In March 2020, Dr. Cynthia Bamdad, founder and CEO of Minerva Biotechnologies Inc. (Minerva), was reviewing the first results of human clinical trials for the company’s novel CAR-T drug therapeutic, one of the first ever to target solid cancer tumors. The results looked promising. CAR-T therapeutics were a new field attracting a lot of scientific interest. They involved genetically re-engineering a patient’s T-cells, a key element of the human immune system, to attack the cancer. The first CAR-T treatments for cancer were developed for the relatively small field of blood cancers, 7% of all cancers. For instance, early pioneer Kite Pharma Inc. (Kite) developed a treatment for a special type of lymphoma that only affected 7,500 patients a year. Still, the financial interest was huge, and Kite was acquired by Gilead Sciences Inc. in August 2017 for $11.9 billion. Similarly, Juno Therapeutics Inc. was acquired by Celgene Corporation for $9 billion in January 2018. Minerva’s therapeutics targeted 96% of all breast cancers and 46% of prostate cancers, a market that was orders of magnitude larger. After 21 years, Bamdad believed that Minerva was on the threshold of something really big. Should Bamdad sell the business and work within a larger organization? Or should she IPO and continue to develop the company’s long-term pipeline of therapeutics and diagnostics?