From The Trenches

By Aimee Raleigh, Principal at Atlas Venture, as part of the From The Trenches feature of LifeSciVC

If you are a first-time founder who has heard the phrase “This isn’t a good time to be raising for X,” where X is a platform, a preclinical play, a non-consensus story, I empathize! After you’ve spent years contemplating an idea, potentially investing some of your own money to generate early data, and carefully thinking through the pitch, it’s difficult to hear that an entire scope of companies is out of style for a more cautious investment environment. Raising money for early-stage companies is difficult, regardless of macro factors, but is particularly challenging today.

Now more than ever, an effective first pitch is essential for biotech companies looking to raise capital. While there is no certain path to success (many more companies seek to raise funding than are ultimately successful in doing so), there are some practices that may increase your odds. My colleague Bruce wrote a post on pitching nearly 15 years ago (!), and the advice is as salient as ever (though make sure to inflation-adjust for some of the financing figures cited 😊). I figured it was worth revisiting this topic, within the lens of the unique challenges of 2025.

Let’s level-set: This is one of the more difficult times to fundraise for a biotech company in the last decade

Despite the broader U.S. market’s recovery from the April “liberation day” meltdown, biotech has not fared so well. 2025 has introduced real threats to our business model, ranging from early-stage research funding to regulatory interactions to drug pricing to potential upheavals to the global supply chain. Most investors dislike uncertainty more than almost anything else, and unluckily for us 2025 has that in spades.

There is still an abundance of capital for private biotech financings, as many VCs raised sizeable funds in the past 1-2 years. Based on an analysis of recent Pitchbook data, I estimate >$55B in dry powder (largely for private deals) across >200 life sciences VCs in the U.S. and EU. That is extremely healthy by historical standards, and on its own could support tens of thousands of seed raises or hundreds of larger private financings of $100M – $300M each. We are likely to continue to see capital skew towards the latter type of deal, with concentration in clinical-stage, asset-centric plays. And that’s not necessarily a bad thing – private biotech companies are increasingly taking programs later in clinical development, and that inherently requires larger raises to fund through important milestones. That said, if fewer total companies are accessing capital in the private markets, it does beg the question of how to effectively pitch so that you have the best shot at funding your breakthrough programs.

With that in mind, let’s take a deeper dive into funding basics, mechanics, and best practices to increase odds of success. These pointers are geared towards first-time founders, but some are applicable even for well-seasoned teams preparing to raise. Of course, each entrepreneur and company are different, as are the venture firms and individual investors on the receiving end of a pitch. Shared here are my perspectives, but they are one of many so take them with a grain of salt!

Venture financing realities: very few deals make it from first pitch all the way to syndicated deal

How many inbound pitches does a “typical” VC receive annually? Fig. 1, while highly illustrative, captures what an average annual deal flow may look like for an early-stage biotech VC. If you are an entrepreneur, consider that your deck is probably one of 10-30 to come through the funnel in a given week. It’s in your best interest to set it up for success in the best way possible – we’ll dig in on best practices below. Given timelines can vary widely and are likely to take longer today than a few years ago, prepare yourself for a marathon and not a sprint when it comes to financing.

Advice to entrepreneurs who are pitching to VCs

Below are some recommendations especially to improve odds of success in the earlier steps of the funnel, where attrition rates are high and planning ahead can go a long way. While I am sure some of these pieces of advice are shared by others, keep in mind every VC is different in terms of style and preferences.

Before you begin:

