Yan Liu: Never Worry About Making Mistakes

Gevorg Tamamyan: Hello everyone. Welcome back to OncoDaily. Today is one of our series on onco-influencers and it’s a great pleasure for me to welcome a good friend of mine, Yan Liu from China.

Welcome, Yan. Thank you very much for having the time for us. I’ll just do a small introduction about you and then we’ll go to our interview, okay?

Yan Liu: Thank you.

Gevorg Tamamyan: So Dr. Yan Liu is the chief medical officer of Mitro. She’s a radiologist with passion for innovation driven by her extensive career and broad recognition in medical imaging. During the recent 15 years, Dr. Liu has dedicated her work to the integration of imaging in multi-central clinical trials and the development of AI-based software as medical device. Previously, Dr. Liu served as the CMO of Median Technologies where she oversaw the imaging implementation of 100 plus clinical trials and supported 17 regulatory approvals using imaging endpoint data.

Before joining Median, Dr. Liu had roles as the head of translational research, radiotherapy and imaging department of EORTC, European Organization for Research and Treatment of Cancer. In this role, she and her team established a tumor biobank to promote translation research, created benchmark for radiotherapy quality assurance and implemented novel imaging biomarkers to accelerate drug development.

Dr. Liu completed her medical studies at the Shanghai Jiaotong University College of Medicine where she also received her master’s of medicine in imaging diagnosis and second master’s of drug development science from the King’s College of London. Dr. Liu also studied brain functional imaging at the Erasmus Hospital in Brussels where she earned her PhD in medical sciences from Université Libre de Brussels.

Dr. Liu has published book chapters and more than 40 peer-reviewed papers in high-impact journals such as Lancet Oncology and Nature Reduce Clinical Oncology. She is a member of Resist core working group, the chair of the ERTC imaging group where she was in 2016-2017 and advisor for the Chinese National Medical Products Administration to develop the standard technical guidelines for imaging evaluation procedures in clinical trials of antineoplastic drugs.

I can continue many more and it’s going to take a long time for us but thank you Yan for again for being with us and you have like really accomplished a lot in a very short period of time. Let’s dive into your story of success if you don’t mind.

Yan Liu: Thank you, thank you, thank you. You’re very happy to share.

Gevorg Tamamyan: Yan, can you, I mean you are besides all these accomplishments, you are also a great mom of three children and I mean what was your experience, personal experience in this career growth and being a foreigner going to Europe and what was your key of success?

Yan Liu: Thank you, that’s very interesting question. So indeed, thanks for that long introduction but I think if I summarize my career path, I can conclude them into two words, that’s imaging and oncology. So this is the radical that’s guided me move forward for the past 20 years.

I never give up this pride I have a family behind. As you said, to be a full-time mother, also a lead of a department and a company, that’s sometimes it’s not easy to have everything well organized. So I think time management is important and also understand the priority and continue move.

It’s, I think interestingly is it’s never how fast you run that will drive the success is whether you can continue and go to the end. I may have a small story to share with you because I always feel myself as a simple woman, I can do anything, anytime but since that time, I realized I also have limitation. At that time, I just changed a new job and I was excited and also I was pregnant of my third child.

In the meantime, I’m finishing my second master at King’s College London. So I was pregnant, I have a big belly and I traveled from between Brussels and London once per month and I also finished all my modules within the time. So I say, okay, now my last step is just to give birth and I will have three months maternity leave.

I can finish my thesis, my dissemination in three months. So that would be the perfect timing and I think this was a perfect plan but in reality, the day when I give birth, when I deliver my third child, my husband was also hospitalized and he was attacked by Lyme disease and he also had the neurosymptom and he was emergently administrated to the third floor at Saint-Luc and at the same day, I give birth. That was quite tough because as a doctor, I know what it means Lyme disease with CNS symptoms.

I was quite worried and when I come back with two kids at home with one baby crying and my husband was still in the hospital, at that time, I realized you can never do everything at the same time. Sometimes we need to pick up priority and that time I choose my family. So I postponed my delivery of my thesis.

