From Biotech Startup to Stock Market | Paul Romness, MHA, Health Policy OS Therapies, CEO

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Mike Koelzer: Paul, introduce yourself to our listeners.

Paul Romness: My name is Paul Romess, CEO, founder, and chairman of OS Therapies, which is a biotech company.

Mike Koelzer: All right, Paul, when I looked at your stuff, I don't think I've had a company like you before. I think your thing is a research company. If I do talk to anybody that's willing to talk to me, in the, uh, pharmacy, manufacturing industry, it's a whole manufacturer, I suppose. So what does that mean, a research company versus a, I guess, a drug manufacturer. And is it common?

Paul Romness: Well, it's, it's what we are before we become a pharmaceutical or biotech company with commercial products, right? So it's, doing the clinical research, and if it's clinical, it means we're in the clinic and we're doing trials in humans. you'll also hear preclinical, biotechs or pharma companies or medical devices, and they're still in the research phase.

Maybe some animal health testing or maybe some design still bench work in the lab. But when you say clinical stage, biotech company. We actually have a product that has gone through a clinical trial. In our case, we finished the trial in October, and it's a phase two b clinical trial in osteosarcoma, which is a very deadly bone cancer.

And there aren't any new treatments for osteosarcoma. The treatments that there are out there now are brutal, Mike. Each one could kill an adult human. they're all long in the teeth, over 40 years old.

And these kids that get osteosarcoma, it's usually teenagers. They usually get this bone cancer in their long bones, and their legs are in their humerus, their arm bone. And, they get nine months of this chemo and it's considered the worst chemo regimen in cancer.

Mike Koelzer: My dad. passed from bone cancer and, when I heard bone cancer with him, I'm thinking, you know, a guy that starts at 2 25 and is gonna be at 98, you know, but thankfully he, I. I guess past of pneumonia or something, he was a good hefty, you know, 200 pounds when he passed away. But, uh, boy, that's sad to hear with that stuff. 

So, Paul, I see. So your company, when it says a research company, it's like research because we're not.

To the final stage of the product yet. And if we were talking a year from now I might be seeing OS therapies. It might be a manufacturer or something like that versus research.

So that's where the research comes in, because you're not at the final product yet.

Paul Romness: We hope to be on the market within a year,

Mike Koelzer: Really,

Paul Romness: Which means that there would be a new treatment for osteosarcoma this will be a biologic. So we're giving the body a biologic infection. happens to be listeria.

Listeria is what's known as an ancient biologic infection that happened way back a million years ago, and the body has a violent immune response to it. If you get the flu vaccine, you've got about two immune responses. When patients receive our therapy, they have 10, 11, 12, immune responses.

It's like a five alarm fire, and we actually shut down the.

Listeria four hours after we give it to the patients with an antibiotic and it kills the listeria. The immune response that we've kicked off, starts in hour one, even though we kill the listeria at hour four, the immune response keeps trucking and the immune response tells the body, Hey, there's this listeria in our body.

We need to secrete some T cells outta the lymph nodes. the body does exactly that. Starts secreting these, what are called killer T cells, and they go out and find those little micro metastases, what we call cancer seeds. And there are these little Darwinian bastards 

and those killer T cells see 'em as a, you know, foreign object. And they go and they gang up on 'em and kill 'em. It's those little micro metastases that are trying to land in your lungs and your brain to then really sit in and get in on the oxygen and soft tissues that's there and build a kind of a beachhead of cancer.

And so we're trying to catch those little micro metastases before they land in the lungs in the brain. 

Mike Koelzer: So Paul, how many people in your company, and are you farming out some of this stuff? Are you farming out the research and how does that work out with a company like yours?

Paul Romness: Yeah, we are very small, we're very agile and we're very efficient. So we did go public, in August, August 1st in the New York Stock Exchange, but we've only got five or six employees. my chief technology officer, I've never physically met. She lives out in Vancouver, off of an island in Vancouver, British Columbia.

 We use a lot of vendors. it gives us a lot of flexibility, the whole idea of rent versus buying an employee.

And, with this new economy, I think it's much more efficient to, Bring in the best people we can find for the period of time that we need them. 

