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116. Bull, Bear & Beyond – Mendus executive interview
6 Plays4 months ago
In this video, we speak with Dr Tariq Mughal, chief medical officer at Mendus. We discuss Tariq’s interest in the blood cancer space before moving on to Mendus’s lead programme in acute myeloid leukaemia (AML) maintenance, as well as the potential to expand vididencel’s application to other indications.
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About ‘Bull, Bear & Beyond’
Bull, Bear & Beyond': features candid conversations with senior executives and from our own team of experts from across industries, exploring strategy, innovation, and the opportunities shaping their markets and 60-second pieces are a compressed summary of content designed to convey our message in a single, easily shareable hit.
About Edison:
Edison is a content-led IR business. We believe quality investment content should inform all investors, not just brokers. Our mission: engage and build bigger, better-informed investor audiences for our clients.
Edison covers 50+ investment trusts, read about them here: https://www.edisongroup.com/equities/investment-companies/
Original interview published on 18/08/2025 and reposted as a podcast
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Transcript
Introduction and Dr. Tarek Mughal's Role
00:00:08
Speaker
Hello and welcome to Edison TV. My name is Aaron Atkar and I'm a healthcare analyst here at Edison. We're joined today by another new guest, Dr. Tarek Mughal of Mendes. Tarek joined as Chief Medical Officer earlier this year.
00:00:20
Speaker
This interview follows part of a series we're recording with Mendes focusing on some of the the broader themes in which the company is working. Today we're going to learn a bit more about Tarek and the blood cancer space. Tarek, thanks for joining me today.
00:00:31
Speaker
Well, thank you very much Aaron. It's very kind of you to invite me for this interview.
Dr. Mughal's Medical Background and Research Focus
00:00:36
Speaker
um So i yeah I trained in ah clinical medicine here in London, ah St. George's Hospital, and then I did my postgraduate training in hematology, medical oncology, and stem cell transplant at the Hammersmith Hospital, ah Imperial College, and also on the other side of the Atlantic in Denver, Colorado.
00:01:01
Speaker
um Much of my early career had been focused on the clinical management of a patients with ah diverse cancers, ah but in particular hematological malignancies and breast cancer.
00:01:16
Speaker
So I've been fortunate enough to have a fairly broad ah spectrum of for therapy for these patients, ranging from conventional chemotherapy to targeted therapy, precision immunotherapy, cellular therapy and transplant.
00:01:34
Speaker
And but much of that is reflected by the the different eras in which I've been practicing medicine, mainly in London but also in the in in different parts of the US, particularly Colorado and then more recently in ah in Boston, Massachusetts, where I still have a chair in cancer medicine.
00:01:55
Speaker
um the The early part of my career um involving translational research was very much focused on ah a disease called chronic myeloid leukemia, which is a a rare form of chronic leukemia, and we were very fortunate and it was purely incidental that we selected this disease, which turned out to be genetically the least complex disease. It is driven by what we call one cancer mutation, which is known as BCR-ABL. And in the late nineteen ninety s our clinical effort or between different academic centers and to an industry led to the availability of but of targeted therapy, which probably was the first successful targeted therapy in human cancer.
00:02:48
Speaker
um And this is known as imatinib. It's a form of what we call tyrosine kinase inhibitors. And this therapy literally overnight changed the treatment um outcomes for these patients.
Success and Challenges in CML Treatment
00:03:06
Speaker
For a disease which was uniformly fatal at that time in the late nineteen ninety s we were able to make this into a disease where the majority of the patients, well over 90%, were successfully treated and they enjoyed a life expectancy not dissimilar from that of the general population.
00:03:29
Speaker
However, um from the disease perspective, we've been struggling to get rid of every last cancer cell in these patients, which obviously would be very, very difficult to monitor anyway. um So we we we've realized that the majority of these patients to enjoy a normal life expectancy, they remain on therapy for long periods of time. And obviously when you take therapy for a long period of time, you subject these patients to toxicity, the chronic toxicity, ah which is both physical and of course financial. And the physical toxicity can be quite devastating in some cases. It impacts the quality of life and rarely can also lead to potentially life threatening side effects, particularly cardiovascular.
