Founder Spotlight #50: Pat Arensdorf @ Exai Bio
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Alix Ventures: Supporting Early Stage Life Science Startups Engineering Biology to Drive Radical Advances in Human Health
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Exai Bio is a next-generation liquid biopsy company with a mission to enable a world where cancer can be detected early, diagnosed accurately, treated in a personalized and targeted way, and ultimately cured. The company’s proprietary RNA- and AI-based liquid biopsy technology delivers actionable clinical insights into cancer biology, detecting the smallest tumors at the earliest stages of disease.
Pat Arensdorf brings more than 20 years of leadership experience as a healthcare entrepreneur to his role as Co-Founder & CEO @ Exai. He previously served as an Entrepreneur-in-Residence at the University of California, San Francisco Innovation Ventures. Prior to Exai and UCSF, Pat was co-founder and CEO for Bluestar Genomics (now ClearNote Health), CEO for Critical Diagnostics, and a member of the founding management teams at Tethys Bioscience (acquired by HDL) and Intersect ENT (acquired by Medtronic).
He has a master’s degree in management from the Stanford Graduate School of Business and a bachelor’s degree in molecular biology from Princeton University.
Personal Spark
What prompted you to pursue a career in Life Sciences? Was there a specific moment in time or influence you can remember? What drives you to work in this space?
My father was a doctor and my mother was a nurse and I think the fact that I came from a family of clinicians most certainly influenced my interest in having a career in healthcare early on in my life. My desire to advance new healthcare innovations was solidified when my wife was treated for breast cancer early in our marriage. Watching her go through this painful and at times, very invasive treatment journey really motivated me to believe there has to be a better way to treat this terrible disease. We need more effective tests that enable not only earlier detection but also provide more information to make better decisions in the clinic.
How did you get your training, if any, to be able to build your company?
By way of background, I studied molecular biology in college and went to business school which were foundational academic steps but the collective professional experiences I’ve had to date are what have prepared me the most. I’ve worked with great teams over the years and also had the good fortune to be surrounded by and learn from brilliant scientists along the way. While there is no formal training or playbook to build a company, learning from past experiences, working with talented teams and remaining curious has prepared me to help build Exai alongside a terrific team and our other co-founders Babak and Hani.
Can you tell us a little bit about your background & career thus far? What were you doing before you started leading a startup?
Before Exai, I was at several other startups so if you were to look at my career path, you can definitely see a pattern! I like the pace and the challenge of taking a new discovery in a lab and ultimately bringing it to patients to enable them to live healthier and longer lives. Diagnostics are the bedrock of everything we do in healthcare and I believe we are still in the early innings of molecular diagnostics and the profound impact they can have on the future of cancer care and other diseases.
Anything else you’d like to share about your life, academic trajectory, etc.?
A fun fact about me is that I grew up in rual Hawaii and I’ve come a long way from Maui, which hopefully encourages others with big dreams who grow up in areas that are less technology-centric.
Company Overview
What problem is your company solving?
Too often, cancer grows silently and aggressively and in a clinical setting, this means patients and physicians are on their heels. The disease has the “upper hand”. Exai Bio aims to solve this issue by developing blood tests that catch cancer not only at the earliest stages, but also the ability to detect the smallest tumors. It is well understood, the earlier we can intervene with treatment, both at initial diagnosis and relapse, the better chance we have at enabling longer and healthier lives.
How did you become motivated to tackle this particular problem?
As I mentioned, my wife was treated for breast cancer several years ago and watching what she went through first hand continues to be a driving factor for me. In fact, future Exai tests may have changed the course of her journey and she might have been able to avoid seven years of treatment. She was diagnosed with Ductal Carcinoma In Situ (DCIS) — where the challenge is that the majority of women with DCIS will never progress but are treated prophylactically with surgery because there isn’t a non-invasive way to determine and monitor if it’s indolent or becoming aggressive. Knowing the painful treatment and years of followup my wife endured could have potentially been avoided if we had better prognostic tests motivates me every day. Thankfully, she remains recurrence-free to this day.
Our aim is to not only be able to detect DCIS (and other cancers) early but also determine and monitor if it’s aggressive or indolent which could be a game changer, enabling less invasive approaches including monitoring and watchful waiting. By focusing on RNA and the transcriptome, Exai has a unique role to play in bringing both market-leading sensitivity together with underlying cancer biology. Having this additional biological information will be a requirement to make the greatest impact on clinical care, and to address physician and health system concerns of potential false positives, over-diagnosis and over-treatment.
Quite simply, what does your company do?
Exai Bio is developing next generation blood tests to detect a patient’s cancer early, both at initial diagnosis or before relapse. Our unique approach has proven we can not only detect the smallest tumors but also provide more actionable information for physicians about where the cancer is in the body, if it is indolent or aggressive, and the biological underpinnings of the disease.
Now in more depth, what are the specifics of what your company does?
