Jonathan Balfour, Panaxium - Studio Interview | LSI Europe ‘22


Jonathan Balfour

Jonathan Balfour

CFO & COO, Panaxium
Read Biography
CFO & COO, Jonathan Balfour and Panaxium aim to make "untreatable" debilitating neurological conditions treatable via the use of precision bioelectronic devices that target specific cellular behaviors at the microscale.


Nick Talamantes  0:00  

Jonathan, thank you so much for joining me here at LSI Europe, tell me a little bit about Panaxium, and what you guys are doing.


Jonathan Balfour  0:08  

Thanks for having me. Really excited to be at LSI. This year. Panaxium is an earlier stage medical device company that is bringing a medical device therapy to market to help heal the brain for all those patients that are left disabled following a stroke.


Nick Talamantes  0:27  

That's interesting. So how are you doing that? Can you talk a little bit about the technology itself?


Jonathan Balfour  0:32  

So one of the things with the brain and the nervous system is that people always associated with sort of electrical activity. And what we know in our world with electrical activity, or like micro electronics, cell phones, things like that, but our bodies are actually more like bags of you know, electrolytes, right to be crude about it. And so there's a mismatch with most technologies that are trying to affect change in the brain. And so what we do is we use a new set of materials that are iron conducting polymers, to create a neural interface to drive cortical stimulation, so to stimulate on the brain to affect and modulate activity, in combination with a mechanism in the body in the brain, where, if there's an injury to a region of the brain, it automatically tries to remap those functions so that you don't lose, for example, your hand function. So it rewires things and tries to make new connections so that you don't lose and live with disability forever. Unfortunately, though, it's messy on its own. And so 90% of people who have a stroke are left disabled. So what we do is with this, these proprietary materials that we build devices have, we implant them on the brain and stimulate the cortex to modulate the behavior and reinforce and basically guide the brain to where is a good way of remapping that function so that more and more people can get, say, their hand function or other disabilities removed and get back to living their lives?


Nick Talamantes  2:08  

Would you say this is a type of bio electronic therapy that you're developed?


Jonathan Balfour  2:12  

Absolutely. So it's yeah, it's a bio electronic cortical stimulation therapy that is really just guiding and reinforcing a really incredible mechanism of action that's in the body. But it's something that there's no treatment out there for right now. These people have nothing, there's nothing out there to heal the brain. When you have a stroke. All that's done is they've made sure your your your acute issues managed, and then they send you off to do physiotherapy. But Physiotherapy is not about healing the brain. It's about making sure your muscles and your limbs, for example, are still working so that a couple months down the road, when that natural remapping happens. Hopefully, they just want to make sure your muscles are still working. But unfortunately, that as I said, that mapping doesn't work very well. So most patients, after three, four months of physio, have plateaued and are still disabled, and there's not much they can do from there. 


Nick Talamantes  3:11  

So what's the sort of initial indication looking like for this technology? Are you looking at stroke first or somewhere else.


Jonathan Balfour  3:17  

So this is a platform technology that can go to a number of different use cases, we have researchers and clinicians in our network that are just clamoring to try this a whole bunch, a whole bunch of things. But our initial indication is within stroke. But even a subset of that because half of stroke survivors are left with upper limb disabilities. And this is one of the most impactful things to your quality of life. Imagine you can't use your hand to feed yourself, use your phone to communicate, drive, all these things are impacted if you lose the function in your arm. There's also a lot of neuroscience and research about how the mechanisms work. And so there's a lot of science that we can build upon to apply our remapping therapy. And so that's what we're going after first. And even if you whittle it down from you know, there's 12 million new cases of stroke survivors every year, half of those have upper limb injuries. And if you take a sliver of those that are at sort of the worst end, not totally disabled, but you know, in that severely affected range, you got a huge population that can benefit from this. And just getting people back to being able to write and use their phones is going to just change their lives forever.


Nick Talamantes  4:39  

You've mentioned sort of the subsets of patients that you'll be able to help with targeting stroke first, what's the market opportunity, the dollar amount look like for this type of technology?


Jonathan Balfour  4:50  

So, simplistically, as I said, there's 100 million people out there who are living poststroke with disabilities now. There's 12 million new people a year, who are having a new stroke, we're all going to be affected by this either directly or through our family and friends. And then when you bring this down to the way we filter down for our first foray, there's, there's over half a million new patients a year that could benefit from this. That puts us in the order of 10s of billions of dollars of, of market opportunity. We're obviously, you know, pre revenue, there's a lot of work to do to figure out price points and all that. But using some comparable technologies in the market, I can safely say this is 10s of billions of dollars of market opportunity.


Nick Talamantes  5:37  

Yeah, stroke is, I believe, the number one or number two leading cause of death worldwide. And so that's obviously affecting a lot of people.