Mike Koelzer: , my son-in-law just got a job and there's a debate about work from home and these people are being spoiled and all that, but it allows him, who's in North Carolina, allows a company in San Francisco to hire him. And so they've got their pick of any great people in the world, basically versus someone who's 30 miles and is willing to live out in California.

So Paul, what kind of things do you use vendors for? Now? Gimme an idea of some of the businesses that are out there that you can hire for that stuff.

Paul Romness: Sure. So the nice thing is both of our platform technologies, the OST, her two that we're using in osteosarcoma. Then we have another technology, Mike called an A DC. It's called Antibody Drug Conjugate. And the way I describe it is it's a cruise missile. That you can target a certain part of the body, and you have these cluster bombs that can, we can drop right in the cancer environment, which will debulk big cancers like ovarian cancer and stuff like that.

Both our technologies came from very renowned institutions. Our two came from University of Pennsylvania and our DC technology work with Scripps Institute. So those technologies were developed at. Top-notch places. The founding scientists are on our team, but we use a lot of vendors.

We used a vendor to run our clinical trial, we used a co-op, the Children's Oncology group. We did the clinical trials at 21 of their 200 sites. We use vendors for accounting, obviously legal. We are, in conversations with vendors around commercialization of our products, both canine and human.

And then we're talking to partners to out license those technologies, and get them to patients, not just in the United States. You know, there are only a thousand kids a year that get osteosarcoma in the United States. 30 to 40,000 dogs a year get osteosarcoma. It's the number one disease killer of dogs.

 number of two killers after automobiles. And there are no treatments , but there are only a thousand kids in the United States that get us osteosarcoma, but there are 20,000 globally. And, you know, we started this company for unmet medical needs.

And so we wanna make sure that we're partnering with someone who can get to the patients around the world with this disease.

Mike Koelzer: Paul, when you mentioned the people that do the research., I'm thinking chicken and egg. Is this something that you start your company and you say, we wanna be in this field and do this. What kind of cool research is out there? And then maybe what can we buy from these, you know, schools?

Is it that it's not you going out and saying, you're hiring some college to invent this

stuff.

Paul Romness: I think it was all a lot of serendipity, Mike. We started this company. I had been in the pharma industry all my career.

Johnson and Johnson, Amgen, Boehringer Ingelheim. And I had tried to start a couple companies with some friends and coworkers from some of my former companies, you know, in licensing, technology from big pharma that wasn't big enough for them to commercialize.

 And you know, there have been some very successful ones. Companies that have done that include Valiant and some others, but it was actually a personal experience when my daughter's best friend was diagnosed with Osteosarcoma and she's doing great. Unfortunately, about half the kids pass away from Osteosarcoma.

And so, we started as a nonprofit. We started a nonprofit and we're shaving our heads. I've shaved my head three times. I'm probably gonna do it again this summer. to raise money for pediatric cancer. it comes back thicker and darker. If you ever get a chance to shave your head, it's an awesome opportunity.

We've raised at least three, if not more million dollars. Uh, raising that, shaving our heads. But then, I read that the university, Pennsylvania, was being given up by another company, called Axxis. It was a phase two B osteosarcoma asset. And I knew why they were giving it up.

It was 'cause there were only a thousand patients.

And This is the business of pharmacy.

A thousand patients isn't a lot right. It's an ultra orphan. and we've built a pretty good business model around it, We also added all these other indications. We added this other technology, but we could be a, 500, $700 million company with a thousand to 1500 patients that are in the United States, and especially if we're keeping them alive, 

so that the patient population grows, which, two benefits of that. One, they're living longer, but it also gives us the opportunity to expand the market.

 So we enlist unlicensed technology. We started the company and started the clinical trial on October 21st, 2021, and finished the trial less than three years later, a year ahead of schedule.

Mike Koelzer: What has to go right for this? To come out within a year and what could go wrong that it doesn't come out within a year, or dare I say, never.

Paul Romness: So this is the business of pharmacy, right?

Mike Koelzer: Yeah, right.

Paul Romness: Everyone knows that drug development stuff's not easy. There are a thousand places where this could have gone wrong, and a few key places where this could go wrong moving forward. But I think we've addressed a lot of those.

We've just recently announced that the FDA has granted us a meeting to review our analysis of our data. As soon as we get that feedback from the FDA, we will submit the data. We have a couple meetings with the FDA. We're also meeting with the UK equivalent MHRA, and eventually may sometime this year with the European equivalent EMA.

