Barbara Wirostko on CMO Leadership and Being the First Woman Chair-Elect of the ARVO Foundation
Barbara Wirostko, MD, CMO & Co-Founder of Qlaris Bio, and Co-Founder of MyEyes, discusses her career journey founding biotech and medtechcompanies and her recent election as Chair of the ARVO Foundation.
Tell us about your career journey as the co-founder of different companies and organizations.
I’ve wanted to be a physician for as long as I can remember, but it was during medical school that I truly discovered my passion for ophthalmology. I was fascinated by how much we can learn about a person’s overall health simply by looking at the retina. The eye is an incredibly complex organ that combines muscular, neurologic and vascular structures along with intricate outflow and filtering systems. That depth and complexity are what drew me to ophthalmology and continue to inspire me in this field.
I didn’t necessarily expect to enter drug development. I wasn’t looking for that type of job, but I started consulting for Pfizer on clinical trials around Macugen, the first anti-VEGF therapy. During that work, I fell in love with the impact drug development can have: the ability to change the course of disease, shape therapies and ultimately help so many more patients rather than just the few you see in clinic.
At the same time, I realized I missed seeing patients, so I made a conscious decision to do both. Being a practicing MD who also conducts drug development research makes me a better clinician. I understand the unmet needs, the reimbursement challenges, the competitive landscape and most importantly, the patients and the mindset of the clinicians who care for them.
Do you have advice for other CMOs, especially as someone who has founded multiple biotech companies?
You have to think outside of the box. I’ve learned that while I can certainly handle logistics and operations, my true strengths are strategy and vision. Founding a company means building from scratch. It is the true white board.
You also need to understand unmet needs not only in today’s environment, but in how medicine will be practiced in five to six years. For example, with MyEyes, I thought about intraocular pressure (IOP) as a physiologic parameter that fluctuates, similar to glucose, blood pressure or heart rate. We continuously monitor these metrics, so why should glaucoma be different? Why are we still measuring a number that predicts future blindness only a few times a year at fixed time points? That doesn’t make sense. MyEyes was born from a patient whose fluctuating IOP changed our thinking, and it’s taken us on a unique journey working directly with patients.
Drug development is a bit different because you’re creating something with the hope that it reaches patients in the clinic. Unlike selling a device directly to patients, drug development involves coordinating multiple stakeholders, navigating a high attrition rate and responsibly managing external investment. To any CMO thinking about creating a company, I would ask, “What is the vision? Does it fulfill an unmet need? Is it commercializable? Who are your stakeholders?”
There was a really good book that I read before I started Jade Therapeutics titled “Nail It Then Scale It.” It emphasized the importance of talking with the people who will use, sell and prescribe your product to make sure it truly fulfills a need, and then you start the process of building the product.
"Being a practicing MD who also conducts drug development research makes me a better clinician. I understand the unmet needs, the reimbursement challenges, the competitive landscape and most importantly, the patients and the mindset of the clinicians who care for them."
You recently were elected to become the incoming chair for the ARVO Foundation for Eye Research. Can you speak to the role of the foundation and your upcoming role as chair?
I’ve been a member of ARVO for over 35 years. I used to attend meetings with my brother, my mom and my dad because my father was an ophthalmologist and ARVO member, so it’s deeply personal to me. I believe strongly in ARVO’s mission and how it advances research and supports researchers.
I got involved with the ARVO Foundation about three years ago. The Foundation focuses on fundraising and creating innovative ways to support vision research and the scientists behind it worldwide. As incoming chair, I’ll lead outreach efforts with industry, academia and nonprofit organizations to advance research not only in developed countries, but also in underserved regions around the globe. I am the first woman chair since the Foundation was established 25 years ago, coinciding with the Foundation Board’s 25th anniversary – pretty cool and a tremendous honor.
ARVO is an incredible platform for exposure, mentorship, collaboration and giving back. It harmonizes so many aspects of vision science, which is why I’m involved and passionate about its mission and potential for impact.
What does being the first woman chair-elect of the ARVO Foundation mean to you?
Diversity matters. You need different kinds of diversity to bring in different perspectives. The ARVO Foundation is a global organization, with colleagues and grant recipients from all over the world. Treating glaucoma in India is different from treating it in Massachusetts. Understanding those experiences keeps our field progressing.
You were also recently awarded the Visionary Award from the Glaucoma Research Foundation. What does being a visionary mean to you?
Over time, I’ve learned that my greatest strength is in the “whiteboard space” where I’m recognizing problems, identifying opportunities and rallying teams to develop and execute solutions.
I call myself a bit of Pollyanna; the glass is definitely half filled. I always see the possibilities and potential. That, to me, is what it means to be a visionary.
"We tend to think about what we want to achieve from a meeting but by thinking about what other people want, we can work towards solutions that satisfy everyone. When you understand everyone’s goals, you can generate opportunities that work for all stakeholders."
How do you balance clinical, academic and industry work?
Staying engaged in clinical care makes me a better CMO. When you’re still practicing, you speak the same language as the clinicians you’re engaging with. It strengthens credibility and builds trust.
It has also allowed investors to recognize the value of my clinical insight and the collaborations I bring. I have always said that I am, first and foremost, a clinician. Yes, I am also a drug developer, but I am still always a clinician.
My experience at Pfizer and the opportunity to return to academia was unique. Dr. Randy Olson, then Chair and CEO of the John A. Moran Eye Center, University of Utah, supported an adjunct appointment that enabled me to maintain my industry roles while continuing to see patients one day a week.
I have also discovered my love of teaching and mentoring medical students, residents and fellows. That work has been incredibly rewarding and truly fills my soul.
What is your advice for other CMOs interested in getting on boards?
Network. Establish your brand. Be visible, have a voice and make connections. Whenever you have the opportunity, let people know that you want to be on boards.
What is your leadership advice for CMOs?
Come prepared. Stay aligned with your CEO. Step up to the plate and voice an opinion but also listen and know your audience. When you’re having a meeting, think about what the other people at the table want to gain. What are their experiences and why are they meeting with you? We tend to think about what we want to achieve from a meeting but by thinking about what other people want, we can work towards solutions that satisfy everyone. When you understand everyone’s goals, you can generate opportunities that work for all stakeholders.
"There is no protocol for your life."
Can you give us an update on what you’re working on at Qlaris?
We’ve completed two Phase 2 studies, including a combination study with first-line prostaglandin therapy, showing an additional meaningful IOP reduction of approximately 3.5 mmHg of additional IOP reduction on top of Latanoprost.
Based on that success, we’re moving forward with a fixed-dose combination, QLS-111 combined with latanoprost for once daily dosing. We’re preparing a bridging study with that preservative free combination therapy, then moving forward into Phase 3 trials. We’re raising a Series C financing round to support this next stage.
We’re also completing a study in normal-tension glaucoma patients. Our investigational product is unique in that it vasodilates ocular vascular tissue to lower IOP and may also improve perfusion to the back of the eye and the optic nerve head. It’s an exciting compound with potential benefits beyond pressure lowering alone.
Anything else?
Be an advocate for yourself. Listen, understand your role, but also don't be shy to seize opportunities that present themselves. There is no protocol for your life.
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