• As illustrated in 1 above, be realistic with yourself about probability of success and timing for a successful financing. It is not atypical to see some investments (regardless of whether they are Seed or Series C) take 9-12 months to close, and these days it may take even longer.
• Map out expectations for the financing. Prospectively define when you anticipate having a read on momentum – what does success look like? If you get to that point in time and haven’t achieved desired momentum, level set. Are aspects of your pitch not landing and could they be reworked? It’s helpful to pay close attention to feedback (both explicit and implicit) and try to address early.
• Given pitching is ultimately a numbers game, many entrepreneurs will need to pitch to a large number of VCs to convert the few who will ultimately come into a deal. If you are pitching a seed concept, maybe that total number is 50. That’s a lot of pitches to sit through – before going after them all at once, think carefully about “tiering” investors based on fit (including stage, check size, types of companies in which they have previously invested, geography, etc.). From there, you can reach out to investors in groupings, such as the below:
  • First, schedule a few lower-stakes calls to practice the pitch and solicit honest feedback. Great if these are friendly faces, but make sure they are able to provide candid and rigorous feedback.
  • Next, consider the ~10 or so investors who are likely highest priority – great overlap in interest, stage, write big enough checks to lead a round, etc. The goal is to try to build momentum with groups of highest likelihood to convert
  • Then come the next set of ~10 – perhaps these are firms for which your company’s thesis seems to fit squarely in strategy, but they write slightly smaller checks, or infrequently lead, etc. If there is momentum in the first group of investors, that can help drive this second wave to be expedient with diligence
  • Batch out firms in sets of ~10 or so and set up “rules” for reaching out (e.g., if you get a certain threshold of investors passing). Try to maintain a consistent number of investors hearing the pitch, in the data room, etc. so that you maintain momentum.
  • If this is your first time pitching, remember that VC firms can be more different than they are similar! Check out this prior post for a basic primer on early-stage biotech VC.
• The pitch deck should not be thrown together overnight
  • Give yourself at least a month (and ideally more) to iterate. I can’t stress enough how important it is to solicit (and listen to / act on!) early feedback.
  • The “aha” of the pitch should be obvious to a new reader of the deck, without requiring a voiceover. Nearly every deck is reviewed quickly for relevance and initial interest – if the narrative is so complicated it cannot be succinctly pitched entirely in deck format, rethink how you are communicating the story.
  • Recently I have seen more and more groups share both a quick 1 or 2-page “executive summary” of a deal in addition to, or in place of, a deck. My personal preference is always for a deck, as oftentimes the summaries are so high-level that it’s impossible to ascertain true differentiation of a technology or program. But to each their own! Some investors may prefer the written executive summary, so consider having one ready to go in case it is requested (or if you are trying to A/B test your pitch email, which can also be an insightful practice).
• Refine what you are asking for and why
  • Be realistic about the differentiated profile for the program(s) you are pitching. VC investors have their own set of investors (Limited Partners, LPs) that they report to, so make sure there is a clear path to programs that will generate value if they are successful. VCs are not altruists who are tasked with pushing biology forward – they need to have a sense of what return profile may look like for them when they invest.
  • When thinking about the amount of capital you are asking for, consider what you will be de-risking in the financing window, and don’t shy away from asking (and answering) the “killer” questions early on.
  • Ask for enough capital. Often I see pitches funding just barely through an inflection point (e.g., preclinical PoC in a relevant model for seed deals, Ph1b or Ph2a data in a Series A). Budgets and timelines expand 95%+ of the time – do yourself a favor and pitch for a financing to cover the base case budget plus 6 months of operations.
• Seek advice from multiple (reasonable) advisors. For first-time founders, try to solicit balanced views from multiple sources when planning out your financing strategy. The fundraising dynamics are very different in tech compared to biotech, so bias your selection of advisors for input towards the types of firms you will be pitching.
• Getting the intro: warm is best. When you are ready to share your story with prioritized investors (and you have refined your pitch with feedback, per above), aim for personal connections vs. cold emails. While we certainly do take pitches that originate from cold outreach, it often goes much further if a mutual connection can share a blurb about the story and you as a founder – think of it as a high ROI way to increase your odds of progressing to step #2 in the funnel in 1. Take the time to map out mutual connections before deciding how best to engage with a given firm or investor.

While pitching:

• Understand your audience. If you are an entrepreneur pitching a novel biology story for seed financing to us at Atlas, we are going to deeply diligence the mechanism and / or technology. I often see pitches that are too high-level, which makes it challenging to dig into details and assess differentiation. Other firms may not want to spend >50% of the time on the science. It’s all about knowing your audience and adapting in real-time to feedback during the meeting.
• Relatedly, try not to give the same rote pitch to every VC firm. Dynamically refine the story based on questions, engagement, any live feedback, etc. Is something not resonating? Consider pausing to explain it in a different way. Ultimately each pitch is a trial-run of a potential partnership – each side should be intellectually flexible and respectful, so this is a good dry run of the dynamic.
• Consider the lift you are asking of investors. Obviously, an investor should be engaged in the story, do their homework, and ask questions respectfully. But be honest with yourself when pitching a complicated story when you are asking investors to “get it” too quickly without the appropriate level of explanation. As a founder, you are embedded in your thesis and pitch, while an investor hearing it for the first time is likely evaluating your story plus perhaps 10 others (see 1) in a given week. Carefully craft the story (both verbal and written) to try to reduce friction in getting to the “aha” moment.
• Advice for when an investor passes: in most cases, try to resist the urge to “correct” the investor and instead use the pass as an opportunity to solicit meaningful feedback that will help you hone the story for the next round of discussions. It is extremely rare that upon passing, an investor would be convinced to reconsider (unless there is new data or market conditions, like an exit in the same space), so there is relatively little to gain from trying to school an investor, and often leaves them feeling belittled and turned off by the interaction.

