Lung Cancer at a Tipping Point: Innovation, Private Equity, and Strategic Partnerships Driving Industry Expansion | LSI USA '24

Diego Serrano  0:04  
Thank you everyone for being here. It's actually extremely exciting to be with the panelists that we have today. I'll briefly introduce them. And then we'll get right into it. I think it's great to have this group here today, because some of you may know and some of you may not. But the lung space is extremely complex. And that's why we have not solved the disease for the last 15 years, things have changed a little bit. And we can be a little bit more optimistic today than we weren't a couple of years ago. But there's still a lot to do. And so that's why it's amazing to have the panelists that we have with us today, because they are the people that are actually working towards creating that change that has not been able to come to the space before. So I'll just start with Justin. Justin has over a decade of progressive m&a and transaction experience, and is currently the director of corporate and business development at all logic, a leader in the early detection and treatment through a portfolio of products across diagnostics, medical imaging and surgical products. In his current role, Justin supports the origination of an execution of inorganic growth initiatives across the logics three divisions, which we will tell more about this later. Additionally, and this is important for the panel today, Justin was involved in the execution of the Mavericks medical platform, and has had the privilege and opportunity to continue supporting mavericks and working closely with the organization's world class partners to address unmet needs across the lung cancer care continuum. So tied to this to the medic Mavericks platform. We have David Bailey here today. David is a lawyer by training previously practiced law with a focus on m&a and venture capital financings and Latham and Watkins. He currently serves as the VP at Ajax Health a medical device focused private equity firm that specializes in joint ventures with large strategics focused on specific therapeutic areas. He also serves as the CEO of Mavericks medical, a dedicated lung cancer platform established biologic KKR, and Ajax Health. And finally, and you could say most important, we have Joanna    Nathan, who's the CEO and co founder of partner thoracic, a Houston based startup focused on developing a minimally invasive device for lung nodule intervention. She has extensive experience in the medical device sector, including managing early stage startups and venture creation at Johnson & Johnson new ventures, they She also served as a strategic consultant for the NIH, and held leadership roles in business and product development that's ran as a start up in the interventional cardiology space. By the way, Joanna, will be presenting her company later at 110 in track for it. So here if I'm not wrong. So I'll just hit it off. Well, my name is Diego, I'm the operating partner at Achillea partners. But I won't go any further into that, because I think what they have to say it's more important. So let's start with you guys. And if you could briefly explain what projects are you currently working on and what motivated you to enter the lung cancer space?

David Beylik  3:12  
Sure, I'm happy to start so spend a lot of my time these days at Mavericks, this platform that Diego did a great job describing with with Justin and others from Hologic. And I would say the vision for Mavericks is to really build out the first dedicated company focused on improving lung cancer outcomes, really across the continuum of care, catering to different specialties, a variety of different tools, including diagnostics, and devices. And I think the vision, I'm sure we'll get more into it as we go on the panel here. But in terms of why lung cancer, one statistic that we just find staggering at Mavericks is the idea that currently, less than 7% of patients who are eligible for low dose CT screening each year, and reimbursed for it, by the way actually get it. If you compare that to breast it's something like 70% compliance, due in large part by the efforts of Hologic and others and driving that. So we look at that delta, I think we see a potential 10x increase in the number of patients that get screened, which remained 10 times the nodules, 10 times the biopsies, 10 times the interventions, et cetera. So we see an enormous potential market and huge potential for patient impact. So those are some of the reasons I'm sure we'll get into more as we go.

Justin Montellese  4:26  
No, all great points, David. And I think, you know, Hologic is a women's health company, right? But fundamentally, our expertise is really in early detection and treatment. And if you think about the business itself, right between our diagnostics, our breast and skeletal health and our surgical divisions, we are really a leader and sort of the foundational DNA of Hologic is in screening, diagnosis and treatment, and particularly in our breast and skeletal health division. We've built this pretty unique and compelling portfolio of products that essentially span the entirety of the breast cancer care continuum right began from screening diagnosis. in treatment, and we think there's a have a compelling thesis around, sort of a high level of conviction around bringing our products to a market that is incredibly fragmented, has tremendous unmet needs. And really, we're looking forward to working closely with David, our partners at Ajax and KKR, to really build a de novo business to address the sort of the challenges that are currently facing the lung cancer space.

