Changing the Face of Cancer — Full Transcript

Understanding genomics, big data & how to ultimately change the face of cancer medicine.

Jasvir Zonobi, Kuveda Co-founder & CEO, and Unity Stoakes, StartUp Health Co-founder & President, delve into Kuveda’s approach to transforming healthcare that could ultimately change the face of cancer medicine.

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Key takeaways from this episode of StartUp Health NOW can be found here.

[00:00] Chime

[00:05] Unity Stoakes: Welcome to StartUp Health Now! The weekly web show that celebrates the healthcare transformers and changemakers reimagining health. My name is Unity Stoakes and we’re here in San Francisco. Incredibly excited about today’s show. We’re going to be meeting with healthcare transformer Jasvir Zonobi who is the CEO and Co founder of StartUp Health company Kuveda. Stick around. It’s going to be a great show.

[00:29] Music Intro

[01:07] Unity: Jasvir, wonderful to be here with you today. I’m really excited about the conversation because I think your mission and what Kuveda’s doing is absolutely essential for everyone to know about.

[01:22] Unity: It’s an extraordinary time in history and recently there was this moonshot to end cancer announced from the white house. Dr Patrick Soon-Shiong announced his moonshot 2020, and it feels like things are different and the future looks different than the past in terms of cancer.

[01:47] Unity: So I thought we’d just start the conversation, would love to learn about you and specifically, the mission you’re on with Kuveda.

[01:56] Jasvir Zonobi: Unity, it’s wonderful to be here and thank you for the introduction. I think it’s right on. A little bit about myself. I”m going to off where ever you might have been imagining. First, I want to say I’m actually an immigrant from a very small village out of India. It’s kind of important because a lot of people get defined by university, or college, or where they come from but rarely do they get defined by what they bring themselves.

[02:21] Jasvir: I think my journey is that I come from a small village. If I had stayed there, maybe my opportunities I had exposure to would have set me on a different course. Coming to the United States, coming to California in particular, which is a diverse area, both from cultural but also technology standpoint and then landing directly in Silicon Valley, is really a huge influence.

[02:42] Unity: Is that where you came first? From India?

[02:45] Jasvir: Right into Silicon Valley. But I came here very young. Went to university here and by the time I went to the university my father was already retirement age. I had the good fortune of being an immigrant, establishing myself, but also needing to pay for my school so I actually worked as I went through university.

[03:05] Jasvir: The interesting part of that is it puts you in charge of where you’re headed. It gives you the tools so you can actually succeed in school at the same time because you’re applying your skills that you’re learning about.

[03:18] Jasvir: That’s kind of a nice background about me. From the beginning I’ve been in technology. Right from two weeks into my university I’ve been working in the field.

[03:30] Jasvir: Because I studied computer science and applied mathematics, and mathematics is another area people don’t pay a whole lot of attention. What are you going to do? Stats, economics? It turns out you can apply math in a lot of different fields. For that reason, I worked in space systems, e-commerce, digital television, now healthcare, genomics. It’s a broad area of application of the background, just as a background.

[03:58] Unity: It’s so interesting because I know a lot about what Kuveda does. It would be helpful to share the context of Kuveda. What the mission is because you’re using mathematics, you’re using data, you’re using numbers in a very, very exciting way for what you’re doing with Kuveda.

[04:18] Jasvir: Exactly. That’s where I was headed. This experience has brought in the background of applied sciences, big data analytics, and then applying them to genomics. What genomics is all about, what Kuveda is all about, is taking vast amounts of information and, you said early about the moonshot, what’s relevant moonshot is, the previous way of thinking about cancer and solutions to cancer, was you have a drug that targets a, what we would call anatomical site of origin, or anatomical lung cancer, brain cancer, etc, but really moon shot is about understanding the underpinnings that drive that cancer, that drive that tumor, and one has to understand the genes involved, the pathways involved, how they interact with each other, where the signalings end, that is in millions of combination.

