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"The main motivation factor for me to start a company was the realisation that publishing papers only take you so far. With commercialization, one can take a research innovation all the way to make a real clinical impact and improve the lives of cancer patients", says Lao Saal, Professor at the Department of Clinical Sciences, Lund, and founder of SAGA Diagnostics, which has focus on monitoring responses to breast cancer treatment, predicting prognosis, and detecting relapses earlier, all from a simple blood test.
He says that more knowledge on what it entails to start up a company could benefit researchers. This knowledge can support and help researchers take the next step. Carl Borrebaeck, Professor at the Department of Immunotechnology, agrees. He has been an active entrepreneur sine the 1990-ties, and has started many companies, including Immunovia which has focus on early diagnosis for pancreatic cancer.
What I learnt is that one needs to visualize the entire journey from start to finish, including your own exit to give the company the best conditions to grow, says Carl Borrebaeck.
"Your research innovation is only one third of what is needed to build a successful company. The other two thirds are about validation, clinical testing, regulatory frameworks and how you package your product, i.e. commercialization strategy.
He commends the support provided by the Lund University Cancer Centre, LUCC, in creating an innovative research environment, which also finance support to University wide structures, such as LU Innovation, Having support in applying for patents, perform innovation checks, define your market fit and how to enter the market, apply for seed money or get advice for how to attract investors is invaluable as you are starting out with a promising research result", he notes.
Hire the right people in the beginning
According to Carl, one of the first individuals one should consider employing is a business developer who can set a correct course for the company, and its product and commercialization strategy. Within life science this often involves either developing and licensing a validated product to a larger pharmaceutical company or developing diagnostic tests. Both Immunovia and SAGA Diagnostics have now moved to USA, which is the case for many cancer focused companies. The market for breast and pancreatic cancer treatment is one of the largest in the world, and the reimbursement system covers the entire country. If a treatment or test gets accepted by the FDA, the US Food and Drug Administration, it could be included in treatments across every state. In Europe, in contrast, one needs to get approval country by country, deterring many companies from expanding in Europe first.
Starting with the US market can also mean that a new diagnostic test or treatment reaches the patient sooner. An US approval usually opens door to launching a product elsewhere, says Lao Saal.
He reflects that the very first team you create within the company needs to be a hundred percent dedicated to getting it off to a good start. Not being afraid of doing all types of jobs is important as you will have to juggle many tasks, as is setting up a good company culture right from the get-go.
Investor relations
Setting the right expectations for investors is also crucial. Life Science companies usually need at least five to ten years to validate new cancer treatments or tests. This means that you need investors willing to wait for that time period to receive return on investments. The sums needed are also substantial, it costs millions to produce, for example antibodies, to develop treatments, different technical equipment or to perform validation or clinical testing procedures.
Thoas Fioretos underscores the importance long-term planning. He is the driving force behind several companies focusing on AI-based diagnostics (Qlucore) and antibody-based cancer treatment (Cantargia and Lead Biologics). He particularly emphasizes the need for self-reflection: What truly motivates you? Setting up a company is not for everyone.
"For me as a researcher, it’s about improving diagnosis and treatment for patients diagnosed with cancer. In many cases, developing new treatments can’t be accomplished within academia alone. The cost can be immense, requiring significant investment and the formation of a company to advance clinical development", says Thoas Fioretos, Professor at the Division of Clinical Genetics.
Strong innovation ecosystem in Lund
Having been an entrepreneur for nearly twenty years, Fioretos is pleased to see the strong innovation ecosystem that has developed around Lund University and Medicon Village. The university’s services have become much more tailored and professional since he co-founded his first companies, Qlucore in 2007 and Cantargia in 2010. By the time he co-founded Lead Biologics in 2022, the ecosystem had become notably more mature and structured, according to Thoas Fioretos.
In the early stages of a start-up company, it is critical to be actively involved to drive development. Over time, as the company moves into a more commercial phase, your input as a researcher becomes less central, but in many cases, you can remain connected as a scientific advisor, says Thoas Fioretos.
Yet, finding investment can be difficult Lao Saal reflects. There is still a gap between the seed money provided by for example LU Holding and investments for about five to ten million SEK. Investments which are crucial to validate early data and attract larger funders.
Thoas Fioretos agrees, adding that it is important to connect early with international investors and life science companies. This allows you to more rapidly benchmark your innovation and to connect with key stake holders for further development and investments. An international presence is crucial for success. Just as important is the creation of informal networks, where more senior researchers such as himself and Carl Borrebaeck can mentor those just starting to explore the idea of taking their research outside the lab.
"Identifying strong entrepreneurs are an important aspect in supporting life science innovation. As mentors, we can help others to avoid many common pitfalls. I myself, have received great advice over the years from Carl for example. Having these mentors placed within an environment like LUCC can further aid entrepreneurship by creating a community of researchers in life science with broad expertise of working outside of academia. Another important aspect is that such a community is well placed to integrate results of validation and testing back into science, with an aim to develop and improve treatments and approaches.
SCAN-B - the development of a clinical test
Someone who has taken a different approach to take his research outside of academia is Åke Borg, Professor at the Department of Clinical Sciences, Lund. He started the research project SCAN-B (Sweden Cancerome Analysis Network - Breast) in 2010 with an aim to link biological properties in tumor tissue to prognosis and treatment by collecting tumor tissue from breast cancer patients. After analyzing almost 10 000 patient tumors, SCAN-B developed and launched a clinical test in 2021 which is now in use in all the hospitals in Region Skåne. The test subcategorizes the type of breast cancer the patient has and also identifies whether this type of cancer has low or high risk of relapse.
For Åke Borg and several of his younger research colleagues, who has been involved in SCAN-B from the start and are set to take over the helm, the challenge has not been to attract investors. Rather, it was convincing research funders to maintain funding in the project during the decade it took to develop the test. As patients can relapse up to ten to fifteen years, or even longer, after first receiving their cancer diagnosis, they had to wait to connect the biomarkers in the tumor tissue to the various sub- and risk categories to the patients’ outcome and survival information.
Convincing the hospitals and patients to join the research project, however, was easy! Since starting in 2010 more than 22 000 patients have agreed to give tumor samples to the project which is continuing to improve the test and identify more relevant biological tumor properties.
Åke Borg reflects that he started SCAN-B because he wanted to make a difference. That is why he chose to develop methods and techniques that can be of use to clinicians.
At the end of the day, to do something like this you have to have both the science behind you and a belief that what you do can change how patients’ treatments are designed and implemented.
"Long term commitment is important. That is why I have stayed. I wanted to see if this could succeed. SCAN-B is an example of what long term research funding can result in."