Joanna Nathan  5:24  
And I'm CEO and co founder Prana Thoracic, so we are working on precision lung surgery tools to drive early intervention in lung cancer. And I think as far as, you know, my personal interest in the space, our team's interest in the space, I think, just echoing you know, what both the other panelists have said, I think lung cancer is that a very interesting inflection point, right now, you know, with a lot of our team has interventional cardiology experience, I like to compare it to kind of where that was maybe a decade or two ago, you know, lots of different specialties intersecting to deal with a disease, that disease state that, you know, we really have not made, unfortunately, too much progress on, in compared to breast cancer and, you know, other kind of major cancers. And so we're very excited about, you know, driving some of that change, and being part of driving some of that change. And especially, you know, as screening comes online, and taxes, you know, how do we, as a healthcare system, as innovators deal with this tsunami of nodules, that's going to come our way from that, from that screening going online. So those are the some of the challenges, we're excited about solving this,

Justin Montellese  6:27  
I like that term, this tsunami of nodules.

Diego Serrano  6:30  
Yeah, I'll just take the risk and put a little bit of those numbers into context of what it's been taught today, based on our numbers, and there may be a fluctuation from which the actual numbers are. But at Achillea, we've looked into it, and we see approximately 1 million population getting screened as of today. And the latest guidelines tell that there is approximately up to 15 million population in the US that would be considered high risk. So that's 14 million Delta, in population in screenings just in the US. And if you look at the number of diagnostics, cases that we're doing, either through T DNA, or bronchoscopic biopsy, it's across 250k In the US per year. So that's a huge delta. And we'll take those numbers, and we'll work from there. So we've introduced this a little bit, but maybe the next question is, why now? Because we know that KKR and logic and Ajax are doing a great deal of effort and timing, a market like this is usually tough. So you could also contribute as well, John, for sure. Why is the right moment to get into the space right now?

David Beylik  7:40  
That's a great question. And I might answer it by saying in some ways, we're too late. I mean, cancer, lung cancer is the most deadly cancer by far biggest cancer killer. And unfortunately, it's an incredibly aggressive disease. So the only way to impact care for the most part is to catch it early. So I'm sure we'll get into that. But I guess I feel a sense of urgency that like even starting now is too late. And I wish we could have done this 10 years ago, and probably made a big difference for a lot of patients that could have needed better tools. So I would say, Now is the time, I would add this narrative that you want to articulate it around observing other fields like interventional cardiology, and how they've taken off. So I think now and seeing Hologic success with breast so I'd say one other piece to that why now is we have a couple incredible examples and proxies that we can learn from and now apply to lung and maybe save ourselves a bit of time. And I know at Mavericks, we view Hologic as our role model and seeing the success they've had in breast taking a multifaceted approach, spanning diagnostics and devices. Huge, huge push on market access, taking out Superbowl ads with Mary J. Blige to help women get screened, et cetera. I think that we've got some great examples, some great role models send the right capital and the right team to, to do it.

Justin Montellese  8:57  
No, I'd echo everything David said. And I think, you know, you have the sort of this advent of the interventional pulmonologist as well, this specialty that sort of evolving and, you know, as the tsunami of nodules kind of comes forward, they're going to have demand for more tools and more devices. And it's going to create, or at least the thesis that we believe strongly, and it's gonna create this sort of flywheel impact, where they're going to proceed your volumes and grow as a function of that demand for new technologies and innovation is going to grow as a function of that capital is going to be deployed further into the sector. And, you know, I think it's a it's a really compelling and exciting time for the all those reasons. You know, there's some tremendous companies and organizations that have tried to be successful in lung cancer and have dedicated capital, both on organic and inorganic initiatives to the space but there hasn't been a player in the market who's sort of taken the disease state from end to end really from diagnostics to devices through that entirety of that care continuum. Right. There's been little niches here and there and, you know, that's, that's why sort of we think now is the right Time to sort of build something really unique that, again, will save millions of lives hopefully.

