Los Angeles is seeing a renaissance in medical technology.
Earlier this month a venture capital firm headed by two former Amgen executives announced they raised $500 million to boost and incubate new life science and biotech companies across Los Angeles. And the firm, Westlake Village Biopartners, is working to develop a 30,000 square foot campus in Thousand Oaks.
Across town, the 20,000 square foot LABioSpace is set to open. Funded through the county, federal funds and private donations, the incubator will feature lab space dedicated to bioscience research and collaboration and is designed to house up to 25 companies.
And yet, another "innovation hub" backed by the county and private funds called BioScienceLA is expected to launch its own space in Culver City next year.
"For years, we have lost talented scientists and entrepreneurs to other regions, due to lack of investment capital and start-up and expansion space for growing companies," said David J. Whelan, the CEO of BioscienceLA. "We are finally at an inflection point, with funding, space, and talent supporting each other to grow the LA life sciences ecosystem."
Here are some trends to watch in healthtech.
Telemedicine Brings Health Access and Equity to Patients at Home
Doctors visits and at-home testing have been made easier during the pandemic as more companies launch platforms to deliver health information to patients from home.
COVID-19 has sparked new demand for telehealth services to test and treat consumers. And more clinics and hospitals are adopting the tech. According to a PitchBook report, companies in the virtual health segment raised about $534 million in venture funding in the second quarter of 2020.
L.A. startups like Healthvana and ConsejoSano, a platform for patients and providers that aims to make healthcare easier to access for multiple cultures and languages. Last week, the North Hollywood company raised $17 million to build out its services like scheduling appointments and coordinating transportation to a patient's provider.
Meanwhile, Los Angeles-based MotiSpark developed a digital tool to send personalized reminders to users. And in September, the Santa Monica-based prescription discount platform GoodRx, went public and became the most downloaded medical app, boasting five million active users and 70,000 pharmacies.
More Investment in Diagnostics
Diagnostic companies typically have a hard time securing capital, but this year changed that. Kevin Zhang, a partner at Upfront Ventures who leads health and biotech investments, said the life sciences industry has seen a spike in gene therapeutics companies over the last few years. And the wave of new drugs brings with it new demand for lab testing.
"Frankly, it was a bit of a dead zone for venture investment," he said. "It's one of the least sexy areas to put money into. Now that's grown tremendously"
The pandemic has only accelerated that need, Zhang said, and investors have shifted their attitude about biotech companies focused on diagnostics.
Since March, L.A. biotech companies and labs like Curative have pivoted to developing and administering COVID-19 tests. The team's testing technology is now being deployed across the nation. Meanwhile, several companies are now producing vaccines and COVID-19 therapeutics as the nation gears up for mass distribution.
Employers Using Mental Health and Wellness Tech
The anxiety and stress caused by the pandemic has stoked demand for mental and physical wellness apps, including several based in Southern California. Experts see interest continuing into the new year as these wellness companies tap corporate partners to drive growth.
Earlier this year, Headspace, the Santa Monica-based meditation app, began offering free subscriptions to healthcare providers and teachers.
"We've seen explosive growth," said Headspace co-founder and CEO Rich Pierson at dot.LA's Summit in October. "CEOs have realized now that mental health is being discussed in every boardroom. That was not the case pre-COVID."
Calm, Talkspace and BetterHelp are among the handful of tech startups selling meditation classes and more affordable therapy access. And both Calm and Headspace offer a corporate product as employers and insurance companies have worked to make mental health resources more accessible since the pandemic began.
Exercise subscription platforms are also seen a boom. Apple launched its Fitness+ app in December, whose classes are filmed at a Santa Monica studio. As gyms remain closed in many parts of the country, consumers are buying up Pelotons and Mirrors. The craze is expected to continue to grow into the next year with several Southern California companies poised to benefit.
Indoor cycling app Zwift scored a $450 million investment in September. The Long Beach-based company is taking on Peloton building "hardware," presumably stationary bicycles, to go along with its 3-D generated worlds where users can compete from their living room. Another L.A.-based company Presence Fit raised $1 million in October for its two-way live interval training classes. And then there's FightCamp, which promises to capture the feeling of a boxing gym in your home.
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Protomer Technologies Inc., a Pasadena-based biopharmaceutical startup, closed a second round of funding to expand the tech platform it's using to develop insulin that adjusts according to a diabetes patient's blood sugar levels.
The undisclosed raise came from the JDRF T1D Fund, a Boston-based venture philanthropy fund that focuses on type one diabetes research.
The pre-clinical stage startup was launched in 2015 by a team of Caltech faculty and alumni to build a "heavy chemistry-based platform," said CEO and founder Alborz Mahdavi, who received his PhD in bioengineering from the university. They're now using the technology platform to create drugs that can activate once they've been injected into patients, including a new type of insulin.
