How to make a winning early-stage therapeutic pitch

I must start this memo with a disclaimer – I thoroughly admire the work founders are doing leading early-stage therapeutic companies. There seems to be no easy road to take that will help a startup find and bring life-saving and disease-modifying therapies for age-related diseases to market. The path isn’t always straightforward. It takes intellect, work, dedication, and a mission-driven mentality to take a company from in-vitro, through preclinical in-vivo, to the final human trial phase.?

Given my admiration of this field, I’ve had a worrisome thought pass my mind. What if the next potentially ground-breaking therapeutic for cancer, cardiovascular disease, diabetes or other devastating disease fields will fail to attract early capital simply due to a clumsy deck?

Digging through many early-stage therapeutic decks as I do every day, you notice certain patterns of structure, storytelling and advantages that founders choose to emphasise. Most importantly, though, you notice common denominators in items that confuse and blur the overall impression of the company. One must remember that no matter how groundbreaking the tech and talented the team, decks are very often subjected to a very pragmatic, almost mechanical, review by funds. In other words, to successfully share your incredible story and the science behind it, you must first grab reviewers’ attention.?

This article provides some quick tips for clarifying and strengthening your early-stage therapeutic deck. These are in no particular order, and take two things as given:

a) An early-stage therapeutic company, for this article, is defined as a startup in a pre-clinical, and, almost always, pre-IND stage.??

b) The purpose of the deck is not to provide every single detail on the company (there is a data room for that) but rather to spark the VC's interest to learn more and offer lead-ins for asking the right questions.?

1. Skip the market definition when it’s well-known. This tip may go against the typical pitch playbook, but VCs already know the impact of cancer, cardiovascular diseases, and neurodegenerative disorders. It is a given that the disease burden is enormous, and there is not a lot you can add that will surprise VCs. When looking at rare diseases, stick to a straightforward problem definition that quantifies disease burden and unmet needs. These numbers provide valuable context to examine the market need when incidence rates are low.?
2. Describe science in a sequential manner. It’s best to summarise prior treatments, the standard of care, and the known limitations. Describe your approach in the context of improving the standard of care and focus on the added value and efficacy it may bring. Science is exciting, but only when presented in the context of tangibly improved performance over a current standard. Having high-profile publications, of course, is a plus but is not necessarily required. Another pointer: never assume that the partner or the analyst looking at the deck will happen to be an expert in your therapeutic’s specific field. In most cases, the reader will have general holistic knowledge, so it’s super important to include sector or technology-unique details.?
3. Spend time on the state of IP. IP is one of the most important due diligence positions on the agenda of a therapeutic deal. This is because it indicates a potential market monopoly of making something unique for a defined period. In other words, it will express your M&A attractiveness. Make sure you list the existing patents, patent applications, items preserved as know-how, and the general IP protection strategy going forward. The latter is best digested as a timeline. NEVER claim that the IP belongs to the founders rather than the company. If this is the case, you may want to fix it, as it can be an immediate showstopper.?
4. Be honest and proud of your pre-clinical data while remaining consistent. In early-stage therapeutics, every completed pre-clinical model counts. Data helps VCs understand the early efficacy, evaluate the risk profile, compare it to competing approaches, and estimate a company’s readiness for further regulatory approvals. Always be consistent - map your pre-clinical work, and provide a timeline. Good data is equally important as pre-clinical experiments that did not yield promising results, and it’s best to demonstrate that you are aware of both. Instead of hiding unsuccessful studies, provide an analysis of what was improved based on the unsatisfactory results. Seriously now - never hide or manipulate data. It will eventually come up and obliterate your round or the whole company.?
5. Demonstrate an overall understanding of the regulatory pathway. Assuming timelines and results when discussing your future IND (Investigational New Drug, an FDA application) approval is perfectly normal. However, it is also perfectly possible and encouraged to demonstrate several more concrete things: a) understanding the steps (like pre-IND or interact meetings) that will help achieve the result; b) understanding limitations and what data you need for any regulatory dialogue, but are still missing; c) understanding the prior practice of companies in a similar space (if they exist).?
6. Acknowledge competing approaches, especially commercially successful ones. Every therapeutic field has multiple dominating hypotheses, with dozens of others that are less well-known. Immuno-oncology, for example, packs various therapeutic areas such as TILs, viral vector usage, IL27-focused therapeutics, anti-PD-1 drugs and general checkpoint inhibitors. This variety of approaches signals a substantial unmet need and extensive research in a given area. Be sure to objectively compare yourself to at least the dominating ideas and companies, especially if these are already approved and commercially successful. For example, claiming higher potential efficacy in scenarios where blockbuster drugs such as Keytruda or Opdivo are ineffective may hint at your future blockbuster capabilities.?
7. Don’t sell snake oil, and acknowledge therapeutic limitations. ?Most age-related diseases are incredibly complex. In some, such as neurodegenerative disorders like MS and Alzheimer’s, we do not even understand the root cause. In others, such as cardiovascular disease and cancer, the causes are numerous, ranging from well-researched explanations to what is still primarily scientific guesswork. Never claim your therapy will be suitable for everything in a particular disease area, as it immediately flags it as “snake oil.” The more defined the target patient population is, the easier it is to estimate the potential impact of a therapeutic. In doing so, you can identify potential partners for future acquisition and evaluate the relevance of pre-clinical models already conducted.?
8. Be focused short-term, and demonstrate your platform’s potential long-term. In pre-clinical rounds, both data and available liquidity are scarce. It requires patience, as IND approval, which will enable more significant clinical fundraising opportunities, takes time. Ensure you communicate a defined focus on a priority therapeutic target/lead indication, even if you have a broad range of potential candidates and disease pipelines. Make sure you describe why this target was chosen as a priority (this will probably be because of the best data). This will suggest to investors where your company will spend the money short term, where the team's attention will be, and what will be the first value inflection driver for the company to unlock future funding rounds. That being said, if you have a platform technology, use your early pipeline to demonstrate how your focus will broaden after securing the first progress-enabling results in a priority area.?
9. Spend time describing the team. Early-stage investing is very much a people's business. Make sure to describe every team member with a concise, relevant background. In other words, when describing a business development lead, stick to tangible professional achievements and track record (e.g., led X deals, raised X capital, etc), while a CTO would probably deserve an abstract on academic traction, patents filed, and former industry-relevant CTO positions held. Here’s another hot tip: I implore you to use human, smiling pictures of your team or work on creating ones. We’ve seen it all for team pictures, from funeral-like solemn portraits to wanted poster-esque photo robots.?
10. Last but not least, be clear with your ask, deliverables, and future capital requirements. Always take the time to clearly list the deal terms and the round structure. Indicating previous investors also helps, if applicable. Make sure to put things into perspective – when investing in you, a VC will typically reserve a larger amount of funding to follow up in the next round. Providing your best estimation of your next round’s timing and size helps VCs plan financially and shows that you understand the road ahead. On the milestone side, a simple list of “We are going to complete X and Y, which will enable us to start raising for V and Z” is enough to start a conversation.?

While these are, of course, not exhaustive, I’ve attempted to list major areas which, if done right, will always spark initial interest and encourage more detailed conversation. I’d like to add - these are also the areas our team usually sees the most issues with when described in decks.?

I encourage you to take another critical glance at your materials, gear up, and raise your pre-clinical round! It takes a good team (and a straightforward deck) to help save millions of lives every year.?