Joanna Nathan  10:04  
And I think as a, you know, startup in this space, it's an intersection of the public health need public health crisis, really around lung cancer, and everything that's been done around screening and paying attention to that public health need. Technology, you know, in especially the imaging space, low dose CT coming, coming online, and actually enabling things like screening to be economically sound for the first time in history for lung cancer. And then finally, you know, players like CoreLogic, and large market players, you know, seeing all of those trends and investing heavily in the space. So, as a startup, it feels like the perfect time to come into the space with those kinds of three intersecting trends.

Diego Serrano  10:43  
That's, that's amazing. And I'm going to continue on that point. We've talked a little bit about the delta of people that should get screened, and then hopefully should get diagnosed. And the amount of people that are actually getting screened today. This is a tough question is the million dollar question. But how do we get more people to their screenings? How do we get all these people that are considered high risk by the guidelines? How do we make the PCPs tell these people, you should really get screened for lung cancer? And how do we bring down the slide stigma that has been around the disease? For so many years?

David Beylik  11:24  
That's a great question. And I don't have to always start, by the way, so you guys feel free to chime in, I guess I would just echo the point that for us Hologic is a real role model. So trying to emulate a lot of what Hologic has done successfully and breast. Justin can probably comment on that more specifically. But from my perspective, it's a combination of there's legislation and policy and reimbursement. And there's also kind of direct to patient messaging and consumer ads, education, etc. So I think it's very much a multi pronged approach. I think at Mavericks, our focus is going to be more on building the right tools and solutions that can empower physicians to catch things earlier with a higher degree of accuracy, to do biopsies in a way with higher precision, to increase safety across all the different types of interventions that will do. So hopefully, that will motivate physicians to feel like they have the tools to make a difference. And that'll flow through to patients. But yeah, defer to others in terms of some of the other levers that the whole ecosystem can do. Yeah, it's

Justin Montellese  12:25  
certainly a multi pronged approach. Right. And I think it's not just the the medical device diagnostics sector is not going to change it independently. I think it's a few things, right? Public Policy and awareness. Of course, the decent thing is D stigmatization is critical, because right now, everyone views lung cancer as a smokers disease, when in fact, it's fundamentally not. Interestingly enough, 20% of men who are diagnosed with lung cancer are non smokers. And I think it's around 50% of women who are diagnosed with lung cancer, are also non smokers. So when I sort of heard those stats, that was sort of mind blowing to me. But I also think, you know, there's parallels to other sort of disease states to right, you think about I previously spent a lot of time sort of in behavioral health. And if you think about addiction, one point addiction was considered sort of a moral failing. Unfortunately, as a result of an opioid crisis in this country, people now recognize that addiction is a sort of is an illness that is, you know, it's actually a disease. It's taken years for that to that sort of narrative to change. But I think it's going to take you know, it's critical that lung cancer is not viewed as a sort of smokers only disease, yes, if you're a smoker, obviously, you increase your risk. But there needs to be innovation and tools that can support sort of that population and maybe get them screened earlier or through blood based diagnostic tests. So that's, that's a few things. I think one thing that's paramount to the situation really is, I mean, healthcare in America is a function really of the payers, right, you think about the largest health care companies in this country, it's all the payers, right. They're multiples of revenue and market cap compared to the device sector. So I think, you know, there's some innovative payment models that other disease states have seen, I think there you need to have, whether it's the affordable the ACOs, the MCOs, the commercial plans, you need to incentivize the payers to, you know, force their patient populations to get screened, whether it's some sort of, you know, a special payment or whether it's, you know, a carrot that they get paid or a sticker that they get slapped with, they're not getting their patients screened. You know, I think that's that's key to the equation here, too.