And we will apply , to get commercialization of the product. OST, her two in recurred, resected, osteosarcoma. It'd be the first new treatment in over 40 years. Really cool thing. There's a program called Priority Review Voucher. and this is probably one of the bigger things going on right now in the pharma world.

There's a movement that should occur to reauthorize this legislation. Um, but it hasn't occurred yet. We always talk about unintended consequences of legislation. Well, this is, this actually meets the intended consequences of legislation. It encourages companies like ours to do more research in pediatric and rare diseases, and it also benefits big pharma because they can get their products to market faster.

What the priority review voucher is, is if we get approved for a rare pediatric disease, we get a transferable voucher that we can sell on the secondary market. The last one sold for about $150 million and what a big pharma can do is, if they've got a billion dollar product coming to market, they can cut in line, I call it the global access or clearance of the FDA and they cut four months in line instead of nine months.

They can get approval in five months. They get to market sooner. Maybe first they start to grow their forecast five months sooner, and they have four months more data exclusivity in the end. So they have four more months of the marketing that they wouldn't have had otherwise 

Mike Koelzer: So let me see if I got this. So the government, if there's success in your company, the government gives this to you, and then on the market you can say, who wants this? And a company's gonna say, Hey, it's worth a hundred, $150 million for us to speed whatever we want. Speed up, and we're gonna pay that then to your company.

And that gives everybody incentive. It gives you guys incentive, gives them incentive. It keeps everything kind of rolling.

Paul Romness: Correct.

Mike Koelzer: Paul. have there always been companies like yours around, or has the internet allowed more of that? I mean, a smaller company doing this, I gotta think that, you know, the web, which is, you know, old for anybody listening to this except old farts like me.

But, uh,

Paul Romness: me,

Mike Koelzer: You know, I didn't wanna say it, I didn't wanna, because you got dark hair. I'm the gray headed one over here.

Paul Romness: Cause I shaved my head three times. Mike, you gotta try it.

Mike Koelzer: it. My wife would kill me. I came down, she recommended a goatee, you know, five or six years ago, and we have a bunch of kids and you don't sit around too often and just say how handsome your husband is, just doesn't happen in the day to day, uh, talk around the house.

But I came down. A year later, after I had grown it, I had shaved it. She looked over at me and said, you do that? and for me that was like, are a handsome devil with that goatee. I mean, that's what that meant. so no shaving for me. So back on that question. would you see this 10 years ago, a company like your size 20 years ago, what has made these pop up? Or have, they always had these sizes.

Paul Romness: There has always been innovation, certainly coming out of the university systems, moving forward. The lack of funding that may be occurring on a federal level may affect that, but, you know, both our technologies came out of NIH. Supported facilities, UPEN Scripps. but they have to be commercialized.

 Big pharma, big bio, they actually invent in-house probably less than 10% of their pipeline.

So they depend on small companies, startups and educational institutions to develop technology and we end up de-risking the product, right?

So we get it through clinical trials. get it approved from the FDA, get reimbursement, get a market, and then big pharma says, huh, that looks. Like something we could put some money in. So they come in and help us expand the market, Or expand our reach.

Mike Koelzer: Do they come in and say, we're gonna buy it from you and give you a price? Or do they always bring a company like yours along for the ride and kind of, do it together?

Paul Romness: it can be either, it can be a licensing deal. And licensing deals are very common in the biotech industry. They usually include an upfront, big chunk of money.

 And then milestones two or three or four or five milestones, and then some type of royalty,

uh, or they can come and buy the company.

I don't think we're ready right now to be bought when we have our data, and when we have some commercial success other than the possibility of buyout, but we also have. multiple shots on goal because if our technology works in osteosarcoma, which is one of the hardest cancers to beat,

then we can pivot to all the other solid tumors that metastasize to your lungs in your brain because those little micro metastases exist in osteosarcoma that survive the chemo and radiation.

They're the same. , her two looking. A little micro-metastasis that's trying to land in your lungs. If it's breast cancer or esophageal cancer, or colorectal cancer and colorectal cancer can be all over the body. So we have a lot of shots on goal with that technology. And then we also have a lot of shots on goal with that.