I did not touch my computer for three months and it was also the first time I did not work during maternity leave and I stayed with my family and after that, it’s very difficult. When we move very fast, it’s like a plan and when you have the plan stopped, either it will crash or there was no kind of in-between and you can slow down. So I put the case college aside until 2020.

I asked myself whether I want to finish it or not. So I decided to pick it up again and I finished my thesis and finally, I graduated after six years of this master study. And yeah, so this maybe echo the first sentence I say, it’s not how fast you run but whether you can be persistent and whether you can continue with your aim.

At the same time, I think if we need to make a choice, family is always more important than career for me as a woman, as a mother. But the second point what I want to say is never give up in a way that we can finally catch it up. It’s not the result that counts, it’s that finally we keep the goal until the end.

So this is a small story to share with you. It’s never every day perfect with accomplishments, with recognitions, but also with a lot of difficulties and the details with children and family. But I think as a foreigner, as also a doctor, as a researcher, as a mom, yeah, we can also make the balance of our career and life.

Gevorg Tamamyan: Wonderful. You know, usually I ask this question to our guests. I say, can you describe in one sentence yourself?

But I mean, you did it in two words. But still, I mean, would you like to describe yourself in one sentence?

Yan Liu: Yeah, so I’m a trained radiologist. So I always believe that images have a lot of things. One image is better than 1,000 words.

This is why I choose radiology as my specialty and also oncology. I started my career in a children’s hospital. And I see that how pediatric patients, they suffer disease.

So I believe that we can use the imaging power to help cancer patients. So it’s more than one sentence. But I will say that using innovation image, and also now we have not only imaging to image the people, we also have the treatment power.

As you know, we have radiotherapeutics. So we can also treat this imaging. So this is also a very exciting piece.

Gevorg Tamamyan: Coming back, you joined EORTC, European Organization for Research and Treatment of Cancer, which is basically their largest similar organization in Europe and the leader in the field, in 2011 as a fellow. And already in 2012, in a year, you were appointed head of the Translational Research, Radiotherapy and Imaging Department, right? This was a great success.

I mean, how it happened.

Yan Liu: Thank you. Oh, you’re really carefully looking to my CV. Indeed.

You also are a fellow of EORTC. I think EORTC is a very nice platform. They give us fantastic opportunity to learn methodology, the network, and also give their opportunities for young people.

I think my experience at EORTC is really, really very appreciated. Until now, I use every day. The reason why I get promoted so quickly, I think there’s a mix of factors behind.

When I joined EORTC, two weeks later, my boss, the head of Translational Research, resigned. And it’s the third one within one year. So they finally find out, why not just give a chance to young people and she’s motivated.

She wants to do the work. Okay, she just started her career, but we can see after one year, she did establish a lot of things. Because this year is like my incubation time.

So I have one year instead of three months. And I was not hired for this position, but I did a lot of things as the acting head of unit. So in this regard, after one year, they say, yes, you know how it works.

And you know how the imaging group works, radiotherapy group works. So yes, then carry on. So I think that indeed I was young at that time.

After one year, I quickly get a promotion. But I also get one year their incubation period to see whether I can do the job or not. Yeah.

So opportunity, when you get the opportunity, take it and yeah, try to make it happen. Sometimes it’s also fair. People will fear about new things and challenge.

So when the opportunity comes, just hold. And if you try, you have 50% of the chance you will win.

Gevorg Tamamyan: Wonderful. Now you are the chief medical officer of Mitro Biotech, right? Yes.

Please, can you explore a bit more about the company and what you are doing there and what the company is doing in the field?

Yan Liu: Okay. So Mitro is a molecular imaging translational research organization. It’s a CIO, but we also do a lot of clinical trials for Dongsheng Pharmaceuticals, which is a group, a very large group, work on nuclear medicine products, so radiopharmaceuticals in China.

And we do clinical trials from phase one to phase three, but we also do investigator-initiated trials focusing on radiopharmaceuticals. And this is the co-business we are doing. Beside the clinical trials, we also have the preclinical side.

We do translational research. We do toxicity studies. And also we have CDMO.

So we also produce drugs, radiopharmaceutical drugs, for trials. So in brief words, it’s an organization for radiopharmaceutical development.

