Jeevan Virk, CEO of Sego Therapeutics

Radiopharmaceutical therapy is gaining momentum as one of oncology’s most promising treatment modalities. By combining diagnostic precision with targeted radiation delivery, radiopharmaceuticals have the potential to offer highly personalised treatment while limiting systemic toxicity.

In this Beacon Consulting Insight Series interview, Alistair Ellmer, Research Director at Beacon Consulting had an opportunity to sit down with Jeevan Virk, CEO of Sego Therapeutics, to discuss the scientific, technical, and commercial considerations shaping the field, from target selection and isotope strategy to supply chain design, clinical translation, and the role of data-driven decision-making.

Could you briefly describe your scientific journey and what led you to become CEO of Sego Therapeutics?

I started working in the field in 2007, initially looking at external beam radiation therapy. With a background in chemistry, I felt there had to be more elegant ways to deliver radiation to patients rather than shooting it through the body with a very high-energy ‘gun’. That led me to diagnostic radiopharmaceuticals and the possibility of converting those agents into therapeutic medicines.

I’d say that my commercial career has been more successful than my scientific one! At Novartis, I held roles ranging from country leadership through to responsibility for the company’s radiopharmaceutical strategy. During that period, I became increasingly tired with the lack of innovation from biotechnology companies in the space. That ultimately led me to bring together a group of colleagues I respected highly and establish Sego Therapeutics.
 

What convinced you that radiopharmaceutical therapy could become a transformative oncology modality?

The first evidence came from seeing patients on treatment between 2007 and 2009. For the first time, I was observing an oncology therapeutic where patients were benefiting without suffering from severe toxicity. That was a significant shift from the traditional oncology paradigm. Seeing patients looking worse while receiving treatment than off-treatment was a real eye-opener for me. That convinced me that radiopharmaceutical therapy could be transformative in oncology.

 

What are the most significant scientific and technical challenges facing radiopharmaceutical development?

I see four broad challenges for the field which I’ll walk through now. The first challenge is target selection. We have seen that more than half of clinical candidates are pursuing the same two targets, with a small number of additional targets also attracting substantial interest. What we’re not seeing is target selection based on radiopharmaceutical therapy as a modality. You cannot simply flip an antibody-drug conjugate target and assume it will work as a radiopharmaceutical target. The target has to be paired appropriately with the mechanism of action.

The second challenge is how companies think about binders. At Sego, we believe finding the binder is the start of the story, not the end. We’re thinking about very complex medicinal chemistry. We are not simply decorating a strong binder with a linker and chelator; we are asking how to build a best-in-class molecule from that starting point.

The third challenge is translating molecules into humans as quickly and effectively as possible. Traditionally, the field has translated agents rapidly through imaging studies, but not using that information to accelerate Phase I therapeutic studies. What we’re doing at Sego, is really thinking about how we collect data from first-in-human imaging studies in a way that helps move drugs to patients in a therapeutic setting more quickly.

The fourth challenge is supply chain complexity, particularly isotope procurement. This is an area large pharmaceutical companies are extremely concerned about before entering radiopharmaceuticals. Sego has truncated the supply chain by placing ourselves adjacent to Nusano, an isotope production facility in Salt Lake City and just four miles from Salt Lake City International Airport. This means we can receive the isotopes on the same day we order it, and dispatch it on the same day we manufacture it. This truncation the supply chain not only reduces the cost of goods, of which isotopes are a large component but also ensures we can service patients with urgent requirements for oncological therapies, meaning we can get the doses to them very quickly in aggressive cancers. This speed of treatment has so far eluded radiopharmaceutical development.

 

Many companies are pursuing established targets such as PSMA and FAP. Where do you see the major opportunities for differentiated target selection?

Putting my old hat on, when I was responsible for business development and licensing, I was getting exhausted at looking at programmes focused on PSMA, SSTR2, and FAP which is still an emerging target. These are highly effective targets, and they are very differentiated in the sense that other mechanisms of action have generally struggled to prosecute them successfully. Radiopharmaceutical therapy has a unique mechanism of action that is well matched to those modalities. The next major opportunities will come from identifying and prosecuting novel targets that are specifically suited to radiopharmaceutical therapy. That is exactly what we are doing at Sego.

 

Do you see a future role for both alpha and beta emitters?

