Bracy Fertig in Conversation with Patrick Short
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Short interactions with CEOs, founders, investors, and innovators who are reimagining the future of global health.
Bracy Fertig in Conversation with Patrick Short
Patrick Short Hi, everyone. I'm Patrick Short. I am the CEO of Sano Genetics, and I'm here today to talk about genomics and personalized medicine. I'm from the US originally, but I live in the UK now, actually in Cambridge, England, where I've been for about eight years now, maybe close to nine. At this point, I'm losing track. I was looking forward to the discussion.
Bracy Fertig Thanks so much for taking the time today, Patrick. And for the first question, perhaps for our audience, if you could just take a quick moment to tell us a little bit about Sano Genetics?
Patrick Short Sure. So we're about a four year old company. We started in late 2018, and we've been working on building what we call a participant engagement platform. So we work with pharma companies, biotech companies, as well as a new class of organizations called population genomics programs. And our software helps them to manage the relationship between the research program and the participants. That includes everything from what the study is about, landing pages, consent forms, screening questions, and a big aspect of what we do is genetic testing and reporting as well. So we help to take large scale multicountry genetic testing studies and make them really easy to take part in for participants, and very seamless as well for the researchers who want to run these kinds of studies.
Bracy Fertig Thanks, Patrick. And is there a defining moment or a person in your life who inspired you to found and to lead Sano?
Patrick Short Good question. So I come from a research background, so I did my undergrad at the University of North Carolina, and I worked in a couple of different research groups there. And then I moved over to the UK to do my PhD at the Sangre Institute here in Cambridge. And in both of those cases, actually, I was surrounded by researchers who were very entrepreneurial. So at UNC, a person named Professor Joe DeSimone, he's in the nanoparticle and 3D printing world, but I was in his research group and got to see almost every year they would take something discovered in the lab and then spin it out into a company. And I thought that was a really great combination because companies are a great vehicle if set up right to actually take new discoveries or ideas and put a business model behind them that helps them to get to hopefully hundreds of thousands, millions, or potentially billions of people around the world. So I was inspired by working with Joe and then also my PhD supervisor at the Sanger Institute, Matt Hurles, who's also spun out at least one company that... There was an interesting intersection between cutting edge science and business and that it was actually... Many academic researchers see these worlds as very far apart.
You either do research and you do it in the lab and you publish papers, or there's this whole business and industry world over here. But I've always seen the two as close together. So that is what had me thinking about starting a business in the first place. In terms of Sano specifically, I encountered a problem time and time again as a researcher in my PhD, that we were collecting large scale genetic data sets, but it's very difficult to actually recontact participants who are involved in these research programs, and this left a lot of missed opportunities. So, for example, if you're collecting genetic data from hundreds of thousands of people, but those people can't get notified about future research opportunities, like a clinical trial that could be incredibly impactful for them, then you've missed a real opportunity to potentially change somebody's life who donated a DNA sample three years ago, and now a new discovery means there could be a treatment that is better for them. And there's a whole bunch of other research questions that become possible if you've got a more fluid relationship between the researcher and the participant. And then on the participant side, I've been a participant in a lot of research studies, and the nature of research is still very analogue, very paper based.
We think about what we ask research participants to do in exchange for what we actually get out of taking part in research, and the balance is often very out of whack. And it's no wonder that we have recruitment and engagement challenges in research. So got us thinking about myself and two co founders, Will and Charlotte. Is there a way we could solve both these problems at the same time? Make research much more compelling for participants to take part in and easier to do, and also, at the same time, make it an order of magnitude easier, faster and more cost effective for researchers like us to bring on the next generation of personalized medicines.
Bracy Fertig Thank you very much for that. And it's so inspiring as an ex researcher myself, to hear how you've made that leap from research to entrepreneurship. And also super interesting to hear about how Sano is helping to engage patients and individuals who integrate with research, to engage with it on a long term and to see a direct benefit instead of a sort of societal benefit for the medical community. And so in Sano Genetics, I understand that you collect large amounts of individual health data. And what I've heard and what I've seen is that one of the founding tenets of the company is the belief that an individual's health data belongs to that individual. Could you tell me about how that belief flows through to what you do on a day to day basis?