Joanna Nathan  14:22  
Yeah, I definitely agree. You know, public health, public policy, I think is going to drive most that change. But I do think, too, that PCPs GPS generally face this kind of chicken and egg issue with their patients, right? Of if I send them to screening, there's, you know, maybe a smoker or a certain age, they're going to have a positive screen 30% of patients in the screening trial, that determined guidelines had a positive screen. And then what right and so I think there is a chicken and egg problem of physicians need need us and our industry to drive kinds of solutions to actually drive intervention both diagnostically and therapeutically, so that their patients don't get stuck in the cycle of it. of imaging kind of surveilling forever and ever without that, that, that chance to know what is definitively going on in their lungs. Because who wants to be stuck in that cycle, right? You can be stuck in it for 18 months, 24 or 24 months. And eventually your nodule gets big enough that they actually want to drive. You know, we can drive interventional today solutions. And at that point, you know, it your life expectancy might have changed because of how big it's gotten, because there's a lot that can happen at that time. So I think there is a chicken and egg problem of solutions, I think, and screening will will drive each other. So having those appropriate technological solutions was really important as well. Yeah,

Diego Serrano  15:36  
that's, that's an amazing point. And I'll bring some more data that I think may be useful for the conversation. Globally, half of the population diagnosed with lung cancer, die in the given year of diagnosis. So I think what what Joanna just mentioned, it's incredibly important, and I think it ties importantly, with the next question, I think it's critical for pulmonologists, to have the appropriate tools to take patients from screening, as John was saying to diagnosis, and to have accurate ways to diagnose those rare findings in the screening, because that's critical. If if physicians cannot diagnose accurately, they're not going to be taking all those patients to screening because they're not going to have any way to continue them through the care continuum path. Until I bring forward next question, which is, what do you think? Or which fields? Do you see the biggest opportunity for innovation? Or where should the early steps be taken by innovators? Which fields do you see as most important across the continuum? And of course, this is a very personal question, and there's no right answer, but

Joanna Nathan  16:56  
yeah, sure. Well, I do think, you know, while we are not in interventional, pulmonology, company with thoracic surgery company, I do think that that is one of the predominant fields where, from a diagnostic perspective, that's what's going to fill the funnel, right. For us, though, our focus is, is thoracic surgeons, and eventually, hopefully interventionalist. But we really are a little more focused on how do we right size, the intervention? Yeah, you know, once there is diagnosis, we do have a diagnosis play. But I think, you know, the, the challenge with the space is the gold standard of care, the gold standard in the spaces, if you can tolerate it as a patient is still to have a look back to me, so to have 25 30% of your lung function removed, regardless of the size of your tumor, regardless of if it's five millimeters or five centimeters. And that's a result of not having screening and not having found things early. Right. And so we think there is a lot of innovation that can be done in the surgical space to right size intervention and intervention as screening enables actually finding these cases early and earlier finding these patients early and earlier. So that's that's our focus.

Justin Montellese  18:07  
Now, it's it's all very good points. And I think fundamentally, the markets so fragmented, right, that there's opportunities across the entirety of the care continuum, right. I think the point Joanna made around the interventional pulmonologist is where maverick's is spending the bolus of our time. But whether it's on blood based diagnostics, write a test that can give a more accurate confirmation of yes, no lung cancer and then help inform the treatment pathway, I think is there's a tremendous opportunity there. The broader interventional pulmonology suite to make the bronchoscopy procedure a little bit more, or get a better diagnostic yield or reach these hard to achieve portions in the lung is going to be a huge opportunity. And, you know, I think this also is all sort of goes without under an AI sort of underpins all of this, right, there's a huge opportunity around AI in general across healthcare, let alone within sort of lung cancer, right and helping to identify how do you manage these patients? How do you triage them do that you they go for what they qualify for a certain chemotherapy versus should they go to radiation or or essentially plan the treatment pathway. So you know, the markets fragmented, it's huge, and there's unmet needs. So I think really, there's, it's it's sort of a greenfield right now. And I just think it goes to the point that, you know, lung cancer is aptly at a tipping point.

