Oriana Papin-Zoghbi on Revolutionizing Early-stage Ovarian Cancer Diagnosis

Oriana Papin-Zoghbi

In this episode, we chatted with Oriana Papin-Zoghbi, Co-Founder and CEO of AOA Dx.

AOA Dx is revolutionizing early-stage ovarian cancer diagnosis by developing a non-invasive ovarian cancer liquid biopsy diagnostic test that will improve clinical practice. AOA Dx has raised their seed funding and is currently raising their series A.

Oriana Papin-Zoghbi is the CEO and co-founder of AOA Dx. She is a visionary leader in the field of women’s health and diagnostics and was recently honored in Inc’s 2022 Top 100 Female Founders for her work in ovarian cancer diagnosis. As CEO of AOA Dx, she has raised over $7M in Seed funding and $1M in non-dilutive grant funding. She also has a proven technical record of creating market entry strategies and product launches in new markets, including launching nationwide HPV screening in East Africa and novel diagnostics in maternal-fetal medicine, oncology, and infectious diseases. Oriana holds a degree from Boston University in Economics and International Relations, and she has experience both living and working in various geographies.

In our conversation, Oriana and I discussed:

• Her journey around the world and landing into AOA
• The current and future standard of ovarian cancer diagnosis
• Transforming academic research into a thriving business
• Building trust with your partners, customers, investors, and yourself

1:19 to 5:00: Oriana ’s Early Foundation

• On her global perspective that led her to her career: Oriana, coming from a Hispanic and Middle Eastern background, was born in Venezuela and grew up in Saudi Arabia. Throughout her upbringing she moved to Switzerland and then attended university in the United States to study economics and international relations at Boston University. Her background helped shaped her global perspective.
• Falling into women’s health: Oriana knew she liked the sciences at a young age and with her mother as a physician, medicine as a career was top of mind. At Boston University, she pursued the pre-med track but realized that traditional medicine career was not for her. The university opened her eyes to understand that you can have a career in the sciences beyond just a research in a lab or being a physician. This led to her interning at a women’s health diagnostic company, AmniSure International, which was looking for someone to translate marketing material into different languages. It was that internship where she found her passion for women’s health and met her two co-founders that would later join her in creating AOA Dx.

5:01 to 14:57: Going Global

• On her early career: After AmniSure International was acquired by a larger Biotech, Oriana along with her peers, later co-founders, were offered full-time roles at the larger company. Oriana went to the headquarters in Germany to work on emerging markets and expand beyond women’s health such as oncology and infection diseases.
• On moving earlier and earlier in a company: One of Oriana’s mentors at the time reached out about their new company they were going to spin out of Harvard’s Innovation Lab and needed a founding team. Oriana and her now two co-founders moved back to Boston to join. It was through the experience Oriana learned how to build a technology and go through FDA approval from start to finish and ultimately selling the company
• On pursuing the right fit: Oriana and her co-founders realized they can do this on their own. They started to map out unmet needs in women’s health and look at academic research that could potentially be the solution to these unmet needs. After intense due diligence and flying across the country, Oriana received a call from one of her mentors about exciting research from a prominent researcher. Professor Saragovi from McGill University had research that may be the right fit for their venture: the ability to detect early-stage ovarian cancer.
• On establishing a partnership: Oriana and her team described their value add to Professor Saragovi as being able a business-oriented team that translates academic into industry. Her team emphasized that they would not take away from his core research as it was focused on therapeutics, but rather find an alternative use case that could make it to market quicker and save women’s lives.

“We didn’t go in heavy with contracts and agreements. We started and spent 6 months building a relationship and a business case of why women needed a diagnostic for ovarian cancer and why his technology is going to be so impactful for patient care.”

After building that trust, the team focused on whether the research was patentable and made sure to get the intellectual property in place. In the world of diagnostics, it is important to have a protective moat. After much deliberation, Oriana and her co-founders decided to bring in Professor Saragovi as a Chief Scientific Officer with equity which was ultimately the most beneficial for both parties.

