Lior Susan & Anil Sethi - Kids & Art Fireside Chat
/At our 2019 Networking Fundraiser, Lior Susan, Founding Partner of Eclipse Ventures and Anil Sethi Founder & CEO, Ciitizen discuss how data can help the fight against cancer.
We provided this lightly edited transcript to expose their conversation to a wider audience.
Lior Susan: Thanks again for having us. Dalia reached out a couple of months ago and kind of asked me like, hey, do you mind to support the organization, do you want to participate? As you can guess, I am getting a lot of them naturally here in the Valley.
We always wants to, to do good things and be part of the stories but this, this organization, just opening up their website, it was kind of an arrow to my heart. My wife's niece was diagnosed with leukemia five months ago, and I went to visit her. I'm from Israel. I went to visit her in Israel. Her father, my brother in law is a pilot in the air force. And he's kind of probably the best is the the Israel version of Rambo. As you know, looks like a Rambo diver person, a big tall, strong pilot, and, me walking into the hospital to visit him and they see him: the big Rambo broken heart in my in my arms. AI think he was the first time I was getting, the first circles of this thing called cancer, especially cancer on their kids.
So I think the organization is just the foundation is just fantastic. And I'm happy to be a small portion of that then naturally have amazing partner here tonight and I'll let him talk a little bit about Human Ciitizen but just companies before, so he was the founder moving to be an investor and the alpha Neela just just stunning about you know how many companies in such a short time and as you know, venture backed companies it's hard to succeed. Somehow you managed to do that, without love to kind of if you can show some of the audience like Ciitizen and cancer and the data issue around that. How the heck in 2019 we're still so behind regarding, using data to just do better in order to fight this thing called cancer.
Anil Sethi: I'm 110 years old. I'll give you 30 seconds on the background. I'm a biomedical engineer from back east. That was decades ago. I started my first what I thought was my only healthcare company that was five or six before we had failure, an IPO and three exits most recently. Apple acquired Glimpse, and Apple as you know, is making noise and public press about correctors. I think that's great. My father keeps emailing me they're doing your marketing for you. They are. After the acquisition, I was in Cupertino running their health records engineering program, and I got the call from back home in Maryland, come home, your sister has two weeks to live.
So of course her big brother goes. I asked Jeff and Tim and they released me. They were very kind. Go take care of your family. Tanya lived another five and a half months as we crisscrossed the country looking for a Hail Mary, which didn't come. 10 days or so before she died in Johns Hopkins, I'm sitting in a room and we're just having a conversation. She's obviously weak. She goes: " What are you going to do?" And I said, Tanya, I'm really tired. I've been doing this a long time. I'm going to go to the beach. She goes: "Forget that. You're not going to take sabbatical, you're not going to retire. You're going to go back and do whatever you can to help kill cancer. in this lifetime" So that's what I'm going to do.
“Cancers faster than our ability to track it, to keep up with. By the time researchers found a molecule or done some research around it, got the team together, published the paper, it’s three and a half years out. The original cancer that is the topic of the paper has mutated nine generations. By the time the paper comes out. It’s current incarnation is laughing at us. ”
Lior Susan: Let's talk about the day you decided to start this Ciitizen and maybe share a little bit about this concept. I was unfortunately that was not that familiar with where's my health data currently and is the pancreas on it? What happened when actually you are diagnosed with something and there is a need for data to be host in some way? Or there is a need for you know all of the new machine learning and artificial intelligence to be interacted with this structured data as you guys doing in Ciitizen but I'd love to, if you can share with the audience a little bit. What is the problem you guys trying to solve around data and where you see the world is going based on that?
Anil Sethi: The problem is this. What chemistry is had a long time to try take down this problem probably millennia. Good people trying to do the best thing. Cancers faster than our ability to track it, to keep up with. By the time researchers found a molecule or done some research around it, got the team together, published the paper, it's three and a half years out. The original cancer that is the topic of the paper has mutated nine generations. By the time the paper comes out. It's current incarnation is laughing at us.