David Beylik  19:22  
Really well said I agree with all of that. And I think the simplest way for me to answer the question is just to share what our first two key bets are at Mavericks, because that's sort of putting our money where our mouth is, but I think the the first category we care a ton about is liquid biopsy. And we'll be announcing a transaction later this week, but just to describe it at a super high level. We're developing a multi omics blood test that we think will help elevate patients from the kind of intermediate category risk category, which is about 50% of patients today where physicians have no idea what to do. There's no clear clinical approach that you should do with that massive segment of the patient population, and helping to upgrade patients to high risk where you know, you need an immediate biopsy or go straight to surgery, or to watchful waiting where you feel comfortable with low dose CT knowing that you're not endangering that patient further. And so for us, a suite of diagnostics that can help chip away at that huge Limbo category and upgrade and downgrade them, I think will will make a huge contribution. So we're very focused on that. The other category, I would say, is in biopsy tools that are safer and more flexible and more precise. And specifically, we have a technology called Sir pecs, that's designed to help you get out of the main airways into the peripheral areas where a lot of the earlier stage nodules are, and even outside of the airways punching into the lung parenchyma, where a huge percentage of nodules are found. So I think those are our first two bets is in the theme of catching it early, try to triage patients more effectively in terms of the risk classification, and then try to do biopsies that can get you the right sample size that you need, even when the nodules are really early and therefore really hard to reach. Those are kind of our first two key bets. I think we agree with all the observations you guys shared in terms of where we can go next. Because there's a lot of low hanging fruit in the space, unfortunately. But yeah, those are the first two things I'd say we're focused on.

Joanna Nathan  21:16  
I'd also like to add, just because we didn't mention it, I think, you know, a shout out to interventional radiologists as well, I think they'll probably sneak up on all of our technologies and procedures and end up taking over the space, I think, you know, don't want to undermine them, since they certainly done that in other fields. But I think they should be a focus as well.

Justin Montellese  21:32  
Very great point.

Diego Serrano  21:34  
I have a question for you. David. Just mentioned liquid biopsy. But I think it may be interesting to see where you contextualize liquid biopsy across the continuum. If I'm not wrong. What I'm seeing is a post screening test to decide whether to go into more invasive biopsy or not? Yes,

David Beylik  21:54  
so I would say our approach is start with a test that's accurate enough to be reliable for confirmation post CT. We actually think we're cautiously optimistic that we might be able to do a test that's accurate enough to serve as a screening before or instead of low dose CT. I think the question is, can you get enough sensitivity sensitivity and specificity to replace CT? And then what will the reimbursement response to that be? FDA tends to be a little bit conservative about screening non symptomatic patients. So I think that's that's an open question. That's an upside case, I would say. But even if you started with a confirmatory test, you could do a lot of good, the call point would also change because today, it's probably interventional pulmonologists for the most part who were doing the confirmation tests, when you get into pre CT, it's more of a family doctor type of call point, which there's many more of those. But yeah, that's That's the short answer, but I think it could be possible.

Diego Serrano  22:54  
Amazing. Um, maybe we could continue with the point that Justin made about the fragmentation of the industry and get into another question that I think it's quite prevalent, especially across the innovators in the space, which is, how do we commercialize in this industry? Given that it's so fragmented, and there are so many actors? Whether this is interventional radiologists, interventional pulmonologist or thoracic surgeons, those I would say, are across the the continuum? Who do we commercialize our products to? How do we approach hospital systems and providers? How are we how do we convince them to change their their methods of treating screening and treating the patients?