You know, cruise missile, a DC, technology I described.

Mike Koelzer: Paul. talking about de-risking, does a company like yours have to de-risk? You mentioned a couple products now. Everything goes smoothly.

This comes out in less than a year. Do you always have to be tough, de-risking yourself? Do you have to have a few things on the burner, or , how do you guys deal with that kind of a situation?

Paul Romness: When we started the company, we were a pure osteosarcoma. One hit wonder if it worked, then the company would be successful. If it didn't work, we would not be successful.

And ? By adding all the other indications in our licensing agreement. And then adding the canine indication. 

I have investors that have dogs. lots of dogs. Dogs are much more of a priority for some of my investors.

I'd love to have it on the market when we go to the F fda, so that. The FDA sees that this drug is available for dogs so it should be for kids.

we'll see how that goes. The idea was that we would add these other indications and then we added that cruise missile, a DC technology.

But very recently, about two weeks ago we settled on buying our licensor. her two, that listeria platform. So we own the entire platform now

and it turns out we have a pretty big investor that now owns 9.9% of us, an institutional investor, the Israeli biotech fund. We've got a really great investor in them, who's now an owner of a company.

Mike Koelzer: talk about your investment structure and so on. I think you mentioned that you're on the stock exchange now. What does that mean in terms of when you weren't on the public stock exchange? you have just single stocks that people go on and buy?

how does that all work 

Paul Romness: sure. So, whether you're a startup, biotech, or any other business In the industry that you know and love and wanna make a difference in, you build a business and at some point, there are two reasons that companies usually IPO, we were neither of those. One is for the owners to cash out for which we didn't.

The two are to raise money, which we did raise some money, but it wasn't a big IPO. It was about. six and a half million dollars. But the real reason we iPod on the New York Stock Exchange American last August 1st was to get some recognition, some visibility for those platform technologies. And as a result, we're doing this interview with you, right?

We have an investor relations firm that sets up interviews and we've had a lot of commercialization conversations with other companies. Around that licensing and sure people can buy our stock. I would suggest you do, we hit a 52 week low, even though we haven't been around for 52 weeks, we hit our all time low last week at a dollar 12.

For reasons you can look up on filings with the SEC, it was a falsely low price because we were resetting a, Pipe, which is, it's an investment device and the reset was last week and it set at a dollar 12. That's the lowest we've ever been, and I've just shared a lot of really good information about where we're going.

So for your listeners, I would suggest looking at OSTX as an individual stock to invest in. And it's, as I've said all along from the beginning of this company, it's a do good, do well investment. This is my life's work, Mike. so if I can get rid of chemotherapy in one very rare deadly cancer life check, right?

Good, I'm done. Put me down. Don't care. But just think if we can extrapolate that out to other cancers from an investment standpoint, you know, you're doing really good things and you do well financially. And what I've said all along from the beginning is we can't do this without everybody helping.

Mike Koelzer: I am wondering on companies like yours, if even though it's on the stock exchange, you have a few big investors, but it's still out there trickling on some, and maybe people did it for reasons to have respect from the market or visibility and so on. Would a company like yours tend to have bigger investors because you wouldn't be able to pile up enough of the individual people 

Paul Romness: So we did really well on our own. Before we iPod, we did all of this for about $20 million, $18 million when another company would've spent $150, $250 million to do the clinical trials and get the. Get the technologies that we have.

Mike Koelzer: And how

many investors on that, Paul, 

Paul Romness: there were about 170 there. There was a time where I knew everybody on the cap table, Mike.

Yeah. So a hundred, 175 different investors. And, you know, then, then we went public. And, you know, for where I think you're going with this, for the institutional investors, the big biotech investors, they wanna see our data. and they wanna see our comparator data and they know it's coming. And we've told 'em it's coming the last week in June.

So between now and then, I foresee the stock creeping up ever so gently and very consistently.

And then we're gonna announce the data at a big osteosarcoma conference in Salt Lake City the last weekend in June. We think that data's gonna be good. We know the data from our clinical trial is good, that there are kids responding and kids without cancer that would otherwise have it right now.

and our side effects are very minimal, chills and slight fever, which means your immune system's getting fired up.

And the current FDA Commissioner is. He sounds like he really wants drugs that are safe to get out in the market and prove themselves, and that's something that'd be a great opportunity for us.

