More funding and another powerful pharma backer have entered the microbiome space, showing that at least some investors and pharma execs believe the field can begin converting preclinical ideas into valid human therapies.
Somerville, Massachusetts-based Finch Therapeutics announced a new agreement with Takeda Pharmaceuticals on Wednesday, a solid endorsement of its sophisticated bioinformatics platform.
Along with oncology and central nervous system disorders, gastrointestinal diseases are one of Takeda’s three therapeutic pillars. As part of the deal, Takeda will pay an upfront $10 million for exclusive worldwide rights to FIN-524, an investigational drug for ulcerative colitis, and any follow-on products for irritable bowel diseases (IBDs). Ulcerative colitis is a form of IBD in which the immune system attacks the lining of the large intestine.
Finch’s science taps into the high-potential, highly-unpalatable concept of a fecal transplant. It involves transferring a microbiota rich stool sample from a healthy individual into someone with severe gut dysbiosis.
It’s a smart approach, given how little we know about the many thousands of microbial strains that occupy our guts. Instead of adding them to a therapy one-by-one, scientists can take a sample ecosystem that is already known to work. Finch then has a feedback loop in place to determine how patients responded to the different donor cultures.
“By working from clinically annotated datasets of donor and patient microbiota before and after fecal transplantation, we can look for the patterns in changes to the patients’ microbiota associated with targeted clinical outcomes,” said Finch CEO Mark Smith in an email forwarded by a company representative.
It underscores how variable our microbiomes are, whether we’re healthy, sick, or somewhere in between.
Smith cited a 70-patient randomized control trial of fecal transplants performed at McMaster University (Moayyedi et al, 2015). Five donors were used in the study, but just one, Donor B, had a demonstrably large therapeutic effect. Without Donor B, the study would have failed.
Just how much Kombucha was Donor B drinking? And how do we learn from the strength of that participant’s microbiota? Finch is working to answer the latter.
While gut bacteria and the microbiome are often used interchangeably, our microscopic citizens really populate our entire body, including the skin. That’s the target for Farmington, Connecticut-based Azitra.
Azitra announced on Wednesday that it had closed a $2.9 million Series A venture round led by Bios Partners. With earlier seed funding, including from Peter Thiel’s Breakout Labs program, the startup has raised $3.75 million to date.
Rather than brewing a complex bacterial concoction, Azitra has identified one key bacteria strain for its lead candidate, AZT-01, to be applied as a cream to affected skin. In its cross-hairs for treatment are eczema, rare genetic skin diseases, and more everyday cosmetic applications such as dry skin.
In an email forwarded by a company representative, Azitra Cofounder and CSO Travis Whitfill said the microbial treatment isn’t just a band-aid — it could address an underlying cause.
“Studies have repeatedly shown that these patients have an imbalanced microbiome, and in the case of eczema, they often have an overgrowth of Staph aureus. There is also evidence that our strain of bacteria can kill some strains of Staph aureus, which is one of the reasons we chose it as a chassis,” Whitfill said.
Applied topically, the good bacteria can colonize the area and begin correcting the dysbiosis.
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Redox Engine, the Madison, Wisconsin health IT startup that’s helping healthcare facilities overcome interoperability challenges has received $1 million in follow-on investment from Intermountain Healthcare Innovation Fund, according to a company release. The funding is part of Redox’s Series B round.
Redox will work with Intermountain in the Salt Lake City-based health system’s push to adopt digital health solutions that fit into their electronic health record. The company will also support applications Intermountain has developed, such as the Rehab Outcomes Management System, as part of Redox’s API platform.
Healthbox has previously run an accelerator for healthcare startups called Healthbox Studio but with the management change last year, Healthbox repositioned itself as a venture capital investment manager with an innovation platform that functions as a consultant to and collaborator with healthcare partners.
Healthbox has managed Intermountain Healthcare’s Innovation Fund since the fund’s launch in 2015. The fund is intended to source, evaluate, and invest in companies that align with Intermountain’s mission. So far the fund has made a handful of investments in healthcare startups, in addition to Redox:
Zebra Medical Vision, an Israel-based health IT business, developed a clinical decision support teaching computers to read and diagnose medical images through machine learning. Last year, Zebra closed a Series B round as it launched a consumer-facing product called Profound. The service allows individuals to upload their medical imaging scans such as computerized tomography scans and mammograms to Zebra Medical Vision’s online service, and receive an automated analysis of key clinical conditions.
Syapse is a precision medicine software meets clinical decision support startup. It seeks to improve care coordination for hospitals by extracting clinical, genomic and other molecular data from medical records, labs and pharmacies and integrating that data to offer more detailed patient profiles. By doing this, the company wants to guide doctors to find the right diagnostic test and therapeutic approach. The Intermountain fund took part in its Series C round.
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When Charlotte Yeh entered medical school decades ago, it was the first year more than 10 percent of the slots were available to women. Fast forward to today, and women make up almost half of medical school classes. Women also hold prominent roles throughout health care, including in management. But getting a coveted spot in the C-suite has been tougher, says Yeh, now the chief medical officer for AARP Services.
“Women are not very well represented in the highest levels of leadership,” she says. “The current generation may feel kind of complacent… but they haven’t realized there’s still the hurdle of getting into the top management.”
That broader picture is similar in the field of telehealth, where women leaders say they’re still underrepresented. So how can women strengthen their roles in telehealth as the industry continues its explosive growth? In a first-ever event, the American Telemedicine Association conference in Orlando this month will feature the panel, “Women Executives in Telehealth: Positioning for the Future.”
