The Readout Loud 393: A conversation with the 'godfather' of biotech
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Mar 20, 2026 Stelios Papadapolous, veteran biotech executive and dealmaker nicknamed the industry's 'godfather', reflects on regulatory turmoil and rebuilding talent at the FDA. He discusses China's rise in biotech and risks from nationalist policies. He also recounts serendipitous drug discoveries and why lone innovators still matter.
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Don't Trust Topline Weight Loss Headlines
- Structure's 16% weight loss headline hides a high discontinuation rate that likely lowers real-world efficacy.
- Elaine Chen notes 28% discontinued during titration and a lower-efficacy low-start dose arm, signaling tolerability concerns.
Always Report Treatment Regimen Efficacy
- Present the treatment-regimen (intention-to-treat) efficacy and disclose discontinuation and side-effect rates up front.
- Elaine Chen urges companies to stop cherry-picking topline metrics because FDA and comparisons rely on regimen estimates.
Lilly's Big Weight Loss Needs Context
- Lilly's ratatrutide produced up to 15% weight loss in a type 2 diabetes trial but included patients with BMI over 23, not just obese participants.
- Elaine Chen highlights missing subgroup breakdowns, raising questions about applicability to non-obese diabetics.