If there is one lesson Dr Sebastian Bhakdi learned during his time at the helm of X-ZELL, a Singaporean start-up specialising in early cancer detection, it’s that behind every overnight success lie years of hard work and perseverance.
Last month’s surprise signing of an investment agreement between X-ZELL and Hong Kong-based EssexBio is a case in point. The high-profile deal may have caused a stir among the HealthTech community, but according to the 46-year-old Founder and CEO, it was years in the making – starting the very day X-ZELL came to life.
X-ZELL’s story is a typical start-up tale, he reveals in an exclusive interview with Galen Growth, one of great ambition and rapid growth, but also one of failure, false hope and a series of painful pivots along the way.
One such pivot occurred early on in his biography and set off a chain reaction that would ultimately lead to the creation of X-ZELL. Born in Germany to a Thai father and German mother, Bhakdi studied at one of Europe’s most renowned medical schools in Freiburg, Germany, where he graduated with dissertation magna cum laude and started working in paediatrics and emergency medicine.
But the classically trained musician quickly realised that he didn’t just want to treat diseases – he wanted to learn how to prevent them from happening in the first place. In search of answers, he turned his back on the hospital and took up a Postgraduate Degree in Tropical Medicine and International Health at the University of Barcelona, which ultimately brought him to Southeast Asia.
“As part of my degree I had the opportunity to work in community healthcare in rural Thailand,” he explains. “It was not just an opportunity to re-connect with my ancestral roots, but also exposed me to a whole new perspective on the purpose of medicine.”
Community nurses in Thailand consider medicine a basic necessity, much like eating and drinking, and therefore value preventative healthcare above reactive care, he adds. “To me that perspective made a lot of sense – both from a patient perspective and from an economic one – so I wanted to bring some of that attitude back into traditional medicine.”
Upon finishing his degree, Bhakdi won a research grant from the German Research Foundation, which allowed him to return to Thailand, set up a lab in Bangkok and get to work. “The rest, as they say, is history.”
In Bangkok, the father-of-three started off developing a new, more efficient method of isolating malaria-infected cells from whole blood, resulting in his first international patent – high flow magnetic cell separation, or hMX.
But he didn’t stop there. “The technology proved so powerful that we applied it to the blood of cancer patients too – and it worked,” he recalls. “We didn’t know it at the time, but what we saw were tumour-associated Circulating Endothelial Cells, or tCEC.”
According to Bhakdi, tCEC are powerful biomarkers for the detection of early-stage cancers, but have long been considered undetectable in clinical routine because they are almost identical to healthy blood cells.
“To confirm what we found, we went on to develop a whole suite of new technologies that would allow us to visualise, scan and categorize these highly elusive cells using cryobiology, next-generation multiplexing and Artificial Intelligence. That’s how X-ZELL, as we know it today, was born.”
Shifting from frontline healthcare to applied research, from malaria to cancer detection, and from mere cell isolation to a full-fledged cell analytics workflow hasn’t always been easy, he admits, but quintessential to the company’s success.
“I think to be successful in HealthTech and remain relevant as a scientist, you have to have the ability to pivot, to see an opportunity and seize it,” he says. “That’s not only true for science or technology, but also for people.”
In 2017, when the platform technology required to isolate and visualise tCEC started taking shape, Bhakdi had a fateful conversation with his long-time friend and serial entrepreneur, Johannes Hille. At the end of it, Hille not only invested in the budding start-up, but took on the mantle of COO.
“Any innovation is only ever as good as the difference it will make for the patient, so I knew I needed to scale the business and bring our technology from bench to bedside,” he explains. “To do so, I needed support from people with a different, much more operational skillset – like Johannes.”
According to Bhakdi, operational experience alone doesn’t warrant success, though – especially in a start-up. “The start-up world is inherently volatile, so you need find people who not only excel professionally, but also share the same vision and values,” he says. “Johannes is one such person, someone who shares the same values and is driven by the same sense of purpose – to contribute to a world without cancer deaths that could have been prevented with suitable early detection technology.”
Focusing on values and vision has proven instrumental in scaling up X-ZELL, he adds, especially during times of crisis. “The COVID-19 crisis is a good example of why a shared value system is so crucial to success. In mid-2019 we moved our global headquarters to Singapore, while our R&D Centre remained in Thailand – meaning our team is now split across multiple locations and has to cope with different rules and regulations, many of which can be extremely challenging.
“But because we share the same values and work towards the same goal, even these worst-case scenarios don’t throw us off course. If you can cultivate a culture that fuses professional excellence with a high level of trust and a clear, collective vision, crisis can set free untapped potential instead of stifling progress.”
