Transforming Women's Health Through Innovation with Oriana Papin-Zoghbi, CEO and co-founder of AOA Dx

I got to chat with Oriana Papanzobi, CEO and co founder of aoadx. I love this conversation because she gave really insightful information about founding a company, actually three companies in the women's health diagnostic space, which is not an easy place to play. She talked about fundraising, she talked about building a network, she talked about all of the fun hoops that she's jumped through to have two successful previous exits and to be growing AOA into what it is now. Can't wait to share this conversation with you and I hope you enjoy it as much as I did. Welcome to Building Biotechs, a podcast by Reconnomics Consulting. We've helped over 75 biotech, life science and venture capital firms strategize, hire and retain thousands of employees to scale companies that bring life saving drugs to patients. We speak with those at the forefront of growing biotechs to learn their tactics on building these companies from the ground floor to the C suite. We're your host, Karina and Allison. Thank you so much. Oriana, this is a pleasure. I'm excited to speak with you. We love aoa. We love what you're doing and let's get into it. We always start by asking about your career path because people need to hear that careers are nonlinear and things happen. So what did you want to be when you were 7? What are you now and how did you get there?

I think I want to be a vet when I was seven. Now that I have a daughter, I can understand children, just love animals. And then as a child, but later as a teenager when I was in high school and gearing up to go to college, I had in my mind that I wanted to be a doctor. My mom's a doctor. I grew up in the Middle east and especially for women, you had sort of traditional career paths. You're a doctor, you're a lawyer, you're an architect. And I was the first in my family to come to the US for an education. So I came here on a pre med path at the biochem nature at Boston University. And I was going to be a doctor because I always knew that I liked the sciences. And for me, liking the sciences meant you're either a doctor or you're in the lab. And I was far too much of an extrovert to be in the lab or in my opinion at least. And so when I got to bu, I did my first semester as a biochem major. I almost almost failed out of bu like my GPA was. I think the threshold to stay is like you had to have a 2.0 and I was at a 1.9 and I was called into the dean's office and I was like, and I came from being like a straight A student in high school and turns out you really need to love what you're studying to excel in it. And I was really not enjoying that. And so I spent about a year in college really figuring out what it meant to like the sciences, what types of careers could involve, could, could evolve from that and what I was going to end up studying. And so I ended up doing a degree in economics and then international relations as well. And I ended up finding most value in my career path by doing summer internships. And one of the summer internships that I did was working at this medical distribution company that was distributing it pro its products globally. And that's when I really learned about sort of products in the life sciences space. And this idea of how do you commercialize innovative technology? Which landed me at the Boston University Career Fair, but introduced but really on the path of like what companies are in life sciences, what companies are doing work here. And getting my first, well at the time with an internship which turned into a full time job at an early stage women's health company called Amnestre International. So I went into all of this knowing that I like the sciences, thinking I was going to be a doctor, and learning through college and internships that actually a life in the sciences can be a variety of different things. And only at my first internship, which later turned into my first full time job, did I discover the passion for women's health that ended up becoming a career.

I think it's so important to hear that you have to like what you're doing in order to excel. I think a lot of people try and white knuckle it or they think, oh, there's aspects that I don't like, but that's okay because it's worth it in the end for the paycheck or the family, you know, approval or whatever it is. But that's not always true.

It's not always true. And the reality is sometimes you don't have a choice, right? A lot of my friends and family in the Middle east don't have as much of a choice on career. A lot of people that come from different economic backgrounds don't have the luxury of falling in love with their career. And I think recognizing that and knowing that it is a, a luxury to be in a position where you love your career and, and you get to do the job that you want to do every day with the passion that you have.

So you founded AOA dx, but that wasn't actually your first company that you were involved in founding.

