#409 ‒ Inside modern drug development: the science, economics, and regulatory hurdles behind bringing new medicines to patients | Lloyd Klickstein, M.D., Ph.D.

Lloyd Klickstein, a physician-scientist with over 20 years in drug discovery and healthy aging, walks through the full arc of modern drug development. He explains how unmet medical needs are identified, how therapeutic targets are selected and engineered, and what it takes to navigate animal testing, clinical trials, and regulatory approval. The conversation uses bimagrumab—an antibody that boosts muscle by blocking myostatin and activin—as a detailed case study, showing how unexpected fat loss and diabetes benefits redirected its development from sarcopenia to obesity in combination with semaglutide. Klickstein also discusses the economics and ethics of early-phase trials, the critical role of failing fast, and his current work on mTOR inhibition for geroprotection and cancer prevention.