Mike Koelzer: I know back in the old days, the trouble that Wall Street had, that the investment firms were the same ones that were putting out the buying suggestions and so on. there wasn't enough, brick walls between, the advice and the people selling it when positive stuff comes out with a company like yours, Paul, do these investors, do they have their ear right to the FDA report or is that usually being sifted through the news or some advice thing and then these companies are getting it from that? how much do people actually have their nose into like, this trial happened and so let's buy now?

Paul Romness: So on the macro level, what the FDA is gonna do, everyone you know, in the macro world of biotech investing covers that in the micro, if you're following us like the three or four different analysts that follow us.

, and there is a very strict wall between the analysts and the bankers and the banks that cover us.

Paul Romness: We have some very respectable analysts covering us, and we appreciate it a great deal, they spend a lot of effort learning our technology. when we have news, they're right on it. That's great for our investors, it's great for companies, but in the end, it's really great for patients because we can't do this unless we're successful business wise.

And institutions developing all this technology if you don't ever commercialize it, if it never gets to the patient. what good was that technology and there's plenty of technology in the biotech world. There have been many treatments and many cures for many diseases that have died because they never got to commercialization.

Mike Koelzer: Sure. Yeah. It reminds me of the people that come in the pharmacy. They're like, 

Paul Romness: I.

Mike Koelzer: selling this for x, something store down the street has it for 0.7 x. Mrs. Smith, why didn't you buy it from them? Well, they're, they don't have it, you know, it's not gonna work unless you sell it. Those analysts, Paul, what's in it for them? Do they have subscribers or something that knows they're watching it? What's in it for an analyst to follow you this closely?

Paul Romness: Well, I mean, they have their bankers that want to see us succeed. They've been involved in our deals before and they have investments in us, and so they want to succeed. It's important to disseminate information, in a very consistent and public way.

Mike Koelzer: So, they're an analyst, but they might not be working just for a magazine, like I'm thinking they're an analyst that's hired by these banks to analyze this and then give their opinion on it.

Paul Romness: Because those banks want the best information for them to make an investment as well, right.

Mike Koelzer: How about once the stock goes public or even before , does that involve then a board and as a board a pain in the ass to deal with what goes on with that?

 I'm imagining there had to be a board just with private investments. Many people are bored. Where does the board get on and when does it become the pain in the ass?

Paul Romness: Well, you know, I'm hoping my board members are listening to this,

this podcast.

Mike Koelzer: My dog and people at the pharmacy that want sleep medication. I suggest the podcast too. Besides that, no one's listening. 

Paul Romness: A board is very important from an oversight standpoint and. You know, when we were a private company, we had an awesome executive chairman that we acquired when we acquired the A DC technology and, just a real mentor, sold his company for $4.2 billion.

To a Japanese pharmaceutical company, Colin Goddard, just a great guy. I've got a couple board members that were board members when we were a private company, but when we did go public, we enhanced our board significantly with three really experienced, very well networked experts in the pharmaceutical industry.

it just so happens, all three of 'em are least partially based in Europe. One of 'em is based in Geneva, Switzerland. The other splits half his time in Basel, and the other half in New Jersey. another board member splits half a time in Brussels and in Atlanta. It just so happens her son.

Uh, passed away in January of last year of osteosarcoma and she's actually the general counsel, associate general counsel of a big pharma company. So, you know, her experience is not only on a personal level, which is very important to us. but on a professional level, her ability to help us with her background during our day job is very helpful, yet not conflicting with her day job at all.

And the same with these other two board members that we've had, we had a great call today on some stuff, and they just gave really good feedback.

Mike Koelzer: I was gonna just ask, that was my next question, uh, thinking this through. I imagine there's different kinds of boards. There's kind of a yay nay board. You come with all the information, they voted up or down. There's a board that really is looking at, you know, a huge strategy, and then there's kind of maybe in the middle it's like, we're gonna do this.

What's your feedback? You mentioned feedback. Would your board kind of fit into that area, would you say,

Paul Romness: I think the boards and the leadership of the companies can be very. Different depending on the type of leadership that's involved in the company.