That college internship at Amnester International turned into a full time job. That's where I ended up meeting both of my co founders at aoa. So. So we've known each other at this point, it's been 15 years. And at Amnesure I was responsible similarly for thinking about how do you increase access to this. It was a women's health diagnostic test for women when they're water broomed too early in pregnancy. How do we think about how this can go to different markets outside of the US And I was primarily responsible for the Middle east and for South America because I speak Spanish and Arabic and so, you know, it's a great fit for advancing the technology from there. Amne sure was very successful and got acquired by a company called Qiagen which offered me a position at their global headquarters in Germany to really think about expanding the women's health portfolio. And I did a lot of work in remote areas of the world that had really different types of access to healthcare. Africa, Middle East, Eastern Europe, parts of Asia. Really thinking about how do you translate certain types of innovations or technologies that work with a certain type of laboratory infrastructure into areas that don't have running water, that don't have running power. But women still have the same health care issues and oftentimes much more exacerbated because they don't have that access. And that's where sort of this fuel and this passion around women's health kept forming. And while I was in Germany, one of my colleagues at Kaij and I ended up co founding a early stage company with that mission of translating sort of research out into, from academia out into industry. It wasn't specifically in women's health and it was an area, it gave me sort of this, the first flavor of how do you look for innovative research that's in academia and how do you translate that into. Into something that can be translated to, to match an unmet need. And from there Steve and I worked on that for a little bit and I was moving to the US because there was another opportunity for me to work with another co founding team in the us So I ended up not doing that anymore and moving to the US is to work with two of their co founders on a another woman self startup. And we worked on that from its very early days of licensing out the IT IP from Kiagen all the way to getting it through an FD approval and eventually selling it back. And again, at that point, it was, you know, what's fueling us was there's such little innovation and investment in women's health. And this begins from an academic research perspective to a grant funding perspective to a capital funding perspective. And time again, you're met with, the market's not big enough, the unmet need is not important enough. And, you know, this. People are not dying of this or. Or whatever it may be. And that just that fueled that passion, right? This is. It's that indignation of, like, that should not be the status quo. That should not be the answer. The world should not work in this way. And after Parson's exit, Anna, Alex and I got back together again and said two things. How hard can it be? I think I read somewhere that entrepreneurs tell themselves that before they start a company, and that's the only reason they end up starting the company, because if they actually knew how hard it would be, they wouldn't do it. And I say, that checks. So we're like, how hard can it be? And then we said, where else are there big problems in women's health that we can help solve? Right? And we have passion for the sciences. We had different backgrounds. None of us were scientists, engineers, or doctors. So we knew that we couldn't go into a lab and start developing something ourselves. We knew we had to partner. But that's where that background then really hunting for academic research, understanding where innovation was sitting, and be able to think about how do we pull that through, led to the founding of.

That's such a great story. And I hear you. How hard can it be? But you had two successful exits, and that is huge in this space. And so I'm curious what you learned from those successful exits and how you've set things up for, hopefully, a third, you know, really hugely successful company.

The first thing across the board, across both was success comes from building a really stellar team. And the people we worked with, both at Amnesure and at Parsigen, were the primary contributors to those successful exits or, you know, positive outcomes. It was not the ip. It was not the technology. It was not the unmet need. It was the people that were executing on the vision and the mission every single day. And then the second thing that I learned is building a company with the intent of selling it is not going to lead to the outcomes that you expect it to. Building a company with the intent to execute will eventually open those doors. And more and more you often get asked the question, especially when you're fundraising to start with the end in mind, which we all understand, right? There is an ROI that's expected. This is not philanthropy, etc. But sometimes I think that question is, I don't want to say misguided, but not always appropriate in the early days, because if that's what you're tuning your company to, I think it ends up being a lot harder to execute on the vision and mission of which you wanted to create the company for. And executing on that often leads to the better returns than anything.

It's really good advice. Speaking of the vision and mission, we didn't really touch on that yet for aoa. So walk me through that. What is the inspiration behind this and what are you really hoping to achieve with aoa specifically?