00:04:18
Speaker
So many efforts ah from the early 2000s when the therapies were first approved or for this disease have been focused on efforts to safely ah and effectively discontinue these therapies.
00:04:35
Speaker
a patient could essentially lead a normal life ah and not required to take therapy. And this is known as what we call treatment-free remission or TFR.
00:04:47
Speaker
This particular concept was introduced, like I said, in the early 2001, 2002, soon after the approval of the first And the efforts at the Hammersmith were led by the late John Goldman, ah who was my mentor and remained a mentor for almost three decades, um went on to become my confidant and a close friend.
00:05:20
Speaker
ah We lived together for a few years as well in Nottingham Gate, and he shaped my career. um And now some... three and three decades after the successful introduction of therapy, we're beginning to see how we can address the treatment-free remission for the majority of the patient.
00:05:45
Speaker
So that's one aspect. the ah In addition to the chronic myeloid leukemia, I've been involved in a number of other myeloid malignancies, acute myeloid leukemia, myelofibrosis, and some of the other related cancers, and of course, breast cancer.
Transition to Industry and Cancer Genomics Work
00:06:02
Speaker
My career ah up until 2014 was almost exclusively focused on the academic and clinical aspects. And then in 2014, in an in an effort to try to understand how I can contribute to the society as a whole in trying to improve ah the medicines, drugs, other therapies which are available to patients who could not be treated with the current therapy.
00:06:35
Speaker
I toyed with the idea of joining the industry. um in parallel with keeping some academic and clinical duties. And I joined a company called Foundation Medicine based in the suburbs of Boston. And there I understood about the the cancer genomics ah and a lot of the initial work which led to the successful application of immunotherapies.
00:07:03
Speaker
and and And this is, now people refer to this as the precision oncology, comprises of targeted therapy and their immunotherapies. And learning about the genomics so in in in this particular role, i was able to understand the identification of cancer targets more effectively.
00:07:27
Speaker
um And then it it increased my enthusiasm to to try to understand ah drug discovery and drug developments better. So it was a natural transition. So after spending almost five years ah with the Foundation Medicine, I joined a ah biotech. in New York called Stemline Therapeutics and there I learned how to validate the cancer targets appropriately, ah understand about the drug discoveries and drug development.
00:07:58
Speaker
ah I yeah led the efforts for the clinical drug development and this is what I did just prior to joining Mendes.
00:08:08
Speaker
The attraction for Mendes to me was the the pedigree of the um immunotherapies going back to almost a decade and they had pioneered how to develop um what we call mature dendritic cell vaccine in an effort to target minimal or measurable residual disease, which is a disease which is left behind in patients where all clinical evidence of disease has been treated. And this is probably one of the major reasons why people relapse.
00:08:47
Speaker
So you do their clinical exam and everything is fine. You do the different ah conventional radiology imaging and everything is fine, but the patient then relapses soon after you you stop therapy.
00:09:01
Speaker
and And this is the disease which is only found at a molecular level. um so And it's' it's a massive unmet need. ah And Mendez has been interested in in in targeting this particular concept in myeloid malignancies.
00:09:22
Speaker
So they started their efforts in acute myeloid leukemia ah almost a decade ago, as soon after the company was formed.
Future Plans and Philosophy at Mendes
00:09:30
Speaker
um and And now they're testing this in the middle to late stage clinical trials in acute myeloid leukemia. So that was one principal attraction.
00:09:44
Speaker
The second attraction was the philosophy which Mendez has. ah And I thought that between the corporate establishment and myself, we had a ah good fit.
00:09:56
Speaker
with my mindset and my background that we could then look at other unmet needs beginning with other hematological malignancies and then also looking at solid tumors such as ovarian cancer and breast cancer.