 If you have leadership that's, you know, thinks they're right all the time. And look, we're talking about pharmacists. You want a pharmacist that is right all the time, but I guarantee you the good ones, ask their partners and their colleagues, you know, what's the better approach to this?

And so whether it's, The most junior person on our team to the most senior person on our team, everyone's opinion is welcome. We hash out what's the best answer and then we all move forward together. It's constant feedback on how we get to the best solutions, and I think that's true in any successful endeavors, particularly the pharmacies that I visit.

Mike Koelzer: I think board stuff has changed over the years. I think back to my dad when he was on school boards and stuff, it's like you'd have a meeting a month and you'd get the mimeograph things, you know, mailed to you a few days ahead of time. Now some of these boards, it's like even just like a school board.

Paul Romness: It's like. 24-7, you know, people have access to emails and all that kind of stuff. Those aren't really boards, though. Those are managing boards and you know, Germany and some other countries, their boards really are more managing boards. We do provide a lot of information to our board members, ahead of a meeting, but that's so that we get the background so that we can have a conversation. Boards are meant to set vision and direction. They're not meant to manage.

Mike Koelzer: That be in general, Paul, that's the definition of the board, or is that more for your company? Like you said, some boards wanna manage 

Paul Romness: for what I envision a board versus a management team,

a board, whether it's a bank, whether it's a. A manufacturer of whatever you want a board that has experience and knowledge that can help the leadership set the best direction and get the best feedback and have an extended network, But you don't want 'em in the day to day 'cause they don't have time to do that,

Mike Koelzer: They don't have time. And then you're gonna slow things down if you want that, bring them on as management, but have that

Paul Romness: right?

Mike Koelzer: I.

Paul, if you were not in the medical field, for whatever reason, you sell this company for $4 billion and, and they say, all right Paul, but you gotta, you gotta hit the road. But let's say you still have the fighter in your belly, but not for cancer. Are there any other fires in your belly that could get you to lead something non-medical?

Paul Romness: So, Mike, do you know the song by Luke Combs? If I wasn't doing this, what would I be doing?

Mike Koelzer: I am not a country guy. I made him turn off the country at work last week. They wanted to hear the radio and I said, no country, so I'm not a country guy.

Paul Romness: You gotta listen to the stories, man.

 They're not the old stories of the old country that we grew up with. It's not where the dog leaves the wife and you lose the house.

Mike Koelzer: What do

they call those country songs or like, I don't know, like good movies in reverse or something like that. I

Paul Romness: right, right. 

Mike Koelzer: That's not old time anymore, huh?

Paul Romness: No. And you know Luke Combs, who's one of the most successful musicians. Yeah. He's asked and the songs about someone asking him in an interview, what would he be doing if he wasn't doing this?

He said I'd be doing this. I just wouldn't get the recognition for it. So I always thought I would never retire.

1. Definitely can foresee retiring now, just 'cause all the work and effort that goes through.

Mike Koelzer: right. 

Paul Romness: But,the passion to change things and to, again, my life's work if we can be successful in getting rid of chemo for just one small cancer, but then what if we extrapolate that to other cancers?

That is amazing. And we got a lot of work to do there. I'm not shying away from that either. But if I wasn't doing this, I'd be advocating for patients, and unmet medical needs, just because that's how we set this company up, and that's our mission, and that's my life's mission. It always has been.

Mike Koelzer: Paul, you had mentioned your pharmacy background. What were some of the places that brought you to this stage?

Paul Romness: So I started, uh,with Johnson Johnson, which is obviously a huge pharma company. They also had a medical surgical division. They sell a lot of orthopedic implants. I grew up in an orthopedic family. My dad, my brother, my brother-in-law are all orthopedic surgeons. I'm a failure.

So, I've got a huge tip on my shoulder. I won't prove 'em wrong. 

Mike Koelzer: There you

Paul Romness: they're all my big brothers too. Right. but I was selling orthopedic implants and I was at Walter Reed Army Medical Center, and it was the Global Center for Osteosarcoma. This was. 30 plus years ago. So any kid that got osteosarcoma around the world would in the military, would be shipped to Walter Reed.

And I worked with an incredible team of physicians there, Dr. Bill Hopkinson, Dr. Tom Temple, who were really some of the first pioneers in what's called limb sparing. So when kids get this big cancer in their legs, instead of taking the whole leg off, which is a great option,

amputation, people always, you know, freak out about it.