David Beylik  23:40  
It's a great question. So I would say at Mavericks, we have a bit of an emphasis on interventional pulmonologist is just alluded to, and I think the reason for that is one, there's only 800 of them. So even though they're a large market, doing an extraordinary amount of procedures, which is gonna grow for all the reasons we've talked about, it's small enough to where you can engage them pretty efficiently with the low cost of a Salesforce and just put it in perspective, we did a GLG survey as we're kind of figuring out different categories. And we were able to talk to 50. And that's like a huge chunk of the 800. And it's pretty amazing that you can do that in a couple of weeks with with GLG. So I think that is a beachhead to think about and they're very underserved because no one well, very few people have built a company catered to interventional pulmonologist specifically. And we hear anecdotes of them borrowing things off the shelf from their GI colleagues and their cardiovascular colleagues and they're doing stuff off label and it's it's, there's not a lot of purpose built tools for them. So I think that is one strategy is to really embrace that community of physicians, which we would love to be a part of. The other thought, because this is a very multidisciplinary disease is to target the NCCN cancer centers. There's these very sophisticated the MS. Ks and Anderson's of the world who you know, They have these tumor boards and other features where if you penetrate the site, you can kind of cater to all the relevant specialties. Yeah,

Justin Montellese  25:07  
I would just echo everything David said, right? I mean, the the IPs are super interesting, there's 800 of them, but there's going to be probably a growth in that specialty, right. And I think, as they grow, they're gonna continue to need more devices and tools. And then, but it is a multidisciplinary approach. So I think you do also have to have relationships and cater to the, the IRS, the thoracic surgeons, because in while these large academic centers, they all work together, and that's sort of the rural, independent, single, you know, single hospital, you know, it's a little bit more, a little bit more siloed. So you'd have, it's almost like you have to have built for purpose tools for the IP and then for certain locations, and then broadly at other locations, you know, it's sort of a different, different commercial approach.

Joanna Nathan  25:50  
Yeah, I think, same in the thoracic surgery space as well. It's a very bifurcated, you know, there's the community surgeons, and then the academic folks, and, you know, they, their approaches to, to therapy to diagnosis are extremely different. In the community setting, actually, I was shocked to find out that a lot of thoracic surgery is actually performed by general surgeons, so not even special, you know, specialty trained, which is crazy to think about in this day and age. So we, you know, we make sure as we're developing our technology, that kind of stuff to have both of those insights, reflected as we're out talking to physicians, because it is a very, two very different kind of markets, but dealing with the same patient populations.

Diego Serrano  26:31  
That's great insights. Just question to continue. And it ties with what we just talked about. Right now, we see from Achilleas point of view, we see the interventional radiologists that take that take the first steps right, in in screening, and then sometimes some, if you're looking at T DNA, they're also doing some of the diagnostics and then we see the patient is going for the interventional pulmonologist. And then once the diagnosis is confirmed, most of them go to the thoracic surgeon, if that patient can get surgery for complete resection, how do you see the future of of the lung cancer space? And and do you think that this continuum is gonna prevail? Or do you see any changes happening across the current continuum and the players or the physicians across the continuum?

Justin Montellese  27:31  
I mean, in terms of players, right. Mavericks medical, we're going after the entirety of the care continuum, we want to be that player that is, you know, from similar, we build that whole logic across the portfolio care continuum. We want to be there from diagnosis all the way through treatment. And we're incredibly excited about that thesis and have a substantial level of conviction around it, right? That's why we're partnering with David and KKR and the broader Ajax ecosystem. I think, as you know, Mavericks medical kind of proliferates, right, we will sort of, it'll create a flywheel effect where there'll be now more and more players entering the space. And I think, ultimately, you know, the way I view it is sort of rising tides, raise all ships and will continue to bring awareness to this space. I think as a result of sort of investment dollars and capital deployed into the IP thoracic surgeon call points, you're going to see sort of greater uptake and more specialization. So, you know, I think, to answer the question, I think, fundamentally, we're excited about I think the it's going to be the logical of the care continuum was essentially sort of, kind of continue in the pathway that it is, and there'll be, you know, one or a handful of companies that are sort of specialists across a bit.