Gevorg Tamamyan: Wonderful. Thank you. And I was reading about your company and it was telling that this year you will open the first in-human imaging center and a clinic in the U.S. with spectral PET imaging, right? Yes. And can you explore a bit more about it, where it’s going to be, what it will do, and how large you are going to expand?

Yan Liu: Yeah, that’s exciting because my tool, we are still a middle, small-sized company, but our footprint, that’s not only our headquarter in Nanjing, also in China as well, but also we have our team in U.S. and in UK. So in U.S., we just created a company called Xing Imaging. Xing was established in 2018, specialized in companion diagnostics with radiopharmaceutical compounds.

So we are now a growth team. Our team, by the beginning of this year, we had eight people. And by the end of this year, we will reach 40 employees.

And we are also building the infrastructures, which will provide new tracers for our sponsors to promote transition research, including phase one units first in human studies. So companion diagnostics, that means we provide the tracers and we can also help to accelerate the drug. And the drug itself can be any drug, like drugs for Alzheimer’s disease, for Parkinson’s disease, not necessarily always radiopharmaceuticals.

So any drug, if we could use a potential radio tracer, that can help for patient selection, patient stratification to enhance their clinical trial success. So this is the aim of our phase one unit in U.S., in New Haven.

Gevorg Tamamyan: Very nice. And good luck with that. I’m sure you will have a great success.

Talking about success, in your opinion, if not the education abroad, would you have the same success story? And what role is played in your success story?

Yan Liu: Yeah, thank you for the question. I cannot say that I’m successful or not in my career. I believe that I just started.

I did the past 15 years in Europe. That’s a great opportunity for me to open mind. And also EOTC as a very, very good platform to bring me to oncology, very specialized and go deep to science, to methodology.

That’s, I think, is great value. So, yeah, I will say that if I remain in China, I stayed in China, probably I would still be in hospital to be a doctor, to do day-to-day practice, maybe as you to be a pediatric specialist. Because I really, really love my patients.

But when I left my country, the experience in Europe also opened my mind and also changed my opinion that only research can improve because day-to-day practice, that we can help patients and maintain and to also provide a solution. But if we want to improve, that only research will help us.

So I think to keep going, I will dedicate myself also in innovation to see whether new technology can help us to increase the survival for patients, to help the drug developers to accelerate their development and bring more good products for patients, which I think is important, not only to develop drugs, but also make those drugs available and accessible for patients.

Gevorg Tamamyan: Very nice. Going to the other part. Within last 20 years, there was a huge kind of boost and development in the healthcare infrastructure and healthcare industry in China.

And we see more and more drugs are coming from China. We see more and more clinical trials and breakthrough research is done there. What to expect in coming years?

Yan Liu: Yeah, I think I’m quite optimistic because I do see that the Chinese government, our regulatory really promote innovation and quality. This is a lot of efforts they are putting. And also, China has a very, very strong population.

I think to keep the healthcare, make it affordable, it’s already a big, big ambition because it covers really the basic healthcare for everybody. And in meantime, we also realize that the basic healthcare is not enough for everybody. And we need also build new drugs to satisfy the unmet medical need.

So also play a role in new drug development, only just to keep and to afford the basic healthcare. So in this regard, you can see the huge development in the past 10 years. There was a lot of drugs which were developed, especially oncology with immuno-oncology and now a lot of ADC or CAR T cells compounds and the development already been approved.

So I think that, of course, has been promoted by the policy. Also, there was a lot of resources, resources that including, so we have human resources, we have people who dedicated to that. We have money because industry also get a lot of fundraising, invest in this innovation compound.

And also the promotion of our regulatory because you can see also the fast approvals when we have the new drugs will go to the market. So, and also when, especially when the mechanism of action is already clear outside of China and we also can have fast developed pathways such as certain drugs, we may waive the phase two because we already know quite well the mechanism of action. So we can do a quick safety run with phase one studies and pass to the phase three.