It goes both ways – advice to early investors

Having also pitched deals myself, a few quick words of advice to fellow investors, especially those starting out in their careers:

• Aim to get to some critical go/no-gos in a first call (valuation, stage, indication focus). It’s tough for a small team to receive a pass after multiple rounds of time-consuming Q&A for an “obvious” reason that is knowable from the non-con deck.
• Sometimes we think we are being kind by digging in on a deal that is clearly off-strategy, but the kinder approach may be to let the team know it’s not in-scope and offer to instead provide transparent and genuine feedback without asking the team for a huge lift.
• Remember teams are often pitching on top of their “day jobs” (i.e., keeping all experiments, discovery campaigns, clinical trials, etc. running) – focus on the critical questions in Q&A vs. aiming to boil the ocean.
• To the extent possible, share feedback when passing on a deal. Depth and extent of feedback should roughly scale with time spent (from both you and team). If you suggest datasets you would have liked to see or other action items, try to make sure these are in fact actions that, if team comes back to you after successful completion, would change your mind. A laundry list is usually not as helpful if it wouldn’t move the needle for you, and may end up distracting the team from true value generation in the long run.

Parting advice to first-time founders

Ultimately, it’s a two-way street: investors and entrepreneurs are each diligencing the other for potential fit during the pitch. And that fit is important – an investment might represent the start of a 5- or 10-year relationship that will face immense enthusiasm, heartburn, and everything in between. The good news is nearly everyone in this industry is incredibly motivated to bring medicines to patients, so when the path forward is unclear or the going gets tough in an uncertain market, keep that end goal in mind. I hope these tactics may help provide some clarity to those taking the leap into entrepreneurship. As Bruce mentioned in his post 15 years ago, “we look forward to hearing about your startup.”

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By Jason Campagna, CMO of Q32, as part of the From The Trenches feature of LifeSciVC

In a recent essay, I argued that biotech is entering its strategic infrastructure moment, a shift from molecule-centric innovation to a layered capability stack beneath the therapeutic. The core claim was structural: the future of biotech depends as much on what supports the drug as what is in it. And it is not just the infrastructure itself, but the way geopolitics now intersects with long-standing challenges around payers, access, and socioeconomic disparity. These pressures are not new, but they are being amplified by the global nature of supply chains, regulatory divergence, and rapidly shifting national priorities. This growing complexity gives rise to a deeper set of questions, ones that extend beyond infrastructure and markets. They concern how we build companies, how we design teams, and how we lead amid shifting forms of pressure and constraint. This essay takes up those questions, not to provide definitive answers, but to explore the contours of a new leadership landscape.

We are not starting from scratch. Over the past two decades, life sciences venture capital has developed a substantial body of data, pattern recognition, and tacit knowledge around what works in early-stage biotech. There is a rich literature and a practiced pedagogy around founding team composition, early leadership selection, and how to scale through clinical inflection points. These models have been tested, refined, and taught with real success.

But as I noted in the earlier piece, the context surrounding these models is shifting. The challenge is not to discard what we’ve learned, but to recognize when the nature of the problem changes beneath our best practices. As the landscape becomes more layered, infrastructural, and globally entangled, the kinds of organizations we build and the leadership they require may need to evolve in response.

Introduction

At this year’s Guggenheim biotech investor conference in Boston, the keynote wasn’t about drug pipelines, IPO windows, or FDA guidance. It was about special operations warfare. On stage were two Navy SEALs, members of the U.S. Navy’s elite special operations force, Mike Hayes and Britt Slabinski, speaking about leadership under pressure. The conversation was moderated by Guggenheim’s CEO. At first, it felt theatrical. Two SEALs at a biotech conference seemed out of place. But the topic wasn’t war. It was decision-making, alignment, and consequence. And something about it stuck. The message was clear: the environment has changed, and the way we lead must change with it.

Before biotech, I was a practicing anesthesiologist, then a hospital administrator. I spent years thinking about how to make high-stakes environments safer, drawing lessons from aviation and the Navy, where small errors can be fatal. That background shaped how I heard the keynote. The parallels were immediate. In medicine, as in biotech, the ground can shift without warning. But unlike medicine, biotech doesn’t pause. There is no reset between cases.