Joanna Nathan  28:45  
Yeah, and I think, you know, the, the way you describe kind of the continuous care continuum of care is the way it should be. But that's not necessarily how it always is, right? We, at least from, you know, our conversations with different hospital settings, we found the referral pathways to be all over the place, you know, very, very different depending on the setting. And so I do think that kind of the future of, of care does look hopefully more like a continuum of care and maybe blurring of lines kind of between some of those, you know, some of those procedures as far as who ends up specializing in taking on some of those patients. So

David Beylik  29:16  
I agree with that. And I would just add that I think those three specialties, you know, IPS, IRS and thoracic surgeons, I think the way you articulated it is a logical kind of continuum and workflow and collaboration that will largely persist. But you might see a little bit of blurring the lines and as an analogy in the cardiovascular space, where we also spend a lot of time, we've seen interventional radiologists, interventional cardiologists, and vascular surgeons. And I think what we saw in many cases is the IRS try something that's experimental and minimally invasive and it ends up succeeding and then you see the interventional cardiologists and the surgeons starting to offer the same procedures and get trained etc. So I wouldn't be surprised if you see thoracic surgeons beginning to do more and more of the The things that I RS and IPs are doing today. But there will be I think healthy collaboration and, you know, certain certain physicians are even now dual trained in IP and thoracic surgery, for example. So, yeah, maybe some blurring, but a lot of collaboration as well. Great. Very

Diego Serrano  30:17  
interesting. And now, maybe if you're willing to do so I think, personally, I think the logic KKR Mavericks HX, health, collaboration, it's, it's extremely interesting. Especially because there's been little collaboration in the field, some strategic players have penetrated the market more or less. But it's been all over the place. The deals that have been made in the space have had different results. And it's interesting to see a large strategic player like logic and large financial institution, let's say financial institution talking about KKR. But also, Ajax Health being in the middle, if you could tell us a little bit how this collaboration came up as much as you can tell us, and how did it happen? Who brought up the idea that history would be interesting, I think it's

Justin Montellese  31:12  
incredibly exciting, right, Diego, and we are at Hologic incredibly enthused by it. But I think it goes back to the point where Hologic yes, we're women's health company, but we're experts in screening, diagnosing and treating, and fundamentally right, we recognize and a lot of the credit goes to our breast and skeletal health division, right, the recognize that there's our tools and expertise as an organization are also aligned with the lung cancer care continuum. And we've, they really see that there's the parallels between the two, and there are substantial, whether it's, you know, the the actual order or the way it actually works in print in reality, but regardless, you know, that that was developed and recognized pretty early, but I think it was also internally at Hologic, a lot of tremendous work and lifting around, you know, gaining consensus and telling that story, because at first, you know, it's it's, it's not particularly logical when you think about a woman's health company. But then, you know, as the the division sort of articulated this vision and journey we got connected through to David in the Ajax network, and started thinking about the collaboration and the opportunity here. And, you know, I think it's, it's been tremendous thus far, it's been, you know, between Hologic, Ajax and KKR, three incredibly sophisticated organization. To me, it's, we've worked together, it's been Oh, one plus one plus one equals four combination, just a lot of natural synergies. And I think, you know, it's it's incredibly exciting. And we're, we're looking forward to the future and continuing to collaborate closely and working together closely. I think it also says a lot about sort of the market itself from a kind of capital deployment perspective, right, you have this really interesting vehicle of sort of KKR healthcare Growth Fund, and the way that they're deploying capital into this, essentially, a de novo project with a sophisticated strategic and other sophisticated investor is it tells a lot about sort of the market itself for financing and med tech right now and building new opportunities in med tech. And I think it's, and I know, Duke will be talking about this tomorrow. But it's incredibly exciting. And I think it's it shows that, and it's nice to see that there's sort of private equity investments going into sort of taking clinical and regulatory risk as well.

