Laura Kleiman is Founder and CEO of Reboot Rx, the tech nonprofit dedicated to fast-tracking the development of affordable cancer treatments using repurposed generic drugs and AI technology. Laura’s career has focused on building collaborations across disciplines and sectors to expand treatment options for cancer patients. She was previously Scientific Research Director in the Department of Data Sciences at the Dana-Farber Cancer Institute. Laura earned a PhD in Computational and Systems Biology from MIT and conducted translational cancer research as an American Cancer Society Postdoctoral Fellow at the Massachusetts General Hospital and Harvard Medical School. Laura was recently featured in Forbes and received the 40 Under 40 in Cancer Award.
Laura joins me today to discuss not only her founder story but the role perseverance plays in all realms of a startup. She shares with us her experiences with fundraising as well as some of the challenges and advantages of choosing to be a tech non-profit.
“I'm passionate about bringing together different people towards a common goal. And in my case, I'm very focused on improving the lives of cancer patients through developing more effective and affordable drugs.” - Laura Kleiman
Today on Startups for Good we cover:
The podcast that Laura referenced was Startup Therapy
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Welcome to startups for good. Thanks so much for coming on.
Thanks so much for having me. I'm excited to chat with you.
Yeah, I'd love to start with understanding how did you decide to be a founder?
Well, I wouldn't say it was a decision. Really, it kind of just happened out of necessity. I observed that there was a problem that needed a solution and eventually realize that nobody else would probably go after that solution or make it a reality if it weren't for me. So I became a founder in the end, but it wasn't something that I intentionally did. It's not like I was going, I was out trying to become an entrepreneur.
And you became aware of this problem by reading a scientific paper, not the origin story you hear all the time?
Yes, I was at the time in my postdoctoral fellowship, and I read an article that changed my life.
And how did you decide that this was a problem you had to solve and that no one else was going to solve?
Well, there's, it became clear to me that there was a market failure and a gap in our drug development system for a particular class of very promising cancer treatments. And the sciences there, it's it's not that we do need more science. But there's a lot of interesting science already. But where I think there really is a gap is in, being able to bring together people in different fields and in different sectors and disciplines to work together to solve this problem. And that's really what I'm passionate about. I'm passionate about bringing together different people towards a common goal. And in my case, I'm very focused on improving the lives of cancer patients through developing more effective and affordable drugs. So that was my outlook is I felt that someone needed to come in and bring together the different stakeholders to solve this problem.
And among your co founders, you do have a range of skills. You put together quite a team. How did you know that it was the right co founder, the right pe rson in each case?
Usually I know, right when I meet them, they typically have the same, they're driven by the same root purpose of finding innovative solutions to help people in need and people suffering from diseases such as cancer. And we all bring a very different skill set. So usually, it's pretty clear that the complementary skill set would be invaluable in building something new, where we need to bring together different types of skills. But when it comes down to it, it's the person and finding incredible people who believe in my vision, and want to work together to change the world.
So purpose, mission alignment, values, alignment, and seeing complementary skill set. That sounds like a powerful combination.
How long did you spend between when you had that idea? And when it was an organization? doing the work?
Yeah, great question. And it also depends on what you mean by an organization doing the work. It was, it's been quite a long journey, I wouldn't have expected it to be such a long journey. And of course, we're still at the beginning. I started in this space, maybe six years ago, that was when maybe six or seven years ago when I read that one article that really opened my eyes to the opportunity here. And then I was I what I realized now I'm not a business person. But I realized that I spent years doing market research, I was talking to anyone who would talk with me so that I can could make sure that I understood what all of the challenges and opportunities were at all of the potential ways to go about solving this problem. I probably talked to hundreds of people. And during that time, I was also having a career at the Dana Farber Cancer Institute where I was running a cross disciplinary center. And it wasn't until about a year and a half ago when we received seed funding, and I was able to finally get paid for doing the work that I love, which was incredible after so many years of persevering, and I was also able to bring on co founders and start building up our team as well as our science and technology infrastructure. We actually started as a fiscally sponsored nonprofit. So we were underneath another organization. And during much of that time, I had a full time job. So it was really a great way to start building our organization. And once we received the seed funding, we split off and became an independent 501C3 public charity. And that was about a year ago that we became incorporated as Reboot RX and became operational as an independent nonprofit.