“I’m very impressed with the ATA,” says Yeh, who will moderate the panel. “It’s remarkable and a positive sign of the times that they’re already talking about leadership.”
In the best, most high-performing organizations in any field, Yeh says, it’s common to see more women included among the board and management. “Let’s face it, men and women are different,” she says. “Women may lend a very different lens or perspective versus if everyone at the table looks the same.”
That’s especially true in health care, as women often make decisions related to their family’s health, says panelist Kristi Henderson, vice president for virtual care and innovation at Seton Healthcare Family. “Without their voice,” she says, “solutions will not appreciate the perspective of women who are the users or facilitators of these services the majority of the time.”
In telehealth specifically, it’s imperative for women to play a role in the direction and innovation of new technologies and how organizations and companies are structuring their strategy, says panelist Julie Hall-Barrow, vice president for virtual health and innovation at Children’s Health, Dallas. “Without the perspective and tenacity of women in key leadership roles,” she says, “the industry as a whole will lack vision.”
Progress made, but more needed
The enormous growth of the health care industry in the last two decades has included increased options for women, says Henderson, who began exploring telehealth 18 years ago and went live with her first telehealth program in 2003. “The number and variety of jobs in telehealth have created new opportunities for women across business, clinical and technology sectors,” she says. “The value of women in health IT leadership roles is evident, resulting in increased numbers of women holding senior leadership roles in telehealth, health systems and health IT in general.”
Hall-Barrow, whose work in telehealth was spurred in the early 1990s, says she’s witnessed a growth of women leaders in the market. “My career has followed this trend,” she says, “and has led to incredible opportunities to lead efforts in one of the largest states in the nation and in one of the leading pediatric health care systems in North Texas.”
But while companies are putting policies in place to achieve equality for women in the workplace, more work is needed to create neutral gender environments, says panelist Paula Guy, president and chief executive of Salus Health.
There remains an underrepresentation of women at the board table, Henderson says. “There has been a slow increase of these women moving into more senior positions and being invited to the table for decisions,” she says. “Now that there is more of a conscious attention to diversity and inclusivity, this underrepresentation is changing.”
There’s still room for women leaders in telehealth, particularly in the C-suite and boardroom, says Hall-Barrow, and current leaders should encourage this by mentoring other women.
Advice from top women in telehealth
Honing an expertise to differentiate yourself from the pack is one way to achieve success in telehealth, Henderson says. “Find your skill and passion, then refine and perfect that skill,” she says. “Determination, integrity and tenacity are critical factors for career advancement.”
Start with a win, Hall-Barrow says. “When putting a program together, creating a technology, or implementing a system, do so with a guaranteed success,” she says. “This success will drive leaders to pay attention to your work and seek your advice for the next opportunity.”
Find a mentor, especially one in the field, Hall-Barrow says. “The more you can learn about the industry,” she says, “the faster you will make an impact in areas that you aren’t expected to make.”
And keep up with the rapidly changing health care market. “The more you know, the more key you will be in your industry,” she says.
Women have a long way to go to be close to where men are in leadership positions in health care, including telemedicine, Guy says. “The women I know in telemedicine are smart, strong, passionate, caring, and they work hard to get the job done,” she says. “If given the opportunity for leadership positions, we would see telemedicine grow like never before.”
Philadelphia-based clinical decision support startup Oncora Medical is collaborating with University of Texas MD Anderson Cancer Center in Houston in a study to help radiation oncologists develop personalized treatment plans with the goal of improving outcomes, according to a news release. The Phase 1 study will focus on data from 2,000 breast cancer patients and last three to nine months.
Oncora’s Precision Radiation Oncology Platform will analyze data from MD Anderson’s electronic medical record system, tumor registry, radiation therapy planning system, and Brocade — a Web-based clinical documentation tool for medical records developed by MD Anderson Associate Professor of Radiation Oncology, Dr. Benjamin Smith.
Oncora will be tasked with creating interoperability between its Precision Radiation Oncology Platform and Brocade to explore the potential value of a combined product, the release said.
“Through this alliance, we hope to improve workflows and processes for radiation oncologists and simultaneously give radiation oncologists access to better information to support real-time, precision medical decision making,” Smith said in the release.
Although most people think of precision medicine as targeted therapy, Lindsay noted that the company defines precision medicine as the “right treatment for the right patient at the right time” and wants to expand the conventionally accepted definition beyond drugs and diagnostics.
The study was a year in the making and will be Oncora’s biggest endeavor to date, Lindsay said.
“Our software needs to access data across multiple software systems at a center that treats nearly 10,000 patients per year. That is part of the reason why we spent so long planning for the partnership. We want everything to go smoothly and we want to deliver MD Anderson a seamlessly integrated product.”
The study will also assess physician utilization and quality of the company’s predictive modeling efforts. But the ultimate criteria for success will be the deployment of a “functioning product” at MD Anderson, noted Lindsay.
The second phase of the of the collaboration with MD Anderson will expand the study to all cancer types treated with radiation.
One of the challenges in healthcare is de-siloing data, particularly for clinical decision support. When it comes to cancer treatment, radiation oncology data risks being siloed in different hospital software systems, which makes it tough to collect and analyze. Oncora Medical views its approach as a way to make predictive analytics and precision radiation oncology succeed.
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