Accelerating clinical portfolio delivery.

The clinical portfolio challenge

Crestview BioPharma had five late-stage candidates moving through repeated trial-design iterations. Research teams and commercial operations had conflicting priorities, making it difficult to align decisions across the portfolio. Each additional iteration carried time and holding-cost implications, while leadership had to determine how limited capital should be directed across candidates with different clinical probabilities. Without a shared framework, teams could assess the same candidates through different priorities as evidence and commercial needs evolved. The mandate centered on bringing those considerations into a clearer decision process, so portfolio choices could be compared across clinical progress, timing and investment requirements.

Our advisory approach

Alder established an executive clinical portfolio committee to connect capital allocation with clinical probabilities. Protocol-approval governance was streamlined, reducing review cycles from weeks to days. Global clinical trial site-management contracts were renegotiated to support recruitment velocity, and an algorithmic capital-valuation model was built to dynamically prioritize lead oncology candidates. Together, the governance and valuation work gave leadership a common structure for reviewing progress, trade-offs and portfolio priorities. It brought candidate value, approval speed and recruitment considerations into the same discussion, helping decision-makers see how operational choices could affect the pace and cost of advancing the portfolio.

The measurable outcome

Time to market accelerated by six months across two flagship clinical programmes, reducing cumulative trial holding costs by £94M. Crestview also secured FDA fast-track review status. The results combine a shorter delivery timeline with lower holding costs and a stronger regulatory position for the programmes. For the portfolio, that created clearer evidence of progress against clinical and commercial priorities. The six-month acceleration applied across two programmes, while the £94M saving captured cumulative trial holding costs. Together, these measures show how governance, recruitment support and portfolio prioritization contributed to faster advancement and improved visibility into the value of the work.

Keeping portfolio decisions aligned

The executive committee and valuation model gave Crestview a shared way to revisit priorities as trial evidence, recruitment progress and commercial considerations changed. That common structure was particularly useful across five late-stage candidates, where decisions about timing and capital had to account for different clinical probabilities. By connecting governance with portfolio valuation, leadership could discuss trade-offs using a consistent frame rather than separate team-level assumptions. The approach kept attention on the relationship between candidate progress, approval cycles and investment needs, helping the organization carry the portfolio forward with clearer ownership of its decisions.