As Laura Esterman some of you know of at UCSF, she she talks about reducing the cycle time in, in cancer discovery. Mutation period is around many hundred days, four months, five months. We need a hit cancer within those five months and the only thing that we've come up, that's as fast as that is computational biology.
That's why it's so exciting that if we can feed the right information to computers, maybe in like that, they can connect information that wouldn't normally be available to us.
So what we are doing is we're saying, look, all these companies are going to create algorithms, machine learning AI, artificial intelligence. Things we've all heard about. They won't. There's no fuel. There's no data. It's like building a car, but no Shell no, Exxon.
What do you put into the computer? It would be nice to munch on data. What we're doing is we're converting thousands of PDF pages from medical record systems and we're building a computer building system to read clinical narrative. You don't need structured data, we can convert word to excel, metaphorically. So we think by the conversion of people's paper or PDF health records into computable data, all of these machine learning tools that we keep getting excited about, they will finally have computable data to pull in and do these magical things.
I'll finish with this if data was oil, we are Exxon Mobil. We take crude and we convert it to 93 octane. So, so that, you know, consumption can be had by cars and tractors and whatever they want to do with it. We are not Ford and GM. So that's what we're doing.
“This is not a technology problem. The sharing of information has been going on forever. I mean, we do this in the social setting. We have social profiles, we have economic profiles in our you know, Equifax, FICA ratings. We don’t health profile. That’s on purpose. It’s not that the system is broken. It was designed to do exactly this.”
Lior Susan: So you told me that, my my data path is currently on PDFs and it's kind of rock the boat for me a bit of like, how it's going to be, you know, 2019 We're live in the Bay Area, why my data is not something that's a little bit more sophisticated than sitting on PDF. There's a lot of, you know, amazing people in the audience who we should push, fight, shout in the ecosystem in order to accelerate the process, because it's feels like there is a really good momentum. We're investing in a lot of companies in the space. You will naturally doing amazing things in the space. It's feels like there is a positive momentum. But from time to time, I feel like, we're finding a little bit headwinds for maybe some organization that not necessarily wants to see things getting improved them, you know, people dying,
Anil Sethi: Economics. This is not a technology problem. The sharing of information has been going on forever. I mean, we do this in the social setting. We have social profiles, we have economic profiles in our you know, Equifax, FICA ratings. We don't have health profiles. That's on purpose. It's not that the system is broken. It was designed to do exactly this. The retention of data is control over the patient. The patient, it's not quite an ATM machine where you punch and when it comes out, but to be coarse that's where it's going. We have to remember that lets me spend 3 trillion US top line health span temporarily and worldwide. Evidence says about a third of that 3 trillion in the US is waste. We gotta remember that, that waste is someone else's wages, and industries not going to walk away from a trillion dollars worth of wages. So this is a regulatoryand a mental approach. It's economics, the only person who's outside of all the draconian regulatory, you know, umbrellas is the patient. The patient can do anything. If you are parents, I can ask you for all my information you must give it to me. You must send it to me in my Google email. I get to tell you what's good and bad.
Lior Susan: Maybe talk a little bit about it because not sure how much people in the audience actually understand that point and maybe, you know double click again on Ciitizen so CMI wants my data I'm going to pass. They by law needs to provide me access to my record, to your record. pretty healthy by the way the health check my wife send me. She's like, you need to really check you are 36 on point. So provide me the data and now wants to become a Ciitizen. partner. I provide you an access to resilience amounts of PDFs, you convert them to modern database, then what?