[05:12] Jasvir: If a patient has five or six different mutations, being able to understand somatic mutations, mutations that are bad, mutations that are not necessarily bad, all those kind of play into the decision that has to be made. That’s where we started, understanding genomics. Having a background in genomics, how do we take this, how do we apply computer science, big data to the problem of healthcare and understand, how do we intersect the patient against the science, known science, which is rapidly changing everyday and keep current with it, and then apply it against millions of patients, learnings from millions of patients. It’s a very large problem.

[06:00] Jasvir: This is how Kuveda came about. Today, about 96% of the advanced stage cancer patients, they end up dying. They died because they tend to be diagnosed or evaluated based on whatever has been published and that takes time.

[06:20] Unity: Just the standard of care

[06:21] Jasvir: Standard of care, right?

[06:22] Unity: And everyone’s pretty much treated the same way.

[06:24] Jasvir: Everyone is treated the same way. And there are exceptions, though. There are a few people that can afford the time, the money to get more refined treatment. But that’s few. Very few. The reason it’s few and the reason it takes, is it takes a lot of effort to analyze. The learnings from that stay with a very small group of people, so they can’t be applied to general, me, or others like me out there.

[06:50] Jasvir: What Kuveda wants to do is take the learnings from every patient continuously, make it available to doctors, to clinicians, so that every patient can benefit from the learnings and the benefits of the data.

[07:04] Unity: So the more data that’s coming in, the better it is for everyone?

[07:08] Jasvir: Exactly. The more data that’s coming in, it actually not only helps this patient, it helps the research because cancer is a complex problem. There isn’t a solution already in the numbers you have. You’re gonna find all kinds of new things that did happen, that weren’t known. The other thing is cancer is continuously changing. We’re going to find, and as things change, the environment changes, all those influences are going to affect the performance, or the agent affects the performance, the other various type of phenotypes affect the performance of drugs. These are different factors that come in to make relevant decisions for the patient. Or, I would say, more evidence based decisions.

[07:52] Unity: In the world of Kuveda, the world of the future, it’s much more about precision medicine. It’s much more about understanding that specific, the data around that tumor, the genomics around that tumor to make the decision on how to treat a patient?

[08:11] Jasvir: Yes. It’s much more about information about the tumor, what other things are going on with the patient. It’s not just cancer in isolation. It’s cancer in the human. It’s the human that has to be looked at. What are the other conditions? Are there interactions between other conditions and cancer? How do you manage the person as a whole and the lifestyle of that person as a whole?

[08:38] Unity: What are some of the lessons learned along this journey of building Kuveda as an entrepreneur. Maybe words of wisdom or thoughts that would be helpful to other entrepreneurs who are thinking about doing something so bold as you and trying to reinvent the future of cancer? What are your thoughts and what have you learned?

[09:03] Jasvir: Goodness. Where do I start. First, find a good incubator. A partner. And I have to say, StartUp Health has been a fantastic partner. So if there’s an example to be found that would be a good one. Then also, recognize that if you’re going into the type of a problem we’re solving, where we are not directly to patients, but we’re enabling patients to better access to healthcare, that means we’re working with clinics, we’re working with hospital, it is not an easy path in. You need patience, you need to have time behind it.

[09:36] Unity: A long view approach.

[09:37] Jasvir: It’s a long view approach. You cannot just give up with the first no. It might be a lot of no’s. But more importantly, every time there’s a no there ought to be that there’s a value proposition acknowledged of what you’re building so that the no’s can turn into yes’s, because this is a transformation of the healthcare. This is, what’s the right word to say, we are, I’m kind of lost at the word. But..

[10:07] Unity: We’re Healthcare Transformers.

[10:08] Jasvir: We are Healthcare Transformers. It’s a, people are not just going to flow with it. There’s a resistance, there’s a time to adoption. That’s what I would advise to others. Just recognize that this is not an easy thing to do.

[10:25] Unity: Right. I think you’re in Silicon Valley, you’re in the heart of tech world, right? I think a lot of the thinking is “let’s do things quickly. Let’s iterate fast, let’s test, let’s experiment.” Often times the thinking is very short term.