Patrick Short A framework that I think is important to think about with research participation in general - what are the barriers to take part and then what are the benefits to take part? If we leave the benefits aside for a second and we just think about barriers, one of the big ones for the last decade in particular, as it's become more and more apparent how important data privacy and ownership is, is we don't want data privacy issues to get in the way of the cutting edge research we want to do. And for a long time, and I think arguably still today, research participants need to make a choice between do they want to seek this benefit for themselves and taking part in a study that could help them or their families, and also the benefit to society of taking part. And how do you balance that against the personal risk that you take on, frankly, of your data being used against you in some way? Different countries, there's no country that I'm aware of that has a watertight insurance non-discrimination policy. Even here in the UK, you can be discriminated against based on your genetic data. So how do we give participants a) as much information as possible about what the potential risks are, but also the confidence that their data is not going to be shared in ways that they haven't signed up for.
So, as you said, that was a central pillar of the way we've built the company from the beginning and this manifests in a lot of ways, but one of the major ways is in the platform and the product itself. Participants can see all the data they've added, exactly who they have or haven't consented for that data to share with. So there's a clear transparency there and also easy controls to remove data, download it for yourself, to have a copy, delete your data if you need to. And just really transparency is a key value for us as a company and I think that it doesn't remove the risks for participants, right? There's still a risk to having your genetic information in part of a research database, but I think we've found that people really appreciate the transparency, the openness about what actually does go on behind the scenes. And most people with rare or common genetic diseases do really want to help and just want to understand what is going on behind the scenes. And can I control that in a way that I haven't able to control it before?
Bracy Fertig I mean, it sounds incredibly empowering to the patients and to the individuals to understand how their data is being used, to understand the risks and to make those empowered and informed decisions themselves.
Now, the next topic I'd love to discuss is personalized medicine, and this has been a hot topic for quite some time now. What does personalized medicine really mean to you? Do you think the global health care system is actually making progress to deliver it? And what's Sano's role within this?
Patrick Short Yeah, another again, great and thought provoking question. For me, I think about... It's kind of two big buckets of personalized medicine that I'm interested in. One is on the rare disease side, depending who you ask, there's 6000, maybe 7000, maybe 8000 different genetic rare diseases. The vast majority of those don't have any treatment whatsoever. And we've seen in the last decade transformative treatments in the form of gene therapies, gene editing, and also just fundamental advances in biology of understanding rare disease, that we're seeing diseases that were previously untreatable. Now there are cures on the market and I think this is one of the major promises to go from essentially no hope and no treatment to something transformative - it's one of the most powerful waves. I think that it's going to take us a long time to actually see this through to the thousands of rare diseases and there's a whole layer of challenges there. But that's one area I'm really excited about. And this starts with diagnostics and genome sequencing in the healthcare system and we'll love to go into a little bit more detail there, but that's one big bucket that I'm really excited about.
Patrick Short The second is the reclassification of most common diseases into rarer genetic subtypes. If we take as an example something like Parkinson's disease, there's now more than 60 different well validated genetic drivers of Parkinson's disease. A number of those are highly penetrant and monogenic, meaning if you have the variant, you are very likely to get the disease and you're also likely to present a little bit differently whether it's earlier onset or different symptoms. And it also points to a different treatment. So we're seeing diseases, and we've seen this with cancer over the last 20 years. It's gone from breast cancer to now 17 and counting different genetic subtypes of breast cancers with different treatments. So we will see this, I think, in almost every major disease category and it's going to change the way we treat disease and also, I think, change the way that we prevent disease. If we can predict the likelihood of somebody developing a common complex disease using their genetics, then we may be able to intervene earlier and not have to wait until someone has full-blown Alzheimer's, for example. Are there ways we can actually identify earlier, treat earlier? And there's a lot of interesting clinical trials on the way and number of neurodegenerative diseases trying to answer this question of what if actually we start to intervene before symptoms became so severe that it may be difficult to unwind the many decades of complex breakdown in the system.