The treatment still needs FDA approval.
Typically, diabetes patients carry with them glucose meters and insulin to track and maintain the sugar levels in their blood. Protomer's product is designed to activate itself automatically depending on a person's blood sugar levels.
"With this insulin, you don't need to worry about that," Mahdavi said. "There's enormous interest in this. This insulin will be completely transformative for people with diabetes."
Mahdavi said the platform could also be applied to other therapeutic settings like neuroscience and oncology. For example, a drug injected in patients with cancer could switch off if the treatment isn't working. It could also activate in a specific region of the body, which means that side effects of chemotherapy would diminish if the drug were "only active locally."
"Imagine you have pancreatic cancer and you're taking an oncology drug," he said. "The problem is that the drug will be active all over the body, which is why you get all these side effects."
Dave Whelan, CEO of BioscienceLA, said several companies in the field are engineering cells designed to fight cancer cells this way. It's a challenge researchers have been trying to crack for a while.
"It's a long time coming," he said. "It's very reassuring to see investments in this space because the last several months there's been so much focus on COVID, and part of that has been at the expense of other disease areas."
As the pandemic ushers in a new way of telemedicine, he sees an urgency in introducing therapeutics that don't require in-person physician attention. Meanwhile, cancer patients and certain diabetes patients may be more at risk if they contract the virus.
"When you see something like this, it just makes me feel good that there's still attention being paid to these diseases and conditions that will be with us long after COVID," he said.
Protomer's first equity investment, also an undisclosed amount, was led by pharmaceutical giant Eli Lilly and Company. Whelan said that move might signify a future acquisition, as big pharma often looks for innovation outside their own companies.
"It's not only an advance for life sciences and care, but because they're making progress and getting additional funding, that helps them grow the whole industry here," Whelan said. "We absolutely need more of that going on in L.A."
Clarification: An earlier version of this post stated that the T1D Fund has spent over $2 billion on type one diabetes research. While its nonprofit parent company JDRF may have spent that much, the T1D Fund has not.
Jo Bhakdi thinks he can extend life with data.
Over the past years, the trained economist and co-founder of Quantgene has helped create a blood test that screens for early signs of some of the deadliest cancers, using millions of culled data points.
"We have a bigger vision behind this," Bhakdi said. "It's what I call decades in a decade — to extend the average human lifespan by ten years in the next ten years."
Quantgene has been developing so-called "liquid test" that can pinpoint the origin of multiple types of cancer by identifying their cellular mutations using artificial intelligence analytics and big data.
The project began five years ago at a U.C. Berkeley lab. Bhakdi partnered with co-founder Monika Hagen to create a system that would screen cancer using algorithms.
Late this year, Bhakdi and Hagen expect to roll out an early cancer screening subscription plan to consumers for an annual cost of around $2,200, pending regulatory approval. And they specifically came to Los Angeles, an image-conscious city that's embraced the idea of wellness, to launch it.
Blood tests are not a new technology for cancer screening, but Quantgene and others are trying to create a more precise tool to identify cancer in its earliest stages by finding mutation patterns that point to the disease. And in the process lower cancer death rates in the U.S.. This year, an estimated 600,000 people will die of the disease. Another 1.6 million will get the grim diagnosis. It's the second biggest killer of Americans year in and year out.
Most blood tests are currently used when doctors already know where the cancer exists, mostly in order to track its progression.
The new tests examine fragments of DNA that break loose in the bloodstream. Quantgene looks at the different mutations of these cells to identify patterns that signal early forms of cancer or other diseases. The company plans to sell the system as part of a line of tiered-price testing called "Serenity" that includes genetic counseling and profiles.
Quantgene is branding the complex sequencing and AI process that analyzes these mutations the "Griffin Deep Genomics Platform." The company has raised more than $13 million, and expects to raise a Series B round this fall. Bhakdi believes it could upend how people test for cancer. But it has competition.
Amazon-backed, Menlo Park-based Grail Inc. has raised nearly $2 billion. In March, the Silicon Valley company released a report that said it could detect 50 types of cancer across all stages, with a false-positive rate below 1%. The company said it can find its location with 93% accuracy. But finding early-stage cancer — the type that actually save lives — has proven elusive.
Of the 12 deadly cancer types that make up 63% of deaths in the U.S., Grail reported a detection rate of 67% for stages one to three. The company's test is expected to be available within 12 months. A spokeswoman said in an email, it's "too early to comment on cost, however, our principal goal is to ensure broad access to our test, and we hope to make this ground breaking technology available to as many people as possible." Investors include Bill Gates, Bristol-Myers Squibb and Merck.
"The problem with a lot of these liquid biopsy technologies right now — Grail and others — is that they are not really good at detecting cancers at the earliest stages. Because there just isn't that much tumor material in the blood," said Timothy Rebbeck, director of the Zhu Family Center for Global Cancer Prevention at Harvard. "So, it's not to say that it couldn't be done. It's just the right now the technology is not refined enough to do it that really well."