14:58 to 22:56 The Current and Future Status of Diagnostic Ovarian Cancer

• On the status quo: Oriana describes that there is no current diagnostic for early-stage ovarian cancer, 80% of women are diagnosed at stage 3 and 4 where at the point the survival rate is only 28% in five years. The only way to diagnose ovarian cancer today is surgery. Typical symptoms for ovarian cancer are common symptoms seen in many other conditions such as bloating, abdominal pain, and changes in bowel movement. The average time to get diagnosed in the United States is 9 months based on tracking a few blood markers that may change over time. At that point patients get referred to surgery to get a biopsy.

“To detect ovarian cancer, the surgeon has to fully remove the fallopian tube and ovary to get a biopsy. This permanent removal drastically reduces their ability to have children. Beyond that, there is immediate hormonal changes and it is a major surgery. Physicians are put in a hard place. A lot of the time it is wait and see, but the wait and see has a dramatic effect because ovarian cancer spreads so quickly.”

• On why there is no good solution for early-stage ovarian cancer diagnostic: Generally it is a hard cancer to detect. Oriana describes that the name ovarian cancer is misleading because it actually originates in the fallopian tube. Overall, women’s health has been severely underfunded and focused on which leads to the lack of diagnostics. There are companies that have platform plays where ovarian cancer is a cancer they could detect but it is never the priority. Oriana and her team made it a priority.
• On AOA Dx’s revolutionary technology: It is known that glycolipids are biomarkers that are present on the surface of tumor cells and also shed into the blood, which is studied most commonly in Melanoma. Professor Saragovi developed antibodies to target these markers and treat the cancer. As a means of patient selection he used the antibodies by both staining tissue and developing an immunoassay to detect the targets in tissue and blood. These targets were elevated in blood as early as stage 1 ovarian cancer. This method for patient selection became the foundation of creating an early-stage diagnostic.

22:57 to 32:36 to Translating Research to Industry

• On going from 0 to 1: The team set out to create a 150-page business plan by conducting diligence on the regulatory, reimbursement, IP, and commercial pathway. The next step was setting up the legal structures for acquiring the research and identify non-dilutive funding to vet out the science further. After an initial study, the team raised their pre-seed and seed round and joined a few accelerators including Y-combinator.
• On deciding where to go-to-market: There is a large trend of at-home testing with a cash pay direct-to-consumer approach. The team realized that their expertise is working with the healthcare system and providers. For them, they wanted to focus on their foundation and strengths.

“We were a team that was good at developing technologies that go thorugh regulatory approvals. We wanted to leverage what we know because we were in a disease state that was new to us and a biomarker class state that was new to us. As an entrepreneur there is so much unknown so we wanted to balance it out.”

By partnering with health systems and providers in this go-to-market strategy the team felt that gave the patients the best chance for survival with more holistic care and comprehensive data when diagnosing cancer. It is essential from day one to identify those key opinion leaders and providers in the space that are friendly to innovation and will be the early adopters. Typically this may be younger providers who want to create a name for themselves and be on the forefront of technology.

On creating trust with investors: In the early days entrepreneurs only have a vision and it is inherently risky. It is important to build trust with the investors. Oriana describes it as simply doing what you say you are going to. You are establishing that early on.

“When you end a phone call and you promise you are going to send them something, you send it to them. When you set the precedent that you are going to send quarterly reports, you send quarterly reports.”

32:36 to 39:01 Navigating the Challenges as a Founder

On challenges as a female founder: Often Oriana and her female co-founder fielded questions from investors about their teams’ family plans and running the business. She encourages society to check their biases. Ironically during their seed round raise, Oriana was four to five months pregnant. Founders regardless of what gender will figure it out if they chose the founder lifestyle. Oriana fortunately had two babies during Covid, her firstborn child and her now thriving business.

AOA Dx has received their first peer-reviewed publication acceptance into a top journal. The company is developing their technology to be commercial grade and enrolling their clinical trial. They are currently raising their Series A and growing their team later this year.

Oriana ends the conversation with “Follow people not companies or products.”