Addex Therapeutics’ Tim Dyer has seen the company through 22 years of ups and downs. He has kept the company afloat, and recently did the same by spinning out a new company.

Private Company Edition: Three consecutive $100m-plus venture capital rounds include Obsidian’s series C, a $132m series B round for Alterome and Diagonal’s $128m launch. Also, The Medicines Company’s Clive Meanwell reportedly is heading up a well-founded obesity start-up.

Public Company Edition: William Blair analysts note that stock prices are rising due to a Q2 boost in dealmaking after a lull in Q1. Nevertheless, layoffs and portfolio prioritizations are ongoing, including at X4 Pharmaceuticals, but others have raised cash following good news, like Revolution Medicines.

It takes a lot of negotiation with regulators, advisory boards, and alignment between commercial and portfolio management teams to define and agree a clinical trial protocol. Why on earth would companies change it once a study is underway?