The Heart of the Matter – Revolutionising the treatment of arrhythmias
Sep 24, 2020
CERN Alumnus: Adriano Garonna At CERN: 2007 – 2019 Summer Student, Fellow and User Now: Co-founder and CEO at EBAMed SA
Medical Tests halted by COVID-19
When Adriano and I first spoke in spring 2020, much of the world had been plunged into a state of suspended animation due to the COVID-19 pandemic. EBAMed SA, the start-up Adriano co-founded only a couple of years earlier and for which he is the CEO, fell victim to the lockdown. Adriano explained that they were on the verge of some exciting tests: “We had finalised a full prototype in March and just when the pandemic struck, we were about to launch a final series of tests in a US proton therapy centre. We had already tested our sub-components, but a lot of work remains to be done. The lockdown dealt us a cruel blow by causing a lot of uncertainty.”
Before delving into Adriano’s previous experience at CERN, I was eager to find out more about the start-up, EBAMed SA and its activities. I even wondered if he was CEO of a start-up, or a fully-fledged company. Adriano explained that he had recently stumbled across a nice definition of a start-up.
“In one book I recently read, it broadly defines a start-up as being a team operating in an uncertain environment (be that because of funding, market, regulations, external support or else)! So, based on that definition, one does not even need to be a company to be a start-up. And, yes, EBAMed is indeed a start-up!”
A fast and irregular moving target: the heart
Having clarified this point, I asked Adriano to explain EBAMed’s activities and what they are hoping to achieve within the medical sector. Adriano begins by describing an affliction that over 15 million people across Europe and North America suffer from: heart arrhythmias. Currently these patients are treated with medication and invasive, costly and lengthy specialist surgery:
“Our focus is on enabling access to non-invasive approaches to treat heart arrhythmias. Proton therapy is increasingly used to treat certain cancers as it is very precise, targeting a specific area and sparing the surrounding tissue. This is used in areas of the body where there is no motion, such as the head, neck, spine or hip region. Our challenge was to find a solution using the precision of proton therapy on a fast and irregular moving target: the heart.”
Thanks to ultrasound technology, the team at EBAMed SA has developed a device composed of an ultrasound imaging system that is placed on the thorax of the patient during treatment. This ingenious piece of technology monitors the patient’s heart activity, interprets the motion in real-time and sends a signal to the proton therapy machine when the radiation should be sent.
“The device senses motion at a very fast rate, can easily predict what will happen and if there is an anomaly it will send a signal to the proton therapy machine to start or stop. We use machine learning to interpret the images in real time, which allows robust decision-making. The beauty of our solution is that, unlike current treatments which can be lengthy and costly, people can be treated as outpatients; the intervention is non-invasive and completely pain-free.”
According to the Particle Therapy Co-Operative Group, as of early 2020 there were over 95 particle facilities worldwide with already over 35 additional facilities under construction. Adriano confirms that proton therapy is booming in Europe and that their solution can be installed in any proton therapy centre, irrespective of its technology. Furthermore, those suffering with heart arrhythmias tend to defer surgery until it becomes absolutely essential, having spent years taking drugs or being fitted with defibrillators to palliate their condition. EBAMed SA’s solution will enable sufferers to access treatment sooner, thus reducing costs and providing improved quality of life. Adriano is optimistic that they will be able to resume pre-clinical tests within the next few months and envisages bringing the solution to market by 2023.
A preordained career path?
It seems inevitable, when retracing Adriano’s path that he would carve out a career in the MedTech industry and reach the position of CEO in this innovative and revolutionary start-up. Adriano’s first professional experience at CERN was in 2007 as a summer student when he worked in CMS on the optical alignment systems at Point 5, which he describes as “a really interesting experience!” Following which, he continued his Doctoral studies with EPFL, PSI and the TERA Foundation focusing on technologies such as proton and carbon ion therapies to treat cancers.
“This was my first experience in that particular domain and it sparked my curiosity, wondering how this technology could be developed in the future. I continued at CERN as a Fellow with the Marie Curie programme, PARTNER. In this experience, my work focused on the modification of the existing LEIR accelerator at CERN, designing a new extraction system and beamline so that it could be used for medical research. In all of my experiences at CERN I was privileged to work in a great community of talented and knowledgeable people.”