00:10:12
Speaker
So the one of the things I have been doing in the short period I've been with Mendez is to to to to beef up their clinical development program. And in the acute myeloid leukemia, I have introduced another concept which we will be rolling out as a clinical trial. um at to to try to broaden our spectrum in in acute myeloid leukemia. And then side by side, we will also look at the targeting measurable residual disease in a patients with chronic myeloid leukemia to optimize what I said earlier in the interview, that is the discontinuing therapy successfully ah ah to achieve what is known as the treatment-free remission. So so this is the these these are the areas I'm i'm working on now.
00:11:08
Speaker
Fantastic. ah Sounds like you've got quite an extensive background in the blood cancer space, so keen to see how your your work at Mendes
Acute Myeloid Leukemia Study and Future Trials
00:11:16
Speaker
develops. um We're curious to know a little bit more about the current status of the lead programme Mendes is conducting. So that's AMR maintenance. And then could you tell us a bit more about the potential to expand? So you touched upon it just there, but what might that that look like for Mendes?
00:11:31
Speaker
Yes. Sure. Thank you for that question. So the in in terms of this the status of the the current principal MENDES study in acute myeloid leukemia, ah firstly, let me just take one step back. So this this is a study which focuses on all kinds of acute myeloid leukemia with the exception of what we call M3, which is treated in a different way.
00:11:59
Speaker
um So, this is newly diagnosed adult patient who received intensive chemotherapy and then they achieved a clinical remission and at the molecular level, ah they may or may not have disease. So, when they have that disease, it's it's called MRD positive and when they don't have molecular disease, it's MRD negative. So, if we wanted to look at the both subpopulation to to see what the Mendez lead therapy, which is known as VD-Dencil, actually offers to these patients.
00:12:35
Speaker
So this is ah and a good design. It's a randomized study where half of the patients receive the VD-Dencil with the conventional therapy for maintenance or consolidation, as we should be called correctly. and that is azacitidine and then the control arm they just received the chemotherapy called azacitidine. And right now as we speak we have ah eight patients who have been accrued into this phase 2 B study and the the ambition is to try to recruit 40 patients in the first part of the study and then make it into a larger international study where we will test about 100 patients. And if the results are robust enough and safety, which comes first and foremost, ah is is demonstrated, then we could transit this to a registration trial and then ah ah apply for regulatory approval.
00:13:35
Speaker
um In terms of what is coming next, so then the second AML trial is going to look at the less intensive induction therapy after the diagnosis of AML, and this involves two two targeted therapies, venetoclax and azacitidine combined together, and this less intensive regimen usually results in success in about 65-70% of the patient. So our plan would be to give patients two or three cycles of this,
00:14:11
Speaker
achieve complete remission and then whether they have molecular residual disease or not, offer them VD-dense with these two targeted agents.
00:14:22
Speaker
So this way when these two trials are running side by side, we will cover the full spectrum of AML. And then the third trial will be looking at those patients with chronic myeloma leukemia who are struggling to achieve TFR or treatment-free remission.
00:14:37
Speaker
And so we would like to consider adding V-D-Dencil to the tyrosine kinase inhibitors, whichever. Right now, we have, actually, we have six generations of tyrosine kinase inhibitors now. so And and and the out of these six generations, the first two generations, which comprises of four different agents,
00:14:58
Speaker
have already been approved for first-line. So people have a lot of choices. So we will allow the the treating of physician to select any tyrosine kinase inhibitor and add the VidiDencil to see if we can achieve our treatment-free remission in patients who struggling. And then subsequently, if the safety of the vaccine has been established and there's robust enough efficacy, we will then test it on the other side of the coin for the treatment-free remission. Because when you achieve it, you want to maintain it in a sustainable way. And right now, we know half of the patients are going to lose their treatment-free remission, and then they need to go back on therapy.
00:15:38
Speaker
So we we will do a randomized study where half of the patient will get Vidadensil only, and then the other half we'll get nothing and we'll observe them. Fantastic, Tarek, that's very insightful. Thank you.
00:15:49
Speaker
Thank you very much. If our audience would like to learn more about Mendes, please refer to the Edison website where we've got our research freely accessible or look at the Mendes website. Tarek, thanks again for joining me today. Thank you, I appreciate it. been a pleasure.