Yeah, our mission at AOA is to transform women's health. And that is big on purpose, right? That's a. That's a big, broad mission. And there is practically how we're doing it with a product that we believe in. And then there is everything else that we do as a company as well. So let's start first with what are we building at aoa? Fundamentally, we believe that there are a number of diagnostic conditions that are not well managed in the healthcare system today, not for a lack of intent, not for a lack of desire, oftentimes for the lack of diagnostic tools. When we started aoa, we did a very big market analysis of where there are conditions for which women are going to the doctor, too. And either they're not getting diagnosed fast enough, they're not getting diagnosed accurately enough, and an accurate diagnosis could significantly impact the way in which their health is affected. And so amongst those, we identified a number of conditions. Preeclampsia, endometriosis, ovarian cancer. And then we went back to the research again. Really, where is the research happening? 90% of medical innovation stays in academia. Can you think of the number of health problems we could solve if we could help translate that innovation into something that could impact the patient? We went there in 2019. We ended up meeting a professor, Professor Saragovi at McGill University, who was looking at an entirely new class of biomarkers that had never been developed diagnostically and had some very early and exciting data in ovarian cancer. And what excited us, and the basis of AOA's innovation today, is we're developing the first and only diagnostic platform that utilizes ganglioscience as its analog. And we are developing what will become the first test to diagnose ovarian cancer in symptomatic Women, these are women that are going to the doctor, they're complaining of symptoms. They end up on average in the US in a nine month diagnostic pathway with numerous of tests, only to be referred to a surgery that requires us to remove the fallopian tube and ovary just to get a biopsy. When over 50% of the time those women did not have ovarian cancer, but now they've lost their organs. And 80% of the women diagnosed are already stage three and four, where their five year survival rate is less than 30%. Yet we know that the lucky few diagnosed at stage one and two, their five year survival rate is over 90%. So our platform, using an entirely novel class of markers, aims to develop, develop a variety of diagnostic tests for women's oncology. And we're beginning in ovarian cancer, where there is an enormous unmet need and where we believe that we can have significant impact on the patient pathway. We then translate that in thinking about how do we transform women's health beyond just the test that we're bringing to market. How do we think about lobbying with the fda? How do we think about policy, how do we think about patient advocacy, how do we think about funding? How do all of those not only play a part in AOA success, but elevate the entire women's health ecosystem overall?

I love that earlier you said that you get pushback, that there isn't a need and I mean, the need is tremendous and your outrage is justified. This is a problem.

I love that I'm gonna say that my outrage is justified.

Wow, that's really inspiring. And I am really excited to watch this develop even more so now. And I'm curious, so you have raised a decent amount of funding. What has that journey been for you in the midst of people telling you that there isn't a need?

So when we started AOA and we went out to fundraise, yes, I'd been involved with other startups before. Yes, I had been in the Bolton ecosystem, but I had never raised capital myself. I'd never been a CEO myself and I didn't have an investor network myself. And so the first fundraise, I want to say the first fundraise was the hardest, but I actually don't think that's true. I think they've gone harder every time after. The first fundraise was the hardest in establishing a network. Right. And in creating a ecosystem of individuals that were going to trust me with their capital and we're going to believe in the idea. And I think where we were successful was showing our previous successes, showing the fact that this is a co founding team that had worked together for a decade and showing that indignation and passion to the problem we were going to solve. Right. We were still met with a single product company only on ovarian cancer is not enough of an roi and you guys have to think about your blood or platform plate. And we already had been thinking about it, but we hadn't been opening with that because is why would we be selling a potential idea that could be 10 years away when there was this one thing that we knew we could do right now. And that was one of my biggest lessons is that I have always been incredibly tactical and accomplished this, accomplished that. And what I had to learn about being a CEO was how to communicate that I had this big vision and that I was going to execute technically on this first and that messaging and that know how. And that understanding escalated fundraise after fundraise, right? The more capital we went on to raise, the more I had to show well this is what we are accomplishing, right? And this is where we are going. And the where we are going got more tangible over time because we'd accomplished more as well over time. So overall at AOA today we've raised about $24 million. We've been a part of phenomenal accelerators such as Y Combinator and then we've also brought in really excellent investors who bring a lot of know how in this space, who are strategic in our world and who've been incredibly value add. And I think one of you know the biggest part of helping bring that capital in was showing the strength of our team and our passion behind it. But also that this isn't a small problem either monetarily or impact wise and that this was worth putting capital dollars behind.