Exai’s unique platform uses RNA sequencing to identify a novel category of cancer-associated, small non-coding RNAs, termed orphan non-coding RNAs (oncRNAs). OncRNAs are actively secreted from living cancer cells and are stable and abundant in the blood of cancer patients. Exai has created a catalog of hundreds of thousands of oncRNAs and thousands of patient oncRNA profiles, spanning all major cancer types. When combined with Exai’s proprietary artificial intelligence, this unique platform has several scientific and practical advantages over tests that focus on circulating tumor DNA including sensitivity, specificity and informative properties for active cancer biology. Exai’s universal platform can be used across multiple cancer care settings and applications, such as screening and early detection, monitoring, molecular residual disease and therapy selection.
Why does your solution matter for the world when you get it right?
If Exai is successful, we can enable a world where cancer can be detected early, diagnosed accurately, treated in a personalized and targeted way, and ultimately cured. Simply put, we can turn the tables on cancer giving patients and their physicians the upper hand to stay ahead of the disease.
Genesis
Tell us about the founding of your company — how did everything come together?
I was working at UCSF on its innovation ventures team and was asked to be the entrepreneur in residence working with Babak Alipinahi and Hani Goodarzi who would ultimately become the other co-founders of Exai Bio. This was during the COVID 19 pandemic and we hunkered down during this time to see if the technology could work beyond its first application in breast cancer. The work we did during COVID has paid off and paid off very quickly. And the moment we realized this technology could work across many cancers in a very efficient manner, we knew we had something special and things took off from there. We were able to do a new proof of concept for a new type of cancer every few weeks. It was also notable, we were having success in detecting certain types of cancers, including breast cancer, at early stages which were notoriously challenging for other scientific approaches.
Accomplishments
What are some of the notable milestones your company has achieved thus far?
In just 18 months since its founding, Exai has generated an impressive amount of data demonstrating our platform can detect cancer accurately and at the earliest stages in both screening and disease monitoring settings. Publicly, Exai has made available research demonstrating high sensitivity across multiple cancers thus far. We have sequenced over 10,000 samples to date and most recently presented a poster at ASCO demonstrating early detection across multiple cancers encompassing a study of more than 3,000 subjects.
What are some of the biggest hurdles ahead? How do these create points of value inflection?
As we continue our R&D efforts, we are at a turning point as a company as we’ve entered into a product development phase for our first indication which is very exciting but also requires hiring new talent and engaging with experts and the broader ecosystem. We are being very thoughtful about how we first introduce our test and are selecting a cancer type where there is a specific pain point for both physicians and patients. The key to success will be to continue to hire the right people to meet our next set of goals as we move from a platform only company to a product company. That said, Exai has become a magnet for hiring some of the best and brightest in the industry.
Pay It Forward
Throughout the journey, what have been some of your biggest takeaways thus far? What advice/words of wisdom would you share from your story for other founders?
Building a company truly is a team sport. It starts with the people and as such, you need to build a strong culture and a shared mission. It’s not always going to be smooth sailing but if you build the right team, then you are never alone in this journey.
What are some of the must-haves for an early stage Life Sciences startup in your eyes? (Key critical components like team, academic papers, industry know-how, etc.)
At its core, a good life sciences company has strong science and conducts the right studies with integrity. Cutting corners will ultimately be a disservice to patients and the industry as a whole. In addition to strong science, a strong team is a “must-have” to make the company’s mission a reality.
What are some of the traits that make a good founder? What type of risk profile/archetype does someone need to have to be a founder in your opinion?
Resilience is key. One thing that is certain in a startup is that there will be ups and downs and being resilient for yourself and the team is critical. To that end, a great founder builds a high sense of camaraderie to weather the challenges and celebrate the wins along the way. Finally, it’s critically important for founders to take time to recharge. Taking care of yourself actually gives you space to reflect and ultimately makes you a better leader.
For folks coming out of academia, what advice would you share?
First and foremost, find good partners and an entrepreneurial culture that will support further discovery. That said, while the research is never finished, be willing to shift into the development stage of R&D to meet the product specs and deliver version 1 of your product.
Not everyone knows everything. Often founders have to learn either the science or the business side better. What advice would you give for someone picking up a new skill set such as this?
Surround yourself with experts, both internally and externally. Lean in and really listen and remain intellectually curious to get the maximum value from your experts. Also, don’t be afraid to bring on external advisors or solicit the opinions of many, including those that may not always agree with you.
Can you demystify the process of what it takes to raise VC funding? What were the highlights & lowlights? Any advice or words of wisdom for future founders?
You have to be willing to put yourself in the shoes of the investor and shift from selling a technology to selling a business opportunity. You can also save a lot of time if you seek out and work with investors who have direct industry experience in your technology domain. In those cases, they become great partners as well as investors.
What advice for managing and hiring a great team can you share?
Anticipating the future needs of the company will help you stay ahead of the hiring process and find the experts you need before it becomes a fire drill. This is critical as it will give you that space and time to not only find the people with the right experience but also those who will be a good cultural fit. Often it’s also possible to hire consultants who may become full time employees in the future to optimize the use of limited resources.
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