Despite the organisational obstacles Bhakdi and his team face amidst COVID-19, he values working in a close-knit environment and appreciates the diversity among his team.
In fact, one of his favourite business books – Loonshots : How to Nurture the Crazy Ideas That Win Wars, Cure Diseases, and Transform Industries by Safi Bahcall – has once again become relevant during the crisis, he says, reminding him of the importance of embracing a diversity of talents and strengths to make a team thrive.
The same concept is also true for choosing the right collaborators, he adds, explaining that being part of Galen Growth’s diverse network of start-ups has proven invaluable for X-ZELL.
Galen Growth’s work with promising start-ups in Asia creates a platform where open communication about the ecosystem is highly advocated. “Galen Growth is always very focused on what they are doing. We can seek their opinion, and enquire about the happenings at the investors’ side. In a convoluted marketplace, there is also a growing need to understand our competitors, which is a time-consuming process and we need Galen Growth to help us in that aspect.”
Finding the right investors is crucial to the company’s long-term success, he adds, pointing out that EssexBio will not just be a passive stakeholder, but also provide commercial and scientific guidance. “We are always looking for investors that add value beyond the monetary dimension,” he explains. “Much like EssexBio, many of them actively contribute to the culture we build and help us get the most of every day – and more.”
The investment will help X-ZELL achieve CE-IVD certification for their first early cancer detection test, X-ZELL Prostate™, and begin developing early cancer detection tests for additional cancers. Bhakdi says it will also generate additional traction for their Cyroimmunostaining Suite, across APAC and Europe.
Inspired by the trust invested in him by X-ZELL’s staff and investors, Bhakdi has turned the COVID-19 crisis into an opportunity to intensify the company’s research into circulating atypical cells – even if it meant temporarily relocating his family from Singapore to Thailand, where X-ZELL’s now operates one the most advanced cancer research labs in Asia.
“As much of our ongoing research is on hold due to the coronavirus, but our R&D Centre in Thailand is still fully operational, we decided that I could add the most value here in Bangkok, where our journey began,” he says – adding the move also benefitted him personally as it helped him maintain a personal routine, ensuring a work-life balance as a family-oriented individual who values time with his 3 young children.
“The rest of the leadership team has taken on more operational duties to free me up, and our local lab staff is doing a wonderful job supporting me even during times like these, with intense hygiene and personal safety regimes. So in some ways the pandemic really brought out the best in us.”
In fact, Bhakdi says the crisis may benefit X-ZELL long-term, as it forced early detection and preventative health back into the global spotlight. “It’s certainly a positive for us that COVID-19 has put early detection systems so high on the political agenda,” he says. “Cancer still is one of the most pressing issues in modern medicine, causing more some 27,000 deaths every day, so I hope we can conserve some of the urgency that has emerged during the crisis and translate it into other areas of research too.”
Digitisation will play a crucial part in that development, he shares – especially in a post COVID world. “It’s been inspiring to see app- and phone based health solutions shine during this time, and they will only get more important,” he says. “You may argue that X-ZELL started out as a deep tech business, but we actually invest a lot of time and resources into digital cell analytics and remote diagnostics too, which will now become more important than ever before.”
According to Bhakdi, X-ZELL’s most prestigious digital health project, nicknamed Cloud Atlas, could bring the company’s early cancer detection technology to millions of patients worldwide. The goal is to create a database of circulating atypical cells that – based on their unique phenomics – will allow the company to remotely analyse blood samples using AI.
The raw data – extracted from a small blood sample – will be collected via local pathology labs using X-ZELL’s platform technology. “What’s so exciting about that approach all is that our technology can be integrated into a standard pathology lab and operated by a technician after a few short hours of training – that way we can make early cancer detection accessible and affordable for anyone, anywhere, and not just a select few.”
X-ZELL specialises in the detection of early stage cancers from small blood and tissue samples using a patented platform technology combining traditional pathology with next generation multiplexing and Artificial Intelligence. For more information visit X-Zell’s website: http://www.x-zell.com/
About the Galen Growth HealthTech Cohort
The Galen Growth HealthTech Cohort is the only acceleration programme built to scale digital health startups to be the next generation powering healthcare innovation in the New Normal in Asia. In 2020, Galen Growth is working with 25 HealthTech startups which will benefit from Galen Growth’s long-established and unmatched curated community of investors, corporate leaders and innovation teams and other essential stakeholders through our proven multi-channel tools. For more information, visit Galen Growth’s HealthTech Cohort webpage or read this article on the launch of the Galen Growth HealthTech Cohort.
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