Hey there, just a quick break. I wanted to let you know that if you're listening to this podcast because you are exploring careers in Biote, which it turns out quite a few of our listeners actually are, you might be interested in the Biotech Career Coach podcast. It is brought to you by our sister company, the Collaboratory Career Hub, which is our career development community. If you would like actionable tips on job seeking and career development, that is the place for you. It is a companion podcast to our Career Coach column that we write monthly in Biospace, but we go a little more in depth and sometimes we have special workshops and all of that good stuff. So if that sounds interesting, click the link in the show notes or search for the Biotech Career Coach on Apple podcasts or wherever you get your podcasts back to the show. Tell me a little bit about your business development background and how that has maybe helped with that fundraise cycle. Did you find that easier? Because we have so many scientists, scientific founders who come in, you know, from the lab, no business background, and they're trying to raise capital. It's hard.

100%. I. I was a salesperson early, early in my career. And I think one of the biggest value add that I had raising money for AOA is that I had that sales and business development experience, that power of persuasion, that ability to tell a story, that ability to disseminate a really complex information in a way that everybody could understand, that you were not alienating people that have, you know, a specific type of degree to connect with the problem that you are working on, to show all parts of risk, so technical risk, as well as, you know, commercial risk, and understand that we were the right team to tackle those risks. So I think my sales and business development background played a major part in my ability to raise capital for this company because at the end of the day, I was selling the value.

Absolutely. And Y Combinator is such a cool ecosystem. We've now spoken to a couple of founders that were YC class this or that. Tell us about your experience with YC and how that sort of helped with the mentorship and all of the things they do.

Yeah, we're a big fan. When we found out about ythear, you know, when we, when we first heard about it, we were like, that's not for us. That's for people building in tech. And we're not in San Francisco. We're an east coast company and we raise on a convertible. No. And not on a safe. And it was just like, we don't fit in there. And then we learned more about it and through the encouragement of Serbi, we ended up applying and primarily to work with Surby. So I went to YSD primarily because I wanted to work with Serby. What I got out of it was far more than our relationship with Serdi, our mentorship and guidance from her. It was insight. It was a network to raise capital. But I think the number one most important and to date lasting impact of YC was the founder community. It was peers of people that were going through the exact same thing that you were, that were unfiltered, that were vulnerable, that were able to share with you and give you advice or hear you out, that were able to connect you with people, that were able to provide resources there's this, there's inherent, I don't know, camaraderie that exists. What's a YC founder? Always a YC founder. And I underestimated the value of that. And I think it was one of AOA's best decisions to do YC when we did.

That's really, really great for people to hear. I've heard this before and honestly, prior to speaking with a few founders, I knew a lot of why. So I'm in a CEO network that is tech enabled startups and I love it. And a lot of folks in there are yc, but they're all tech. And so I thought, well, this is just a tech incubator, you know, but not at all. And some of the things that have been coming out of there in the biotech space are just amazing. So I'm hoping more people throw their hat in the ring there and join that community.

Yep, I fundamentally hope so too.

Given that there's such an enormous need here in women's health and women's diagnostics, what would your advice be for other founders that are maybe wanting to jump into this space with another type of diagnostic? What could they do or avoid?

Yeah, that's a great question. My biggest piece of advice is find an unmet need clinically that where your solution solves what we at AOA call sort of the three pronged approach, where it solves the pain point for the patient, it solves the pain point for the provider, and it solves the pain point for the payer. The absence of any one of those in diagnostics makes it incredibly difficult to adequately commercialize the technology and drive adoption to, at the end of the day, impact the patient, which we all have in mind. But if we cannot bring the provider and the payer along with us, it makes it incredibly difficult to impact that patient. And what often ends up happening, and I see in women's health is the absence of the others too put the burden of care on the woman for them to educate themselves, for them to advocate for themselves and for them to pay for it on for themselves. And that is unfair. So for those really wanting to innovate in women's health, the biggest impact we can have is to innovate for the patient, innovate for the provider who's going to care for her and innovate for the payer so that they will pay for it.

Love a good framework. Have you named that? The triple P framework or something like that?

Yeah, you need to trademark this. I think about this all the time and I'M like, I want to. I don't know, I don't write blogs or I'm not as cool as most people are on social media. But I was like, I have this and I want to put it out there, and I really want people to talk about it. Because I think so many times I see so many innovations and I understand, I understand the motivations behind them, and I understand the ability to go to market with a $200 price tag and for women to pay for. But I don't see a single test designed for men's health, you know, with that same sort of price tag or with that same sort of burden on men. And I. I want to see that change.

