of companies are putting a ton of resources into this. They're all somewhat constrained by what their internal libraries are and what they can test against. If you're a company, you can usually test against what you have and that's about it. But this is still an incredibly important deal. And just as a little anecdote, we've seen
you know, places that we could make drugs in areas that were previously thought of to be untouchable. There's a couple oncogenes that...
We didn't really see any parts that we could make anything to perturb now have potential candidates. They may not work, but we've gone from nothing to candidates at the very least. And that's a big deal. So I don't want to diminish really the effects here. The acceleration has been enormous. Explain what an oncogene is for us. An oncogene is something that's promotive of cancer in a way that is a bit
unstoppable. So a good analogy is like someone who has a stroke while driving and their foot is on the gas pedal. It's a little like that. One of the classic examples is something called epidermal growth factor receptor. So every cell in your body has this receptor to tell it to divide. So like, you know, in adolescence, when you're growing, your cells are dividing a lot because you have to grow. And every cell needs this signal.
For many cancers, when they get advanced, this pathway becomes mutated and it basically becomes turned on all the time. This is what drives a lot of the uncontrollable growth. It could be on the top of the pathway. It could be kind of downstream. It doesn't really matter. The point is that the entire cell is getting this signal to just divide constantly. And that's the kind of thing where you need to basically just like –
Either disrupt that signal or just shut that off entirely. And it's a very, very complex thing to do. Right. And treatment, that's the last bucket, was the throat right treatment itself. That is getting a little bit more complicated. You know, for that, we're really interested in looking at, say, patient modeling and what
for certain aspects of clinical trials that you could probably model out instead of have to recruit patients for. One example is something called the synthetic comparator arm.
So this is a little wonky, but basically, instead of having one arm on the drug that you're testing and one arm that's the standard of care, if it's something that's really common and the standard of care is being reproduced across a lot of different trials, could you work with the FDA to make one standard of care that is just conserved across all those so you don't have to keep recruiting patients for it? And that's one promising area. Yeah.
Of AI. So do you think that AI is going to change every aspect of life sciences and biotech? And what are your concerns? Those are two separate questions. But do you think it has to be changing everything given it's also an idea generator, right? Beyond human recognition of it? That's a really interesting question in terms of what is it?
Mm-hmm.
I'm sure it will not change every aspect of medicine. I don't want to, you know, be too promotive of the hype there. Well, you're the only one in Silicon Valley who isn't, but go ahead. Why don't you call yourself Yosemite AI and see what happens? Oh my gosh. I think we're going to pass on that one. I think Yosemite is pretty great just standing alone. And any concerns? What are your concerns when they apply AI to everything? What is your biggest worry?
I guess my biggest worry, and this is not something I have a lot of control over, is that if we dramatically accelerate the process of drug development and drug discovery and clinical trials, that that doesn't translate into lower costs. So it doesn't really help people. That's right. So I have two more questions. When you come to the end of your life, what would you hope...
would be the result of what you did, if you could pick one or two things of these efforts you're making. And secondly, you grew up in Silicon Valley. You've seen the ups and downs. You've obviously been at the center of it. How do you look at it right now? There's the hugeness of these companies. How has it changed from your perspective, the wider tech market, not just biotech, but all of tech? Sure. So to take them one at a time,
I only think that anyone is going to really do two or three great things in their life. That was something that my family kind of has drilled into me, which is you have to focus what you're going to be good at and you have to pick extremely disciplined and diligently, which –
is really hard. What that means on a daily basis is you have to say no to things you desperately want to do because it's not quite as important as the thing you need to do, which is extremely difficult. And I still haven't totally mastered that. But ultimately, I want us to be part of
a few amazing companies that really changed the paradigm on how we think about cancer. And that's likely going to be both on the diagnostic side, on the therapeutic side, and likely on the digital health side as well. But all of these systems, whether it's, you know, hospital systems that haven't been updated since the late 90s, or the way that we're thinking about, you know, immunotherapy and gene editing, and it's just the beginning of all these things. And you can kind of see how they could be combined, but it's still so early. And I think that's
figuring out where that story is going to be written and having somebody play a role in that, ideally a prominent role, is really what I'm aiming for. I agree that I think this is the biological century. It's one of the most important places, not just in the economy, but for people, for ideally millions of people who will unfortunately suffer these diseases. If we could make that
significantly better for a large chunk of those, that would be a succeeding beyond my wildest dreams. So I would say, you know, patient outcomes is the yardstick that we're measuring against. It's going to take a long time, but being part of great companies that help move that significantly is the biggest thing for me. In terms of just your question on the Valley, it's amazing to see how the incentives have really changed and
I hope to be a bit of an old school type that cares about making a few great things. That mindset hasn't really lasted or been preserved that well, in my opinion, in the last couple decades for a whole host of reasons. But I just really believe that at its very best, this place can make things that really take people's breath away and that can really, really change the world.
In an unambiguously positive way. And for us and for myself, that's the spirit that I still hold and that I really just want us to bring to the table every day. Just so you know, you're one of the first people who said the word people to me in technology. Your dad talked about people and consumers. But I would agree, the narrative has been lost in a lot of ways from something. But people should be the focus of everybody. That's always been my...
That's been my goal. But I really appreciate this, Reed. This is such a thoughtful interview. And I wish you the best in this. This is a wonderful way to spend your life. You know, I hope I'm not being pretentious, but your dad would be very proud of you. Oh, that's sweet, Kara. He'd be very proud of the stuff you're doing. Yeah. Yeah.
On with Kara Swisher is produced by Neha Miraza, Christian Castro-Rossell, Kateri Yochum, and Megan Burney. Special thanks to Mary Mathis, Kate Gallagher, and Andrea Lopez Cruzado. Our engineers are Fernando Arruda and Rick Kwan, and our theme music is by Trackademics.
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