March 2014 saw Adriano accept a position as Head of Therapy Accelerator Commissioning at EBG MedAustron Gmbh, his first operational experience in the MedTech industry.
“It was tough, we were time restricted and had plenty of challenges; thankfully, I was working in an amazing team. We were able to deliver the first patient treatments as planned, which I think was an amazing feat.”
Meeting with TERA
His next challenge came in 2016, with the TERA Foundation, where Adriano was appointed Technical Director. Gradually a new opportunity emerged, in which Adriano became increasingly involved,
“I was invited to participate in an informal discussion at CERN with Professor Ugo Amaldi, with a senior entrepreneur and former CERN engineer, Giovanni Leo, who was specialised in the field of treatment of arrhythmias with surgical devices and with Dr. Douglas Packer, a cardiologist from the US who is a world-wide authority in the treatment of arrhythmias and who had tested proton and carbon ion therapy on animal hearts. The consensus was that the animal data showed that it made sense to pursue research to develop similar treatments for humans. I started dedicating more of my time and competencies to this initiative.”
A leap of faith into the unknown
With Adriano, this group of people became co-founders of EBAMed SA in 2017, during a gradual process that took place over one and a half years EBAMED SA was finally incorporated in October 2018. During this time, the Geneva incubator FONGIT provided Adriano with essential mentorship, access to experts and first funding. He had already determined that although he liked technology and physics, a career in academia was not for him. He was drawn towards applying technological solutions to medical applications; becoming an entrepreneur was a process.
“Initially, we needed to define a common vision and strategy around the inception of EBAMed SA, while remaining agile. As CEO, I was the main person driving the project. Certainly, I had my doubts and I did indeed take some risks, both professional and economic. Becoming an entrepreneur was not my initial purpose, but I was fascinated by the project and convinced that a start-up was the best vehicle to bring it to market.”
Not having a business background, Adriano benefitted from the CERN Knowledge Transfer entrepreneurship seminars as well as the support and courses organized by Innosuisse, the Swiss Innovation Agency. He also drew on previous experiences he gained whilst at CERN,
“At CERN most of my projects involved exploring new areas. Whilst I benefitted from the support of my supervisors, I had to drive projects on my own, seek the right solutions and build the appropriate ecosystem to obtain results. This certainly developed an initiative-driven, entrepreneurial streak in me. It goes without saying that in academia, one also develops problem-solving skills, as well as critical and analytical thinking. Furthermore, academia prepares you very well for public speaking and pitching, you learn to present your ideas in front of a large audience. I am very grateful to CERN for that.”
CERN is also renowned for its openness and collaboration, Adriano underlines the importance of building networks and sharing ideas in the start-up world.
“I would advise budding entrepreneurs to talk to as many people possible about their idea, which does not mean accepting all advice, you can still think out of the box. Don’t be afraid to ask, push yourself out of your comfort zone and invite someone for a coffee to brainstorm, for example.”
Exposing one’s ideas can be a daunting prospect, not least because competition in the start-up world is fierce. Nevertheless, Adriano states the benefits of not being alone in the market,
“We do have a US competitor, who has developed a planning system using conventional radiotherapy. We are grateful that there is another player on the market as it helps pave the way to non-invasive treatments. Additionally, it is dangerous to be alone, as that could imply that there is no market in the first place.”
“The scope is big. EBAMed SA can bring value to a wide population, it can greatly reduce the healthcare burden and revolutionise the field. We already have prospective patients contacting us as they have heard of our device and wish to benefit from the treatment. As a company, we want to be the leaders in our field. On a personal level, I am delighted with the fast-paced path I followed despite the fact that it is sometimes challenging. Contributing to improve patients’ and doctors’ lives is what drives me.”
We were delighted that Adriano joined us as a panelist on Friday 4 September for the CERN Alumni Moving out of Academia to MedTech event. Watch the event and discover more about Adriano’s journey from academia to CEO of EBAMed SA here: https://youtu.be/VuMp_Mfz-T4