Getting to Cancer Screening at Earlier Stages
For the last few decades, physicians have screened individual organs for signs of cancer, trying to suss out whether a patient has a cancerous growth on the pancreas or breast or lung. These early screenings, coupled with advances in cancer treatments, have been credited with a decline in U.S. deaths related to cancer.
"The median point of diagnosis in these 1.6 million is between stage three and stage four.
If you can shift that point of stage two and one, you would be saving 400,000 people a year," Bhakdi said. "That's crazy if you think about that."
Bhakdi, who comes from a family of scientists and doctors, began the search less than a month before his own mother was diagnosed with stage four colon cancer.
At the time, a family member asked his help in solving a genomic question about whether one could determine if a random, isolated cell was cancer. The answer is very difficult to get. It lays in sequencing the cell's DNA and then comparing it to thousands of others. That ability to compare cells with a massive data trove is now at the heart of their company.
A flow cell used for deep-sequencing produces 6 billion data points per patient sample.Courtesy Quantgene
Bhakdi believes it would have saved his mother.
"If you are diagnosed with colon cancer at stage one, you have a 94% survival rate," he said. "In stage four, you have an 11% survival rate."
Sidestepping Insurers in Santa Monica
One of the best ways to bring down deaths is to diagnose cancer early, said Rebbeck. But even when these technologies are developed for widespread use they could exacerbate disparities for the poor, underserved and uninsured. That's because there remains systemic hurdles of access and cost.
Bhakdi said he understands those concerns. He had hoped originally to work with insurers to get the product out, but they required long-term economic studies to prove they would lower costs. Unable to produce that quickly, Quantgene moved to Santa Monica last year.
"We asked the question, 'What region has the most innovation-driven and future-oriented consumers and physicians and health care experts that are most likely to adopt new technologies?'," he said. "And what we found was very clear, very clear: Los Angeles."
In short, people in Los Angeles pay well to be healthy and beautiful. He pointed to companies that thrive in the metropolis like Next Health, a self-described longevity center that offers cryotherapy, or Remedy Place, a social wellness club.
"There's a big population here, a lot of whom are focused on health and wellness and are willing to spend the money," said David Whelan, chief executive of BioScienceLA, "The Goop effect sort of worked here. This is the place to be able to get a lot of customers very quickly when you're charging a high price point for customized service."
Beyond that, Bhakdi said there's also an extreme level of excellence in clinical infrastructure from medical institutions at UCLA, USC, City of Hope and Cedars-Sinai.
The move, he said, will hopefully allow Quantgene to demonstrate the product's value and convince insurers to offer it, eventually getting it into more people's hands. At the same time, the cost should draw down.
By 2024, the marketplace for personalized medicine and testing is expected to hit $85 billion, according to Pitchbook.
How does it work?
The company uses what's called cell-free DNA in the bloodstream to look for somatic mutations, those that are unrelated to hereditary factors and indicate a cancer growth.
"It's not a black and white thing," Bhakdi said.
It's more like matching different cancer profiles via machine learning. Using algorithms, the company traces the mutation patterns and compares those patterns to others who have the disease. By comparing the patient's mutation pattern along with their profile, Quantgene determines whether a specific cancer is maturing and tries to spot it.
"What the report does is not tell you whether you have cancer or not. That would be irresponsible," Bhakdi said. "It looks into the mutation pattern of the DNA that is in your gut — which means all the DNA that comes from, say, the diet in your body — and it takes these patterns and gives you a very high-resolution insight into how this compares with people with... all other kinds of medical conditions, including the ten leading cancers."
In 2016, Quantgene launched a clinical trial that will help them determine the sensitivity and specificity of the tests. Their goal is to have 10,000 patient blood samples. So far the company has about 5,000.
Quantgene has developed a custom assay for DNA extractionCourtesy of Quantgene
But those working with the company think once it comes to market, it could be a game changer, helping physicians figure out how to deal with early signs of cancer.
"A lot of the companies working in molecular diagnostics don't have a good approach to telling physicians what to do and helping out with decision making. Quantgene has come to understand that that aspect of integrating clinical information and then providing guidance on what to do based on probabilities is helpful and necessary," said Jorge Nieva, an advisor to the company and an oncologist and associate professor at the University of Southern California Keck School of Medicine. "It has the real potential to revolutionize the field of cancer screening because our approach to cancer screening up to this point has really been organ-based."
What distinguishes the company, he said, is they are largely driven by math instead of biology.
"With the large database that Quantgene has built of some 40,000 tumors across 15 different cancers types, you can begin to build those patterns so that you can map those genetic abnormalities back to the anatomy," Nieva said.
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