Anil Sethi: Will step back a second. Outside of financial data, we think we need to protect healthcare data, probably at the top. It's the number one thing to protect. And so, institutions like Pamfth research, Pfizer, Merck Everyone who deals with a patient's PHI personal health information, is under these regulatory restrictions about privacy, access, release of information or that.Tthe patient is not. So in a weird way, if you were pamf, and I asked you for my information, and you were good enough to give me everything, not just what's on the silly portal, but everything. You could ask for a great back and do lots of things with it. It is scrubbed when you share it and mediate it and use the patient to carry their information. But that's why I think you had an earlier question, what will break this logjag? Patients, patients and patients. That's it, and it's worldwide. Everyone recognizes it. Even in Europe with GDPR and other regulations that are coming around with it's my data and this is very much in the public press. You're allowed to own your data in every country, whatever their regulation. Whatever their approach to health privacy, the patient always has access as long as we're working with the patient. We can help them
We don't work for the industry we call it Ciitizen for a reason.
Lior Susan: Have a question to you. Recently I brought my parents a present for the anniversary. Talking with my dad, being soldier all of his life were saying I said again,
Anil Sethi: Mercedes?
Lior Susan: Mercedes close and I'm like Dad I bought you something even Mom is like what? We're going to Can Can. Oh, no, actually, you went to LA to do sequencing. I bought you a package you know, someone's going to sequence 100% of you. It was a little bit disappointment is that there's no white sand in that the lab in LA, but I'm curious like, Where do you see the conversion of health data with the world of, you know, DNA sequencing. That seems like making progress definitely on the cost wise, right? I think it's, you know, dropping 10 x almost every five years now. Do you think that's the solution? Maybe. So let's digitize, let's be as a consumer. First day we want our data will give you the data. So again, you know, put it in a modern database so we can do something with the data, then sequencing will be the complimentary solution to go solve some of the tough problems against them.
Anil Sethi: There's three tiers of information, one is clinical that comes out of, you know, institutions that are images and CT and MRI, then there's genomic information, and that's exploding and we think for the right reason, and then there's lifestyle information, because about 70% of disease is influenced greatly by lifestyle, as opposed to genetic or genomic. So these are the three things we concentrate on. And the problem with either genomic or clinical or something else is that it's not this or that or that it's a combination. Because genomic is a key, it's looking for a lock. The lock is expression that comes off of your body, you know, brown eyes and I've suffered from migraines for 30 years, these red wine migranes, it doesn't stop me, believe me, but I've suffered from lots of migraines. What we need to do is say, what kind of data exists on a group of people with migraines? And what kind of data have we captured in the clinical setting? If something says in the clinical setting, I have migraines, but we also find in the genomic profile, every single one of them has a little snip or a little piece of, you know, DNA or something that is related. Maybe that's a discovery because before we knew red wine causes headaches, we didn't know it. And now we do. I think there's a ton of those out there
Lior Susan: Going to same topic double click one more layer that we love and recently invested in companies. Call it personal medicine, right so the idea that you extract the DNA out of your body, take it to a process to build the drug that dedicated just for you. And still la there is only the four drugs now is being approved by the FDA, but I was a fortunate enough to have the diligence. We talked with the girl that she's now seven years old and when she was four, she basically was one of the patients of Kite pharma. You know, the company that the space that develop a drug that she had the stage three, I think and got cured like one shot. It's a thing, personal you know DNA based.
Anil Sethi: So the topic you're talking about obviously has a name personalized medicine.What is that? That means that in relation to how let's say drugs are you know built right now: you have the the biochemical stuff, you've got the business, the drug manufacturer, but the actual data that's collected on the safety and the efficacy of the drug is collected about a whole bunch of people and then they drop out the women and the average out the height so the average up the weight so we have one for everybody. That's not personalized.
The last time we are going to see a drug like that is Lipitor, you know $13 billion dollars. Personalized medicine will require personalized information about you. So that if you have a personal health profile like your FICO score, your you know Equifax profile is shoving into a system. It prints the pills that you're supposed to take your height, weight, what what progression of disease you're in. That's not science fiction. That's absolutely going to happen. So when you go to the pharmacy, you're going to give them some data and they're going to go, that's your pill just for.
You can't do personalized medicine, which is what we think is the solution, connecting genomics with the death of cancer. We need the personalized data.That's what we're about.
Lior Susan: Thank you so much.
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