Profile: Bob Graham AO

If you’re a company developing a new class of drugs to treat heart attack, it helps to have one of Australia’s most eminent cardiologists as a founder and director.

Professor Bob Graham AO is a pioneer in molecular cardiology, with more than 50 years of experience as a clinician-researcher, and 26 years as Executive Director of the Victor Chang Cardiac Research Institute.

While he has worked at some of the world’s leading research and medical institutions in Australia and the US, early in his medical career he worked in a tiny clinic in the highlands of Papua New Guinea.

From PNG to the US and nephrology to cardiology

Bob spent three months as a locum in Goroka, where he was exposed to “a world of fascinating medicine”.

“A lot of people told me not to go because they had tribal wars,” he says. “Those didn’t affect me, but I’ve never worked so hard in my life.

“I saw patients from 7am to 11pm, everything from leprosy to tuberculosis to malaria to Kuru, a prion disease spread through cannibalism.”

After this position, Bob returned to Australia and worked as an internal medicine physician specialising in kidney disease.

“I came to cardiology through the back door,” Bob says.

“I ran a study on prazosin, a Pfizer drug for high blood pressure, and found that the mechanism of action was not what Pfizer thought. We showed it was the first of a new kind of drug that blocks certain alpha1 adrenergic receptors.”

This study piqued Bob’s interest in high blood pressure, which in Australia is treated by nephrologists and endocrinologists.

But then Bob moved to Boston in 1982 to work at Harvard Medical School and Massachusetts General Hospital, where high blood pressure was treated by cardiologists, so he retrained in that field.

Building an institute from the ground up

Bob spent seventeen years in the US, working at hospitals and institutes across the country and under two Nobel Laureates, before returning to Australia in 1994 as the inaugural Executive Director of the Victor Chang Cardiac Research Institute.

“I started with one person in some very crude laboratory facilities,” Bob says.

But the son of refugee parents who came to Australia with nothing, and worked hard to provide a wonderful and supportive childhood for him, did not view the humble beginnings of the Institute as a challenge.

Instead, Bob saw it as an opportunity.

“I had been running a large cardiology department at the Cleveland Clinic – the largest heart hospital in the US—where I had inherited some people who weren’t high-calibre. I had to rebuild that department, whereas this was an opportunity to start fresh and recruit really outstanding people.

Under Bob’s leadership, and with the support of an excellent board, the Institute flourished.

The humble laboratory was replaced by an impressive building that was officially opened by Diana, Princess of Wales, in 1996. And the Institute grew from two scientists to over two hundred, working across 21 laboratories to publish more than 100 papers each year, making seminal cardiovascular research discoveries.

One of these was Bob’s work overturning the dogma that heart cells could not regenerate.

“We played a major role in showing that the developing heart retains a certain ability for the heart muscle cells to regenerate, giving us a window of opportunity to allow repair of the heart after injury,” Bob says.

But he counts the biggest discovery—from a translational point of view—to be Professor Peter Macdonald’s research into extending the life of donor hearts.

“Peter developed a cocktail of drugs that makes the donor heart resistant to deterioration for up to 14 hours, and he also developed a technique that allows for the transplant of donor hearts after they have stopped beating but have been revitalised to start contracting again,” Bob says.

“This revolutionised heart transplantation and allows us now to do 30 per cent more transplants. It’s a big, big advance that has been taken up worldwide.”

The founding of Infensa

“This is the best idea I’ve heard of in 40 years of cardiovascular research.”

So said Bob to Professor Glenn King, after hearing his talk on the discovery and use of a spider venom peptide to protect the heart and brain from damage following a heart attack and stroke, respectively.

“You should commercialise it, start up a company,” Bob continued.

It was a fateful conversation that led to the founding of Infensa Bioscience, which licensed the research from The University of Queensland (UQ).

Bob and Glenn started working on Infensa in 2020. Bob had just stepped down from his Executive Director role, meaning he had more time to devote to raising money for the nascent company. But there were challenges.

“We raised all the funding for Infensa via Zoom during the pandemic,” Bob says. “It was amazing we were able to do this. It’s not easy to get people interested in a very novel idea through a screen.”

But the science was strong and the origins of the treatment coming from spider venom captured attention. In July 2022, Infensa announced it had secured $23 million from Australian private investors – one of the largest initial fundraises ever in Australia.

The future

Even after a 50-year career, Bob has no intentions of slowing down.

He maintains an active research group at the Victor Chang Cardiac Research Institute, with a current focus on spontaneous coronary artery dissection (SCAD).

“It’s the commonest cause of heart attack associated with pregnancy and accounts for 25% of heart attacks in women under 50,” Bob says. “There’s a major psychosocial component because it can recur in up to about 30 per cent of cases, so these women live in fear that they’re going to have another attack.”

Bob, who now only sees SCAD patients, has done a lot of work with colleagues at the Victor Chang on the genetics of the disease. And with overseas colleagues they have identified 16 different loci associated with a susceptibility to develop SCAD, but he suspects there are many more to find.

In addition to his own research, Bob chairs the Strategic Advisory Board of UQ’s Institute for Molecular Bioscience, where the research licensed to Infensa originated, and he sits on the Board of Directors of the Lowy Medical Research Institute in the US, as well as being Vice-President of the Australian Academy of Science.

And, of course, he provides guidance to Infensa through his seat on the board. Bob is eager to acknowledge and thank everyone who has helped the company grow.

“We have a strong board, so ably led by our chairman, Ananth Siva, and dedicated investors,” he says.

“Our CEO Mark Smythe is arguably the best peptide chemist in terms of drug development in Australia by a long way. He has more compounds in clinical trials than anyone. He is always looking to de-risk the company – that’s a godsend.”

“Glenn King, who discovered the spider-venom peptide, Mark, and Professor Nathan Palpant deserve a lot of credit. As does Peter Macdonald, who has worked with them on showing rescue of the transplanted heart with the spider-venom peptide.

“I’m very proud that we are about to take the first treatment that allows salvage of heart muscle cells after a heart attack to clinical trials.”