So that I think thanks to also the global drug development and that also promote China to bring those kind of drug development on the shoulder of a giant. So I think this is the past 10 years, but for the future, I think China may also invest more on the real innovation, not me better on that. That will also invest more and more in the basic science, IND and what we do see that this is quite a resource that we’re putting on.

And myself, because I’m working in oncology, in imaging, I’m very focusing on radiotherapeutics. I see this is also a booming field in China. Also global wide, you can see that there were lots of exciting merger positions happened in the past years.

And we see all the big pharma’s and then see, they have quite interesting merge actions recently. And this also gives the market good signals about radiopharmaceuticals. We always say that maybe the biotech is now certain biotech entry the winter period, but radiopharmaceuticals, there was no winter.

Maybe this is too optimistic, but we do see that there was a lot of resource that coming to the field. And I’m very happy to see that I’m part of it.

Gevorg Tamamyan: Yes. And how do you see that being a part of it? That just not being a part of it, but also like you have all these connections, you build all this network during your career, not only in China, but outside of China, importantly.

I mean, how do you see yourself maybe as an ambassador or an advocate, or I don’t know, a diplomat maybe of kind of building this collaboration between the China and the outside world?

Yan Liu: Yeah. Thank you for this very interesting question. Indeed, I see that in China, we adapt very quickly.

We have a lot of new drugs, but quite often those are me too or me better drugs behind. So I also see that in reality, we do have a lot of things in the pipeline. We see a lot of trials.

I think in terms of number, really China get a lot of increase in the past years, especially in my field. However, I see that a target there were very focused. A lot of PSMA, a lot of FAPI, a lot of SSTR2, for Neuroquan and the tumor.

So quite focused. And this is what I see. I see that also in the market value, US is still the leading piece.

That’s a reality. In radio pharmaceuticals, US takes 45% of the market and following that it’s Europe. So Europe, meaning driven by three countries, France, Germany, UK.

So I think thanks to my experience as being Europe, so I’m living in Belgium for more than 17 years and also very closely with work with our US team. I think there was a lot of new things that we can exchange, promote and collaborate together.

And so not only like before we continue this kind of me too or me better, but really we can start an early stage to see whether already when a new products, when they have the signals to have good effect, we can already introduce that in China and co-develop or we can also to see whether scientifically there was some collaborations to promote those kind of development.

And to not only be the faster follow-up, but also be part of this innovation. I think if I could contribute in this field, I will be very, very happy to do so.

Gevorg Tamamyan: Yeah. Very noble.

Yan Liu: And also since you know that the reason why we have the office in New Haven is we had some, so we acquired a company, Qi Energy. So our team is in New Haven, but New Haven, Xinjiang, Beijing is owned by a Chinese company. So I think business, sometimes we have country, but science we don’t have.

So we can have this kind of interactions without really have a border. OK, this is China. This is outside of China.

But I think to help patients, the principle is whether we can bring new treatment to our population as early as possible. So I think that we can really contribute and promote to facilitate this kind of exchanges.

Gevorg Tamamyan: You have also expertise in AI. And how is it going to change the field of radiopharmaceuticals in the future, AI?

Yan Liu: That’s really exciting for me. You know, artificial intelligence is not new word. We think back early to 1950s, people are really working on AI.

I think now this period, why it’s booming is really thanks to the new technology, because calculation power that’s really booming the technology and also innovation. In the radiopharmaceutical phase, we have a lot of pieces that we can use AI. Simulate that AI already implemented in the manufacturing that we can have a shorter acquisition time, but have equivalent qualitative images so people can stay shorter time in the machine.

Then we can also improve our productivity. AI can also be in imaging. So it can automatically detect lesions.

So that’s for lesion detection. And we can also do segmentation. We can also do diagnosis.

So AI can also predict the diagnosis by our ways behind, by machine learning behind. And another very interesting piece is prediction piece of AI. So we can also use our big data, link with imaging information, link with clinical information and also outcome of patient genomic information try to help us to select more, so better compounds for drug development.

And also to predict whether the drug can be helpful or can be useful for the patient or not. So this is also a very interesting period to predict response and also help drugs. Some of the drugs can maybe even can help us to do the drug repositionary.