Jonathan Balfour  5:45  

It's also the number one or number two cause of disability in the world. And sadly, people are having strokes much younger now. And so being disabled from an age of 30 40 50, is a lot different than from 80. And so we've got a lifetime of people, people's lifetimes, who are going to be disabled and affected and the burden on them, on their families, and on society has meant that this is one of the leading socio economic challenges of our society today.


Nick Talamantes  6:18  

You mentioned that you're early stage. Could you talk a little bit more about where you are companies that right now?


Jonathan Balfour  6:25  

Right, so we have built our business on the basis of decades of neuroscience research, our company has been around for almost six years now extracting IP from some leaders in the field, bringing this together into a manufacturable process that can create real devices to be used. So we have are in the what we call the later preclinical stage. So we are working with primates, because you need a brain model that is representative of the human so you can translate what you're doing in the model to what will ultimately happen clinically. So we're doing that research right now, in a couple of different locations. And primarily, there's a really impressive researcher and clinician, Dr. Cook out of Queen's University in Canada who has a translational stroke lab that he runs. And so we're doing preclinical work there. We also have a clinical study that's starting in Paris later next sometime next year, where the recording capability of our platform is being used as part of a clinical trial, trying to support neurosurgeons in their tumor resection procedures for people with glioblastomas. And then we also further that have a commercial partnership that's going to be announced sometime in the next couple of weeks, to take a component of our platform technology to market in combination with a large neural navigation, capital equipment company,


Nick Talamantes  8:00  

Very exciting to hear. So obviously, LSI Europe, we're bringing together the innovators like yourself, the strategics, the investors, what are you hoping to get out of this, you know, this gathering of the different elements in our industry.


Jonathan Balfour  8:14  

So obviously, like many people, we've been, you know, hunkered down for the last couple of years. And so it's nice to have an opportunity and a platform to sort of share what we're doing and what we've been doing over the last couple of years. And so we really wanted to come out and promote and we looked at the audience that was coming in, this is a perfect fit for who we are, we're a French based company, with people in North America as well. And the caliber of people and companies and and venture capitalists that were here were a perfect fit for who we're looking at. So we're obviously we're raising money. We're raising a seed round to fund these activities, these important steps steps that we have, with the objective of gathering the data to file an IDE with the FDA, sometime in the next year or so, which will then kick us off for a larger seed round.


Nick Talamantes  9:09  

Is there anything else that you'd want to share with our audience here?


Jonathan Balfour  9:13  

Um, well, when it comes to a device therapy, really having a therapy is more than just hardware. And when it comes to the brain, things are very intricate, and interconnected. And while we've created a device that is very precise, and able to really precisely selectively target regions of the brain that you want, things, functions to be remapped to. You can't do that without knowing where to go. And so the diagnostic and the personalization component is equally as important. And so we've also put a lot of effort into that side of the equation, where we have a proprietary combination of MRI protocols that we use to assess a patient post stroke, and what that information is processed using an AI optimization algorithm to kick out a personalized functional map of a person's brain. So you can see where the wiring is. And then you can also see where it's been disrupted by the stroke injury. That does a few things. So it gives the clinician information that just doesn't exist anymore, right now, they can help to predict what that patient's likelihood is to recover is because, as I said, 10% of people get very good recovery on their own. And you don't want to, you know, get in and muck around with an interventional therapy with those people, right. So you need to be able to predict that and that's going to evolve over time, we're going to get better at that to allow us to treat more and more patients. But once the clinician has said, You know what, you're not looking like you're recovering or going to recover. Well, you should take Panaxium, interventional cortical stimulation therapy, it allows them to know what's going on in that person's brain, because each injury in each brain is different. And so they can create a very personalized treatment plan for that patient. So you know, your injury is in this region, and you need to have a stimulation therapy that's precisely located there. So it really comes down to delivering a therapy is diagnosis, personalization of the treatment, and then delivering on that in a very precise, safe way. And safety's equally as important as being able to deliver effective stimulation. And one of the things is, as I mentioned, like, you know, we treat our brains like their electronics, plugging electrodes in with metal and this led, it's just not the right fit for us. Sadly, when things like deep brain stimulation, they do wonderful things. But you know, when you charge metal pieces into your brain and creates peroxide, these things damage the very parts that you're trying to heal. And when it comes to things like tremor, it's not as crucial. But if you're trying to remap a function, you don't want to be damaging the very neurons where you're trying to do it. So that's where our material science, the organic bio electronic materials we use really come into their own. So it's, it's no one piece that solves it, it's putting them all together, that that really creates a an effective solution


Nick Talamantes  12:21  

This diagnostic element that you've mentioned. I'm not familiar if anyone else is really doing this mapping of the brain and its injuries in the network post stroke or post injury is this novel to you guys.