Absolutely. Just as targets must be matched to the mechanism of action, diseases need to be matched to the isotope. Different diseases and different binders will require different isotopes to ensure a highly effective therapeutic index for patients with that particular disease.

The emission profile of an isotope also matters when considering combinations with other oncology therapies which is a core pillar that needs to be explored further. Radiopharmaceuticals are an orthogonal mechanism of action. They are not using a biochemical mechanism of action, but by actual physical particles travelling through cells and disrupting DNA. That creates opportunities to think about which mechanisms of action may combine effectively with radiopharmaceutical therapy. Those opportunities will differ by isotope and emission type.

 

Are any concerns about radiopharmaceuticals overstated, or are investors right to scrutinise the field carefully?

I think radiopharmaceutical development is actually very challenging. It requires deep domain expertise and many years of experience to be successful. Drug development is inherently difficult, and investors are wise to look carefully at the specific challenges in this space.

The field is attracting a lot of interest, but the challenges are hard to overcome. Target identification remains constrained by the profiles required for radiopharmaceuticals. Medicinal chemistry is complicated, because developers need to ensure that the radiation dose is delivered to the right location in the body. Beyond that, the supply chain is incredibly complex. For those reasons, investors should be very diligent about where they place their money in this field.

 

Looking ahead to 2035, how do you expect the radiopharmaceutical landscape to evolve?

There is incredible growth potential in this space. Industry forecasts suggest huge acceleration and huge CAGR and what we anticipate is the market will grow from around $3 billion last year to approximately $30 billion, representing roughly a tenfold increase. That growth will be driven partly by the exploration of new targets in radiopharmaceutical therapy, and partly by large pharmaceutical companies seeking to replace medicines affected by patent cliffs through 2030.

At the same time, unfortunately more patients globally are being diagnosed with cancer, creating a need for more specific and personalised treatment. Radiopharmaceutical therapy supports that personalised approach by using a diagnostic scan to confirm that a patient has the relevant receptors before moving them to a space where they can undergo therapy. That ability to select patients more precisely is one of the reasons I believe the field can achieve its forecast growth.

 

“We anticipate the market will grow from around $3 billion last year to approximately $30 billion, representing roughly a tenfold increase.”

 

Beyond market growth, what will the field need to achieve by 2035?

I think there is a lot of potential. Further exploration of novel isotopes will be very interesting and will potentially unlock additional targets. More broadly, the field needs to answer two key questions. First, within the modality, how do we optimise dosing for the right indication and the right target? Second, adjacent to the modality, how do we identify the best combination therapies? If radiopharmaceutical therapy is to fulfil its potential, it will need to think about what combination therapies ensure sufficient duration of response to displace standard of care in relevant settings. Optimising dose, target, indication, and combination strategy will be central to that progress.

 

How important are high-quality data sources and competitive intelligence when making strategic decisions?

It is critical to stay aware of the competitive landscape when making any kind of decisions. We actively use Beacon’s database to assess which areas are competitive and where the white space may be. And specifically, when it comes to in-licensing opportunities, we use Beacon to triage potential assets and identify the right people and organisations to approach.

 

Where do you see the greatest opportunity for AI to accelerate innovation in radiopharmaceuticals?

There is a lot of interest in AI across drug development. Sego is based in Salt Lake City, which is a hub for machine learning and AI biotechs, and we are continuing to learn and unlock the capabilities AI has every day.

The biggest challenge for AI in radiopharmaceuticals is that most, if not all, existing models have been built around traditional medicines and commonly focus on lighter elements in the top three rows of the periodic table. Radiopharmaceutical development often involves lanthanides and actinides, which makes modelling more complex because these are physics- and mass-based systems that are not easily tuneable to incorporate heavy metals.

Where I think the greatest opportunity may come from is using AI to unlock the potential of development candidates and accelerate early-phase clinical studies. This is an area where Sego is investing time and effort, with the aim of helping pioneer how AI can be used in radiopharmaceutical development.

 

Finally, what is next for Sego Therapeutics?

We have several important milestones coming up. We are proud to be moving into our new facility, which will be the fastest GMP facility ever built in the radiopharmaceutical space. With a lot of help from our partners, we have achieved that milestone in less than a year from commencement to completion.

That facility will enable us to deliver doses in the first half of next year which is a huge achievement for us and those doses will fuel our early-stage clinical trial development and an important step in advancing our pipeline.