A Doctor of Many Talents

Dr. Josh Bilenker discusses how he has combined his medical and investment acumen into Loxo Oncology.

For Dr. Josh Bilenker, starting Loxo Oncology in 2013 was the culmination of his life’s work in both the medical and the investment arenas. Each step in his career moved Bilenker closer to building the company, which specializes in discovering, developing, and commercializing cancer drugs.

“Taking care of cancer patients provides a fast lesson in being dissatisfied with the status quo,” explains Bilenker, who is also Loxo’s chief executive officer. “The need for better therapies is so great. But to make the contribution I wanted, I realized I needed to speak the languages of clinical medicine, drug development and finance.”

Prior to starting Loxo Oncology, Bilenker was a partner at the multistrategy healthcare investment firm Aisling Capital from 2006 until 2013, where he remains an operating partner. Prior to that, he worked for two years at the U.S. Food and Drug Administration (FDA) in the Office of Oncology, reviewing novel cancer drugs. Bilenker trained at the University of Pennsylvania in internal medicine and medical oncology, after earning his M.D. at The Johns Hopkins University School of Medicine.

It was during his time at the FDA that Bilenker was exposed to both large and small biopharma companies. That experience kindled his entrepreneurial spirit, and the fates aligned when Bilenker was introduced to Aisling Capital by a medical school classmate who was already working in finance. He joined the New York–based private equity and venture capital firm and helped the investment team to to diligence the scientific, clinical, and regulatory risks of potential deals. He stayed with the firm through two fundraising cycles, all the while soaking in the experience.

“This was another piece of the puzzle for me,” says Bilenker. “I learned how important careful capital formation is to the success of a biotech company.”

One of the most valuable lessons he learned during his time with Aisling Capital was the importance of reducing investor risk with each drug development milestone. He brought that learning to Loxo Oncology, by focusing on drugs that could be developed in genetically defined cancer populations, rather than according to classical diagnoses, which rely on anatomic descriptions, such as lunch or breast cancer.

“Our approach provides an opportunity to see results unequivocally and early in drug development,” Bilenker explains. “Patients know very quickly that they are getting better, and their doctors can see tumors shrink on CAT scans. Investors do not have to wait until Phase 2 or Phase 3 to learn whether the treatment works—nor do they have to take binary bets on randomized trials that are not dilenceable.

“We think everybody wins this way.”

Bilenker recognized a treatment trend was afoot and built Loxo Oncology—relying on his medical expertise and dealmaking know-how. The pharmaceutical company has allied itself with experienced medicinal chemists, leading cancer researchers, clinical trialists, and genetic testing laboratories to bring novel medicines to patients with metastatic cancer.

Bilenker considered the most responsible ways to capitalize the company, working with blue chip venture capitalists, a family office, and crossover investors who shared a common vision of building a sustainable, multiproduct cancer drug development company. Through two rounds of private financing, he worked hard to align all investors around a valuation that would quickly enable an initial public offering. The company went public in August 2014, 15 months after company formation. He also relied on his experience at Aisling Capital in keeping operating expenses low, and achieving development milestones with a lean organization.

“We are still in the early days of the company, and there is a lot of work to do, but I wake up every day grateful that we have a chance to alter the lives of patients who have otherwise exhausted hope,” says Bilenker. “The investment community—those who allocate capital to worthy science—should share in the same satisfaction. Their vision, diligence and commitment are transforming the face of medicine.”