So existing drug, whether it can be using other therapeutic areas. So those three piece in the manufacturing that can help to improve the image quality, reduce time, increase the signal. So the signals to help us to get better quality image.

In imaging diagnosis can help us to detect religions, segment, reduce radiologist time, increase accuracy. And the third part is the most exciting thing for me is the projection for the future. Predictive response, select your compounds and also help us to reposition of your drug for new therapeutic indications.

Gevorg Tamamyan: And so how do you see, I mean, in a short, like, how do you see the future of oncology?

Yan Liu: That’s the question, I think. Like oncology is no longer really a type of disease, because oncology that also combined a lot of knowledge together as you oncologists, you pediatric oncologists. So now these days, when you work, you work with multiple people, multiple talents.

It could be your engineer, it could be your technician, it could be your lab specialist. So the future of oncology, I think we will no longer treat one disease. It’s really thanks to technology we can empower precision medicine and also to push forward cancer patient survival.

I think there was a lot of things behind. As doctors by training, we still have the basis of medicine behind. But I think with multiple talents contribute to oncology, oncology will be really interdisciplinary with a lot of contributions, thanks to innovation technology that will help us to improve the quality of life and survival of a patient.

On disease also, I think go back to my first point is I dedicate now my career in research and no longer treat patients day to day. But we believe that by that, that can improve really the survival of patients because only research can improve the current practice.

Gevorg Tamamyan: Yan, what are your top three books to read?

Yan Liu: Oh, wow. Yeah, that’s very, very good question. Top three books.

So, you know, recently I’m reading some books, but that’s really, let me, oh my God. I have several ones on my back. Maybe I can just say one and then I will give you because select three is very difficult, but just to take one, which I just recently finished and the book named Build.

Build? Yes. Have you heard about that?

No, no, no. Yeah. Build, it’s just Build, Build something.

And this was written by Tony Bell. I can send you also. He was an inventor of iPod and he was also one invest a lot in new technologies.

Interesting thing is that he also made mistakes. He worked with a lot of successful people in Silicon Valley. And this is also because we do AI.

So I’m very excited by all this technology. And he’s very good coach. He showed his way how he become first a talent, then become a good manager, then become a good CEO and a founder and then become a coach.

And this book, I think it’s easy to read. Really, there was also audio book. You can also drive and listen.

So first time I read the book and the second time I read, I listened again in my car because there was a lot of philosophies. I felt that I had those problems in my day to day life. And his experience really give me some spirit how to find a way.

Very interesting book. That’s a combined technology, people management and also human philosophies behind. Yeah.

Gevorg Tamamyan: Talking about human philosophy, what is the thing you are the proudest of?

Yan Liu: Philosophy. So, you know, as a Chinese, I like quite a lot the way of Chongyun. That means in the western way is we need to put the church in the middle of the village.

It’s a little bit like this. So you should get always the balance and not too extreme. And I think this is very, very interesting is to always see the two sides of a coin and good things, bad things and balance that.

A very good saying. I think there’s also something I follow quite often is you do actions and then you learn things. And when you learn things that will implement in your actions.

That’s interesting because when you have a career, you start to summarize what you learned. And this is from your actions. You can summarize what you learned and you can have those theories be noted.

And those kind of things can guide you in the future. However, quite often, you never see this attack. So you don’t have theories to guide you.

So the only way that you can do is without theories and you move forward, you do actions and you learn, you fill in the gaps and you learn, you fill in the gaps. This is something I learned also from Chinese philosophy is if you don’t know, you will never know. You need to move forward and you will know and you correct your errors.

This is something you move, you go and never worry about making mistakes because you only learn from your mistakes. And go again to a Western way to say that is, I think I heard about one CEO. He shared his experience to the interviewer.

And he said, how can you be successful? He said, I learned from success. How can you have your success?

I learned from my mistakes. So success comes from mistakes. So this is also, I think, simply with the saying, the Chinese Pope says, you get theories from your actions, but you can only take actions you will get your theories.

Gevorg Tamamyan: Thank you so much for having the time with us.

Yan Liu: Thank you for the opportunity and talk to you. Very nice talk to you.