[10:48] Unity: But, I think it’s also very important when we’re talking about health care to have a long view to really get around those obstacles and those roadblocks. What have the biggest challenges been for you? Is it just managing those expectations from the beginning and really making sure that you can handle the long term? What are the biggest challenges?

[11:17] Jasvir: Ok

[11:18] Unity: Convincing the old school industry on how to do things differently perhaps?

[11:22] Jasvir: Right. The word was disruptive. That I was looking for.

[11:25] Unity: Good. We’re back. [laughs]

[11:27] Jasvir: We’re back. But continuing from that. I think the agile approach is still very relevant. Regardless of the industry. And the agile approach, whether you take bite sized, which is in technology two weeks or four weeks,

[11:42] Unity: You just need to be agile every day for multiple years.

[11:45 Jasvir: Exactly. You need to be agile but your agility should be towards what the industry needs and it needs to be continuously evaluated. Whenever there’s a no, you have to understand what the basis of that no is.

[1:57] Unity: I like that.

[11:27] Jasvir: Right? Apply that to the agility and adjust the product. You might have the, we do, we have great vision. We have a lot lined up. What is relevant now? What is the incremental, where can we apply now and how does that take us towards our long term vision?

[12:13] Jasvir: So, yes. Long term vision should never be not looked at, but tactically you have to look at how does my decision support my long term approach.

[12:24] Unity: Wonderful. What does the future look like? What are your predictions for how quickly things are evolving? We see a lot of money flowing into big data companies. We see a lot of technology changing very quickly.

[12:42] Unity: We’re also seeing government initiatives around precision medicine. How quickly will things change? How quickly will we really change the face of cancer and really end it as we know it today?

[12:59] Jasvir: I probably won’t make a prediction on the end as much but I can say that the

[13:04] Unity: Or maybe where it’s more of a chronic in some cases

[13:07] Jasvir: It’s not much more a chronic or, let’s say at least transitioning from stand of care to me care.

[13:13] Unity: Precision.

[13:14] Jasvir: Relevant care, right?

[13:15] Unity: Me care.

[13:16] Jasvir: Evidence based, right? That I think is happening very soon. In fact, we’re seeing trends around the world while the United States tends to be on the vanguard of this, we’re beginning to see the rest of the world responding to that.

[13:27] Jasvir: But, where digital health is going and what we do is very relevant is, it’s no longer you have to have extraction of that solid tumor for you to be able to tend to this. Patient has a journey and in order to have a personalized precision medicine, that is a tracking of monthly every, it’s a regular tracking and not just whenever you do a biopsy.

[13:49] Jasvir: So to that end there are a number of innovations that are going on which deal with fluids, taking and extracting DNA from the fluid, and being able to then assess what are those changes? Or right or wrong, or good or bad. Then getting to the level of mobile when all that comes together the ability to deal with that vast amount of information per patient and then to be able to apply it back, doctors are going to need tools. So we think that that’s probably within a couple of years.

[14:19] Unity: Wonderful. What would you say to maybe someone in the village where you grew up or somewhere around the world that may have a dream like you? What would your words of wisdom to those people be that hopefully now have access via the internet to hear your words of wisdom?

[14:43] Jasvir: Which, amazingly they do. I think a lot of those countries have more access to the internet than we do. I would say that don’t let yourself be defined by where you are. Define yourself. I have always been the way I am. Challenged. Challenge was around me. That doesn’t mean that you have to be a rebel in a negative way. It just means that you have to be

[15:09] Unity: Pushing forward?

[15:10] Jasvir: You have to be pushing forward. You have to be able to analyze the situation. Just adapt yourself. A lot of people come from small places, villages. In fact there was an amazing thing that I saw, came out of a small village out of Africa. Amazing innovations come from there so don’t let the background you come from define you. Let you define yourself.

[15:32] Unity: Wonderful words of inspiration. Thank you for everything that you do. Thank you for being a active Healthcare Transformer in the ecosystem and sharing so much with the community. Thank you.

[15:42] Jasvir: Thank you, Unity. Thank you. Pleasure.

[15:44] Unity: Thank you. We’ll see you soon.

[15:49] Chime

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