Jonathan Balfour  12:35  

So we have this is a there are people who are looking at ways of mapping the brain and very detailed ways that this is a unique application within the stroke space that is really designed to, you know, it's kind of like a pharmaceutical that needs a diagnostic right combination. I can't remember the name of that, what are those called? I'm calling? Yeah, anyways, it's very much like that, where you need to have the right tools to identify your patients, and then deliver the treatment because too many drugs, too many devices fail by trying to treat the wrong people in their clinical trials. So this is a way for us to ensure that we know who should be getting treated and and how to treat that individual because the brain is an individual thing. 


Nick Talamantes  13:25  

You've got a pretty precise device. It sounds like how do you know where to pinpoint and treat?


Jonathan Balfour  13:32  

Well, I mean, the brain is very complex. And there's still more we don't know about it than we do. But over the last couple decades, imaging has advanced a lot. And so we have some collaborators who have come up with a really innovative way of assessing the brain and the functional networks in the brain around an injury. And so we realized that to get somebody to take an interventional therapy on the brain, and let's not kid ourselves. This is fairly invasive, it's brain surgery, you need to convince the people and be sure that this is the right treatment for them. And so we've invested in kind of like a co diagnostic where we do a really detailed personal assessment following the injury using a proprietary combination of MRI that gets processed using some AI optimization in the background so that you can really pinpoint for you what your functional networks are look like and where the stroke injury has disrupted those one step further. Once you've started feeling your brain starts to remap itself. You can do another assessment and see where that's starting to happen. And those two things together, allow the clinician to figure out What your prospects for recovery are on their own. And then even more so get down to a level of precision that they can pick areas within, say, the motor cortex that you want to selectively stimulate or not stimulate, to give the patient the best possible outcome for them. And it's different for each patient, there's some commonality, but you need to know for you exactly where your injury happened, what the features of your brain are, and allow the clinicians to say, Okay, I have some information now that I couldn't get before. And so we think that that is incredibly important in order to deliver a precise, personalized treatment.


Nick Talamantes  15:40  

So Jonathan, give me a sense of what you think is happening in the neuro tech space.


Jonathan Balfour  15:47  

So neuro technology right now is an incredible space, there's so many massive problems that are unsolved. I mean, a lot of people smarter than me tested this as the, you know, the last great frontier in medicine. Now, there'll be a new one afterward, I'm sure. But right now, that just speaks to the types of massive problems that are unsolved there. So I'm glad to see that there's a lot of investment going in. And there's a lot of technologies because there's so many different problems, we need a lot of different solutions. And that's, there's no one company that's going to win at all right? The, the problems being solved are diverse and, and require very unique approaches. That said, like, one of the things that a lot of people are trying to do is really tap into the brain and figure out how to interface well with it. There's been big investments in some brain computer interface, technology companies, that are trying to really work hard at reading from the brain incredibly well. And that's a capability we have that that we're going to exploit more and more over time as well. But one of the things, these companies, some of these companies are really doing well, right now is being able to done a very fine, high fidelity way, interpret intent and what's going on in the brain. And, and there's a great outcome of that is that they're, they're able to control prosthetics from the brain directly. I mean, examples like, you know, somebody who's lost the function of their legs, they can, they can control a wheelchair with the brain. Because if you are quadriplegic, and you can't use your hands or your feet, how are you going to move in your wheelchair, so being able to connect the brain, to the wheelchair and control that's liberating for so many people. But our approach is a little different. And we know that you can heal a lot of the brain by remapping functions around damage. And so our objective is to take that patient who may have lost their hand function or something like that, and give it back to them. Because let's not give up and like you do want to give people the freedom. But if you can heal them, why wouldn't you do that? I'd much rather be able to, you know, use my own hand to get up and walk around. And it's it's accessible. This is this is going to happen. But both solutions are needed. So there's there's a lot of as To summarize, there's a ton of problems that neuro tech can solve. There's a lot of different approaches. But each solution has to be tailored to a problem. And our focus is on giving people who've had a stroke, back their function, relieving their disability so they can go on living as close to as normal as possible.


Nick Talamantes  18:37  

I'm really looking forward to following the work that you and Panaxium are doing.


Jonathan Balfour  18:42  

We were really excited for the future. There's, as I said, like, the upper limb stroke recovery market is a massive unmet need. But we through our work are building quite a collaborative network. And once we get this thing a little further along, we're going to be doing a lot and planting a lot more seeds and a lot more indications across like schizophrenia, depression, neurodegenerative diseases, there's a whole lot that this platform can do and cortical stimulation can really benefit a lot of people. We just We were excited to get the first step done correctly, though.


Nick Talamantes  19:22  

I believe neuro Tech is one of the most exciting industries in the med tech industry. So I love seeing what you guys are doing and thank you so much for telling me more about what you guys are working on.


Jonathan Balfour  19:33  

Excellent. Thank you for for the time


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