That keynote became the seed for the earlier essay. But there’s an irony I didn’t fully appreciate at the time. I focused on what was changing in the field. Only later did I begin to see how those shifts might reshape leadership itself. A capability stack is not just technical, it’s organizational. This essay isn’t meant to add to the vast literature on leadership or teaming. It’s a field note. A response. The keynote hit a nerve, and it left me thinking about what’s changing in biotech, and what that shift might ask of us as leaders. Today’s biotech companies are modular, global, and often fragile. The structures that support them, how we align, coordinate, and decide, may need to evolve as much as the science they advance.  That’s the premise of this essay: not that we must reinvent how we lead, but that the context is changing in ways that make that reflection worth taking seriously.

After hearing that keynote, I did what many others might do: I went looking. A cursory search of Amazon or Goodreads reveals a vast ecosystem of books by former military leaders, special operations commanders, and crisis-tested strategists, nearly all offering frameworks for leadership under pressure. These models aren’t hard to find. They show up on business bestseller lists, in executive off-sites, and across management training programs. The issue isn’t scarcity, it’s selection.

From that broader landscape, I selected three. Not because they’re definitive, but because they feel aligned with the realities biotech leaders now face. Each was shaped in high-consequence, rapidly evolving environments. Each offers something practical when applied to the unique demands of our field. These principles aren’t exhaustive. Others could have been chosen and more will emerge. This essay doesn’t aim to settle the question. It aims to provoke it, to invite a broader conversation about how we lead when, as one of these authors put it, the terrain refuses to hold still.

Dynamic Subordination

Principle: Let the Best Information Lead

Based on the leadership framework of Mike Hayes, former SEAL Team TWO Commander

Mike Hayes introduced the concept of dynamic subordination as a response to the limits of rigid hierarchy. As Commander of SEAL Team TWO, he led operations in some of the most unforgiving and high-consequence environments imaginable: Iraq, Afghanistan, and other theaters where delay often carried greater risk than autonomous action. In those settings, success hinged less on rank and more on who had the most immediate, relevant information. Leadership had to be situational. Roles shifted based on proximity to the problem and real-time judgment.

Dynamic subordination didn’t reject structure; it required a more adaptive version of it. Hayes emphasized that speed and agility were only possible when everyone had a clear understanding of mission and intent. The leader’s role, then, was not to dictate each move, but to create the conditions where initiative could emerge from anywhere in the system without sacrificing coherence.

This resonated with me not only as a biotech operator, but as someone who spent years in acute care medicine. I thought of the experience of running operating rooms overnight in smaller regional hospitals, what Hayes might call austere environments. These hospitals aren’t academic centers; they function with lean staffing, limited resources, and personnel often spread across units. The acuity of cases can change in an instant. And often, the person with the chart isn’t the one with the clearest picture. Nurses, techs, anesthesiologists, even transport staff can hold critical insight. Recognizing and acting on that insight quickly can change outcomes. In those moments, leadership moves. It must.

That same dynamic is emerging in biotech. While the field has long operated globally, the rationale has shifted. It’s no longer just about accessing lower-cost manufacturing or early-phase trial speed. Today, discovery itself is global. Development may begin outside the U.S. and remain there through pivotal studies. Candidates originate in China, India, and elsewhere, with strategy and execution often playing out far from legacy biotech hubs.

This decentralization strains traditional command models. Forward teams are separated not only by time zones, but by differing regulatory regimes, cultural norms, and operational tempo. Decisions at the edge often outpace central systems’ ability to respond. In this setting, responsibility must be distributed deliberately. Authority must flow outward, retaining accountability while enabling action. Dynamic subordination offers a way forward. It supports models where local expertise drives decisions, anchored by a shared mission. It invites us to rethink how context is shared, how trust is built, and how authority moves, not to weaken leadership, but to strengthen it.

Shared Consciousness

Principle: Align on Purpose, Execute Independently

Based on the leadership framework of General Stanley McChrystal

General Stanley McChrystal reshaped how special operations teams functioned in a world where centralized command could no longer keep pace with distributed, fast-moving threats. As head of the Joint Special Operations Command (JSOC) during the Iraq War, McChrystal confronted a fragmented fight against decentralized insurgent networks. Traditional hierarchies—designed for linear operations—simply couldn’t respond at the speed required. His core adaptation was shared consciousness: build deep alignment on mission and intent, then empower decentralized teams to act independently.

In McChrystal’s model, autonomy wasn’t permitted despite complexity, it was necessary because of it. When everyone shares context, coordination doesn’t rely on constant oversight. Coherence replaces control. That principle has increasing relevance in biotech, particularly within platform-native companies. These organizations rarely follow a single asset path. They run portfolios across multiple programs, modalities, and often geographies. One team might be working on a cell therapy, another on RNA, another on small molecules. At the same time, external collaborators: CROs, CDMOs, academic groups, all operate on varied timelines. In this environment, the logic of a rigid command model falters. What’s needed is not tighter control, but shared context and aligned intent across teams that may never sit in the same room.