I agree. What are the future plans for aoa? I know that you are just in the midst of it right now, but you said that there are some other directions, like, where's this going? I'm excited.

Yeah. We want to develop a slew of diagnostic tests in women's oncology. We really want to be the women's oncology global platform. We want to begin in ovarian cancer and the symptomatic population. And then we want to really think about how do we continue to innovate or unlock the patient. The ovarian cancer patient journey right from the moment she's diagnosed all the way to either the moment she's cured or she goes to remission. How do we help assess the viability of the right treatments for her? We really want to think about how do we go down that ovarian cancer continuum. Then from there, we really want to expand beyond ovarian cancer. We want to understand where does our technology have an impact in areas that are really struggling with good diagnostics today. Endometrial cancer, there are certain types of areas in breast cancer, uterine cancer, leomyosarcoma. There is a lot that affects women that is understudied under research we don't have enough data on, and that's. We cannot serve and develop the diagnostics for. And so our vision is to really go beyond ovarian cancer and think about how else can we have an impact in women's oncology.

That's fantastic. So simple, affordable, or paid for tests for early diagnosis across all of this myriad of women's cancers that we all live in fear of, frankly. I mean, they're just so internal. And for better or worse, our reproductive system is highly active and those cells turn over and they become cancerous.

And this is just absolutely. I am. I'm too informed now, and I'm Like, I'm too informed not to do something about it because this affects my health. I have a daughter. This affects my daughter's health, this affects my mother's health. This is too close not to do something about it.

So what do you personally hope to achieve in the next 10 years?

We just recruited our chief scientific officer and I was on a call with her just before this, and one thing I said to her was, I can't guarantee that the platform that we are developing or the indication we are pursuing will be successful. I can't guarantee that. What I hope to say 10 years from now is I was really proud of the effort I made and I was proud of the people I worked with. And I think what I want beyond anything else is to have an impact on women's health and to really think that I moved the needle in any way and to have built a company with such incredible people that we will likely succeed. But startups are high risk. We may not. We will all walked away without regret. Having said that, this was the best journey that we went on and that these are the best colleagues.

That's beautiful. And if your track record is any indication, I'm pulling for you because you have a great track record and yeah, your founding team is excellent.

This is the riskiest of them all. I will just say that this is the riskiest of them all. Yeah, we're excited. We're making a significant amount of progress. We fundamentally believe we will be successful. But this one, remember I said, how hard can it be? Thank God I asked that question.

Yeah, well, we're pulling for you. So just a fun question. We have really smart people on the show and we like to read books. And so what are you reading? What have you read? What's your favorite book that you recommend?

I end up reading far too many parenting books at this time because, you know, that's. I have a two year old and oftentimes it's how do you do this? Or how do you do that? That said, I took a break from that recently and I read Shoe Dog by the founder of Nike Film. My co founder, Anna had been telling me to read this and I was like, I'll get to it, I'll get to it. I'll get to it. I could not put it down. Audiobook when I'm on the train, but I just, I could not stop. I would walk home and be like, time for dinner. I'm like, I need to get through this chapter. And it's because it, yes, it's telling a founding story. Yes, it's telling, like business advice, but it's so much more than that. It is truly the depth of resilience and the creativity and the like, I cannot go to sleep passion of a human being. And I was blown away. So I think I love that book. And again, not directly related to what I'm doing in aoa, but just that you could resonate with that resilience of like when terrible things happen, you can overcome them.

Love a. Love a good founder's resilience story.

Yeah.

And for people who want to learn more about you or AOA is LinkedIn ideal? We'll link some stuff in the show notes. Where do they want. Where do you want them to go?

LinkedIn is the best for us. So you could follow us@aoa dx. You could find me directly, Orianna, Pop and Sophie and we share all of our company updates. We do a lot of work around awareness of ovarian cancer. What are the symptoms of ovarian cancer? Exciting research happening in the space. Company news. And so that's the best place to learn more.

Awesome. We'll link that in the show notes. Thank you so much. This was a pleasure. I loved hearing your story.

Thank you so much for having me. I really had a great conversation.

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