But sometimes amputation can be a great option. but, these pioneers really started to. put implants into these kids that were designed for adults and they put small sizes in so the kids could save their limbs. And that was an early thing, and that was the only part of the treatment that I saw was the surgery.

I didn't see the nine months of chemo and radiation. I didn't see the end of life. So when Olivia, my neighbor, my daughter's best friend, was diagnosed, we decided to do something about it.

And actually, for your listeners, there's a really cool movie coming out on PBS next month. It's called, Shelter Me, Cancer Pioneers. And it's all about our technology, around osteosarcoma and another technology around another sarcoma, treating canines and then treating humans.

And there are researchers and our patients, both canine legged and three legged, and two legged patients.

Are in this movie. And, it's really impressive, it's a whole world of what's called, comparative medicine. So you compare it in animals seeing if you can

prove that it works in humans.

Mike Koelzer: I think about those osteo doctors. One of my children had a. in one of their joints, years ago, and the doctor came in and said, we're gonna take it out.

 It won't be too bad. And then, can you picture it like this? Tug of war stands, you know,

Paul Romness: Mm-hmm.

Mike Koelzer: only one foot, back,

Paul Romness: Mm-hmm.

Mike Koelzer: the rope.

Paul Romness: Mm-hmm.

Mike Koelzer: a, had a hold of that pin with that kind of stance. And I said, oh boy. And then I think it slipped off and the force threw him up against the back wall or something like that.

 I wouldn't like the bone. I told my brothers I had 'em on, The episode came out today and I was just commenting how when I went to pharmacy school, some of my fellow students would say they didn't want to be a physician because they don't like the sight of blood.

And I always say, ah, you're not smart enough. I'm in this class. I know you're not smart enough , but two things I wouldn't be, I know for sure I wouldn't be a dentist. You couldn't pay me to be a dentist. And the other one I think is maybe a bone doctor. I don't think I would do well with that.

Paul Romness: I think, either you have it or you don't. One of our daughters was watching an orthopedic case and had to grab a wall and slide to the ground. The other had to keep her from jumping into the surgical field. 

Mike Koelzer: So, Paul, what does your week look like as the CEO of this? 

Paul Romness: A lot of what I do is advocacy for the disease, osteosarcoma advocacy for, making sure that rare and pediatric diseases get the attention from a regulatory standpoint.

managing a really passionate team. There's no one on my team that's less passionate about this than I am.

We all are very focused on making sure that patients get a new treatment for this really rare and really deadly disease. dealing with bankers, dealing with investors, dealing with the market. And the market's been tough, but we actually have had a great few days and I think that's gonna continue.

Mike Koelzer: Besides that, voucher, 

Paul Romness: The priority review voucher.

Mike Koelzer: Besides that, are there other incentives? For a company, like when you're only making something for a thousand patients, and I know each one's important, but when you're in the market, when you're making it for a thousand patients, is there other funding that makes it worth it for a company to do that? Or is the priority review voucher, the big one.

Paul Romness: Well, obviously getting the product to market and selling the product at market, and, you know, the markets around the world are not as lucrative as the US market, but, you know, European markets 70% of what the US market is, and it's a bigger market. 

Mike Koelzer: just selling it on the open market, you get reimbursed. It's not like you are looking for grants all the time. I mean, you're pricing

Paul Romness: no.

Mike Koelzer: to get a reimbursement and so on, or to get, 

profit 

Paul Romness: Correct. And it's not, you know, it's not a bank buster, so we don't foresee a real challenge in getting reimbursement 'cause it's not a lot of patients. It will probably be expensive compared to most things we don't know what that price will be, but it will probably be expensive. But if you're gonna treat at most 1500 patients, you know, that's not like treating. 300,000 patients or how many ever patients are on GLP ones right now? \

Mike Koelzer: Paul, a listener has half a minute when they pull up in their car, what could they do?

Can they look up your symbol 

Paul Romness: look up OSTX, osteo OS therapies on the New York Stock Exchange, OSTX.

Mike Koelzer: Well, golly, Paul, thanks for your time. The business part is fascinating to talk about, so thanks for a good vision of that. Very cool. 

Paul Romness: Great. Thank you very much, Mike. It's my pleasure.