That distinction, between control and coherence, resonated with me. In acute clinical medicine, especially in trauma or critical care, proximity matters less than alignment. A trauma team doesn’t function because it reports to a single individual. It functions because each member holds a shared mental model of the situation, the priorities, and the path forward. That clarity allows distributed action without losing the thread. It was never about hierarchy. It was about shared judgment under pressure.

Biotech is moving in a similar direction. Platform companies now operate more like networks than pyramids. Yet many leadership models still assume a central cadence that no longer fits. The challenge isn’t just managing complexity; it’s distributing the ability to manage it. That starts with how we build and transmit context across teams.

Biotech hasn’t yet produced many mature examples of shared consciousness at scale. But that’s what makes the concept useful. It names a gap that is already emerging and offers a way to think differently.

Command Under Ambiguity

Principle: Lead with Intent, Not Doctrine

Based on the leadership framework of Pete Blaber, former Delta Force Commander

Pete Blaber spent his career leading Delta Force, the U.S. military’s elite counterterrorism unit,

in environments where the usual rules no longer applied; settings defined by incomplete information, shifting variables, and unstable terrain. These weren’t scenarios that rewarded rigid execution. They required a different kind of leadership: one rooted in clarity of intent, shared understanding, and the judgment to act even without certainty. Blaber’s model, shaped by the demands of high-risk missions, emphasizes that when doctrine breaks down, leadership must be anchored in purpose and informed by trust.

That same dynamic increasingly defines biotech. The exuberance of 2020–2021 has given way to a more constrained, unpredictable landscape. Across the industry, companies are making hard decisions not because their science has failed, but because the terrain has shifted. These aren’t small adjustments, and in many cases, they’re structural resets: choices to shelve lead programs, downsize teams, return capital. It’s a kind of organizational triage that can’t be navigated by process alone. What’s needed is a leadership model that can absorb ambiguity without being paralyzed by it.

I saw this firsthand at Q32 Bio, where we decided to discontinue a program central to the company’s founding and refocus around a single remaining asset. It wasn’t a decision driven purely by financial models and it tested our leadership system, demanding that we move quickly, communicate clearly, and keep the team aligned even as the outcome remained uncertain. What carried us wasn’t certainty. It was coherence: a shared sense of purpose that allowed the organization to move together through ambiguity.

That moment echoed my experience as a critical care anesthesiologist. The operating room—especially in urgent or complex cases, is a space of partial data, fast-moving variables, and razor-thin margins. In those moments, waiting for perfect clarity can be as dangerous as acting too soon. The best clinical teams I worked with weren’t immune to uncertainty; they were fluent in it. They knew how to move with incomplete information because they shared a goal, a language, and a structure that enabled action under pressure.

Biotech is beginning to require that same fluency. In a landscape where the map keeps changing, the role of leadership isn’t to eliminate ambiguity. It’s to create the conditions in which teams can move through it, with trust, judgment, and intent.

Conclusion: Toward a New Organizational Stack

What can a SEAL Team commander, a battlefield general, and a Delta Force strategist teach biotech? At first glance, the connection might seem remote. But the conditions they navigated: dispersed teams, incomplete information, compressed timelines, are now part of biotech’s daily operating reality. These are systems-level challenges that demand structural solutions. The models above aren’t doctrine; they’re tools. They matter because biotech’s organizational demands are evolving alongside its scientific ones. We can’t manage this shift with hierarchy alone or by adding layers to the org chart. Something deeper is needed.

That realization struck me during the keynote. But the themes weren’t new. They brought me back to 2003, to the night of the Station nightclub fire in Rhode Island. Nearly a dozen burn victims were transferred to Mass General, where I was working as an attending. There was no protocol. No playbook. Teams formed on the fly. Even there, resources were stretched thin for hours—sometimes days. The complexity was staggering. What held us together wasn’t just training or experience, though both mattered. It was a kind of leadership architecture long familiar in medicine: where the person with the clearest context led, even if not the most senior; where autonomy stayed anchored to mission; where purposeful action persisted, even in uncertainty.

These principles will be familiar to anyone who’s led under pressure. That’s what makes them relevant, not that they’re clever or new, but because they describe something real. Biotech is changing. So must the way we lead, how we delegate, align, and decide. Not just for resilience, but out of fidelity to the work itself. Most of us believe we are contributing, in some way, to the future of human health. My argument here is simple: that goal deserves an operating model that can keep up.

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