David Beylik  33:24  
It's really well said I agree with all of that, and would just add in terms of the the arc of how these conversations progressed. From my vantage point, I think we started with a specific asset and a specific opportunity, which was this biopsy needle, sir pecs, that was an HX portfolio company. And we were kind of surprised by how logics interest in it. And as we looked at it, I think both sides immediately thought this is a good technology. But there's a much larger opportunity here to build out a portfolio and to do something at scale. And I think what resonated with us about Hologic is the the appetite for scale. And if you're going to do something, do it to win and, and do it big. And that's certainly how we view things at Ajax and KKR, as well. So I think we ultimately got to a place where we were able to combine in a new platform, the expertise in with Hologic as a strategic partner, as a role model, the kind of operational and investing expertise of Ajax, and the capital from from KKR, which has been a terrific partner to us, and put together a full portfolio and hopefully built the first really dedicated lung cancer company in this space. Each

Justin Montellese  34:31  
each party brings a pretty unique skill set to the relationship, right, I mean, speed and efficiency with Ajax, commercial and operational and strategic sort of expertise with Hologic, in addition to a business that's already built a portfolio of products across a cancer care continuum. And then finally, you know, KKR, obviously bringing capital but a lot more than that, right, a tremendous amount of resources to the organization. So it's it's been fun and we're looking forward to the future.

Diego Serrano  35:00  
Yeah, that's, that's extremely exciting. I think we all hope you are successful in this enterprise, because I believe it should act as a snowball to bring additional capital into the industry. And creating a true successful story in the industry will definitely call the attention of many people that has already been called, just because of the the announcement you made. Just as a disclaimer from Achillea, we are invested in the lung cancer space, in which I believe it's a great company by division, medical, who will be presenting later today. So if anyone has any questions, I'm happy to reply to it. But I think, John, we are at a perfect spot right now to finish this panel with you. As an innovator, I think you guys are the ones that are changing the industry and the rest of us are just trying to support us in the best way we can. So what do you think needs to happen? Where do you see the opportunities for collaboration? And how could different actors in the industry benefit the innovators and make your life easier? In a sense? Yeah,

Joanna Nathan  36:06  
I think, you know, there's two places certainly that, you know, earlier stage startup, can use the most help. And I think, you know, what you talked about, about Hologic bringing kind of that commercial expertise and already having the channels to the very complex, you know, specialties and continuum of care that we talked about, I think being able to partner at an early stage to navigate the complexity of care that is that it does take to take care of a lung cancer patient today is really important. And then I think the second piece is finding funders that really understand are excited about the space. You know, I early on, in our pitching journey, we talked to an investor that said, smoking is not a thing anymore. So lung cancer is not a problem. That's not the case, right? As we discussed, so I think, you know, getting getting for the investors, you know, in the room and here at the conference, like get really learning about the space, getting smart about it, I think and learning kind of the where it's going, as you're looking at companies in the space, I think is really important as well, for companies like ours.

Diego Serrano  37:13  
Amazing. Um, so just to finish up, how can people get in touch with you? Can people get in touch with you? If they want to how should they approach it?

David Beylik  37:24  
Absolutely would love to hear from anyone in the audience, especially if you're an innovator and interested in building in this space. But you can find me on LinkedIn with my name, or my email is just d Bay like at Ajax health.com. So or find me on the LSI app, which is phenomenal, by the way, so any of the above would work and I'd love to hear from

Justin Montellese  37:43  
you. All easy. Same for me. Here happy to meet in person, LinkedIn, or Justin dot monta lisi@hologic.com Same

Joanna Nathan  37:52  
LinkedIn LSI app, or Joanna thoracic.com.

Diego Serrano  37:57  
Amazing. If anyone is interested in contacting me, I'm available at Diego achillea.io Or on LinkedIn as well. I just want to finish up by extremely Thank you, all of you for coming together today. It's been amazing to have this group together, Henry and the organization for enabling this to happen and of course, all the other people listening to us today for for attending and listening. So thank you very much, everyone.

Justin Montellese  38:24  
Thank you.

David Beylik  38:25  
Thank you, Diego. Great questions.