And when did you start identifying as a tech nonprofit?
Yeah, for the for many years, I did not realize that technology would be such a key component to our work. When I, when I read that article that we've been referring to what it was talking about, were all of these promising cancer treatments that were being ignored. And were not being fully developed due to a lack of financial incentives. So the traditional pharmaceutical companies that develop drugs weren't interested in these cancer, potential cancer treatments, because they wouldn't be able to make a lot of money off of these drugs, because they're low cost generic drugs. So really, I thought the problem that we had to solve and the only problem we had to solve was how do we develop innovative funding models to get these treatments through clinical trials and into the standard of care. I started developing the first clinical trial like this, that I wanted to run testing a repurpose generic drug for lung cancer, and started talking with potential funders of that clinical trial. And they pretty quickly started asking questions like, Well, why should I fund this clinical trial? How many repurposed generic drugs are there out there? How many opportunities? Why is this clinical trial more promising than other clinical trials? We could fund with generic drugs. And, you know, I had realized that already, there were hundreds of opportunities, like the one that I was pitching to them to test in a clinical trial, and, and so much data on these drugs and their potential effects on cancer, that I felt that I couldn't really answer that question very well, because we didn't have a good grasp of all of the evidence. And any way to prioritize which drugs are most promising and should be tested in clinical trials. And that's really when it dawned on me that we had to take a systematic approach to understand all of what's already known about these drugs and come up with a systematic approach for prioritizing the opportunities based on which could have the greatest impact on the lives of cancer patients. And that was impossible to do in any manual way. There are millions of studies to sift through to find the data on these drugs. And we just it became clear that we had to use approaches like AI and machine learning to decrease that manual effort that was needed to sift through all of the data and prioritize opportunities. So that was when we became a tech nonprofit.
And what have been the implications of seeing yourself as tech non profit or taking that approach?
I will say that I didn't really know there was such a thing as a tech nonprofit until about a year ago, actually, when we learned about the this incredible community called Fast Forward. And that's when I that's when I would say I we came up with the term tech nonprofit, it just wouldn't have even dawned on me. We're just a nonprofit, but really it is different to build technology. it as a nonprofit. And I often get asked, Why are you a nonprofit building technology, but we it while we did find that incredible community we went through the accelerator program with Fast Forward last year. It is a pretty small community. And I would say that most philanthropists and foundations are not really aware that technology could be built within a nonprofit, so it, it does make us different from the traditional nonprofit. And sometimes funders aren't really sure what to do with us, because they've never, you know, they're not aware that you could build technology as a nonprofit. So part of my job is to raise awareness that there are unique advantages to doing so, building technology as a nonprofit, and it's a really exciting direction to go in, in my opinion.Miles:
what are some of those unique advantages and challenges?Laura:
Yeah, so in terms of being a nonprofit, a tech nonprofit. Something that we strive for, is to find a balance between making the output of our technology and as much as we can our algorithms freely available to immediately benefit society and have an immediate impact on clinical decision making. For example, I think when you're you're building technology as a for profit company, it's more difficult to do that. We also as a nonprofit have access to data and expert collaborators, that wouldn't necessarily be available to us if we were a for profit company. And that enables us to accelerate the development of our technology. In terms of other aspects of being a nonprofit, maybe not directly tied to the technology. Obviously, being a nonprofit enables us to pursue treatments that have the highest potential to help patients regardless of profitability. So it's a completely different direction in terms of which drugs we're able to pursue, and how quickly they can impact the lives of patients. And then the other aspect of our work is it's highly collaborative, and especially once we complete the clinical trials and gather the evidence needed to prove that a drug is effective for treating cancer, how we get those drugs into the standard of care is going to require multi collaborations across multiple sectors that I don't, I think, would be much harder to do as a for profit company.Miles:
That makes sense. You mentioned your seed funding. How did you go about raising that?Laura:
So we were extremely fortunate to get our seed funding. Unfortunately, I can't say much about it, because it was an anonymous donation of one and a half million dollars. But I will say overnight, we went from raising $15,000 total over five years, or four or five years to having one and a half million dollars, which was just a dream come true. And just such an incredible opportunity for us to really start launchibng the development of our science and technology. So what I can say is, it was probably in the end, a result of talking with those hundreds of people who I've mentioned earlier, really being out there raising awareness of the opportunity and the need to develop develop technology in this way to benefit humanity. And we found somebody who believed in that idea, and the traction we had made up until then, and gave us this beautiful gift.Miles:
So is there any lesson there for other founders on fundraising?Laura:
Well, I'm no expert. Let me start there. We are now in the process of raising or next bunch of money. But besides the 1.5 million, haven't raised a significant amount since then. So I just want to say a caveat that I'm no expert. But I think, again, being out there taking every opportunity. getting as many introductions connecting with people in an authentic way. As many as as much traction and credibility as possible to build is very useful. We maybe what I can say is when we were being considered for the one and a half million. At first, we didn't get it when when we were initially considered for that we didn't have enough traction yet. And then we finished the mass challenge accelerator program, which is the one that we did before fast forward. That was, I think, two years ago, a little less than two years ago. And by chance, that donor ended up making doing a second round of funding. And they came back to us to see what progress we had made over the last five months or so since we had spoken with them last. And they were really happy and excited about our progress and ended up making that gift. So I think perseverance and relationship building are incredibly important.Miles:
Wow, thank you for sharing that with us. That's a wonderful story. I remember from our my first startup, we got a lot of investment from people who initially said, no. There's a lot of power to keeping that relationship and going back and saying, look, this is the progress I've made. And not everyone will be convinced, but sometimes it works. Thank you. That's a wonderful story. I'd love to hear more about mass challenge and what that was, like, I think it's normally oriented towards for profit ventures.Laura:
Yes, it is. Yes. So there were I think around 100 startups in our cohort, which was 2019. Hopefully, I'm getting yours right here. And I think it was 2019. Out of the 100 startups, and this was in the Boston accelerator program, there was one other nonprofit. So it was a great experience. And there are a lot of lessons that we can learn still from programs, programmatic experiences that were focused on for profits. But what what was really lacking for us was the fundraising side, because fundraising is quite different between a nonprofit and a for profit, of course, pitch decks, you need pitch decks for both. But what's in a pitch deck might be different, and I think is different, in some ways. So it was a great experience, we actually met the it's the person who became the chair of our board of directors, and is a very close partner and mentor of mine. Through that program, she approached us to be our mentor through Mass Challenge, and it was incredible. And I still work with her almost every day. So very grateful to that to the Mass Challenge accelerator for enabling that introduction and the relationship that has been fundamental to our success over the last few years.Miles:
Well, that's a wonderful connection that you made there. Tell me more about how pitch decks are different. I'm curious to hear your thoughts.Laura:
Again, I am no expert. But oftentimes, you know, it's for profit pitch decks. And maybe you need to tell me, but they're there, there's probably a focus on how much revenue may be generated over time. So impact perhaps in the sense of revenue. Whereas, of course, with a nonprofit, the impact is going to be measured, but mostly on the social impact or the impact on patients. So that's, that's one difference. And we've been in a few situations where it's mostly, you know, accelerators and other competitions, where it's mostly for profits. And I think it has hurt us a bit to to not have those types of slides. And to think about impact in a different way when the audience are mostly a venture capitalist, for example. What are other ways that they differ? I'll be honest, we don't really have competitor landscape slide decks, which I think are pretty common in for profit pitch decks. But Miles I think you need to tell me.Miles:
No, no, I think you're doing great. This is all things that that make sense to me. I think that the social proof might be even more important in nonprofit fundraising. I don't know for sure. But I have an intuition about that. What do you think, like on on that social proof of who else is backing this? So? Certainly, for profits, yeah. And for profit fundraising, it's it's common to talk about who your investors are. I have a sense that that gets emphasized even more in philanthropic fundraising, if you're able to, you know, talk about particular foundations that are seen as leaders.Laura:
Yeah. And what's just funny about this is that we have not been able to talk about who our major donor is, and maybe that's been added an additional challenge for us. So that's kind of funny.Miles:
No, I'm not sure. I'm not sure. But I have an intuition that That's even more important.Laura:
I think, maybe, but in a way, it's in the way that I think about it, it's talking about who our collaborators are, is maybe just as important as funders. So really showing that we are working with prominent foundations, even academic groups like universities, company corporations, I think that lends a lot of credibility. And in terms of the funders sure, if you have a well known funder supporting you, I'm sure that that helps.Miles:
Yeah. What most people not understand about repurposing generic drugs.Laura:
I don't know how, how much people understand about the market failure for repurposing generic drugs. I think a lot has changed over the last year in the time of COVID, where many generic drugs have been tested for COVID-19, that are repurposed drugs. So I think there is greater awareness now than there was a year ago about the need and opportunities for repurposing generic drugs. But maybe the public is also more aware of the challenges of funding generic drugs in terms of who has something to gain here. And when drugs are off patent, like generic drugs are, and there's no market exclusivity for these drugs, it means that many companies are manufacturing and selling them, and therefore, the prices are driven down. So that's why generics are often quite low cost. And it also means that nobody is no one company is incentivized enough to find new uses for these drugs, because everybody will benefit from them. And since the prices are low, that benefit will be not as large as a drug that costs $100,000 a year and is now being used for additional patient populations. So I don't know. I'm curious Miles, are you surprised that there's a market failure for these drugs? Were you aware of this has COVID changed anything about your awareness of the space?Miles:
I certainly learned a lot in talking with you and learning about Reboot Rx, I think I was aware of, you know, drugs not being developed where there wasn't as much of a market, you know, I was probably more aware of diseases that are more common in emerging markets or countries with less ability to pay and those tending to get less investment. I think I was more aware of that then necessarily research about how to repurpose generics.Laura:
Yeah, and one of the things that I was surprised about when I first got into this space is, why doesn't, why don't why doesn't government and why don't cancer foundation's fund the research that's needed to get these treatments to patients if there's this market failure so that pharmaceutical companies aren't, aren't going to pursue them. And that's where I was surprised, because many people say, well, government should fund something like that. And they don't, because government cancer foundations are really focused on funding basic research, early stage research, because and they assume that pharmaceutical companies will pick up the rest because they'll they have an incentive to do so. So I was surprised that there is really this gap where nobody is pushing them forward, and nobody is incentivized to do so.Miles:
So paint the picture for us, years down the line, things have gone really well. What is reboot RX able to do or what have you accomplished?Laura:
Our main goal is to get more treatments into the standard of care for cancer. So over the next few years, we aim to identify the most promising repurposed generic drugs for cancer, get them into clinical trials and then into the standard of care for cancer. And clinical trials may take some time. So while the drug development timeline is significantly reduced when you're working with a drug with a known safety profile that's already has some indications of efficacy. clinical trials still will take let's just say five years or so to be completed so that we can gather that definitive evidence that the drug is effective or not and where we hope to have a more immediate impact is if there are any opportunities to change the standard of care based on the existing data because many randomized controlled clinical trials have already been completed where these generic drugs have been tested for specific cancer patient populations and if we can marry that with some real world evidence so data that's gathered outside of a clinical trial setting it's possible that in some cases there might be opportunities to go directly to changing the standard of care without needing those additional clinical trials we don't know whether that's going to be the case yet we'll be learning that over the next few years but that's where we would be really excited to have a more immediate impact and then even more immediately than that what we're doing with our technology which is synthesizing data on generic drugs and their effects on cancer is trying to get the information the synthesize information and insights out there into the public domain so for example there are 1000s of cancer patients who are already taking these drugs for the treatment of their cancer based on say some of those randomized controlled clinical trials that have been completed and published on and they're making decisions about using these drugs based on whatever information they happen to find when they Google or search on PubMed which is the repository of biomedical research papers and we hope to provide a the bigger picture of what are all of the studies about this drug for this type of cancer saying and how does that compare to the evidence that already exists for other drugs for this type of cancer and that information can be used immediately by physicians doctors and their patients to make better informed treatment decisions today.Miles:
So walk us through how that works you've you've got your machine learning models running on all of these studies it surfaces or prioritizes data that you should be looking at and then i assume a person's reviewing it before you're publishing it or or what's your pipeline like?Laura:
Yeah, we have people reviewing things all along the process so first of all we spent a lot of effort to build training data sets where as cancer researchers were giving many examples of how we evaluate scientific papers and we use those examples to train machine learning models to do that much faster and at scale then of course we're validating what's coming out of the machine learning models tweaking our pipeline to try to improve the performance of it and then we generate so we synthesize the data generate a score that denotes how strong the evidence is for any cancer drug pair and generate a ranked list and after that there's a lot of manual effort and validation that comes in with panels of clinical experts to help us review the data for the top candidates and then think through what the next steps might be in terms of for example designing a clinical trial to definitively evaluate whether the drug is effective for that cancer typeMiles:
I'm curious if you have any ideas how clinical trials could be sped up?Laura:
Yeah so do you mean not the funding aspect but logistically how you run a clinical trial or design a clinical trial?Miles:
Let's say that you had the will and the money resources to do it. You know i'm thinking for the COVID vaccines there were certain things done in parallel for example and i'm sure there are other ways that were used to speed it up and i'm curious if we did have the will and the resources what could be done to speed up clinical trials in this area?Laura:
Yeah there are a few different ways so one could be so an advantage with generic drugs is the ability to test multiple drugs side by side within the same clinical trial so you could design a clinical trial where you have for example one control arm and multiple arms where different drugs or combinations of drugs are being tested so that is much more efficient than running one clinical trial with a control arm versus one treatment and then a separate clinical trial with a control arm and another treatment so that's one way to speed it up another way is using information from real world studies to either have like a historical control arm or perhaps gather information that is not from a clinical trial but for example through mining information in electronic medical records and claims data to what's called emulate a clinical trial and we may see more of these real world studies leading to regulatory decision making down the road.Miles:
To make sure I understand that you're saying that you would give the drug to some people and then compare how they do to a group of people who weren't ever directly involved in the clinical trial but you just choose as a similar population and you're able to look at their medical recordsLaura:
So what i was describing was a different type of study where i'll give you an example so say there are cancer patients who also have diabetes and there'll be they've been treated over the years with different treatments different drugs for their treatment of their diabetes one of those drugs might have been Metformin for which there's also evidence that Metformin could be useful for directly treating cancer so if you take a cohort of millions of cancer patients with diabetes some receiving Metformin and others receiving other anti diabetes drugs you can now look at cancer outcomes to see whether use of Metformin correlated with better cancer outcomes or not so more correlative but that type of real world study could provide some signals about the potential effect of Metformin on cancer.Miles:
gotcha what's an example of repurposing a drug that's been successfulLaura:
one example is a drug that was originally developed to treat acne called ATRA to type of vitamin A and it's now been repurposed as a treatment for leukemia there's also thalidomide which was originally developed as a treatment for morning sickness and while not successful for that purpose is now standard of care treatment for multiple myeloma.Miles:
Well yeah that's one probably people have heard of yeah for all the wrong reasons i would guess.Laura:
I'm curious what advice would you give to an aspiring founder?Laura:
Persevere and I think i've mentioned many of these things already, talk with as many people as possible. With the term that i've heard before that i kind of like is build your build an army of engaged people people who support your mission support you as a founder that support system is incredibly important also with other founders and that's one thing i've i've really enjoyed from participating in accelerator programs is meeting other founders especially nonprofit founders and tech nonprofit founders because we're all going through the same struggles and the same experiences and there's so much we can learn from one another so find your army of the engaged you like that termMiles:
Yeah that sounds very powerful. Do you have a book article or website you'd recommend?Laura:
So I really like it's it's not a book article, it's a podcast. I love your podcast.Miles:
Oh thank you.Laura:
I also like a podcast called Startup Therapy have you ever heard of it?Miles:
i don't know it tell us aboutLaura:
I think that's what it's called now i need to check but they it's so it's for for profits i'm looking at my library right now just to make sure that i'm calling it the right thing yes Startup Therapy. It's it's really practical advice each episode focuses on a different challenge that founders face and it's they these two guys are just chatting about their experiences facing those challenges how they've overcome them. I found it to be very useful advice, and practical. And so it's not each episode is it's not focused on interviewing a different person. It's focused on a different challenge. So I've really, I've really enjoyed those.Miles:
I'll have to check that out. In closing, where can people follow you online?Laura:
You can find us at www.RebootRX.org. So that's our website. We're also on Twitter and LinkedIn and Facebook and Instagram. We don't go beyond that though.Miles:
No, that sounds like plenty. Thanks so much for coming on. I really appreciate it.Laura:
Thank you so much. I really enjoyed chatting with you. And I look forward to hearing from some of your listeners.