So those are the two big buckets. Happy to go into more detail in any of those, but as you can probably tell, it's an exciting time and you could probably hear my dog barking excitedly in the background at the mailman, so he's excited too.
Bracy Fertig Everyone's excited about the future of personalized medicine. Thank you very much for that, Patrick. And the final sort of long form question that I'd love to ask you today. What do the next five years, even ten years, look like for you and for your business?
Patrick Short So we today work in about 20 different diseases of the 7000 or so that I mentioned before. For us, we're excited that the sky is the limit in terms of the number of diseases that precision medicine approaches can be applied to. So we're looking to expand our impact in terms of the number of diseases we're working in. So today we're working in Parkinson's and ALS and Alzheimer's and long COVID, a number of immunological diseases like inflammatory bowel disease. But there's whole disease categories that are still not really touched by precision medicine that as the science advances, we'll advance with that. And the second is actually internationalizing our business. So we operate right now in the US, the UK and some parts of the EU, and even between the US, UK and EU, the availability of genetic testing and the way precision medicine is being folded into the healthcare system is really different and it's a global opportunity and a global problem that we need to solve. How do we make sure that genetic testing and precision medicines, the research underpinning them, but also the access to those medicines in the form of clinical trials and ultimately, as well approved therapies, is something that we can deliver worldwide and not just in those countries that I mentioned.
So we're investing a lot right now in building our internationalization capabilities and working with our customers, the pharma biotechs and population genomics programs, to offer a research experience that's multilanguage, multi country and delivers that great participant experience around the world and not just in those handful of countries.
Bracy Fertig It sounds like more and more people will start to benefit from Sano Genetics platform and services. So thank you so much for that. It sounds like very exciting times.
Patrick Short Yes.
Bracy Fertig And so the next stage of this interview will be a series of five rapid fire 'either-or' questions. And so no thinking, just answering. And so I'll just start that now.
Bracy Fertig So, Patrick. Treatment or prevention?
Patrick Short Prevention.
Bracy Fertig Growth or profit?
Patrick Short Profit.
Bracy Fertig Fiction or nonfiction?
Patrick Short Fiction.
Bracy Fertig Morning or night?
Patrick Short Morning.
Bracy Fertig Coffee or tea?
Patrick Short Coffee. That's my fastest answer.
Bracy Fertig Great. I don't think I've ever interviewed an entrepreneur who didn't have coffee as an answer. So maybe that tells you something.
Patrick Short You learn a lot from somebody. People who don't drink coffee amaze me. I think we have a lot to learn from them and how they do it.
Bracy Fertig Very good, very good. And then as a final question, we always ask any interviewee to nominate somebody who they think would form a great interview for the next in the HealthTechX Stories series. So please, Patrick, nominate the next interviewee and let us know why.
Patrick Short I would like to nominate Charlotte Barttelot. She is a principal at MMC Ventures. They led our series A and we've been working really closely with them and she in particular focuses on their digital health practice and she's got a lot of really interesting theses and ideas about where digital health is going over the next decade and how they, as a fund, want to put their money to work. So I think she'd be a great guest. I actually don't know if she's available. I'm sure she is. I'm going to put her out there on this, but I think she'd be a really good one.
Bracy Fertig Thank you so much, Patrick. And we'll certainly reach out and we look forward to hosting her on HealthTechX Stories. For anyone who enjoyed hearing Patrick's story today, you can hear more by listening to his hosted podcast, the Genetics Podcast, which will be linked in the comments. Thank you so much, Patrick, for being on today and telling us more about your story and about Sano Genetics. We look forward to tracking what is the future for Sano Genetics and to see how many patients you help along the way.
Patrick Short Thank you. I appreciate you having me on the podcast.